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YR5 Specialties > Paeds DERM > Flashcards

Paeds DERM Flashcards

1
Q

What is erythema infectiosum?

A

Infection by parvovirus B19
“5th disease”
“Slapped-cheek syndrome”

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2
Q

What are the symptoms of erythema infectiosum?

A

Asymptomatic/ mild feverish illness- headache + runny nose
After several days develop red rash on cheeks
Child starts to feel better as rash appears
Rash spreads to trunk, arms + legs

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3
Q

How does the rash in erythema infectiosum differ from many other rashes?

A

RARELY effects palms + soles

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4
Q

Describe the rash in erythema infectiosum

A

Raised, blotchy red areas + lacy patterns
“Reticular, erythematous eruption”

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5
Q

What is management for erythema infectiosum?

A

Self-resolving
No school exclusion (not infectious once rash appears)

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6
Q

What is roseola infantum?

A

Infection by human herpes virus 6 (HHV6)
“6th disease”
“Exanthem subitum”

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7
Q

Which age group are most commonly affected by roseola infants?

A

6m-2y

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8
Q

Give 6 signs/ symptoms of roseola infantum

A

High fever lasting a few days followed later by a
Maculopapular rash
Nagayama spots: papular enanthem on uvula + soft palate
Febrile convulsions (10-15%)
Diarrhoea
Cough

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9
Q

What is the management of roseola infantum?

A

Self-resolving
No school exclusion

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10
Q

Describe the levels of acne

A

Comedones: open (blackheads) or closed (white heads)
Papules/ pustules
Nodulocystic/ scarring

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11
Q

From what age can acne be managed medically?

A

12

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12
Q

What skin cleaning advice can you give to adolescents with acne?

A

Don’t over clean: BD with gentle soap

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13
Q

Why should picking/ squeezing of comedones be avoided?

A

Risk of scarring

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14
Q

How long does It take topical medication to start working in acne?

A

Up to 8w

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15
Q

How can mild to moderate acne be managed?

A

Topical retinoid +/- benzoyl peroxide
OR
Topical abx + benzoyl peroxide
Azelaic acid 20%

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16
Q

How can moderate acne be treated?

A

Max 3m of oral abx
Add BPO/ retinoid to Abx OR
COCP + BPO/ retinoid

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17
Q

When should a referral to a dermatologist be made in acne vulgaris?

A

Nodulocystic acne/ scarring
Severe form (eg acne conglobata/ acne fulminans)
Severe psychological distress
Diagnostic uncertainty
Failure to respond to medications

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18
Q

Where is eczema commonly found?

A

Flexures

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19
Q

What 2 differentials should always be considered in suspected eczema?

A

Contact dermatitis (do patch testing)
Food allergies (blood or skin prick testing)

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20
Q

What treatment can be used in all severities of eczema?

A

Emollients

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21
Q

What other treatments are available in mild eczema?

A

Mild-potency topical corticosteroids

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22
Q

What other treatments are available in moderate eczema?

A

Moderate-potency topical corticosteroids
Topical calcineurin inhibitors
Bandages

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23
Q

What other treatments are available in severe eczema?

A

Potent topical steroids
Phototherapy
Topical calcineurin inhibitors
Bandages

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24
Q

How should infected eczema be managed?

A

Flucloxacillin

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25
Q

How should eczema herpeticum be managed?

A

Oral aciclovir

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26
Q

Recall the steroid ladder

A

Help Every Busy Dermatologist
Hydrocortisone
Eumovate
Betnovate
Dermovate

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27
Q

When should an immediate referral be made in eczema?

A

Eczema herpeticum

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28
Q

What does eczema herpeticum look very similar to?

A

Impetigo

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29
Q

What is the fancy medical name for port-wine stain?

A

Naevus flammeus

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30
Q

Where are port wine stains found?

A

In trigeminal nerve distribution

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31
Q

What is the cause of port wine stain?

A

Could be all kinds of syndromes with long names
Most often = Sturge Weber syndrome

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32
Q

Recall 3 alternative names for naevis simplex

A

Salmon patches/ stalk bites/ angel’s kiss

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33
Q

Describe the appearance of naevus simplex

A

Pink/ red patch at birth that goes redder when the infant cries

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34
Q

When does infantile haemangioma develop?

A

A few days/ weeks after birth

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35
Q

How long do infantile haemangiomas last?

A

6-10m, then they shrink

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36
Q

Where are most infantile haemangiomas found?

A

Head + neck

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37
Q

Describe the appearance of the different types of infantile haemangioma

A

Superficial = bright red area of warm skin
Deep = blue lump
Mixed = bright red areas on a blue lump

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38
Q

Recall 3 causes of infantile haemangioma

A
  1. Kasabach-Merritt: kaposiform haemangioendothelioma –>thrombocytopaenia –> haemangioma with thrombocytopaenia
  2. PHACES syndrome
  3. LUMBAR syndrome
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39
Q

What is PHACES syndrome?

A

Posterior fossa malformations
Haemangioma
Arterial abnormalities
Cardiac abnormalities
Eye abnormalities
Sternal abnormalities

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40
Q

What is LUMBAR syndrome?

A

Lower body/ lumbosacral haemangioma
Urogenital anomalies
Myelopathy
Bony deformities
Anorectal/ arterial anomalies
Renal anomalies

41
Q

When should an MRI be used in investigation of an infantile haemangioma?

A

If deep/ multiple/ near the eye

42
Q

How should infantile haemangiomas be managed?

A

Conservatively: medical photography + review in 3m

43
Q

If an infantile haemangioma is in a sensitive area, what can be prescribed?

A

Topical timolol

44
Q

What is the prevalence of congenital haemangioma?

A

Very rare

45
Q

What are the 3 types of congenital haemangioma?

A

Rapidly involuting congenital haemangiomas (RICH)
Non-involuting congenital haemangiomas (NICH)
Partially-involuting congenital haemangiomas (PICH)

46
Q

How can rapidly-involuting congenital haemangioma and non-involuting congenital haemangioma be clinicially differentiated?

A

RICH is at max. size at birth, involutes by 12-18m
NICH continues to grow as baby does: do NOT shrink

47
Q

Other than the haemangioma itself, what sign might be present in congenital haemangioma?

A

Transient thrombocytopaenia

48
Q

If a congenital haemangioma needs to be removed, how should it be done?

A

Embolisation

49
Q

What is erythema toxicum?

A

Benign skin condition present in 50% of newborns

50
Q

What is the prevalence of erythema toxicum?

A

50% of newborns

51
Q

What needs to be excluded in suspected erythema toxicum?

A

Congenital infection

52
Q

How does erythema toxicum appear?

A

Maculo-papular-pustular lesions

53
Q

Where does erythema toxicum begin and spread to?

A

Begins on face + spreads to limbs

54
Q

How does Milia appear?

A

White pimples on nose + cheeks

55
Q

What is the cause of milia?

A

Retention of keratin + sebaceous material of the pilosebaceous follicle

56
Q

How should milia be treated?

A

Self-limiting

57
Q

What is the pathogen in molluscum contagiosum?

A

Pox virus

58
Q

What age group does molluscum contagiosum affect?

A

2-5y

59
Q

How does molluscum contagiosum appear?

A

> 1 small pink skin-coloured/ pearly papules, ulcerated/ umbilicated

60
Q

What are the signs and symptoms of molluscum contagiosum?

A

Painless usually
occasionally itchy

61
Q

How long does molluscum contagiosum usually last, and when is it considered chronic?

A

6-9m
>2y

62
Q

How is chronic molluscum contagiosum managed?

A

Cryotherapy

63
Q

How does mongolian blue spot appear?

A

Blue/ black maculopapular discolourisation at base of spine + on buttocks

64
Q

In which infants is mongolian blue spot most likely?

A

Afro-caribbean or asian infant

65
Q

How is mongolian blue spot managed?

A

Self-limiting

66
Q

What is the most common pathogen in impetigo?

A

Spathylococcus aureus

67
Q

How does impetigo appear?

A

Golden-yellow, crusted appearance

68
Q

Recall the 3 grades of impetigo

A

Localised, non-bullous
Widespread, non-bullous
Bullous, systemically unwell

69
Q

How do you treat each different grade of impetigo?

A

Localised: topical hydrogen peroxide

Widespread: oral flucloxacillin OR topical fusidic acid

Bullous: PO flucloxacillin

70
Q

For how long should children with impetigo be excluded from school?

A

Until lesions crusted over/ 48h after Abx started

71
Q

What is nappy rash most commonly a form of?

A

Contact dermatitis

72
Q

Recall the signs and symptoms of each different type of nappy rash

A

Irritant: well-demarcated variety of erythema, oedema, dryness + scaling

Candida albicans: erythematous papules + plaques with small satellite spots or superficial pustules

Seborrhoeic: cradle cap + BL salmon pink patches, desquamating flakes

73
Q

How can mild erythema be managed in nappy rash?

A

Use of a barrier preparation

74
Q

How can moderate erythema be managed in nappy rash?

A

Hydrocortisone 1% cream

75
Q

How can candidal infection be managed in nappy rash?

A

DO NOT USE BARRIER
Topical imidazole cream e.g. Clotrimazole

76
Q

How should bacterial infection be managed in nappy rash?

A

Oral flucloxacillin

77
Q

What are the signs and symptoms of seborrhoeic dermatitis

A

Dandruff: erythematous, yellow, crusty, adherent layer (cradle cap)

78
Q

What pathogen is seborrhoeic dermatitis associated with?

A

Malassezia yeasts

79
Q

After how long should seborrhoeic dermatitis spontaneously resolve?

A

8 months

80
Q

Recall the 1st line treatment for seborrhoeic dermatitis

A

Regular washing with baby shampoo + gentle brushing to remove scales
Can soak crusts overnight in vaseline/ olive oil

81
Q

When should 2nd line treatment be considered in seborrhoeic dermatitis, and what is it?

A

If scalp is affected
Topical imidazole cream BD/ TDS

82
Q

What is the 3rd line treatment for severe seborrhoeic dermatitis?

A

Mild topical steroids (1% hydrocortisone)

83
Q

What is the type of pathogen involved in tinea?

A

Dermatophyte fungi: Trichophytum rubrum

84
Q

What drug is used to treat scabies?

A

Permethrin

85
Q

How does tinea appear?

A

Ringed appearance +/- kerion

86
Q

How is tinea capitis treated?

A

Oral antifungal: terbinafine

87
Q

How are non-capitis types of tinea treated (mild/ mod/ severe)?

A

Mild: topical terbinafine
Mod: hydrocortisone 1%
Sev: oral terbinafine

88
Q

What advice should you give in cases of tinea?

A

Very contagious so infection control:
Wear loose-fitting cotton clothing
No sharing towels
Dry thoroughly after washing
Avoid scratching
No need for school exclusion

89
Q

What is the most common cause of neck lumps?

A

Lymphadenitis

90
Q

Recall 5 red flags in neck lump to screen for?

A

Sepsis
Poor feeding
Rapid progression
Stridor
Change in voice

91
Q

What is the most common midline congenital mass?

A

Thyroglossal cyst

92
Q

What is the cause of thyroglossal cyst?

A

Failure of thyroglossal duct to involute

93
Q

What is the most common lateral congenital neck mass?

A

Brachial cleft abnormality

94
Q

What is the cause of brachial cleft abnormality?

A

Failure of pharyngeal clefts to involute

95
Q

How long does lymphadenitis last?

A

6w: self limiting

96
Q

How should thyroglossal cyst be managed?

A

Asymptomatic: conservatively
Symptomatic: Sistrunk’s procedure (surgical removal)

97
Q

How should brachial cleft abnormality be treated?

A

Asymptomatic: conservatively
Symptomatic: Sistrunk’s procedure (surgical removal)

98
Q

Recall the typical distribution of atopic dermatitis in infants, older children and young adults

A

Infants: face + trunk
Kids: extensor surfaces
YA: localises to flexures

YR5 Specialties (27 decks)

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