Skin

Question 1

A 3-year-old girl is taken to the GP due to a rash on her upper arm. On examination multiple raised lesions of about 2 mm in diameter are seen. On close inspection a central dimple is present in the majority of lesions. What is the likely diagnosis?

Answer 1

Molluscum Contagiosum

Virus of same name - pox virus. Spreads by close personal contact or contaminated surfaces such as shared towels.

May be single but usually multiple lesions
Small skin coloured pearly papules with central umbilication

Question 2

Management of Molluscum contagiosum?

Answer 2

Lesions tend to disappear within a year- reassure
Advise it is infectious so don’t use same towel etc
No need to be absent from school or activities
Topical abx to prevent/trat secondary bacterial infection

Crytoherapy (2-3 years only) for more chronic leasions

Question 3

Erythematous, scalded appearance around anal and pelvic area. Flexures spared

Answer 3

Nappy Rash

Flexures spared is the clue

Due to faeces and not changing enough.

Rx:
o Emollient
o Topical 1% hydrocortisone (severe)

Question 4

Erythematous rash in perianal and pelvic area, including the flexures. Satellite lesions present

Answer 4

Candida

Flexures is the clue

Rx topical antifungal

Question 5

4 months old, yellow greasy scaly plaque on head, not itchy

Answer 5

Infantile Sebbhoraic dermatitis

clue is yellow and age of Pt, NOT ITCHY

Rx emollient + steroid
For the cradle cap itself, sulphur and salicylic acid ointment

Question 6

Itchy erythematous rash, itch and scratch, flexures

Answer 6

Atopic eczema

Treat with topical cream and steroid

most common infection assoc is Eczema herpeticum

• Fever, unwell Pt
• regional lymphadenopathy

Hospital admission and acyclovir stat!