Paediatric dermatology Flashcards
How does eczema come on?
Red, dry itchy skin
Flares and settles quickly
Is there a familial tendency for eczema?
Yes
What would you suspect if atopic eczema presents prior to 3 months of age?
Cow’s milk protein allergy
What is a barrier defect?
Increased permeability of skin to irritants and allergens
Filaggrin mutation/deficiency
E.g. eczema
What is the main stay of eczema management?
Topical steroids
What are some other parts of eczema management after topical steroids?
Emollient helps with itch
Use non-soap substitute for washing
What area does 1 finger tip unit cover?
Surface area of 2 adult hands
About 0.5g
How often do you use topical steroids for eczema on body?
Once daily for 1-2 weeks
Reduce to alternate days if improving
Twice per week if persistent
What is the topical steroid ladder from mild, through moderate and potent, to very potent?
Hydrocortisone
Eumovate
Betnovate
Dermovate
How often do you use topical steroids for eczema on face?
Mild-moderate steroid like eumovate for 3-5 days then repeat if any more flares
Which ointment may be used if steroids are being used regularly, especially on the face?
Tacrolimus
What are some immunosuppression options if topical steroids don’t work?
Methotrexate
Ciclosporin
Mycofenalate mofetil
Name a steroid sparing agent to use if topical steroids aren’t working?
Protopic ointment
Eidel cream
What is dupilomab?
Biologic therapy option when topical steroids aren’t working
IL-4 inhibitor
When should you suspect a food allergy?
Immediate reaction of lip swelling and face red/itchy
Late onset GI problems, failure to thrive, worsening eczema
What does discoid eczema look like?
Scattered circular patches
How is discoid eczema treated?
Betnovate
Maybe antibacterial component as well
What is seborrheoic dermatitis?
Cradle cap
Proliferation of various species of skin commensal malassezia
How is seborrheoic dermatitis managed?
Emollient to loose scale
Daktocort ointment
Protopic ointment
What causes impetigo?
Staph aureus
How is impetigo treated?
Topical antibiotic fucidin
Oral flucloxacilin
What causes molluscum contagiosum?
Molluscipox virus
What does molluscum contagiosum look like?
Pearly papules
Umbilicated centre
How is molluscum contagiosum managed?
Self limiting
Clears within 24 months so just reassure
Are viral warts self limiting?
Yes
What causes viral warts?
HPV
How are viral warts transmitted?
Direct skin contact
What are viral exanthems?
Maculo papular eruption from toxin produced by viral organism
Self limiting
What are some common causes of viral exanthems?
Chicken pox Measles Rubella Roseola Parvovirus B19
What causes roseola?
Herpes virus 6
What causes chicken pox?
Varicella zoster
What is a rare complication of parvovirus?
Aplastic crisis
May cause intrauterine death or hydrops fetalis in pregnant women
What is hand foot and mouth?
Coxsackie A16
Blisters on the areas
Viral symptoms
Self limiting
What does eczema herpeticum look like?
Monomorphic punched out lesions
How is eczema herpeticum managed?
Withold steroids for 24 hours
Aciclovir
What does eczema coxsackium look like?
Flared sites pick out areas of eczema
Is eczema coxsackium managed?
Self limiting
What has a stuck on appearance?
Seborrhoeic keratosis
What does orofacial granulomatosis look like?
Lip swelling
Oral mucosal lesions
Ulcers and tags
Cobblestone appearance
How is orofacial granulomatosis managed?
Avoid benzoate and cinnamate
What does dermatitis herpetiformis look like?
Blisters over knees, buttocks and elbows
How is dermatitis herpetiformis managed?
Coeliac screening Skin biopsy Emollients Gluten free diet Topical steroids
What does urticaria look like?
Wheals/hives
Angioedema
How do we treat urticaria?
Remove triggers
Antihistamines
Ranitidine
Ciclosporin
What are infantile haemangioma?
Very common vascular birth mark
Not present at birth
What causes PHACES?
Haemangioma
Arterial anomalies
