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Dermatology Flashcards

(56 cards)

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1
Q

Define vernix caseosa

A

Chalky-whit greasy coat of newborn infants

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2
Q

Skin in preterm infants

A 
Thin
Poorly keratonised
Transepidermal water loss
Lacking subcutaeous fat
Unable to sweat
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3
Q

Features bullous impetigo

A

Uncommon
Blitering form of impetigo
Causes by staphylococcus aureus

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4
Q

Mx Bullous Impetigo

A

Systemic antibiotics .e.g. flucloxacillin

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5
Q

Features congenital pimented naveai

A

Rare
Involve extensive areas of skin (>9cm in diameter)
4-6% risk of malignant melanoma

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6
Q

Features albinism

A 
Defective biosynthesis of melanin
Lack of pigmentation of skin and eye
Failure to develop fixation reflex
Pendular nystagmus
Photophobia (constant frowning)
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7
Q

Mx albinism

A

Correction of refractive errors
Fitting of tinted lenses
Sun protection

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8
Q

Features epidermolysis Bullosa

A

Blistering of the skin and mucous membranes
Blisters occur spontaneously and following minor tauma
Oral ulceration

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9
Q

Mx epidermolysis bullosa

A

Avoidance of minor trauma
Maintenance of adequate nutrition
Analgesia when dressings changed

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10
Q

Cx epidermolysis bullosa

A

fusion of fingers and toes

Limb contractures from repeated blistering and healing

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11
Q

Features collodion baby

A

Dry and scaly skin
Infants born with taut, shiny, parchment like membrane
Risk of dehydration

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12
Q

Mx Collodion baby

A

Application of emmoliants

Membrane fissues and separates within a few weeks

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13
Q

Causes of nappy rash

A 
Irritant contact dermatitis
Infantile seborroeic dermatitis
Candida infection
Atopic eczema
Acrodermatitis enteropathica
Langerhans cell histiocytosis
Wiskott-Aldrich syndrome
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14
Q

Features irritant dermatitis nappy rash

A

Occurs if nappies changed infrequently or in diarrhoea
Irritant affect of urine on the skin
Urea splitting organisms in faeces increase alkalinity
Affects converse surfaces of buttocks, perineal, lower abdo, top of thighs
Sparing of flexures
Erythmatous with scalded appearance
Erosions and ulcer formation present

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15
Q

Features candida nappy rash

A

Erythematous
Includes skin flexures
Satellite lesions

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16
Q

Mx candida nappy rash

A

Topical antifungal

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17
Q

Mx irritant dermatitis nappy rash

A

Mild topical corticosteroid

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18
Q

Features Infantile seborrhooeic dermatitis

A

Present within 3m
Scalp
Erythematous scaly eruption
Scales form a thick yellow adherent layer (cradle cap)
Spread to face, behind ears, flexures and napkin area
Not itchy- child unbothered

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19
Q

Mx Infantile seborrhoeic dermatitis

A

Emollients
Scales cleared with sulfur and salicylic acid ointment
-applied daily for a few hours and washed off
Mild topical corticosteroid- widespread body eruptions
+/- antibacterial and antifungal

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20
Q

Features atopic eczema

A 
Genetic deficiency in the skin barrier
Onset within 1y
Uncommon in first 2m
Associated with atopy (1/3 develop asthma)
Exclusive breastfeeding can delay onset
Usually self resolves
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21
Q

Clinical Diagnosis atopic eczema

A

Itchy rash
Scratching
Excoriated areas become weepy, erythematous and crusted
Dry skin
Linchification from prolonged scratching and rubbing

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22
Q

dDx Itchy rash

A 
Atopic eczema
Chickenpox
Urticaria/allergy
contact dermatitis
Insect bite
Scabies
Fungal infection
Pityriasis rosea
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23
Q

Causes of exacerbation of eczema

Study These Flashcards
A 
Bacterial infection.e.g. strep, staph
Viral infection .e.g. herpes
Ingestion of allergen .e.g. Egg
Contact with irritant or allergen
Environment .e.g. heat, humidity
Change or reduction in medication
Psychological stress
Unexplained
24
Q

Distribution of atopic eczema

Study These Flashcards
A

Infant >2m: predominantly face, also trunk

Older children: flexor and friction surfaces

25
Complications atopic eczema
Infection .e.g. staphylococcus, streptococcus Eczema herpaticum Regional lymphadenopathy
26
Mx eczema
``` Avoidance of precipitants -allergens .e.g. cows milk -avoiding nylon and woollen garments -cutting nails and using mittens Emollients Topical corticosteroids Immunomodulators (children >2y): topical tacrolimus ointment or pimecrolimus cream Occlusive bandages: impregnanted with zinc/tar paste -worn overnight for 2-3d at a time Wet stockinette wraps in widespread itching -diluted topical steroids with emollient Antibiotics/antiviral/antifungal Dietary elimination Psychological support ```
27
Features viral warts
Caused by human papilomavirus Common in children Usuaully on fingers and soles (verrucae) Most disappear spontaneously over a few months
28
Mx viral warts
Only indicated for cosmesis and painful lesions Daily application of proprietary salicylic acid and lactic acid paint / glutaraldehyde lotion Cryotherapy with liquid nitrogen- only older children
29
Features molluscum contagiosum
Caused by poxvirus Small, skin coloured, pearly papules with central umbilication Often widespread Spontaneously regress within a year
30
Mx molluscum contagiosum
Topical antibacterial to prevent 2' infection | Cryotherapy for chronic lesions in older children
31
Features ringworm
Dermatophyte fungi invasion f keratinous structures Annual ring appearance of skin lesions Kerions: severe inflammatory pustular ringworm Tinea capitis: scalp, acquired from pets, scaling and patchy alopecia
32
Ix Tinea capitis
Examination under filtered UV woods light shows bright greenish yellow flourescence of infected hairs Microscopic examination of skin scrapings show fungal hyphae Definitive identification of fungi is by culture
33
Mx ringworm
Topical antifungal preparation Systemic antifungal in severe infection and scalp Treatment of household animals if infected
34
Features Scabies
Infestion by burrowing along stratum corneum Severe itching occurs 2-6w after infestation Worse in warm conditions and at night
35
Scabies locations
``` Older children: -between fingers and toes -axillae -flexor aspect of wrists -belt line -nipples,penis, and buttocks Infants: -palms and soles -trunk Babies: -head, face and neck involvement (uncommon) ```
36
Cx Scabies
Excoriation of skin causing eczematous/urticarial reaction 2' bacterial infection Norweigan scabies
37
Mx Scabies
Treatment of child and household Primethaprin cream (5%)- applied to all areas and washed off after 8-12h -In babies face and scalp should be included Benzyl benzoate emulsion (25%)- applied below neck only, left for 12h -smells and has irritant action Malathion lotoin (0.5%)- applied below neck, left 12h
38
Features Pediculosis (Headlice)
Typically primary school age Itching of scalp or nape Identification of live lice on scalp or nits (egg cases) on hair Suboccipital lymphadenopathy
39
Mx Head lice
Dimeticon 4% lotion / Malathion 0.5% aqeous solution -rubbed onto hair and scalp and left overnight -repeated 1w later Wetcombing with fine tooth comb to remove lice -repeated every 3-4 days for 2 weeks No school exclusion necessary
40
Features psoriasis
Familial disorder Presents after 2y Plaques and annular lesions Fine pitting of nails in chronic disease
41
Features guttate psoriasis
Common in children Small, raindrop like, oral or round erythematous scaly patches Trunk and upper limbs Attack resolves over 3-4m
42
Mx guttate psoriasis
Bland ointments
43
Mx Chronic Psoriasis
Coal tar preparations Calcipotriol (vit D analogue) children>6y Dithranol preparation in resistant plaque psoriasis
44
Features Pityriasis Rosea
Acute benign self limiting condition Single round or oval scaly macule (herald patch) - 2-5cm in diameter Trunk, upper arm, neck, or thigh Numerous smaller dull pink macules develop Rash follows line of ribs posteriorly (fir tree pattern) Lesions may be itchy Resolves within 4-6w
45
Features Alopecia Areata
Common form of hair loss in children Hairless non-inflammed smooth areas of skin, usually over scalp Remnant of broken hairs (exclamation marks) on edge of active patches
46
Prognosis Alopecia Areata
Usually hair growth occurs within 6-12m in localised hair loss Poorer prognosis is associated with greater hair loss Prognosis more guarded in children with atopic disorders
47
Features Granuloma Annulare
``` Ringed lesions Flesh coloured non scaling edge Over bony prominences especially hands and feet Usually 1-3cm in diameter Disappear spontaneously within 12m ```
48
Features Acnes Vulgaris
Begins 1-2y before onset of puberty -androgenic stimulation of sebaceous glands Open and closed comedones, papules, pustules, nodules and cysts Face, back, chest and shoulders Cystic and nodular lesions may cause scarring Exacerbation with menstruation and stress
49
Mx Acne Vulgaris
``` Topic treatments: -benzoyl peroxide (keratolytic agent) 1/2 daily -sunshine in moderation -topical antibiotics -topical retinoids Systemic therapy -Oral antibiotics (tetracycline/erythromycin) >12y -Oral retinoid (isotretinoin) ```
50
Causes of erythema nodosum
``` Streptococcal infection Primary TB Inflammatory bowel disease Drug reaction Idiopathic ```
51
Causes of erythema multiforme
``` Herpes simplex Mycoplasma pneumoniae Infections Drug reaction Idiopathic ```
52
Features erythema multiforme
Target lesion Central papule surrounded by erythematous ring Vesicular or bullous lesions
53
Features Steven-Johnson Syndrome
Severe bullous form of erythema multiforme Involvement of mucous membranes Starts with URTI Eye involvement: conjunctivitis, corneal ulceration, uveitis
54
Features Urticaria
``` Flesh coloured wheals Delayed hypersensitivity reaction Commonly on legs Bite from flea, bedbug, animal/bird mite Irritation Vesicles Papules Wheals Secondary infection due to scratching common ```
55
Features hereditary angioedema
``` Rare AD Deficiency or dysfunction of C1-esterase inhibitor Subcutaneous swelling Abdominal pain Physical trauma or stress as a trigger Lasts a few hours Can cause respiratory obstruction ```
56
Mx hereditary angiodema
Resolves over few days | Severe acute attack: purified preparation of inhibitor

Paediatrics (22 decks)

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