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Paediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is eczema?

A

Itchy, dry inflammatory skin condition

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2
Q

What are the different types of eczema?

A 
Atopic
Seborrhoeic 
Varicose 
Pomphylx 
Discoid 
Allergic contact dermatitis
Irritant contact dermatitis
Photosensitive eczema
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3
Q

What is the most common type of eczema?

A

Atopic

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4
Q

What is a typical presentation of atopic eczema?

A

Dry, itchy skin on cheeks of infant, flexural surfaces of children

Skin barrier dysfunction –> loss of water, penetration of irritants/allergens

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5
Q

What causes atopic eczema?

A

Overactive immune response to environmental stimuli –> immune mediated defect in skin barrier function

Abnormality in filaggrin protein which binds keratin together

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6
Q

What are common flares for eczema?

A

Infection, central heating, cold air, pets, teething, stress

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7
Q

How can you treat eczema?

A 
Emollients (creams, lotions, ointments) 
Topical steroids (for 1-2weeks BD + wkend dose)
Calcineurin inhibitors
UVB
Immunosuppression
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8
Q

What are the steroids we can use on the skin in order of strength?

A

Mild - hydrocortisone
Moderate - eumovate (25x)
Potent - betnovate (100x)
Dermovate - 600x

Don’t use above eumovate on face

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9
Q

What is a typical presentation of seborrheic eczema?

A

Face and scalp
<3m old
clears up by 12m
Gets infected by Malasseizia yeast –> cradle cap

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10
Q

How do you treat seborrheic eczema?

A

Antifungal cream/shampoo
Emollients
Steroids

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11
Q

How does discoid eczema present?

A

Annular itchy patches

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12
Q

How does pomphylx eczema present?

A

Vesicles on palms/soles

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13
Q

How does varicose eczema present?

A

Oedema/venous insufficiency/varicose veins –> irritation of skin
usually legs which are dry and inflamed/ulcerated

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14
Q

How do you treat varicose eczema?

A

Emollients, topical steroids, compression stockings

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15
Q

What is allergic contact dermatitis due to?

A

Sensitisation of an allergy (commonly diary, soy, wheat, dander, pollen etc.)

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16
Q

How might you investigate an allergic contact dermatitis?

A

Blood test for IgE

Prick testing

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17
Q

What features might be suggestive of a food allergy?

A

Anaphylaxis, GI probs, late reactions, failure to thrive, severe eczema unresponsive to Rx

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18
Q

What is treatment for allergic contact dermatitis?

A

Dietary restrictions >8wks
Eliminate 1 food at a time
Dietician input
Reintroduce to see if allergic

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19
Q

What causes irritant contact dermatitis?

A

Repeated contact with water, citrus, soaps, friction

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20
Q

How can you identify photosensitive eczema?

A

T-shirt lines

Places not struck by sun unaffected

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21
Q

What is impetigo? What does it present like?

A

Superficial bacterial infection

Pustules and honey-crusted erosions

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22
Q

What causes impetigo?

A

Staph aureus

23
Q

How do you treat impetigo?

A

Fudicin/flucoxacillin

24
Q

What does molluscum contagiosum present like?

A

Pearly, papules, umbilicated centres
Takes 24m to heal
benign

25
Q

What causes molluscum contagiosum?

A

Molluscipox virus via direct contact

26
Q

How do you treat molluscum contagiosum?

A

Molutrex

27
Q

What do viral warts appear like?

A

Skin coloured, non cancerous growths

Known as veruccas on the foot

28
Q

What causes viral warts?

A

HPV transmitted by direct contact

29
Q

How do you treat viral warts?

A

Stimulate immune system against them using cryotherapy or topical paints (like salicyclic acid)

30
Q

What is the presentation of a viral exanthems like?

A

Viral illness assoc (headache, fever, malaise)

Maculopapular rash

31
Q

What are viral exanthems due to?

A

Reaction to toxin produced by organism/damage to skin by organism/immune response

32
Q

What diseases can cause viral exanthems?

A

Chickenpox, parovirus B12 (slapped cheek), measles, rubella, roseola (herpes virus 6)

33
Q

What does chickenpox present like?

A

Red papules progressing to vesicles starting on trunk
Intensely itchy
viral symptoms

34
Q

What causes chickenpox?

A

VZV - which is v contagious from 1-2d before symptoms till lesions crusted over

35
Q

What is rarely associated with chickenpox?

A

Pneumonia, encephalitis

36
Q

What does slapped cheek present like?

A

Erythematous rash over cheeks –> lace like network on trunk/limbs
takes 6 weeks to fade

37
Q

What cell does parovirus target?

A

RCs in bone marrow

38
Q

What can parovirus lead to in vulnerable groups?

A

Aplastic crisis in those with haemolytic anaemia

Hydrops fetalis/IUD in pregnant woman

39
Q

What does hand foot and mouth present like?

A

Blisters on hands, feet, mouth
Viral symptoms
Epidemic in late summer/autum

40
Q

What usually causes hand foot and mouth?

A

Enterovirus - usually coxsackie A16

41
Q

What is orofacial granulomatosis?

A

Lip swelling/fissuring

May get cobble stone appearance

42
Q

What causes orofacial granulomatosis?

A

Crohns

43
Q

What is erythema nodosum/

A

Painful, erythematous nodules over shins

Slow resolution

44
Q

What can cause erythema nodosum?

A 
Infections - strep throat, URTI
Sarcoidosis
IBD
Drugs - OCP, sulphonamide, penicillin
Mycobacterial infection
Idiopathic
45
Q

What investigations might you want to do in erythema nodosum?

A

Serum ACE/check hx of lung probs for sarcoidosis

ASO titre for strep

46
Q

How do you treat erythema nodosum?

A

Steroids

47
Q

What is dermatitis herpetiformis?

A

Itchy blisters in clusters on scalp, shoulders, buttocks

Usually symmetrical

48
Q

What is dermatitis herpetiformis linked to?

A

Coeliac disease

49
Q

What investigations should you do in dermatitis herpetiformis?

A

Hx
Coeliac screening
Skin biopsy

50
Q

How do you treat dermatitis herpetiformis?

A

Emollients
Gluten free diet
Topical steroids
Dapsone

51
Q

What is urticaria?

A

Wheals/hives
Assoc. angioedema
LASTS <24H

52
Q

What is chronic vs acute urticaria?

A

Chronic >6wks, acute <6wks

53
Q

What can cause urticaria?

A

Viral/bacterial infection, food/drug allergy, NSAIDs/opiates, vaccinations, idiopathic

54
Q

How do you treat urticaria?

A

Remove triggers
Antihistamines (desloratadine)
Ranitidine, Montelukast
Omalizumab, cyclosporin

Paediatrics (35 decks)

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