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Paediatrics and Child Health > Dermatology > Flashcards

Dermatology Flashcards

(102 cards)

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1
Q

What is a macule?

A

Small flat area of altered colour/texture

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2
Q

Give 3 examples of diseases that present with macules on skin

A
  1. Rubella
  2. Measles
  3. Roseola
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3
Q

What is a patch?

A

Large flat area of altered colour/texture

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4
Q

Give an example of a disease that presents with patches on skin

A

Vitiligo

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5
Q

What is a papule?

A

Small raised lesion

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6
Q

Give an example of a disease that presents with papules on skin

A

Acne

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7
Q

Give 3 examples of diseases that presents with a maculopapular rash

A
  1. Scarlet Fever
  2. Measles
  3. Human Parovirus B19
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8
Q

What is a plaque?

A

Large raised lesion

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9
Q

Give an example of a disease that presents with plaques on skin

A

Psoriasis

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10
Q

What is a nodule?

A

Large raised lesion with deeper components involved (dermis/ subcutaneous fat)

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11
Q

Give an example of a disease that presents with nodules on skin

A

Erythema Nodosum

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12
Q

What is a vesicle?

A

Small clear blister

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13
Q

Give an example of a disease that presents with vesicles on skin

A

Varicella infection–> chickenpox, shingles

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14
Q

What is a bulla?

A

Large clear blister

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15
Q

Given an example of a disease that presents with Bulla on skin

A

Bullous Impetigo

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16
Q

What is a wheal/weal?

A

Transient raised lesion due to dermal oedema

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17
Q

Given an example of a disease that presents with wheals on skin

A

Urticaria (Hives)

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18
Q

What is a pustule?

A

Pus- containing blister

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19
Q

Give an example of a disease that presents with pustules on skin

A

Acute Paronychia

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20
Q

What is purpura?

A

Bleeding into skin/mucosa–> NON-BLANCHING

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21
Q

Give 4 examples of diseases that present with purpura on skin

A
  1. DIC
  2. Meningococcal Septicaemia
  3. Immune thrombocytopaenia
  4. Henoch– Schönlein purpura
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22
Q

What is Excoriation?

A

Scratch mark, loss of epidermis following trauma

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23
Q

Give an example of a disease that presents with excoriation

A

Atopic Dermatitis (Acute rubbing)

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24
Q

What is lichenification?

A

Roughening of skin with accentuation of skin markings

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25
Give an example of a disease that presents with lichenification
Atopic Dermatitis (Chronic rubbing)
26
What are scales?
Flakes of dead skin
27
Give an example of a disease that presents with scales
Seborrhoeic Dermatitis
28
What is a crust?
Dry mass of exudates (serum, dried blood, scales, pus)
29
Give an example of a disease that presents with crusts on skin
Impetigo--> GOLDEN CRUSTS
30
What is a scar?
Formation of new fibrous tissue post-wound healing
31
What is erosion?
Loss of epidermis and dermis (heals with scarring)
32
Give an example of a disease that presents with erosions on skin
Epidermolysis Bullosa
33
What is an ulcer?
Loss of epidermis and dermis (heals with scarring)
34
Give an example of a disease that presents with ulcers on skin
Ulcerating haemangioma
35
Give 5 examples of viral rashes that present with maculopapular rash
1. Human Herpes Virus (HHV6/7) 2. Enterovirus rash 3. Parovirus--> Human Parovirus B19 4. Measles 5. Rubella
36
Give 3 examples of viral rashes that present with vesicular/bullous/pustular rash
1. Varicella Zoster--> Chickenpox, Shingles 2. Herpes Simplex Virus 3. Coxsackie Virus--> Hand Foot Mouth
37
At what age will patients with HHV6/7 infection present?
< 2 years old
38
How will patients with HHV 6/7 infection present?
Exanthema Infantum--> High fever and malaise for a few days then Generalised macular rash
39
Describe the rash in HHV 6/7 infection
Generalised Macular Rash--> Rose-coloured small dots that begin on belly and spread to other parts of the body
40
How is Enterovirus rash transmitted?
Faecal-Oral and Respiratory droplet routes
41
How do patients with Enterovirus Rash present?
90% asymptomatic | Rash--> Blanching, consisting of fine petechiae
42
How is Human Parovirus B19 transmitted?
1. Respiratory secretions 2. Vertical Transmission 3. Infected blood products
43
How do patients with Human Parovirus B19 present?
1. Fever 2. Malaise 3. Myalgia 4. Headache 5. Characteristic Rash on face--> "Slapped cheek" which progresses to maculopapular 'lace'-like rash on trunk and limbs
44
How do patients with Measles present?
- Fever - Cough - Runny Nose - Conjunctivitis - Malaise - Koplik Spots - Maculopapular Rash
45
Describe Koplik Spots
White spots on buccal mucosa, seen against bright red background
46
Describe the Maculopapular Rash in a patient with Measles
- Spreads downwards from behind ear to whole of body - Discrete maculopapular rash initially then becomes blotchy and confluent - May desquamate in second week
47
What are the respiratory complications of Measles?
1. Pneumonia 2. Secondary bacterial infection and Otitis Media 3. Tracheitis
48
What are the neurological complications of Measles?
1. Febrile Seizure 2. EEG abnormalities 3. Encephalitis 4. Subacute Sclerosing Panencephalitis
49
How would you manage a patient with measles?
Supportive treatment | If immunocompromised--> Vitamin A and Ribavarin
50
How is Rubella transmitted?
Respiratory Droplets
51
What are the clinical features of Rubella (excluding Rash)?
1. Mild fever 2. Joint pain 3. Sore Throat 4. Lymphadenopathy (behind ears and back of neck)
52
Describe the rash seen in Rubella infection
Erythematous macular rash that starts on the face and spreads to rest of body--> lasts 3 days
53
How would you investigate a patient with suspected rubella infection?
Confirm diagnosis by serology
54
How would you manage a patient with rubella infection?
Supportive management | Notify public health and avoid pregnant women
55
Describe the rash seen in chickenpox
Vesicular rash--> appears as crops of papules, vesicles with surrounding erythema and pustules at different times for 1 week Starts on head and trunk and progresses to peripheries
56
How would you manage a patient with chickenpox?
Supportive treatment mainly Immunocompromised--> IV Acyclovir, PO Valciclovir, Human Varicella Zoster Immunoglobulin
57
What causes Shingles?
Reactivation of latent Varicella Zoster Virus
58
Describe the rash seen in Shingles
Vesicular eruption in the dermatomal distribution of sensory nerves--> any dermatome can be affected but thoracic region most common
59
Where will lesions be found in patients with Herpes Simplex Virus infection?
HSV-1--> Lip and Skin | HSV-2--> Genitals
60
What is the most common HSV illness in children?
Gingivostomatitis
61
What ages does Gingivostomatitis affect?
10 months to 3 years
62
Describe the lesions seen in Gingivostomatitis?
Vesicular lesions on lips, gums, anterior tongue and hard palate, progressing to extensive painful ulceration w/ bleeding
63
How will patients with Gingivostomatitis present? (other than vesicular lesions)
1. High Fever 2. Painful eating and Drinking 3. Dehydration
64
How would you manage a patient with Gingivostomatitis?
1. Symptomatic treatment 2. Acycloir 3. IV fluids
65
What is Eczema Herpeticum?
Vesicular lesions on eczematous skin
66
What are the complications of Eczema Herpeticum?
- Secondary bacterial infection | - Septicaemia
67
What are Herpetic Whitlows?
Painful, erythematous, oedematous white pustules on broken skin--> usually fingers
68
Describe how a patient with Coxsackie Virus infection will present?
Hand, Foot, Mouth Disease--> Painful vesicular lesions on hand, foot, mouth, tongue and buttocks + mild systemic features
69
How would you manage a patient with Hand, Foot, Mouth Disease?
Supportive management
70
What viruses cause Petechial, Purpuric Rash?
1. Enteroviruses | 2. Adenoviruses
71
What causes Molluscum Contagiosum?
Poxvirus
72
Describe the lesions seen in Molluscum Contagiosum?
Small, skin-coloured, pearly papules with central umbilication--> widespread but disappear spontaneously within a year
73
How would you manage a patient with Molluscum Contagiosum?
1. Topical Antibacterial | 2. Cryotherapy (away from face)
74
What are the clinical features seen in a patient with Eczema?
1. ***Itch (pruritis)--> Itch-scratch-Itch cycle 2. Excoriated areas--> Erythematous, weeping, crusted 3. Lichenification (prolonged scratching & rubbing of skin)
75
What causes exacerbation of eczema?
1. Bacterial Infection 2. Viral infection e.g. Eczema herpeticum 3. Ingestion of allergen 4. Contact with irritant/allergen 5. Environment--> heat/ Humidity 6. Change or reduction in medication 7. Psychological stress 8. Unexplained
76
How would you manage a patient with eczema?
1. Avoid irritants and precipitants 2. Emollients** 3. Topical Corticosteroids 4. Immunomodulators 5. Occlusive bandages--> may be impregnated w/ zinc or zinc + tar paste 6. Antibiotics, Antivirals & Antihistamines 7. Dietary elimination of allergens/ precipitants 8. Psychological Support
77
Describe the distribution of eczema in an infant > 2 months old
Predominantly face and trunk
78
Describe the distribution of eczema in an older child
Predominantly flexor and friction surfaces
79
What irritants/ precipitants should patients w/ eczema avoid?
1. Soap and biological detergents 2. Nylon and pure woollen garments 3. ***cut nails short to avoid skin damage from scratching
80
What kind of emollients should patients with eczema use?
Ointments--> equal parts white soft paraffin and liquid paraffin
81
What kind of topical corticosteroids should be used in patients with eczema?
1% Hydrocortisone ointment--> caution: excessive use causes thinning of skin
82
What kind of immunomodulators should be used in patients with eczema?
Short-term tacrolimus/pimecrolimus--> in patients > 2 years of age
83
What is impetigo?
Localised, highly contagious, staphylococcal/ streptococcal skin infection
84
What are the 2 types of Impetigo?
1. Non-bullous Impetigo | 2. Bullous Impetigo
85
Describe the lesions seen in Impetigo
Erythematous macules that may become vesicular/pustular which rupture Exudates from lesion dries to form 'GOLDEN CRUST' lesions
86
How would you manage a patient with Non- Bullous Impetigo?
Medications: 1. Topical Fusidic Acid 2. Antiseptic Cream (Hydrogen Peroxide 1% cream) 3. Oral Flucloxacillin - Avoid Touching/ scratching lesions - Avoid sharing cutlery, face towels - Be off school
87
What causes Bullous Impetigo?
Staphylococcus Aureus--> Produce epidemolytic toxins
88
Describe the lesions seen in Bullous Impetigo?
1-2cm fluid-filled vesicles form on skin & burst, forming GOLDEN CRUST
89
How would you manage a patient with Bullous Impetigo?
PO/IV Flucloxacillin
90
What is Scabies?
Infestation with Sacoptes Scabiei that burrows down the epidermis along the stratum corneum
91
How would an older child with scabies present?
Very itchy burrows, papules and vesicles on: - Fingers and toes - Axilla - Flexor aspects of wrist - Belt line - Nipples - Penis - Buttocks
92
How would an infant with scabies present?
Very itch burrows, papules and vesicles on: - Palms - Soles - Trunk
93
How would you investigate a patient with suspected scabies infection?
Microscopic Examination of Skin Scrapings
94
How would you manage a patient with Scabies infection?
1. Permethrin Cream--> on whole body covering skin for 8-12 hours then washed off & repeated 1 week later ***Whole family must undergo same treatment
95
What causes Erythema Nodosum?
1. Streptococcal Infection 2. Primary Tuberculosis 3. Inflammatory Bowel Disease 4. Drug Reaction 5. Idiopathic
96
How would a patient with Erythema Nodosum present?
Red, Inflammed, Subcutaneous Nodules (raised, painful, tender) across both shins
97
How would you investigate a patient with suspected Erythema Nodosum?
1. Inflammatory Markers--> CRP/ESR 2. Throat Swab (Strep. infection) 3. Chest X-Ray--> TB, Sarcoidosis, Lymphoma 4. Stool Microscopy and Culture (Salmonella, Campylobacter) 5. Faecal Calprotein (IBD)
98
How would you manage a patient with Erythema Nodosum?
1. Treat Underlying Cause 2. Rest + Analgesia 3. Steroids
99
What causes Erythema Multiforme?
1. Herpes Simplex Infection 2. Mycoplasma Pneumoniae Infection 3. Other Infections 4. Drug Reaction 5. Idiopathic
100
How would a patient with Erythema Multiforme present? (other than rash)
1. Mild fever 2. Stomatitis 3. Muscle, Joint aches 4. headaches 5. General flu-like symptoms
101
Describe the rash seen in Erythema Multiforme
- Widespread Itchy Erythematous Rash | - Target Lesions--> central papule surrounded by erythematous ring, may be vesicular or bullous
102
How would you manage a patient with Erythema Multiforme?
Supportive Management--> resolves spontaenously over 1-4 weeks If severe--> IV Fluids, Analgesia, Topical Steroids, Antibiotics/ Antivirals

Paediatrics and Child Health (5 decks)

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