Well Baby With A Rash

Question 1

What are milia?

Answer 1

Small raised pearly white or yellow bumps on the skin

Question 2

Where are milia often seen?

Answer 2

Cheeks, nose, eyelids, forehead and chest (although can occur anywhere)

Question 3

What age of infants are milia common in?

Answer 3

Newborns

Question 4

How many babies get milia?

Answer 4

About 50%

Question 5

What causes milia?

Answer 5

Retention of keratin and sebaceous material in sweat glands that are not fully formed

Question 6

Describe erythema toxicum

Answer 6

Small firm yellow or raised bumps filled with pus on top of a red area of skin
- red rash spread in 24 hours

Question 7

In erythema toxicum, what does the pus contain?

Answer 7

Eosinophils

Question 8

Where does erythema toxicum occur?

Answer 8

Any part of body except palms and soles. Often begins on face and spreads.

Question 9

What is a naevus simplex ?

Answer 9

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

Question 10

What is another term for naevus simplex?

Answer 10

Stork bite marks (they are commonly found at nape of neck)

Question 11

Where do naevi simplex often occur?

Answer 11

Forehead, nose, eyelids, back of head

Question 12

Does naevus simplex fade?

Answer 12

Over 95% fade as the skin develops and thickens

Question 13

How long does erythema toxicum usually last and is it benign?

Answer 13

Around 10 days

Yes it is benign

Question 14

Describe cradle cap

Answer 14

Large, greasy, yellow or brown scale on the scalp

Question 15

What is another term for cradle cap?

Answer 15

Seborrhoeic dermatitis

Question 16

Is cradle cap benign?

Answer 16

Yes

Question 17

Where does cradle cap occur?

Answer 17

Usually on scalp, but can affect face, ears, neck, nappy area or skin folds

Question 18

Is cradle cap itchy?

Answer 18

No - if baby scratching = atopic dermatitis

Question 19

What is another term for strawberry naevus?

Answer 19

Cavernous haemangioma

Question 20

When do strawberry naevi typically appear?

Answer 20

Often not present at birth and appear in first month - increase in size until 3 to 15 months and then regress

Question 21

Is treatment needed for strawberry naevi?

Answer 21

No unless interfere with vision or airway

Question 22

Where do strawberry naevi occur?

Answer 22

Usually on face, neck or trunk

Can occur internally - liver, heart, brain

Question 23

Describe a naevus flammeus

Answer 23

Well demarcated, flat birthmark
Vascular malformation if the capillaries in the dermis
Dark red to purple

Question 24

What are naevi flammeus also known as?

Answer 24

Port wine stains

They are less common than naevus simplex

Question 25

Where to port wine stains typically occur?

Answer 25

Face - often unilateral with distinct cut off | Although can occur anywhere

Question 26

What happens to naevi flammeus over time?

Answer 26

Persist, darken and thicken

Question 27

What syndrome can naevus flammeus be associated with?

Answer 27

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

Question 28

What are Mongolian blue spots?

Answer 28

Blue / black macular discolouration at the base of the spine or on the buttock, occasionally occur on legs or other body parts

Question 29

What can Mongolian blue spots be misdiagnosed as?

Answer 29

Bruises

Question 30

Who do Mongolian blue spots usually affect?

Answer 30

Afro-Caribbean or Asian babies

Question 31

Are Mongolian blue spots benign?

Answer 31

Yes, usually disappear 3 to 5 years after birth

Question 32

What is molluscum contagiosum?

Answer 32

A common viral skin infection of childhood that causes localised clusters of epidermal papules called mollusca

Question 33

What causes molluscum contagiosum?

Answer 33

A poxvirus

Question 34

How is molluscum contagiosum spread?

Answer 34

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

Question 35

How does molluscum contagiosum present?

Answer 35

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

Question 36

Is molluscum contagiosum benign?

Answer 36

Yes often go after a few months

Question 37

What is another term for ringworm?

Answer 37

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

Question 38

What type of infection is ringworm?

Answer 38

A dermatophyte fungus

Question 39

Can ringworm occur at any age?

Answer 39

Yes

Question 40

Describe the appearance of ringworm (tinea corporis)

Answer 40

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

Question 41

Describe the appearance of tinea capitis

Answer 41

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

Question 42

Is ringworm itchy?

Answer 42

Yes

Question 43

When is ringworm rash not ring shaped?

Answer 43

If it is on face, neck, scalp

Question 44

How is ringworm treated?

Answer 44

Oral antifungals - griseofulvin (not topicals)

Question 45

What is nappy rash?

Answer 45

An irritant contact dermatitis

Question 46

What shape lesion typically occurs?

Answer 46

W shape, affecting convex areas

Question 47

What is nappy rash associated with?

Answer 47

Change in diapers or use of new baby wipes

Question 48

How can nappy rash be treated?

Answer 48

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

Question 49

How does a perianal candidiasis rash present?

Answer 49

A widespread vivid red sharply bordered erythema with satellite papules or vesicles

Question 50

If there is a perineal candidiasis rash, what other location must be examined?

Answer 50

Oral cavity

Question 51

What is a well known trigger for perineal candidiasis?

Answer 51

Systemic antibiotic therapy

Question 52

What is another term for head lice?

Answer 52

Pediculus humanus capitis

Question 53

Head lice is common in...

Answer 53

Young children, pre school and infant classes

Question 54

Where do head lice infestations occur?

Answer 54

Almost exclusively on head, may include eyebrows

Question 55

How is head lice treated?

Answer 55

Wet combing with special fine toothed comb