Paediatric Dermatology

Question 1

Which virus causes hand, foot and mouth disease?

Answer 1

Coxsackie A virus

Question 2

How does hand, foot and mouth disease present?

Answer 2

Starts as an upper respiratory tract infection- sore throat,t dry cough, fever

Then after 1-2 days -

small mouth ulcers

Blistering red spots mostly on hands, feet and around mouth

Question 3

How is hand foot and mouth disease managed?

Answer 3

Supportive

Question 4

How can you differentiate between a nappy rash and a candida infection?

Answer 4

Signs that point to candida =

Rash extending into the skin folds

Well demarcated border

Circular pattern - similar to ringworm

Satellite lesions

Question 5

How does Scabies present?

Answer 5

Incredibly itchy small red spots

Track marks where the mites have burrowed - classically between the fingers

Question 6

How is Scabies managed?

Answer 6

1st line = Permethrin cream

All household and physical contacts must be treated

Question 7

What is crusted scabies and how is it treated?

Answer 7

Crusted skin with scabies

Occurs in immunocompromised patients

Treated with ivermectin

Question 8

What is the most common causative organism of impetigo?

Answer 8

Staph aureus

Question 9

How does impetigo present?

Answer 9

Golden crusted lesions typically around the mouth

Question 10

How is impetigo managed?

Answer 10

1st line = Hydrogen peroxide 1% cream

Topical fusidic acid is an alternative

If widespread = oral flucloxacillin

Question 11

How long do children with impetigo need to be kept off school?

Answer 11

Until lesions are crusted and healed , or 48 hours after starting treatment

Question 12

What virus causes Roseola?

Answer 12

Human herpesvirus-6 (HHV-6)

Question 13

How does Roseola present?

Answer 13

High fever that comes on suddenly, lasts for 3-5 days then disappears

Then an erythematous macular rash for 1-2 days

Often diarrhoea/vomiting

Febrile convulsions can occur

Question 14

How does measles present?

Answer 14

Prodrome of fever, coryza and conjunctivitis

Koplik spots - spots on Buccal mucosa. Pathogenomic for measles

Erythematous macular rash which starts on the face - classically behind the ears

Question 15

What are complications of measles?

Answer 15

Otitis media

Pneumonia

Encephalitis

Meningitis

Hearing loss

Vision loss

Death

Question 16

How does rubella present?

Answer 16

Milder erythematous rash than measles

Starts on face then spreads to body

Lymphadenopathy

Question 17

How does a Parvovirus B19 infection present?

Answer 17

“slapped cheek syndrome”

Starts with mild fever, coryza and non-specific viral symptoms

Then a few days later - bright red rash on both cheeks

Then a reticular (net-like) erythematous rash on trunk and limbs

Question 18

When is Parvovirus B19 infection infectious? (Slapped cheek syndrome)

Answer 18

Prior to rash forming - not once rash has formed

Question 19

What are complications of Parvovirus B19?

Answer 19

Aplastic anaemia - especially in those with sickle cell anaemia, thalassaemia, and haemolytic anaemias

Encephalitis/meningitis

Question 20

What is the most common complication of chickenpox?

Answer 20

Secondary bacterial infection of the lesions