Paeds Derm Flashcards
What is an exanthema?
- eruptive widespread rash
What is measles and how does it spread? Incubation period
- caused by measles virus
- spread by droplets
- 10-12 days incubation
What are Koplik spots?
- greyish white spots on buccal mucosa
- appear 2 days after fever
- pathognomic for measles
How does measles present?
- fever
- after 3-5 days: rash on face starting behind ears
- spreads to rest of body
- resolves after 7-10 days
How is the measles rash described?
- erythematous
- macular
- flat lesions
What are complications of measles?
- otitis media
- pneumonia
- encephalitis
- hearing loss
- death
How is measles contained?
- notifiable disease to PHE
- isolation until 4 days after symptoms resolve
What is scarlet fever?
- group A strep infection
- caused by exotoxin produced by strep pyogenes
- associated with tonsillitis
How can the scarlet fever rash be described?
- red-pink
- blotchy
- macular rash
- rough sandpaper skin
How does scarlet fever present?
- rash starts on trunk and spreads outwards
- red, flushed cheeks
- fever, lethargy
- sore throat
- strawberry tongue
How is scarlet fever managed?
- Penicillin V for 10 days
- notify PHE
- keep off school until 24h after starting Abx
What are complications of scarlet fever?
- post streptococcal glomerulonephritis
- acute rheumatic fever
What is rubella and how does it spread and how long is the incubation period?
- caused by rubella virus
- spread by resp droplets
- 2 weeks incubation
How is the rubella rash described?
- mild erythematous rash
- starts on face and spreads to rest of body
- lasts 3 days
How does rubella present?
- mild fever
- joint pain
- sore throat
- lymphadenopathy
How is rubella managed?
- supportive
- notify PHE
- keep off school for >5 days after rash appears
- avoid pregnant women
What are complications of rubella?
- thrombocytopenia
- encephalitis
- congenital rubella syndrome
What is congenital rubella syndrome?
- deafness
- blindness
- congenital heart disease
What is Duke’s disease?
- non-specific viral rashes
What is parvovirus B19?
- slapped cheek syndrome
- caused by parvovirus B19 virus
How does parvovirus B19 present?
- starts with mild fever, coryza
- muscle aches and lethargy
- rash appears after 2-5 days
Describe the parvovirus B19 rash
- diffuse bright red rash on both cheeks
- few days later: reticular mildly erythematous rash
- affects trunk and limbs
- raised and itchy
How is parvovirus B19 managed and how long do symptoms last?
- supportive
- fluid and analgesia
- symptoms fade over 1-2 weeks
- contagious prior to rash but not after
Who is at risk from complications from parvovirus?
- immunocompromised
- pregnant
- sickle cell anaemia
- thalassaemia
What testing is done for patients at risk of complication from parvovirus?
- serology testing
- FBC and reticulocyte count
- check for aplastic anaemia
What are complications of parvovirus?
- Aplastic anaemia
- Encephalitis or meningitis
- fetal death
What is roseola and what is the cause?
- roseola infantum
- HHV-6 or HHV-7
How does roseola present?
- 1-2 weeks incubation
- sudden high fever for 3-5 days
- coryza, sore throat, lymphadenopathy
- rash after fever settles
Describe the roseola rash
- Lasts 1-2 days
- mild erythematous and macular
- across arms, legs, trunk, face
- not itchy
What is the main complication of roseola?
- febrile convulsions
- myocarditis or Guillain-Barre if immunocompromised
What is Stevens-Johnson syndrome?
- immune-complex mediated hypersensitivity disorder
- ranges from mild to severe
- including toxic epidermal necrolysis
How does SJS present?
- non-specific symptoms of fever, cough, sore throat and mouth
- sore eyes and itchy skin
- can affect urinary tract, lungs
Describe the rash in SJS
- purple red
- spreads and blisters
- skin breaks and sheds
- also happens to lips and mucous membranes
How is SJS/TEN managed?
- medical emergencies
- admit to hospital
- supportive care
- steroids
- immunoglobulins
- immunosuppresants
What is eczema?
- chronic atopic condition
- defects in skin barrier
- leads to inflammation
What is the epidemiology of eczema?
- genetic component
- prevalence decreases with age
- FHx of atopy is significant
- urbanisation associated with higher prevalence
What is the pathophysiology of eczema?
- defects in skin barrier
- provides entrance for irritants, microbes and allergens
- creates immune response
- results in inflammation etc
