Paeds - derm

Question 1

What type of rash is caused by urine? which areas are spared?

Answer 1

Irritant dermatitis

- Flexures spared

Question 2

Treatment of mild irritant dermatitis? and severe?

Advice?

Answer 2

Use disposable nappies

mild :emollients
severe: topical steroids

Question 3

Cradle cap - appearance? does it bother the child?

Answer 3

Yellow + scaly

Non-pruritic - doesn’t bother the child

Question 4

Tx of seborrheic dermatitis

Answer 4

If on scalp: baby oil to soften scales –> baby shampoo to wash the scales off with gentle brushing

If ineffective –> use low dose topical antifungal

Question 5

Nappy rash with flexure surfaces involved..?

Answer 5

Candida

Question 6

Tx of nappy rash with satellite lesions + flexure involvement

Answer 6

Candida dermatitis!

Topical antifungal

Question 7

Atopic eczema - prognosis?

Answer 7

50% resolve by 12yo

75% resolve by 16yo

Question 8

Clinical fx of eczema?

Answer 8

PRURITIS

• Dry skin, erythema, weeping, crust
• Lichenification

Question 9

Useful investigations for suspected eczema?

Answer 9

Usually a clinical Dx

• Skin prick test
• Serum IgE
• Trial of extensively hydrolysed protein formula

Question 10

Serious complication of eczema?

Answer 10

eczema herpeticum - HSV

Question 11

Management of eczema in a child?

Answer 11

emollients + moisturisers, oilatum, mittens, tar bandages

Topical steroids
Oral antihistamines

Question 12

What can be given to a child to stop scratching in eczema?

Answer 12

Tar/zinc bandages,
Mittens,
Oral antihistamines

Question 13

How can diet be altered in eczema?

Answer 13

Trial of extensively hydrolysed protein formula if bottle fed

Question 14

management of a child with impetigo?

School exclusion?

Answer 14

topical/oral antibiotics (fluclox)

-do NOT return to school until lesions are DRY

Question 15

Ix and Management in a child with pain + swelling of the eyelid and limited ocular movement?

Answer 15

Mx: IV Abx (periorbital cellulitis)

Ix: CT + LP (to exc meningitis + spread)

Question 16

Cause of scalded skin syndrome

Answer 16

Staphylococcal toxin

Question 17

Nikolsky sign - what is it? what does it suggest?

Answer 17

Separation of epidermal skin on mild pressure

Scalded skin syndrome

Question 18

Does scalded skin syndrome lead to scarring?

Answer 18

No

Question 19

Management ladder for acne

Answer 19

1) benzoyl peroxide
2) topical abx + topical retinoids
3) oral abx
4) oral retinoids

Question 20

Sarcoptes cabiei

Answer 20

Scabies

Question 21

Fx of scabies - what exacerbates it?

Answer 21

Pruritus + burrows

Worse when warm/at night

Question 22

How does distribution of scabies differ in infants vs older children?

Answer 22

Infants: trunk, palms, soles

Older: Axillae, between fingers + toes, nipples/penis/buttocks

Question 23

Which investigation confirms scabies?

Answer 23

Skin scrapings

Question 24

Mx of Scabies

Answer 24

Treat patient and the whole family

Permethrin cream for 8-12 hours over whole body up to ears and scalp

Question 25

scaly circle on skin + patchy alopecia

Answer 25

ringworm

Question 26

3 causes of erythema multiforme

Answer 26

HSV
mycoplasma
drugs

Question 27

Causes of erythema nodosum

Answer 27

IBD
TB
Strep infection

Question 28

Neonate with little white papule on red base.

Answer 28

erythema toxicum

Question 29

When do hemangiomas go away?

Answer 29

after 1 year

Question 30

Hemangiomas - when would you consider US/MRI?

Answer 30

> 5 lesions –> liver USS

affect airway/vision
ulcerate
bleed

Question 31

Tx of simple hemangioma

Answer 31

topical timolol