Dermatology Flashcards

Question

Incontinetia pigmenti diagnostic criteria

Answer 1

Major criteria - Typical neonatal vesicular rash with eosinophilia; (in most cases cutaneous manifestations are present at birth) - Typical blaschkoid hyperpigmentation on the trunk, fading in adolescence; - Linear, atrophic hairless lesions. Minor criteria - Dental anomalies, - Alopecia, - Wooly hair - Abnormal nails

Answer 2

The risk of allergic disease/atopy in a child approaches 50% when one parent in allergic and 66% when both parents are allergic. In families with more than two allergic first degree relatives, 67% of children had an allergic disease/atopy.

Answer 3

Pimecrolimus is anti-inflammatory. It inhibits calcineurin thus blocking T cell proliferation and preventing release of inflammatory cytokines. Adverse effects include: Common: local irritation, burning sensation, itch, erythema, skin infections Infrequent: local rash, aggravation of eczema, herpes simplex dermatitis, impetigo Rare: alcohol intolerance (facial flushing, rash, burning sensation), allergy (eg urticaria, angioedema) In contrast with topical steroids, pimecrolimus does not produce skin atrophy.

Answer 4

Inflammatory skin disease often (~50%) associated with underlying systemic disorders such as inflammatory bowel disease, arthritis, and lymphoproliferative disorders. As an example, pyoderma gangrenosum occurs in up to 5% of patients with ulcerative colitis and 2% of those with Crohn's disease. Among patients with inflammatory bowel disease, PG may parallel the activity of the bowel disease. The eruption may begin as an isolated pustule or scattered lesions on the trunk or extremities. There is surrounding oedema and purplish induration with rapid progression into a large ulcer which heals ultimately with cribiform scars.

Answer 5

Benign self-limiting rash Present at birth or shortly after with pustular lesions, neonate is otherwise well Pustules resolve spontaneously but may leave areas of hyperpigmentation More common in dark skinned children Microscopic examination reveals neutrophils with no associated organisms

Answer 6

Eosinophils Occurs in 50% of term babies

Answer 7

Zinc deficiency occurs rarely in exclusively breast-fed infants (usually premature) whose mothers have a low level of zinc in their breast milk. The clinical presentation is similar to that of acrodermatitis enteropathica. Zinc is an essential mineral i.e. needs to be obtained from the diet as cannot be synthesised in the body. One of the causes of zinc deficiency is excessive losses in intestinal illnesses as malabsorption occurs and diarrhoea results in excessive losses of zinc. In this case the mother has extensive Crohns disease and so is likely to have zinc deficiency hence her breastmilk will have low levels of zinc. Cases of zinc deficiency during breast-feeding are accompanied by skin rashes or dermatitis which are the main symptoms, often in combination with failure to thrive, low serum zinc and irritability. Numerous signs and symptoms have been associated with zinc depletion. Mild zinc deficiency is associated with depressed immunity, impaired taste and smell, onset of night blindness, and decreased spermatogenesis. Severe zinc deficiency is characterised by severely depressed immune function, frequent infections, bullous pustular dermatitis, diarrhea, and alopecia. The skin changes are the most distinctive manifestations. These usually consist of dry scaly eczematous placques, often on the face and anogenital area; the lesions often resemble psoriasis.

Answer 8

Extramedullary erythropoiesis

Answer 9

``` Tumours such as: Congenital leukaemia cutis Langherhans cell histiocytosis Neuroblastoma Congenital rhabdomyosarcoma ``` Blood disorders such as: Haemolytic disease of the newborn – rhesus or ABO incompatibility Hereditary spherocytosis Twin-twin transfusion syndrome ``` Congenital infections such as: Rubella Toxoplasmosis Cytomegalovirus Herpes simplex Coxsackie virus Parvovirus Epstein Barr virus Syphilis ```

Dermatology Flashcards

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