Well Baby With A Rash Flashcards
What are milia?
Small raised pearly white or yellow bumps on the skin
Where are milia often seen?
Cheeks, nose, eyelids, forehead and chest (although can occur anywhere)
What age of infants are milia common in?
Newborns
How many babies get milia?
About 50%
What causes milia?
Retention of keratin and sebaceous material in sweat glands that are not fully formed
Describe erythema toxicum
Small firm yellow or raised bumps filled with pus on top of a red area of skin
- red rash spread in 24 hours
In erythema toxicum, what does the pus contain?
Eosinophils
Where does erythema toxicum occur?
Any part of body except palms and soles. Often begins on face and spreads.
What is a naevus simplex ?
A common, benign capillary vascular malformation - distension of dermal capillaries. It presents at birth as a pink or red patch that is flat with ill defined boarders.
Become more noticeable when baby cries
What is another term for naevus simplex?
Stork bite marks (they are commonly found at nape of neck)
Where do naevi simplex often occur?
Forehead, nose, eyelids, back of head
Does naevus simplex fade?
Over 95% fade as the skin develops and thickens
How long does erythema toxicum usually last and is it benign?
Around 10 days
Yes it is benign
Describe cradle cap
Large, greasy, yellow or brown scale on the scalp
What is another term for cradle cap?
Seborrhoeic dermatitis
Is cradle cap benign?
Yes
Where does cradle cap occur?
Usually on scalp, but can affect face, ears, neck, nappy area or skin folds
Is cradle cap itchy?
No - if baby scratching = atopic dermatitis
What is another term for strawberry naevus?
Cavernous haemangioma
When do strawberry naevi typically appear?
Often not present at birth and appear in first month - increase in size until 3 to 15 months and then regress
Is treatment needed for strawberry naevi?
No unless interfere with vision or airway
Where do strawberry naevi occur?
Usually on face, neck or trunk
Can occur internally - liver, heart, brain
Describe a naevus flammeus
Well demarcated, flat birthmark
Vascular malformation if the capillaries in the dermis
Dark red to purple
What are naevi flammeus also known as?
Port wine stains
They are less common than naevus simplex
Where to port wine stains typically occur?
Face - often unilateral with distinct cut off
Although can occur anywhere
What happens to naevi flammeus over time?
Persist, darken and thicken
What syndrome can naevus flammeus be associated with?
Sturge-Weber syndrome
It is the association of capillary vascular malformation affecting the skin supplied by one branch of the trigeminal nerve of the face with defects in the underlying tissues. These may result in shrunken brain, calcification inside skull, seizures, meningeal angioma and eye abnormalities
What are Mongolian blue spots?
Blue / black macular discolouration at the base of the spine or on the buttock, occasionally occur on legs or other body parts
What can Mongolian blue spots be misdiagnosed as?
Bruises
Who do Mongolian blue spots usually affect?
Afro-Caribbean or Asian babies
Are Mongolian blue spots benign?
Yes, usually disappear 3 to 5 years after birth
What is molluscum contagiosum?
A common viral skin infection of childhood that causes localised clusters of epidermal papules called mollusca
What causes molluscum contagiosum?
A poxvirus
How is molluscum contagiosum spread?
Direct skin to skin contact
Indirect contact via shared towels or other items
Auto inoculation into another site by scratching or shaving
Sexual transmission in adults
Transmission more likely in wet conditions
How does molluscum contagiosum present?
Clusters of small, round papules
Pearl like with central depression - flesh coloured, translucent, white or yellow
Do not occur on palms or soles
Each contain a white cheesy material
Is molluscum contagiosum benign?
Yes often go after a few months
What is another term for ringworm?
Dermatophytosis
Tinea pedis = athlete’s foot
Tinea corporis = fungal infection of arms, legs, trunk
Tinea capitis = scalp
Tinea unguium = fingernails and toenails
Tinea cruris = groin area
Tinea faciei = face
What type of infection is ringworm?
A dermatophyte fungus
Can ringworm occur at any age?
Yes
Describe the appearance of ringworm (tinea corporis)
Red or silver, scaly, circular rash that can be pustular or swollen
Often less red/scaly in the middle
One ring can arise inside an older ring
Describe the appearance of tinea capitis
May present in several ways
Dry scaling - like dandruff but with moth eaten hair loss
Black dots - hairs broken off at scalp surface, which is scaly
Smooth areas of hair loss
Kerion- inflamed mass, like an abscess
Favus- yellow crusts and matted hair
May cause swollen lymph glands
Is ringworm itchy?
Yes
When is ringworm rash not ring shaped?
If it is on face, neck, scalp
How is ringworm treated?
Oral antifungals - griseofulvin (not topicals)
What is nappy rash?
An irritant contact dermatitis
What shape lesion typically occurs?
W shape, affecting convex areas
What is nappy rash associated with?
Change in diapers or use of new baby wipes
How can nappy rash be treated?
Keep skin clean and dry
Dry gently after cleaning
Use water of fragrance free and alcohol free baby wipes
Change nappy every 3-4 hours or as soon as possible after wetting or soiling
Zinc oxide ointments
How does a perianal candidiasis rash present?
A widespread vivid red sharply bordered erythema with satellite papules or vesicles
If there is a perineal candidiasis rash, what other location must be examined?
Oral cavity
What is a well known trigger for perineal candidiasis?
Systemic antibiotic therapy
What is another term for head lice?
Pediculus humanus capitis
Head lice is common in…
Young children, pre school and infant classes
Where do head lice infestations occur?
Almost exclusively on head, may include eyebrows
How is head lice treated?
Wet combing with special fine toothed comb
