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Year 5 - Paediatrics > Skin diseases in a child - (acne, eczema, haemangioma, milia, molluscum contagiosum, mongolian blue spot, nappy rash (irritant, candida, seborrhoeic), seborrhoeic dermatitis, tinea) > Flashcards

Skin diseases in a child - (acne, eczema, haemangioma, milia, molluscum contagiosum, mongolian blue spot, nappy rash (irritant, candida, seborrhoeic), seborrhoeic dermatitis, tinea) Flashcards

(incl. acne, eczema, haemangioma, milia, molluscum contagiosum, mongolian blue spot, nappy rash (irritant, candida, seborrhoeic), seborrhoeic dermatitis, tinea)

1
Q

What is shown on the pictures?

A

Left: forceps mark - can sometimes cause facial/trigeminal nerve palsy. Tested in newborns when crying.

Right: subcutaneous fat necrosis, could be from hypercalcaemia

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2
Q

What is the definition of macular, papular and pustular?

A

Macule - are circumscribed changes in the color of skin that are neither elevated nor depressed and ≤ 1 cm in diameter.

Papule - elevated, solid, palpable lesion that is ≤ 1 cm in diameter. They may be solitary or multiple.

Pustule - a circumscribed elevation of the skin that contains a purulent exudate that may be white, yellow, or greenish-yellow in color.

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3
Q

What condition is shown?

A

Erythema toxicum - “baby rash”, high in eosinophils and may get secondary bacterial infection but usually asymptomatic

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4
Q

Describe the features of erythema toxicum.

A
  • Common skin condition in term neonates
  • Self limiting benign lesions
  • Blotchy widespread red rashes
  • No discomfort to the babies
  • Self-resolve within 1 week
  • No treatment needed
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5
Q

What condition is shown? What is it caused by?

A

Epidermolysis bullosa

This is a genetic skin condition

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6
Q

Name 3 bullous skin conditions that you may find on a child.

A
  1. Epidermolysis bullosa - genetic
  2. Staphylococcal scalded skin syndrome - Staph. aureus
  3. Stevens Johnson syndrome - drug reaction
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7
Q

What is this?

A

Haemangioma

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8
Q

What is this?

A

Haemangioma taht has disappeared with time

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9
Q

What might haemangiomas be treated with?

A

Beta blockers

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10
Q

What is this condition?

A

Port wine stain AKA Sturge Weber syndrome

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11
Q

What are the features of Sturge Weber syndrome? What is it also known as? What is the cause?

A

AKA: Neuro Cutanous Syndrome - “port wine stain”

  • Glaucoma (ipsilateral)
  • Hemiparesis (contralateral)
  • Seizures

Sporadic condition

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12
Q

What condition is this?

A

Fungal diaper rash with right sided hydrocele - manage with frequen change of nappies, barrier cream (Sudocream) and antifungal creams in fungal superinfection

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13
Q

How do you diagnose a hydrocele? What is the management?

A
  • Differentiate from hernia (reducible? cough?)
  • Use transillumination

No treatment requires - resolves by 1 years. If hernia, refer to surgeons for repair within a few weeks.

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14
Q

What condition is shown?

A

Umbilical granuloma

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15
Q

How do you manage unbilical granulomas?

A
  • Dead tissue
  • Usually no treatment
  • If big in size, cauterise with silver nitrate (ensure this does not touch normal skin)
  • Salt also can be applied
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16
Q

What condition is shown?

A

Molluscum contagiosum

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17
Q

What is the cause of molluscum contagiosum? What is the treatment?

A

Pox virus - spreads by direct contact or can be sexually transmitted in adults

No active treatment required

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18
Q

What condition is shown? What is it caused by?

A

Viral wart - human papilloma virus (there are 150 types/strains). Spread by touch and close contact. Can cause cervical cancer.

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19
Q

How are viral warts treated?

A
  • Peeling medicines like salicylic acid
  • Cryotherapy if extensive
  • Laser treatment
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20
Q

What condition is shown here?

A

Skin and tissue necrosis in meningococcaemia

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21
Q

What condition is shown? What is the causes?

A

Impetigo - staphylococcus aureus

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22
Q

What is the management of impetigo?

A
  • Antibacterial cream
  • In extensive cases - oral antibiotic e.g. flucloxacillin, erythromycin
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23
Q

What condition is this?

A

Scabies

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24
Q

What are the features of scabies? How can it be treated?

A
  • Very itchy condition
  • Secondary bacterial infection can occur
  • Treatment of whole family
  • Local treatment with permethrin or malathion
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25
What is this condition called?
Ring worm - fungal infection
26
What itch mite causes scabies?
Sarcoptes scabiei
27
What is ringworm of the head called? What is the treatment?
Tinea corporis - topical antifungal cream
28
List 3 causes of alopecia in a child.
* Tinea capitis * Alopecia areata * Trichotillomania * Telogen effluvium * Nutritional deficiency
29
What is tellogen efluvium?
Increased proportion of hairs shift from the growing phase (anagen) to the shedding phase (telogen). Normally only 10% of the scalp hair is in the telogen phase, but in telogen effluvium this increases to 30% or more
30
What are the causes of telogen effluvium?
* Childbirth: postpartum hair loss. This can resolve after a few months or transition into female pattern alopecia. * Endocrine disorders (eg, hypothyroidism, hyperthyroidism) * Discontinuing the contraceptive pill * Physiological neonatal hair loss * Acute or chronic illness, especially if there is fever * Psychological stress * Weight loss, unusual diet, or nutritional deficiency (eg, iron deficiency/) * Certain medications * Skin disease affecting the scalp (eg, erythroderma) * Excessive sun exposure.
31
What is the underlying cause of alopecia areata?
Autoimmune condition causes patchy hair loss
32
What is this condition?
Kerion
33
What is the cause of kerion? How is it treated?
Host immune response to fungal infection of hair follicle with secondary bacterial infection Manage conservatively with antibiotics and antifungals - does not require surgery.
34
What is this condition called?
Hand, foot and mouth disease
35
What is the cause of hand, foot and mouth disease? How is it managed?
Coxsackie virus A16 - managed symptomatically
36
What is this condition called?
**Pityriasis alba** - common skin condition in dark skinned children, more common in summer, no treatment needed (should distinguish from Tinea vesicolor)
37
What is this condition? Where is it most common? What is it caused by? How is it treated?
**Tinea vesicolor** - common skin condition caused by a fungus that normally lives in skin. In right conditions like warm, moist and oily skin the fungus **Malassezia furfur** overgrows and causes the rash. Treatment: Antifungal cream
38
What is this condition?
* Skin pigmentation disorder * May be auto immune mediated * Refer to dermatologist
39
What is this condition called?
Pityriasis rosea - there is a herald patch and the rash is in a Christmas tree distribution
40
What are the features of pityriasis rosea? How is it treated?
* Common harmless red scaly skin rashes * Presence of Herald patch is important * Can last several weeks * Self limiting * No treatment needed
41
What is this condition? What is the cause?
Carotenemia - benign condition which occurs in vegetarians and young (Polish) children from excess consumption of beta carotene e.g. carrots, sweet potatoes
42
What is this condition ? What is it associated with?
Acanthosis nigricans - associated with diabetes type 2, obesity and malignancy
43
What is this condition?
Henoch Schonlein Purpura
44
What are 4 causes of purpura?
* Idiopathic Thrombocytopaenic Purpura * Henoch Schonlein Purpura * Platelet function disorders * Coagulation disorders
45
What are the main systems affected by Henoch Schonlein Purpura?
* Systemic Vasculitis * Purpura * Joint pain * Abdominal pain * Renal impairment
46
What are these patches called?
Café au lait spots - occurs in type 1 and 2 neurofibromatosis
47
What is the inheritance pattern of neurofibromatosis?
Autosomal dominant - causes lesions in the skin, nerves, brain, spinal cord and bones.
48
What is this condition? (NB: it may also have nail manifestations)
Tuberous sclerosis may have associated periungal fibromas
49
What is tuberous sclerosis and how is it inherited?
**Tuberous sclerosis complex** (TSC) is an a**utosomal-dominant,** neurocutaneous, multi-system disorder characterised by cellular hyperplasia, tissue dysplasia, and multiple organ hamartomas Lesions in the skin, eyes, kideneys, and brain.
50
What is this condition?
Ataxia telangiectasia - prominent blood vessels (telangiectasia) over the white (sclera) of the eyes usually occur by the age of 5–8 years, but sometimes appear later or not at all
51
How is ataxia telangiectasia diagnosed?
It is a rare, neurodegenerative, **autosomal recessive** disease causing severe disability.
52
Name 4 neurocutaneous sydnromes found in children.
* Neurofibromatosis * Tuberous Sclerosis * Sturge Weber Syndrome * Ataxia telangiectasia
53
What is seen here?
White reflex indicates: * Congenital cataracts * Retinoblastoma
54
What is this condition called?
Seborrhoeic dermatitis AKA "cradle cap"
55
What is the management of seborrhoeic dermatitis ?
* Greasy and yellow crusts * Can be seen in scalp and eyelids * Baby shampoo and olive oil application
56
What is the cause of this skin condition?
Nickel allergy - contact dermatitis
57
What is this skin condition?
Hives AKA urticaria
58
What is this skin condition?
Urticaria * Transient itchy skin swelling * Prevalence is 10-15% of population * Acute * Chronic: recurring or lasting \> 6 weeks
59
What is this condition?
Urticaria and angioedema
60
Name 5 common causes of urticaria.
* Idiopathic in 50% of cases * Foods: milk, egg, nuts, seafood * Drugs: penicillin, NSAIDS * Viral infections * Bees & wasps * Blood products
61
Summarise the management of urticaria.
* Non sedating antihistamines * Higher doses may be needed * Short term steroids * Montelukast * Cyclosporine in severe cases * Reassurance
62
What is this condition?
Eczema (NB: can sometimes look similar to seborrhoeic dermatitis)
63
What are the features of eczema/atopic dermatitis?
* Chronic inflammatory skin condition * Common,10 – 20% of children suffer * In 60% of cases start before 1yr of age * In infants affects cheeks, chins and limbs * After infancy affect flexural surfaces * Commonly resolves with age
64
What is the pathogenesis of eczema?
* Complex and multifactorial * Genetic predisposition * 20% risk if one parent is affected * 50% if both parents had AD (atopic dermatitis)
65
How is eczema managed?
* Topical Treatments * Emollients +/- containing antimicrobials * Topical steroids * Topical calcineurin inhibitors (tacrolimus, pimecrolimus; reduced IL-2 release and IL-2R expression) * Oral antihistamines * Treatment of infections
66
What is the inflammatory response in atopic dermatitis?
TH2 cell response leading to the release of IL4, IL5 and IgE
67
What skin barrier defects can predispose to eczema?
* Deficiency of **filaggrin or ceramide** * Deficiency of antimicrobial peptides
68
Why is eczema so dry?
Predisposing factors lead to trans epidermal water loss
69
What is this condition?
Lick eczema - saliva is an irritant and can cause eczema. Can be prevented with a barrier cream
70
What is this condition?
Eczema herpeticum
71
What causes eczema herpeticum? How is eczema herpeticum managed?
* Viral superinfection of eczema * A serious condition with 50%mortality if untreated * Treatment: flucloxacillin + acyclovir
72
How do allergy symptoms change with age?
73
Name some common food allergens.
* •Cow’s Milk Protein * •Soya * •Eggs * •Wheat * •Peanuts * •Tree nuts * •Fish * •Shell fish
74
What are the potencies of different topical steroids?
Use topical steroid ladder * Hydrocortisome = mild * Dermovate = very potent
75
How does % of steroid absorbed vary across different body areas?
* Forearm absorbs 1% * Armpit absorbs 4% * Face absorbs 7% * Eyelids and genitals absorb 30% * Palm absorbs 0.1% * Sole absorbs 0.05%

Year 5 - Paediatrics (91 decks)

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