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Sydney Child Health Program > 9.3 Birthmarks > Flashcards

9.3 Birthmarks Flashcards

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1
Q

3 main types of birthmarks?

A

vascular
epidermal
melanocytic

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2
Q

2 main vascular birthmarks?

A

vascular tumours

Vascular Malformations

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3
Q

examples of vascular tumours birthmarks?

A

infantile hemangioma

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4
Q

examples of vascular malformations?

A

capillary
lymphatic
Arteriovenous

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5
Q

who gets infantile haemangiomas more likely?

A 
females 3:1
prematurity
multiple gestation
caucasian
advanced maternal age, placenta paevie
pre-eclampsia
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6
Q

when do infantile haemangiomas grow?

A

first 3-9 months

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7
Q

when is infantile haemangiomas onset?

A

within 1-2 weeks of birth

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8
Q

when does infantile haemangiomas regress?

A

during childhood

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9
Q

tell parents regression ages?

A

50% age 5
70% age 7
90% age 9

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10
Q

if uncertain about infantile haemangiomas dx?

A

ultrasound

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11
Q

two types of infantile haemangiomas?

A

superficial

deep

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12
Q

Complications of infantile haemangioma?

A
  1. Ulceration
  2. Interference of function: amblyopia, airway, oral
  3. Cosmetic disfigurement
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13
Q

What if the baby has a large sacral infantile haemangioma?

A

Spinal defects

urogenital defects

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14
Q

What is baby has mandibular infantile haemangioma?

A

Risk of sub-glottic laryngeal haemangioma impeding airway

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15
Q

Risk of multiple infantile haemangioma?

A

Underlying visceral, liver/cardiac failure

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16
Q

What is multiple haemangioma defined as?

A

More than 5

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17
Q

What is PHACES syndrome?

A
  1. Posterior intracranial fossa anomalies
  2. Haemangioma
  3. Aortic / arterial anomalies
  4. Cardiac Abnomalities
  5. Eye Anomalies
  6. Sternal defects
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18
Q

what kind of haemangioma in PHACES syndrome?

A

segmental haemangioma

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19
Q

investigations for mandibular haemangioma?

A

lateral neck x-ray

ENT exam

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20
Q

investigations for sacral haemangioma?

A

USS

MRI

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21
Q

investigations for multiple haemangioma?

A

liver U/S, doppler

MRI

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22
Q

investigations for PHACES haemangioma?

A

eye exam
MRI head & neck
ECG, ECHO

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23
Q

when to referral for haemangioma?

A

ulceration
interference of function
cosmetic - threatened

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24
Q

Treatment for infantile haemangiomas ulceration?

A

dressings
analgesia
vascular laser

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25
Treatment for infantile haemangiomas functional or cosmetic impairment?
1. propanalol 2. oral steroids 3. intralesional steroids 4. vincristine
26
difference between infantile haemangiomas vs. congenital haemangiomas?
fully developed at birth | -no rapid growth phase
27
two kinds of congenital haemangiomas?
RICH - rapid involution | NICH - non-involuting
28
Rx for congenital haemangiomas - NICH?
surgical
29
4 kinds of vascular malformations
Capillary Venous Arteriovenous Lymphatic
30
2 main types of capillary malformation?
1. salmon patch (angel's kiss, stork bite) 40% of newborns | 2. Port Wine Stain
31
where are salmon patches normally?
``` central face usually bilateral nuchal region upper eyelid perialar region thoracolumbar ```
32
how many salmon patches usually?
multiple normally
33
facial salmon patches fade?
fades in 1-2 years
34
neck salmon patches fade?
persists into adulthood
35
Rx for salmon patches ?
not really unless persistent on face
36
Port Wine Stains incidence?
0.3%of all newborns
37
Port Wine Stains presents?
at birth
38
Port Wine Stains description?
confluent non-palpable erythema
39
Port Wine Stains locations?
dermatomal distribution 85% unilateral 15% bilateral
40
Port Wine Stains resolution?
non spontaneous
41
Port Wine Stains Rx?
pulsed dye vascular laser
42
Port Wine Stains long term complications?
darken skin hypertrophy nodules
43
all Port Wine Stains have when kind of problem?
underlying AVM, VM, LM
44
Limb Port Wine Stains tend to?
hypertrophy (Klippel-Trenauney)
45
Craniospinal Port Wine Stains need investigation?
yes | ?spinal cord anomalies
46
how to tell if Port Wine Stains is AVM?
warm to tough, thril/pulsatile
47
how to tell if Port Wine Stains is VM?
bluish | dilated veins
48
how to tell if Port Wine Stains is LM?
vesicles, deeper swelling
49
what is Sturge-Weber synfrome
1. Facial port wine stain, V1 or hemifacial 2. ipsilateral leptomeningeal vascular malformation: epilepsy, intellectual disability etc. 3. choroidal vascular malformation of the eye: glaucoma
50
limb Port Wine Stains manifests when? how?
- early 1-2 years | - hypertrophy of soft tissue and bones
51
limb Port Wine Stains syndromes?
Klippel-Trenauney (CM, VM, LM) | Parkes-Weber (CM, AVM, VM, LM)
52
when does Becker's naevi appear?
at start of puberty
53
epidermal naevi types?
``` Keratinocytic Sebaceous Follicular apocrine eccrine becker's ```
54
which epidermal naevi likely to have underlying problems?
epidermal naevi syndrome 1. extensive sebaceous naevi 2. located in centrofacial regions 3. multiple naevi
55
sebaceous naevi tend to develop where?
scalp
56
sebaceous naevi complications?
-can have growth, should be biopsied -usually benign -
57
sebaceous naevi complications occur when?
in adulthood normally
58
pigmented birthmarks 3 kinds:
- hyperpigmented macules - hypopigmented macules - congenital melanocytic naevi
59
hyperpigmented macules aslo known as?
cafe au lait spots
60
-hyperpigmented macules -hypopigmented macules usually follow which lines?
lines of blaschko
61
multiple cafe au lait spots, how many? worry about?
5< | neurofibromatosis type 1
62
multiple hypopigmented naevi, worry about?
tuberous sclerosis
63
-hyperpigmented macules treatment
no treatment | laser
64
-hypopigmented macules treatment
none or | cosmetic camouflage
65
congenital melanocytic naevi
dark spots, can have hair in them
66
congenital melanocytic naevi occur when?
1st year of life
67
congenital melanocytic naevi classification?
small <1.5cm intermediate 1.5-19.9cm giant >20cm
68
congenital melanocytic naevi single? multiple
can be multiple
69
congenital melanocytic naevi natural history?
- proportionate growth - thicken & daken - more hairs - don't resolve
70
problems with giant congenital melanocytic naevi?
- neurocutaneous melanosis | - intracerebral/leptomeningeal melanocytic proliferations
71
risk factors for neurocutaneous melanosis?
- >2 congenital melanocytic naevi | - giant congenital melanocytic naevi
72
prognosis for neurocutaneous melanosis?
symptomatic - poor prognosis
73
congenital melanocytic naevi complications?
melanoma 2-3% of giant ones highest risk
74
congenital melanocytic naevi complications for small ones?
no increased risk of melanoma
75
giant congenital melanocytic naevi investigations?
1. MRI baseline or symptomatic | 2. biopsy
76
congenital melanocytic naevi treatment
1. excision | 2. laser not really

Sydney Child Health Program (113 decks)

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