Special Problems In Children Flashcards
What’s the most common lesion in neonates?
The Mongolian blue spot
(AKA Congenital dermal melanocytosis)
How do you treat a mongolian blue spot?
You don’t.
They usually regress over time.
What is this called?
Naevus of Ota
It is over the 1st or 2nd branch of the trigeminal nerve.
At what age peaks does the Naevus of Ota form?
1st peak = <1 year old
2nd peak = puberty
What is this?
Naevus of Ito
(Involves the supraclavicular, scapular or deltoid region)
Does a naeuvs of ito or a naevus of Ota spontaneously resolve?
No
Q-Switched Ruby Lasers have been successfull in the past.
What is this and how do you treat it?
Erythema Toxicum Neonatorum
Affects 50% of neonates
Usually begins on the face
Resolves spontaenously over a week or two.
What is this
At what age does it start?
How do you treat it?
Infantile Acne
About 3 months
Topical BPO & Topical Erythromycin.
Can consider Topical Tretinoin or Adapelene.
What are the two types of vascular birthmarks?
Infantile Haemangiomas
Vascular Malformations
What is this?
Who does it occur in?
Does it spontaneously resolve?
- Infantile Haemangioma (Strawberry naevus)
- More common in girls and premature infants.
- It usually involutes leaving a hypopigmented patch:
- 30% by 3
- 90% by 9
When should an infantile haemangioma be referred?
Refer if there is:
- Ulceration
- Recurrent bleeding
- Large facial haemangiomas
- Significant areas - perioral, periocular etc.
What is the treatment for infantile haemangiomas by the specialist?
- Propranolol is first line. (2 to 3 times daily until the child is 12-15 months)
What is this?
A port wine stain
It is the most common type of vascular malformation.
In which condition do port wine stains occur and when should you refer?
Sturge-Weber Syndrome
10% of neonates with SWS will have a port wine stain.
Refer all port wine stains involving the opthalmic branch of the trigeminal nerve due to risks of eye abnormalities.
Name the 6 common skin tumours in children.
- Naevus Sebaceous
- Becker’s Naevus
- Epidermal Naevus
- Epidermal Naevus syndrome
- Pilomatricoma
- Juvenile Xanthogranuloma (JXG)
What is this?
A Naevus Sebaceous
10-15% become cancer (Usually BCC)
Excise when in teenage years if possible.
What is this and how is it treated?
Becker’s Naevus
IPL and Lasers to reduce pigmentation.
What condition is this?
Epidermal Naevus Syndrome
What 2 other syndromes can Epidermal Naevus Syndrome be associated with?
- CHILD syndrome (females, hemidysplasia, limb defects, ichthyosiform naevus)
- Proteus syndrome (overgrowth of tissues in skin, fat, blood vessels, kidneys, lungs and other organs)
What is this?
Pilomatricoma
Benign bluish hard nodule of calcium deposits.
What is this?
Juvenile Xanthogranuloma (JXG)
Majority flatten in 3-5 year
What is this and in what condition is it seen?
Cafe au lait spot
Neurofibromatosis
What are these?
Angiofibromas of Tuberous Sclerosis
What is this?
Shagreen patch and an ash leaf macule
Both seen in Tuberous Sclerosis.
What is this?
Periungual Fibromas - seen in tuberous sclerosis
What is this and how do you treat it?
Tinea Capitis
- 1st line Griseofulvin or oral terbinafine.
- 1nd line Itraconazole.
1% of children will have residual scarring.
How do you treat scabies?
- Permethrin ceam inlcuding face and scalpe
- Leave for 8 hours.
- Repeat after 1 week.
- Treat all family members.
What is this?
Gianotti-Crosti Syndrome
Monomorphic papules on extensor surfaces.
Usually clears in 8 weeks.
Asociated with Hep B and other viral infections.
What is this and tell me about it?
Henoch Schonlein Purpura
- IgA Vasculitis of the skin
- 4-7 years old
- Boys more than girls.
- Associated with abdominal pain.
What is the most common complication of HSP?
Nephritis
What is this?
Mastocytoma
(Mast cells go into the skin)
- Occurs in the first 3 months oflife.
- Urticates on stroking (Darier’s Sign)
What is this and how is it treated?
Urticaria Pigmentosa
- The most common form of mastocytosis.
- Develops between 3-9 months.
- Darier’s sign positive.
- 50% of cases resolve by adolescence.
How is urticaria Pigmentosa treated?
Antihistamines
(Although rarely patients can collapse due to systemic histamine release)
What can precipiate urticaria pigmentosa?
- Aspirin
- Opiates
- D-tubocurarine
- Iodine-containing radiological dyes
- Bee stings
- Shellfish
