Spots and Rashes Flashcards
What are strawberry marks
When are they dangerous
- Haemangioma - raised marks on the skin and are usually red
- They are usually self limiting and rapidly increase in size in first 6 months before shrinking and eventually disappearing
- Around the eye and in the airway - can interfere with vision and breathing
What is a port wine stains
Capillary malformations
- Often affect one side of the body and usually occur on face, back and chest
- They are permanent and deepen in colour over time (also sensitive to hormones e.g pregnancy)
What rash looks like a bruise
Mongolian Blue Spots
- Look blue/grey
- Seen in non- caucasian ancestry
- They can last months/years
What are congenital moles called
Congenital melanocytic naevi
- Large brown moles
- They have a low risk of cancer but the larger the bigger the risk
What are the two main types of birth marks
Vascular birthmarks: Usually pink/red/purple - caused by abnormal vessels under the skin
Pigmented Birthmarks: Usually brown - Caused by clusters of pigment cells
What are types of Vascular Birthmarks
Port wine stain
Strawberry marks/Haemangioma
Salmon patch (around eyes, neck, forehead)
What are the types of Pigmented Birthmarks
Cafe-au-Lait Spots
Mongolian spots
Congential Melanocytic Naevi
What are cafe-au-lait spots
Coffee coloured skin patches
- normal to have a couple
- More than 5 at once - could be neurofibromatosis
What are milk spots/milia
Tiny white bumps on the skin
They are sebaceous plugs
What is erythema toxic neonatorum
Common benign condition seen in newborns doesn’t need treating
- Erythematous macules, papules and pustules (Raised red, yellow and white spots) usually appear on the face, body, upper arms and thighs.
- Usually lasts a few days, The rash can disappear and reappear.
- Diagnosed from skin biopsy will show infiltration of inflammatory cells (eosinophils and neutrophils) - thought to be histamine reaction
What does a smallpox rash look like
Small spots and blisters
- Rash starts as lesions on tongue and in mouth before spreading to the face and spreading to the trunk, palms and soles
- Lesions develop uniformly throughout disease (lesions develop all at same time)
- Start as papule before coming vesicles then eventually become pustules - these will eventually crust and scab over
- lesions are most concentrated to hands, face and feet
What does chickenpox rash look like
Small spots and blisters
- Widespread rash starting on the trunk, spreading to the face, scalp, and extremities
-Simultaneous occurrence of various stages of rash (successive fashion):
erythematous macules → papules → vesicles filled with a clear fluid on an erythematous base → eruption of vesicles → crusted papules → hypopigmentation of healed lesions
- Pruritus
- lesions concentrated to torso fewest on hands and feet
What does measles rash look like
Prodomial phase CCCK:
- Cough
- Coryza
- Conjunctivitis
- Koplik spots (tiny white/bluish spots resemble grains of sand)
Followed by widespread erythematous (red/brown) maculopapular rash - which is blanching
What does rubella rash look like
- Similar to measles but milder
- Beware congenital form - is teratogenic and causes multi organ inflammation
What virus causes slapped cheek syndrome
Parvovirus B19
What does HHV6 cause
Roseola Infartum - produces similar rash to measles and rubella (maculopapular rash)
How does hand, foot and mouth disease rash present snd what causes it
Blisters on hands and feet and ulcers in the mouth
Cause by Coxsackie
What is the rash seen in mumps
Macular erythematous rash usually begins on face
What rash is seen in herpes
Red sores and vesicles seen on the skin, eyes and mouth
What is molluscum contagiosum
small firm dome shaped spots with small dimple in the middle typically pink, red when they rupture think/yellow substance comes out (highly contageous substance)
What is impetigo caused by and how does it present
Highly contagious!!! - caused by Staph Aureus
- Red sores and vesicles which are very itchy which leave golden, crusty patches behind
What is scalded skin caused by
Staphylococcus Aureus Toxin causing skin to be painful, blister and peal
(only 5% Staph produce proteins toxic to the skin)
What is Staph aureus a common cause of skin infection
Impetigo Boils and Abscesses Styes and Conjunctivitis infections in grazes and wounds Infective eczema Cellulitis
How does cellulitis present and what’s it main cause
- Streptococcus, occasionally Staph
- Warm, Erythematous, painful, swollen skin
What does the rash of Meningococcaemia
Non-blanching purpuric rash
What other conditions present with a non blanching purpuric rash
Henoch Schonlein Purpura
Idopathic Thrombocytopenic Purpura (presents with petchiae and easy bruising)
What is the scarlet fever rash
Caused by Group A streptococcus toxin
Pink/red rash feels like sandpaper and looks like sunburn
What is acne caused by
Blockage of skin hair follicles due to:
1. Increased production of oily sebum by sebaceous glands
2. Increased deposition of keratin
3, Infection of follicle
How does acne present
Open Comedomes- Blackheads
Closed Comedomes - Whiteheads
Papules and Pustules
What is the management of acne
Conservative: Avoid triggers, regular washing
1st line: Topical Keratolytics, Topical retinoids and Topical Abx
2nd line: low oral dose Abx e.g erythromycin
or Hormonal treatment e.g COCP
3rd line: Oral Retinoid
What causes nappy rash
Candida
What is a red silver ring like rash called and what’s it caused by
Ringworm
Fungal - Tinea (also causes athletes foot)
What are some common protazoa/insect skin infections
Toxoplasmosis - cat poo
Nits ans Lice
Scabies - intense itching especially at night caused by mites burrowing and laying eggs
Toxocara - dog poo
What is the most common type of eczema
Atopic Eczema - T-cell-mediated delayed-type hypersensitivity reaction - The triad
What are exacerbating factors for eczema
Strong detergents
Chemicals
Cat and Dog fur
Dietary
What are clinically features of eczema
- Itchy, erythematous scaly patches especially in flectures e.g elbows, knees
- Skin can become hyperpigmented
- Broken skin may become infected by S.Aureus (impetigo) or Herpes (blisters/ulcers)
how is eczema managed
Avoid irritants
1st line: Regular emollients (aqueous cream) and mild steroids for face (1% hydrocortisone) and more potent for body (betamethasone)
2nd line: Oral prednisolone, oral immunomodulators e.g Azathioprine
Abx for bacterial infection
How do you distinguish between eczema and contact dermatitis
Eczema - more genetic develops all over body
Contact Dermitis - external factors and develops at site of contact
What is contact dermatitis
Acute or Chronic Skin inflammation produced by substances coming into contact with skin
What are the causes
Chemical irritant - cleaning, solvents, regular hand washing
Type IV Hypersensitivity reaction (allergic dermitis e.g latex)
What are the clinical features of Dermatitis
unusal rash with clear cut edges or odd shapes of erythema and scaling
Pruritus
Pach testing of allergen is placed on skin and can help identify
What is the management
Causative agent removed
Steroid Creams in severe disease
