The Child with Rash

Question 1

What is a naevus flammeus?

Answer 1

• Dilated capillaries over the neck (stork-bite) and nose bridge, eyelids, forehead. Fade over 6-12 months

Question 2

What is the difference between milia and miliaria?

Answer 2

• Milia - small white blocked sebaceous glands over the nose. Common. Resolive in first week of life
• Miliaria - small blocked sweat ducts forming clear-walled blisters or red blisters. Resolve in weeks

Question 3

What is erythema toxicum? What is the red-flag differential?

Answer 3

• Red urticarial-appearing spots that resolve in the first week of life. DDx staphylococcal infection

Question 4

What is a mongolian blue spot? What is the natural history of one?

Answer 4

• Increased melanin deposition over the lower back/sacrum. Lightens over a few years

Question 5

If a newborn is found to have a port-wine stain over their face, what syndrome might you suspect them of having?

Answer 5

Sturge-Weber (refer for investigation !eye-brain malformation)

Question 6

What is the natural history of a haemangioma? Which ones need special care/management? What is the normal management?

Answer 6

• Not normally present at birth but can be.
• Care with eye (amblyopia) and “beard” (airway) proximity.
• Managed expectantly, or with propranolol, laser