Paediatric Dermatology

Question 1

What is eczema?

Answer 1

Itchy, dry inflammatory skin disease

Question 2

What is the normal gene expression in eczema?

Answer 2

Abnormality in filaggrin expression

Question 3

What is the function of filaggrin?

Answer 3

Proteins bind keratin filaments together and help maintain moisture

Question 4

What is the distribution of eczema?

Answer 4

Flexural in older children
Face, neck, hands in infants
Discoid, generalised

Question 5

What can eczema flares be associated with?

Answer 5

Infections/ viral illness 
Central heating, cold air 
Pets 
Teething 
Stress

Question 6

What is seborrheoic dermatitis also known as?

Answer 6

Cradle cap

Question 7

Where is seborrheoic dermatitis found?

Answer 7

Scalp and face

Flexures- neck, wirst, hands

Question 8

What is the treatment for seborrheoic dermatitis?

Answer 8

Emollients
Antifungal cream and shampoo
Mild topical steroids

Question 9

What does discoid eczema look like?

Answer 9

Scattered annular/circular patches

Question 10

What are the features of pompholyx eczema?

Answer 10

Hand and foot eczema
Vesicles, bullae
Intensely itchy

Question 11

What is the treatment for pompholyx eczema?

Answer 11

High potency steroid

Question 12

What type of reaction is allergic eczema?

Answer 12

Type 4 hypersensitivity

Question 13

How can allergic eczema be tested for?

Answer 13

Patch testing

Question 14

What can cause irritant eczema?

Answer 14

Water, saliva
Soaps, bubble baths
Irritant foods (citrus, tomatoes)
Chemical irritants

Question 15

When should a food allergy be suspected?

Answer 15

Angioedema, facial rash 
Worsening of eczema 24/48 hours after ingestion 
GI symptoms (vomiting) 
Failure to thrive 
Severe eczema unresponsive to treatment 
Severe generalised itching

Question 16

What are the most common food allergies?

Answer 16

Milk/diary 
Soy 
Peanuts 
Eggs 
Wheat

Question 17

What are the common airborne allergies?

Answer 17

House dust mite
Pet dander
Pollens

Question 18

How can allergies be tested for?

Answer 18

Blood test for specific IgE antibodies
Skin prick testing
Dietary restrictions/ eliminations >8 weeks
Alter one food at a time

Question 19

What are the treatment options for eczema?

Answer 19

Emollients (creams or ointments) 
Soap substitutes 
Topical steroids 
Calcineurin inhibitors 
UVB light therapy 
Immunosuppressive medication

Question 20

What is the steroid stepwise approach for eczema flare ups?

Answer 20

Mild -hydrocortisone 
Moderate - eumovate 
Potent - betnovate 
Very potent - dermovate 
Once daily for 7-10 days, then reduce

Question 21

What are the potential adverse effects of topical steroids?

Answer 21

Skin thinning with prolonged use

Systemic absorption

Question 22

What is the common bacterial cause of impetigo?

Answer 22

Staph aureus

Question 23

What are the symptoms of impetigo?

Answer 23

Pustules

Honey-coloured crusted erosions

Question 24

What is the treatment for impetigo?

Answer 24

Topical antibiotic 
Oral antibiotic (flucloxacillin)

Question 25

What causes molluscum contagiosum?

Answer 25

Mulluscipox virus

Question 26

What are the symptoms of molluscum contagiosum?

Answer 26

Pearly papules | Umbilicated centre

Question 27

What is the common organism that causes viral warts or veruccas?

Answer 27

HPV

Question 28

What conditions can cause viral exanthema?

Answer 28

``` Chicken pox Measles Rubella Roseola Erythema infectiosum (slapped cheek) ```

Question 29

What are the symptoms of chicken pox?

Answer 29

Red papules progress to vesicles, rupture and crust | Itchy and viral symptoms

Question 30

What are the symptoms of parovirus?

Answer 30

Viral symptoms Lace like rash Red cheeks

Question 31

What virus usually affect the hands, feet and mouth?

Answer 31

Enterovirus | Coxsackie virus A16

Question 32

What is the appearance of orofacial granulomatosis?

Answer 32

Lip swelling and fissuring | Ulcers and tags, cobblestone appearance

Question 33

What disease is orofacial granulomatosis linked to?

Answer 33

Crohn's disease

Question 34

What are the clinical features of erythema nodosum?

Answer 34

Painful, erythematous subcutaneous nodules Shins Slow resolution, usually 6-8 weeks

Question 35

What are the causes of erythema nodosum?

Answer 35

``` Infections - strep, URTI IBD Sarcoidosis Drugs - OCP, sulphonamides, penicillin Mycobacterial infections Idiopathic ```

Question 36

What disease is dermatitis herpetiformis linked to?

Answer 36

Coeliac disease

Question 37

What are the clinical features of dermatitis herpetiformis?

Answer 37

Itchy blisters in clusters | Scalp, shoulders, buttocks, elbows, knees

Question 38

What is the treatment for dermatitis herpetiformis?

Answer 38

Emollients Gluten free diet Topical steroids Dapsone