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Paediatrics and Child Health > Dermatology > Flashcards

Dermatology Flashcards

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
Q

Give an example of a disease that presents with lichenification

A

Atopic Dermatitis (Chronic rubbing)

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26
Q

What are scales?

A

Flakes of dead skin

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27
Q

Give an example of a disease that presents with scales

A

Seborrhoeic Dermatitis

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28
Q

What is a crust?

A

Dry mass of exudates (serum, dried blood, scales, pus)

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29
Q

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

A

Impetigo–> GOLDEN CRUSTS

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30
Q

What is a scar?

A

Formation of new fibrous tissue post-wound healing

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31
Q

What is erosion?

A

Loss of epidermis and dermis (heals with scarring)

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32
Q

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

A

Epidermolysis Bullosa

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33
Q

What is an ulcer?

A

Loss of epidermis and dermis (heals with scarring)

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34
Q

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

A

Ulcerating haemangioma

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35
Q

Give 5 examples of viral rashes that present with maculopapular rash

A
  1. Human Herpes Virus (HHV6/7)
  2. Enterovirus rash
  3. Parovirus–> Human Parovirus B19
  4. Measles
  5. Rubella
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36
Q

Give 3 examples of viral rashes that present with vesicular/bullous/pustular rash

A
  1. Varicella Zoster–> Chickenpox, Shingles
  2. Herpes Simplex Virus
  3. Coxsackie Virus–> Hand Foot Mouth
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37
Q

At what age will patients with HHV6/7 infection present?

A

< 2 years old

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38
Q

How will patients with HHV 6/7 infection present?

A

Exanthema Infantum–> High fever and malaise for a few days then Generalised macular rash

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39
Q

Describe the rash in HHV 6/7 infection

A

Generalised Macular Rash–> Rose-coloured small dots that begin on belly and spread to other parts of the body

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40
Q

How is Enterovirus rash transmitted?

A

Faecal-Oral and Respiratory droplet routes

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41
Q

How do patients with Enterovirus Rash present?

A

90% asymptomatic

Rash–> Blanching, consisting of fine petechiae

42
Q

How is Human Parovirus B19 transmitted?

A
  1. Respiratory secretions
  2. Vertical Transmission
  3. Infected blood products
43
Q

How do patients with Human Parovirus B19 present?

A
  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
Q

How do patients with Measles present?

A
  • Fever
  • Cough
  • Runny Nose
  • Conjunctivitis
  • Malaise
  • Koplik Spots
  • Maculopapular Rash
45
Q

Describe Koplik Spots

A

White spots on buccal mucosa, seen against bright red background

46
Q

Describe the Maculopapular Rash in a patient with Measles

A
  • Spreads downwards from behind ear to whole of body
  • Discrete maculopapular rash initially then becomes blotchy and confluent
  • May desquamate in second week
47
Q

What are the respiratory complications of Measles?

A
  1. Pneumonia
  2. Secondary bacterial infection and Otitis Media
  3. Tracheitis
48
Q

What are the neurological complications of Measles?

A
  1. Febrile Seizure
  2. EEG abnormalities
  3. Encephalitis
  4. Subacute Sclerosing Panencephalitis
49
Q

How would you manage a patient with measles?

A

Supportive treatment

If immunocompromised–> Vitamin A and Ribavarin

50
Q

How is Rubella transmitted?

A

Respiratory Droplets

51
Q

What are the clinical features of Rubella (excluding Rash)?

A
  1. Mild fever
  2. Joint pain
  3. Sore Throat
  4. Lymphadenopathy (behind ears and back of neck)
52
Q

Describe the rash seen in Rubella infection

A

Erythematous macular rash that starts on the face and spreads to rest of body–> lasts 3 days

53
Q

How would you investigate a patient with suspected rubella infection?

A

Confirm diagnosis by serology

54
Q

How would you manage a patient with rubella infection?

A

Supportive management

Notify public health and avoid pregnant women

55
Q

Describe the rash seen in chickenpox

A

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
Q

How would you manage a patient with chickenpox?

A

Supportive treatment mainly

Immunocompromised–> IV Acyclovir, PO Valciclovir, Human Varicella Zoster Immunoglobulin

57
Q

What causes Shingles?

A

Reactivation of latent Varicella Zoster Virus

58
Q

Describe the rash seen in Shingles

A

Vesicular eruption in the dermatomal distribution of sensory nerves–> any dermatome can be affected but thoracic region most common

59
Q

Where will lesions be found in patients with Herpes Simplex Virus infection?

A

HSV-1–> Lip and Skin

HSV-2–> Genitals

60
Q

What is the most common HSV illness in children?

A

Gingivostomatitis

61
Q

What ages does Gingivostomatitis affect?

A

10 months to 3 years

62
Q

Describe the lesions seen in Gingivostomatitis?

A

Vesicular lesions on lips, gums, anterior tongue and hard palate, progressing to extensive painful ulceration w/ bleeding

63
Q

How will patients with Gingivostomatitis present? (other than vesicular lesions)

A
  1. High Fever
  2. Painful eating and Drinking
  3. Dehydration
64
Q

How would you manage a patient with Gingivostomatitis?

A
  1. Symptomatic treatment
  2. Acycloir
  3. IV fluids
65
Q

What is Eczema Herpeticum?

A

Vesicular lesions on eczematous skin

66
Q

What are the complications of Eczema Herpeticum?

A
  • Secondary bacterial infection

- Septicaemia

67
Q

What are Herpetic Whitlows?

A

Painful, erythematous, oedematous white pustules on broken skin–> usually fingers

68
Q

Describe how a patient with Coxsackie Virus infection will present?

A

Hand, Foot, Mouth Disease–> Painful vesicular lesions on hand, foot, mouth, tongue and buttocks + mild systemic features

69
Q

How would you manage a patient with Hand, Foot, Mouth Disease?

A

Supportive management

70
Q

What viruses cause Petechial, Purpuric Rash?

A
  1. Enteroviruses

2. Adenoviruses

71
Q

What causes Molluscum Contagiosum?

A

Poxvirus

72
Q

Describe the lesions seen in Molluscum Contagiosum?

A

Small, skin-coloured, pearly papules with central umbilication–> widespread but disappear spontaneously within a year

73
Q

How would you manage a patient with Molluscum Contagiosum?

A
  1. Topical Antibacterial

2. Cryotherapy (away from face)

74
Q

What are the clinical features seen in a patient with Eczema?

A
  1. ***Itch (pruritis)–> Itch-scratch-Itch cycle
  2. Excoriated areas–> Erythematous, weeping, crusted
  3. Lichenification (prolonged scratching & rubbing of skin)
75
Q

What causes exacerbation of eczema?

A
  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
Q

How would you manage a patient with eczema?

A
  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
Q

Describe the distribution of eczema in an infant > 2 months old

A

Predominantly face and trunk

78
Q

Describe the distribution of eczema in an older child

A

Predominantly flexor and friction surfaces

79
Q

What irritants/ precipitants should patients w/ eczema avoid?

A
  1. Soap and biological detergents
  2. Nylon and pure woollen garments
  3. ***cut nails short to avoid skin damage from scratching
80
Q

What kind of emollients should patients with eczema use?

A

Ointments–> equal parts white soft paraffin and liquid paraffin

81
Q

What kind of topical corticosteroids should be used in patients with eczema?

A

1% Hydrocortisone ointment–> caution: excessive use causes thinning of skin

82
Q

What kind of immunomodulators should be used in patients with eczema?

A

Short-term tacrolimus/pimecrolimus–> in patients > 2 years of age

83
Q

What is impetigo?

A

Localised, highly contagious, staphylococcal/ streptococcal skin infection

84
Q

What are the 2 types of Impetigo?

A
  1. Non-bullous Impetigo

2. Bullous Impetigo

85
Q

Describe the lesions seen in Impetigo

A

Erythematous macules that may become vesicular/pustular which rupture

Exudates from lesion dries to form ‘GOLDEN CRUST’ lesions

86
Q

How would you manage a patient with Non- Bullous Impetigo?

A

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
Q

What causes Bullous Impetigo?

A

Staphylococcus Aureus–> Produce epidemolytic toxins

88
Q

Describe the lesions seen in Bullous Impetigo?

A

1-2cm fluid-filled vesicles form on skin & burst, forming GOLDEN CRUST

89
Q

How would you manage a patient with Bullous Impetigo?

A

PO/IV Flucloxacillin

90
Q

What is Scabies?

A

Infestation with Sacoptes Scabiei that burrows down the epidermis along the stratum corneum

91
Q

How would an older child with scabies present?

A

Very itchy burrows, papules and vesicles on:

  • Fingers and toes
  • Axilla
  • Flexor aspects of wrist
  • Belt line
  • Nipples
  • Penis
  • Buttocks
92
Q

How would an infant with scabies present?

A

Very itch burrows, papules and vesicles on:

  • Palms
  • Soles
  • Trunk
93
Q

How would you investigate a patient with suspected scabies infection?

A

Microscopic Examination of Skin Scrapings

94
Q

How would you manage a patient with Scabies infection?

A
  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
Q

What causes Erythema Nodosum?

A
  1. Streptococcal Infection
  2. Primary Tuberculosis
  3. Inflammatory Bowel Disease
  4. Drug Reaction
  5. Idiopathic
96
Q

How would a patient with Erythema Nodosum present?

A

Red, Inflammed, Subcutaneous Nodules (raised, painful, tender) across both shins

97
Q

How would you investigate a patient with suspected Erythema Nodosum?

A
  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
Q

How would you manage a patient with Erythema Nodosum?

A
  1. Treat Underlying Cause
  2. Rest + Analgesia
  3. Steroids
99
Q

What causes Erythema Multiforme?

A
  1. Herpes Simplex Infection
  2. Mycoplasma Pneumoniae Infection
  3. Other Infections
  4. Drug Reaction
  5. Idiopathic
100
Q

How would a patient with Erythema Multiforme present? (other than rash)

A
  1. Mild fever
  2. Stomatitis
  3. Muscle, Joint aches
  4. headaches
  5. General flu-like symptoms
101
Q

Describe the rash seen in Erythema Multiforme

A
  • Widespread Itchy Erythematous Rash

- Target Lesions–> central papule surrounded by erythematous ring, may be vesicular or bullous

102
Q

How would you manage a patient with Erythema Multiforme?

A

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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