pead dermatology

Question 1

eczema

Answer 1

dermatitis

itchy dry inflammatory skin disease

Question 2

varicose eczema

Answer 2

oedema/venous insufficiency

Question 3

atopic eczema/dermatitis

Answer 3

most common eczema esp in kids

inherited abnormality in skin - filaggrin expresion

Question 4

filaggrin

Answer 4

binds keratin filaments together

role in producing natural moisturising factor

Question 5

atopy

Answer 5

overreactive immune system response to environmental stimuli

3 commonly linked conditions: asthma, eczema, hayfever

Question 6

atopic eczema distribution

Answer 6

infancy: starts face/neck then spreads more generally

older children: flextural pattern - antecubtial fossa, popliteal fossa, hands, wrists, ankles

Question 7

atopic eczema: loss of skin barrier function

Answer 7

loss water
irritants may penetrate: soap, detergents, dirt
allergens may penetrate: pollens, dustmite, microbes

Question 8

associations with childhood eczema flares

Answer 8

infection 
environment: central heating, cold air
stress
teething 
pets

Question 9

seborrhoeic eczema

Answer 9

mainly scalp and face

scale assoc
often babies <3mo, resolves by 12mo

Question 10

seborrhoeic eczema associations

Answer 10

proliferations of various species of skin commensal Malassezia in yeast form

cradle cap in infants

Question 11

seborrhoeic eczema Mx

Answer 11

emolionts
anti-fungal creams
mild topical steroids

Question 12

discoid eczema

Answer 12

scattered annular/circular patches of itchy eczema

can occur in this pattern with atopic dermatitis or in isolatoin

Question 13

prophylx eczema

Answer 13

hand and feet eczema
characterised by vesicles
intensely itchy

Question 14

exogenous eczema

Answer 14

allergic eczema: sensitised to allergen, TIV hypersensitivity

irritant eczema: water + soap, irritant foods, citrus, tomatoes, chemical irritant

Question 15

food allergy tI hypersensitivity

Answer 15

lip swelling

facial redness/itching

Question 16

food allergy TIV

Answer 16

worsening eczema 24/48hrs after
GI probs 
FTT 
severe eczema unresponsive to Rx
severe generalised itch

Question 17

food allergy and eczema: Ix

Answer 17

TI: IgE, skin prick testing

TIV: restriction/elimination diet

Question 18

eczema Rx options

Answer 18

emolients
topical steroids
calcineurin inhibitors: protopic 
UBV light therapy 
immunosuppresion

Question 19

topical steroids: potency

Answer 19

very potent - demotove 600x
potent - betnovate 100x
moderate - eumovate 25x
mild - hydrocortisone

Question 20

topical steroids use

Answer 20

once daily 1-2 weeks
if improvement use on alternative days
if stubborn ares use twice daily

if flare go. back to daily use
finger tip unit

Question 21

impetigo

Answer 21

common superficial bacterial skin infection
s. aureus
pustules and honey-coloured erosions

Question 22

impetigo Mx

Answer 22

topical antib: fucidin

oral antib: flucloxacillin

Question 23

molluscum contagiosum

Answer 23

common benign, self limiting condition
mulluscipox virus

pearly papules, umbilicated centre

Question 24

molluscum contagiosum incubation and spread

Answer 24

2wk-6mo

close direct contact

Question 25

molluscum contagiosum Mx

Answer 25

reassurance
5% potassium hydroxide

can take up to 24mo to clear

Question 26

viral warts

Answer 26

non-ca growths of skin assoc w HPV infection

sole foot = verruca
transmit via direct skin contact

Question 27

viral warts Mx

Answer 27

topical Rx like salicylic acid
cyrotherapy
90% resolve 24mo

Question 28

viral exanthems

Answer 28

assoc w viral illness
common: fever, malaise, headache

reaction to toxin produced by organism, skin damage caused by organism or immune response

Question 29

viral exanthems examples

Answer 29

chicken pox
measles
rubella
parovirus B19

Question 30

chicken pox

Answer 30

highly contangious disease

caused by primary infection with varicella zoster virus

Question 31

chicken pox features

Answer 31

red papules, progressing to vesicles
often start trunk
itchy
assoc viral Sx

Question 32

chicken pox incubation period

Answer 32

10-21 days

Question 33

when is chicken pox contagious

Answer 33

1-2days before rash appears and until lesions crusted

Question 34

parovirus

Answer 34

incubation 7-10days
viral symptoms
erythematous rash cheecks

6wks to full fade, mild and self limiting

Question 35

rare consequences parovirus

Answer 35

aplastic crisis - if haemolytic disorders

risk to pregnant women - IUD, hydrops fetalis

Question 36

hand, foot and mouth

Answer 36

enterovirus, usually coxsackie virus A16

blisters of hand, feed and in mouth
viral symptoms

Question 37

Mx hand foot + moth

Answer 37

self limiting

Rx supportive

Question 38

eczema coxsackium

Answer 38

assoc viral symptoms
Hx eczema
flares sires picks out areas of eczema
self limiting

Question 39

eczema herpeticum

Answer 39

unwell child
Hx eczema
monomorphic punched out lesions

Question 40

eczema herpeticum Mx

Answer 40

withhold steroids 24hrs
aciclovir: oral or IV
opthalmology review if near eye

Question 41

erythema nodosum features

Answer 41

painful, erythematous sunbcutaneous nodules
over shins
slow resolution - 6/8wks

Question 42

erythema nodosum causes

Answer 42

infections: streptococcus, UTRI
IBD
sarcoidosis
drugs: OCP, sulphonamides, penicillin 
mycobacterial infection 
idiopathic

Question 43

dermatitis herpetiformis

Answer 43

persistent immunobollous disease

linked to coeliac

Question 44

dermatitis herpetiformis features

Answer 44

itchy blitsters, clusters
symmetry
scalp, shoulder, buttocks, elbow, knees

Question 45

dermatitis herpetiformis Mx

Answer 45

emolients
gluten free diet
topical steroids
dapsone

Question 46

urticaria

Answer 46

wheals/hives
assoc angiodema
areas of rash can last few mins - 24hrs
acute<6wks
chronic >6wks

Question 47

causes urticaria

Answer 47

viral , bacterial infections
food/drug allergy 
NSAIDs, opiates
vaccination 
chronic - iatrogenic

Question 48

urticatia Rx

Answer 48

consider possible triggers, medication

antihistamines