Skin Disorders

Question 1

Which skin disorder presence in early life with a scaly, non-itchy rash on the scalp that can spread to the face, flexures and napkin area?

Answer 1

Infantile seborrhoeic eczema

Question 2

Which skin disorder normal starts on the extensor surfaces and the face (in infants). It is a dry, red and itchy?

Answer 2

Atopic eczema.

Starts in flexures in older children.

Question 3

What is the mainstay of treatments for eczema?

Answer 3

Mild :Emollients and mild topical steroids
Mod: emollients, mod topical steroids, topical calcineurin inhibitors (e.g. Tacrolimus and pimecrolimus), wet wraps
Severe: emollients, potent topical steroids, topical calcineurin inhibitors, wet wraps, phototherapy, systemic therapy

Question 4

What usually causes nappy rash?

Answer 4

Prolonged contact of urine and faeces with the skin. (Skin wetness and ammonia from the breakdown of urine by faecal enzymes). Red moist and can ulcerate. The inguinal folds are spared.

Rx- leave nappy off to air and barrier cream e.g. Sudocream (zinc oxide)

Question 5

What causes bright red skin, with satalite lesions and skin fold involvement in the napkin area?

Answer 5

Candidiasis

Rx- nappy off, sudocream, clotrimazole, 1% hydrocortisone cream

Question 6

Child presents with erythematous macules that develop golden crust lesions on the face. What is the most likely causative agent?

Answer 6

Impetigo - staph aureus

Highly contagious

Question 7

Which severe skin condition, disrupts the epidermal granular cell layer by a toxin mediated process?

Answer 7

Scalded skin syndrome - staph aureus
Blistered skin
Potentially life threatening - need fluid balance and iv flucloxacillin

Question 8

Child has a widespread erythemous rash starting on the trunk. A throat swab is positive for streptococcus. What other clinical features may be present?

Answer 8

This is scarlet fever:
Tonsillitis 
Strawberry tongue 
Palatal petechia
Rash (as above)
Fever

Question 9

Child presents with bright red painless rash on both cheeks. What is the name for this and the infective agent?

Answer 9

Slapped cheek= erythema infectiosum

Parvovirus b19

Question 10

What agent causes high grade fever for 3days, which is then followed by a maculopapula rash starting on the neck and trunk which then spreads to the face and extremities?

Answer 10

Agent: human herpes 6.
Roseola infantum or sixth disease

Well from after rash
Self- limiting

Question 11

What is Kawasaki disease?

Answer 11

Type of vasculitis seen in children. 
Fever- 5days
Eyes- conjunctival 
Lips - red and cracked
Tongue- strawberry
Lymphnodes
Hands and soles- red

Rx- aspirin (only time given in children)
Do echo!

Question 12

Finger tip peeling?

Answer 12

Scarlet fever and kawakasi

Question 13

Cause of scarlet fever?

Answer 13

Strep

Question 14

Complications of strep (scarlet fever)?

Answer 14

Glomerular nephritis

Rheumatic heart

Question 15

What is the rash in measles?

Answer 15

Morbilliform 
Starts behind ears 
Sprees to trunk 
Kolip spots in mouth 
Conjunctiveits 

Coryzal and v.unhappy
Complications - seizures, pneumonia, Otitis media, encephalitis, sub-sclerosing pan encephalitis,

Question 16

Timeline of varicella?

Answer 16

Incubation 
Vesicular 
Rupture to papules 
Ulcer in the middle 
Everywhere! Any epithelial surface 

(Latent - Shingles)

• complications
  Immunocomprimised - encephalitis
  Pregant - foetal abnormallities or neonatal sepsis (worse 1 and 3 trimester) - Rx IV Ig (crosses placenta), acyclovir ?,

Question 17

What does cocksaccie a16 lead to?

Answer 17

Hand foot and mouth

Question 18

What is Tinea corporus?

Answer 18

Dermatophite (Fungi) - asymetric patches (Rx - turbinifin fungalcide, not fluconazole!)
(Looks bit like eczema- DONT Prescribe steroids)