Special Problems in Children Part 2 Flashcards Preview

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Flashcards in Special Problems in Children Part 2 Deck (42)
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What is this?

Cutis marmorata

(Physiological Livedo Reticularis)


What is this and what causes it?

Harlequin Colour Change

It is suspected to be linked to the immaturity of the hypothalamus controlling the dilation of peripheral blood vessels.


What is this?

What causes it?

What is the treatment?

Milia (50% of babies get it)

A Build up of keratin in the pilosebaceous glands

Self limiting (Although cryotherapy or squeezing out the contents helps)


What is the cause of Milia in young adults?

Usually damage to the skin secondary to sun exposure.


What is this?

How do you treat it?

Miliaria (Heat Rash)

Keep the skin cool.


What are the causes of nappy rash?

  • Dampness
  • Friction
  • Exposure to urine and faeces
  • Presence of microorganisms.


What type of nappy rash is this?

Irritant Contact Dermatitis


(It spares the skin folds & has shiny macules and papules)


What type of nappy rash is this?

Candida dermatitis

(Satellite Lesions are a hallmark of Candida Dermatitis)


What sort of nappy rash is this?

Psoriasiform dermatitis

(Pink well demarcated plaques involving the creases)


How do you manage nappy rash?

  1. Avoid the causative agent/ Regular nappy changes
  2. Barrier cream Bepanthen ointment (containing dexpanthenol) or Sudocrem
  3. Low potency steroids at the start (A nappy gives occlusion so be mindful of this)
  4. Topical Imidazole if Candida
    1. Check for oral thrush - treat with nystatin drops or miconazole gel.


What is thought to cause Seborrheic Dermatitis in children?

Malassezia furfur 


What is the treatment for seborrhoeic dermatitis in children?

  1. Soft brush after overnight olive oil or emollient
  2. Topical antifungal creams - ketoconazole cream with or without hydrocortisone.


What are the 3 types of warts?

  1. Plane warts (Verruca Plana)
  2. Common Warts (Verruca Vulgaris)
  3. Filiform Warts


What types of warts are these?

What subtype of HPV causes them?

Where are they most commonly found?

Plane Warts (Verruca Plana)

HPV 3, 10 & 28

Face, hands and shins.


What types of warts are these?

What subtype of HPV causes them?

Where are they most commonly found?

Common Warts (Verruca Vulgaris)

HPV 1,2 & 4

Fingers, Periungual Folds and Plantar Surfaces


What types of warts are these?

What subtype of HPV causes them?

Where are they most commonly found?

Filiform warts

Same subtype of common warts (HPV 1, 2 & 4)

Eyelids or perioral


What is the resolution of warts?

65% in 2 years


What is the instruction for using salicyclic acid for treating warts?

  1. Soak daily in warm water and pared with a file, emery board or pumice stone prior to application of salicylic acid.
  2. Care should be taken to protect the surrounding skin.
  3. Occlusion with cling film or plaster will enhance penetration.
  4. Perseverance for at least 8-12 weeks is required.



What other topical agents can be used for warts?

  • Imiquimod (off-licence but effective)
  • Retinoids
  • Glycolic acids
  • 5-FU
  • Podophyllin
  • Bleomycin
  • Dithranol


What common pigmented lesions are most common in children?

  1. Ephelides (Freckles)
  2. Specled Lentiginous Naevus(Naevus Spilus)
  3. Blue Naevi
  4. Spitz Naevus(Spindle Cell naevus, juvenile melanoma)
    1. Pigmented Spindle Cell Naevus of Reed (PSCNOR)
  5. Halo Naevus


What is this?

Speckled Lentiginous Naeevus (Naevus Spilus)

Melanoma can arise from these lesions so carefulmonitoring, serial photography & referral if suspicious lesions.


What is this?

Blue Naevus

(Homogenous and stable whereas melanoma is heterogenous and changing)


What is this?

Spitz Naevus (Syn. Spindle Cell Naevus or Juvenile Melanoma)

A form of benign Melanocytic compound naevi

They grow rapidly but usually never exceed 1cm in diameter.


What is this?

Who usually gets this?

What should you do about them?

A Pigmented Spindle Cell Naevus of Reed (PSCNOR)

More prevalent in young girls and on the thighs.

They have a starburst pattern.

They should be excised to exclude melanoma.


What is this?

Halo Naevi


A form of benign melanocytic naevi

More common in teenagers and will usually regress overtime.


What is Idiopathic photodermatosis is this?

Juvenile spring eruption.

Affects only the ears.

Boys > Girls

8-24 hours after sun exposure



How is juvenile spring eruption treated?

  • Prevention - Sun avoidance, Sunscreen
  • Treatment
    • Topical steroids
    • Antihistamines
    • Emollients


What photodermatosis is this?

Acitinic Prurigo

  • Itchy erythematous papules and nodules to sun exposed areas.
  • Treatment -systemic and topical steroids for shortterm.
  • Thalidomide if very difficult to treat.


What % of cases of psoriasis cases are seen in children?

1/3 of all cases


What form of psoriasis is more common in children?

Plaque or Guttate