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Year 4 > Paeds - Dermatology > Flashcards

Paeds - Dermatology Flashcards

1
Q

what is impetigo?

A

superficial bacterial skin infection usually caused by staph aureus

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2
Q

characteristic appearence of impetigo?

A

golden crust

usually on the face

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3
Q

what causes impetigo?

A

usually staph aureus

can be strep pyogenes

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4
Q

should kids be kept off school with impetigo?

A

yes

v contagious

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5
Q

2 types of impetigo?

A

bullous

non-bullous

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6
Q

features of bullous impetigo?

A

staph produces epidermolytic toxins that break down proteins holding skin together causing 1-2cm fluid filled blisters to form on the skin
vesicles grow then burst forming a golden crust
lesions can be painful and itchy
may have some systemic symptoms of infection if v bad

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7
Q

does bullous impetigo leave scars?

A

no

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8
Q

who is bullous impetigo more common in?

A

neonates and kids under 2

but can occur in older kids and adults

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9
Q

how is bullous impetigo diagnosed?

A

swabs of vesicles

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10
Q

features of non-bullous impetigo?

A

usually occurs around nose and mouth
exudate from lesions forms golden crust
looks bad but doesnt cause systemic symptoms

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11
Q

how is non-bullous impetigo managed?

A

uncomplicated, not unwell or at risk of complications = topical hydrogen peroxide
if hydrogen peroxide unsuitable = topical antibiotic (fusidic acid) for 5 days
if widespread or severe can give oral fluclox

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12
Q

how is bullous impetigo managed?

A

oral antibiotics (fluclox)

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13
Q

what is molluscum contagiosum?

A

viral skin infection caused by molluscum contagiosum virus (Poxvirus)

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14
Q

characteristics of molluscum contagiosum?

A

small, flesh coloured papules (raised) which usually have a central dimple
typically appear in crops of multiple papules in a local area

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15
Q

how does molluscum contagiosum occur?

A

spread through direct contact or by sharing towels/bedsheets etc

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16
Q

course of molluscum contagiosum?

A

usually resolve without treatment but takes up to 18 months

skin returns to normal afterwards but should advise against picking/scratching them as it may cause scarring

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17
Q

how is molluscum contagiosum managed?

A

no real treatment needed
advise against sharing towels or close contact with the lesions etc
may need topical antibiotics if superficial bacterial infections occurs (eg from picking/scratching) but this is rare

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18
Q

what causes chickenpox?

A

varicella zoster

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19
Q

chickenpox rash features?

A 
widespread
erythematous 
raised
vesicular 
blistering
usually starts on trunk or face and spreads outwards affecting whole body over 2-5 days
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20
Q

is chickenpox contagious?

A

yes

once lesions have scabbed over though its not contagious

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21
Q

other symptoms of chickenpox?

A

fever often first symptom
itch
general fatigue and malaise

22
Q

how is chickenpox spread?

A

direct contact with the lesions or infected droplets through cough/sneeze

23
Q

when do chickenpox symptoms start?

A

10 days - 3 weeks after exposure

24
Q

complications of chickenpox?

A 
bacterial superinfection
dehydration
conjunctival lesions
pneumonia
encephalitis (presents as ataxia)
reactivation
25
Q

how does chickenpox reactivate?

A

virus lays dormant in sensory dorsal root ganglion cells and cranial nerves reactivate later in life as shingles or ramsey hunt syndrome

26
Q

how is risk of chickenpox managed in pregnancy?

A

no risk if immune to chickenpox (already had it)

if not immune (never had it) then they are given varicella zoster immunoglobulins after exposure

27
Q

what can chickenpox cause in pregnancy?

A

if before 28 weeks, can cause developmental problems in foetus (congenital varicella syndrome)
if around time of delivery can cause life-threatening neonatal infection

28
Q

how is chickenpox around time of delivery managed?

A

varicella zoster immunoglobulins and aciclovir

29
Q

how is chickenpox managed?

A

usually self limiting and needs no treatment
aciclovir sometimes used if immunocompromised, neonates or if over 14 and presenting within 24 hrs
itching can be helped with calamine lotion and antihistamines

30
Q

what causes measles?

A

measles virus

spreads via resp droplets

31
Q

symptoms of measles?

A 
starts 10-12 days after exposure
- fever
- coryzal symptoms
- conjunctivitis 
- koplik spots
erythematous, macular rash with flat lesions starts on face (classically behind ears) 3-5 days after fever then spreads to rest of body
32
Q

what are koplik spots?

A

greyish white spots on buccal mucosa
appear 2 days after fever
pathopneumonic for measles

33
Q

how is measles managed?

A

usually self resolves after 7-10 days
kids should be isolated until 4 days after symptoms resolve
should be notified to public health

34
Q

what causes scarlet fever?

A

group A strep (strep pyogenes)
caused by exotoxin produced
associated with tonsillitis

35
Q

features of scarlet fever?

A 
red/pink blotchy macular rash with rough sandpaper skin
starts on trunk and spreads outwards
can have red, flushed cheeks
fever
lethargy
sore throat
strawberry tongue
cervical lymphadenopathy
36
Q

how is scarlet fever managed?

A

antibiotics for the underlying strep infection (phenoxymethylpenicillin) for 10 days
should be reported to public health
keep kid off school until 24 hrs after starting antibiotics

37
Q

other conditions associated with group A strep?

A

post-strep glomerulonephritis

acute rheumatic fever

38
Q

how is rubella spread?

A

rubella virus spread by resp droplets

39
Q

rubella symptoms?

A

symptoms start 2 weeks after exposure

  • erythematous macular rash starting on face and spreading to rest of body
  • rash usually lasts 3 days
  • can be associated with mild fever, joint pain and a sore throat
  • often have enlarged lymph nodes behind ears and back of neck
40
Q

how is rubella managed?

A

self limiting
notify public health
stay off school for 5 days after rash appears
avoid pregnant women

41
Q

complications of rubella?

A

thrombocytopaenia
encephalitis
congenital rubella syndrome in babies born to mother with rubella

42
Q

signs of congenital rubella syndrome?

A

triad of deafness, blindness and congenital heart disease

43
Q

other names for slapped cheek?

A

erythema infectiosum

parovirus B19

44
Q

what causes slapped cheek?

A

parovirus B19

45
Q

symptoms of slapped cheek?

A

starts with mild fever, coryza and non-specific viral symptoms (lethargy, muscle ache etc)
after 2-5 days the rash appears on the face then spreads to trunk and limbs after a few days

46
Q

describe slapped cheek rash?

A

diffuse bright red rash on both cheeks appears rapidly a few days after viral symptoms
few days later a reticular, mildly erythematous rash on trunk and limbs, can be raised and itchy

47
Q

what does reticular mean?

A

net-like

48
Q

course of slapped cheek?

A

self limiting and rash/symptoms usually fade over 1-2 weeks

49
Q

management of slapped cheek?

A

fluids and simple analgesia
self limiting
only infectious prior to rash forming so dont need to stay off school once rash has appeared

50
Q

who is at risk of complications from slapped cheek?

A

imunocompromised
pregnant women
people with haematological conditions

51
Q

how are high risk people managed after expsoure to parovirus B19

A

require serology testing to confirm parovirus B19

check FBC and reticulocyte count for aplastic anaemia

52
Q

possible complications of slapped cheek?

A

aplastic anaemia
encephalitis or meningitis
pregnancy complications including foetal death
rarely hepatitis, myocarditis or nephritis

Year 4 (83 decks)

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