derm Flashcards
(13 cards)
how common is eczema in children
Eczema (or atopic dermatitis) occurs in around 15-20% of children and is becoming more common.
age distribution of eczema
It typically presents before 2 years but clears in around 50% of children by 5 years of age and in 75% of children by 10 years of age
features of eczema
itchy, erythematous rash
repeated scratching may exacerbate affected areas
in infants the face and trunk are often affected
in younger children, eczema often occurs on the extensor surfaces
in older children, a more typical distribution is seen, with flexor surfaces affected and the creases of the face and neck
management of eczema
avoid irritants
simple emollients - large amounts
topical steroids
wet wrapping
large amounts of emollient (and sometimes topical steroids) applied under wet bandages
in severe cases, oral ciclosporin may be used
give deets on emmolient application in eczema
large quantities should be prescribed (e.g. 250g / week), roughly in a ratio of with topical steroids of 10:1
if a topical steroid is also being used the emollient should be applied first followed by waiting at least 30 minutes before applying the topical steroid
creams soak into the skin faster than ointments
emollients can become contaminated with bacteria - fingers should not be inserted into pots (many brands have pump dispensers)
pressure sore stages
Stage 1 - non-blanching
Stage 2 - partial thickness
Stage 3 - full thickness skin loss
Stage 4 - full thickness tissue loss
Unstageable: full thickness skin or tissue loss
pressure sore management
pressure relief
wound care
nutritional support
pain management
infection control
surgical interventions
complications of pressure sores
Infection of the wound
Cellulitis or abscess formation
Osteomyelitis (bone infection)
Sepsis
Delayed wound healing
Scarring or tissue contractures
Effective management and prevention strategies are crucial to reducing complications associated with pressure sores
whatis necrotising fascitis
Necrotising fasciitis is a life-threatening soft tissue infection that, despite its rarity, must be considered when assessing patients with skin infections due to its high mortality rate.
causes of necrotising fascitis
Bacteria causing necrotising fasciitis include polymicrobial infections (affecting those with immunocompromise or comorbidities),
group A streptococcus (affecting any age group)
, gram-negative bacteria (from seawater contamination),
and fungi (in wound or burns patients or in immunocompromised patients).
presentation of necrotising fascitis
Initially, it may resemble cellulitis, but distinguishing features include severe pain, bullae, ecchymoses, tense oedema, discolouration, and necrosis.
Later signs include hypotension, shock, and altered mental status.
how is diagnosis of necrotising fascitis made
Diagnosis is clinical and confirmed via surgery. Essential tests include blood tests, cultures, and tissue histology.
necrotising fascitis management
Management involves urgent surgical debridement, empirical antibiotics, and supportive care, often requiring ICU input.
