red, dry, itchy skin - familial tendency - atopic march - asthma, hayfever

Paediatric dermatology Flashcards by Sophie C

Features of eczema?

red, dry, itchy skin

familial tendency
atopic march - asthma, hayfever

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Atopic eczema before 3 months.. suspicion of?

cows milk allergy

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Triggers of eczema?

illness
stress
teething
environmental 
heating

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the barrier defect of eczema

increased permeability to irritants and allergens

- water loss

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key proteins identified with eczema?

Filaggrin - often more severe eczema

- lot of lines over the themar eminence

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management of eczema? (3)

topical steroids

moisturiser/emollient to help with itch

soap substitutes

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1 Finger tip unit is?

0.5g

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3-6 months FTU = 1 , what is covered

1.5?

face, neck
arm and hand
front of chest
leg and foot
back and bum

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1-2 year old FTU of steroid measurements?

1.5?
2?
3?

face and neck
arm and hand

leg and front
chest and abdomen
back and legs

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3-5 year old FTU

1.5?
2?
3?
3.5?

face and neck

arm and hand

leg and foot +front chest and abdo

back and bum

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6-10 year old FTU

2?
2.5?
3.5?
4.5?
5?

face and neck

arm and hand

chest and abdo

leg and foot

back and bum

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how to use topical steroids?

one day for 1-2 weeks

if improved step down

stubborn areas - twice weekly

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mild steroid?

hydrocortisone

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moderate steroid?

Eumovate

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potent steroid

betnovate

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very potent steroid

- when might it be used?

dermovate

sclerosis

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if child needs to use topical steroid on face regularly.. what can you add?

topical tarcolimus

only use steroids for 3-5 days

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when do topical steroids not help? - triggers?

allergy
contact allergy
photoaggravation

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when topical steroids do not help, what can you give? (2)

protopic ointment or Eidel cream

phototherapy UVB

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IMMUNOSUPRESSION options when steroids don’t work ?

methotrexate
ciclosporin
mycofenalate
mofetil
azathioprine

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Example of biologic you can use?

Dupilomab (IL4)

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When to suspect food allergy? - type 1 reaction

lip swelling, facial redness, itching

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what reaction is eczema

type IV hypersensitivity

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Late reactions associated with cows milk allergy?

worsening of eczema after ingestion

Gi problems
failure to thrive
unresponsive to treatment
severe itching

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what is discoid eczema?

scattered, circular - itchy - can be isolated

treatment of discoid eczema?

potent - betnovate C - give with antibacterial component apply for 14 days

Seborrheoic dermatitis is seen in babies of what age? - what does it affect? associated with?

under 3 months - often resolves by 1 year - mainly the scalp and face - cradle cap

Seborrheoic dermatitis is associated with what yeast?

malassezia

treatment of Seborrheoic dermatitis?

emollients - daktocorts - protopic

young child presenting with flare up and potential CMPA - what is the treatment plan?

Eumovate - face - once daily for 5 days betonovate - body - once daily for 7-10 days (7.5 FTU) per application = 4g hydromol ointment - bath and shower

impetigo features?

pustules and honey-coloured crusted erosions

Treatment of impetigo?

topical - fucidin oral antibiotic - flucolxacillin - not improving, or child is unwell

what causes impetigo?

staph aureus

what are molluscs caused by?

molluscipox virus

molluscum - transmission , what do they look like?

to close contacts - pearly papule, umbilicate centre - can take a year to clear

molluscum - possible treatment

5% potassium hydroxide - causes irritation

viral warts are transmitted by?

direct skin contact

how are viral warts caused?

HPV virus

treatment of viral warts?

no treatment - topical - salicylic acid - cryotherapy - oral zinc

viral exanthems is associated with?

viral illness, fever, malaise, headache

viral exanthems is due to ? (3)

toxin produced damage to skin immune response

viral exanthems - examples (5)

chicken pox measles rubella rosella - herpes 6 erythema infectiosium - slap cheek, parovirus B19

chicken pox (varicella zoster virus) - who is susceptible to flare ups?

immunocompromised individuals

chicken pox (varicella zoster virus) - clinical features

red papaulesm progressing to blisters - crusted - itchy - viral symptoms

what is the incubation period of chicken pox?

10-21 days

when are children contagious with chicken pox?

1-2 days before rash appears and until lesions have crusted

chicken pox can be rarely associated with ?

pneumonia and encephalitis

parovirus - slapped cheek - clinical features and incubation period

7-10 days - 5th disease - viral symptoms - erythematous rash cheeks and then lace like network to limbs and trunk

what does parovirus target?

red cells in the bone marrow

paroivirus can rarely cause ?

aplastic crisis (if haemolytic disorders)

parovirus - risk to?

pregnant women - spontaneous abrotion, intrauterine death and hydrops fetalis

hand, foot and moth virus cause?

enterovirus | - coxsackie virus A16

Clinical features of hand, foot and mouth?

blisters on hand and feet - mouth involvement - late summer/autumnn

eczema coxsackium is?

- associated viral symptoms - children are relatively well - flared sites - self limiting

Eczema coxsackium treatment?

swab lesion - can you culture - aciclovir

eczema herpticum clinical features - what must you withhold?

children are unwell - monomorphic punched out lesions topical steroids for 24 hours

eczema herpticum - treatment?

aciclovir - oral or iv - opthamology near the eyes

orofacial granulomatosis patients present with ?

lip swelling and fissuring | - oral mucosal lesions - ulcers and tags

orofacial granulomatosis is associated with?

Crohn;s disease

orofacial granulomatosis - investigations ? treatment?

faecal calprotectin if GI symptoms - patch testing - benzoate and cinnamate free diet

Erythema nodosum clinical features?

painful, sucutanous nodules over the shins - slow resolution - like bruse - 6-8 weeks

Erythema nodosum- CAUSES? (5)

infections - streptococcus, URTI - IBD - Sarcoidosis - mycobacterial infections - idiopathic

what drugs can cause Erythema nodosum? (3)

OCP, sulphonamides, penicillin

Dermatitis herpiforms has been associated with?

coeliac disease

Erythema nodosum treatment?

NSAIDS

Dermatitis herpiforms clinical features

blisters in clusters over the knees and elbows, shoulders, scalp

Dermatitis herpiforms - investigations

- history - coeliac disease - TTG 0 skin biopsy

Dermatitis herpiforms- treatment

- emollients - gluten fre diet - topical steroids - dapsone

Urticaria causes ? <6 weeks

infection

Urticaria clinical features?

weaves/hives - associated angiodema - rash can last up to 24 hrs

the causes of acute Urticaria ? (5)

- viral inefctions - bacterial infections - fungal or drug allergy - NSAIDs, OPITES - VACCINATIONS

Treatment of acute Urticaria?

triggers - withdraw - antihistamines - 3x daily

Urticaria - antihistamine examples?

*Deslortadine* reanitidine montelukast omalizumab - over 12 yrs ciclosporin - younger children

infantile haemangioma are more common in?

- premature infants - girls - low birth weight - family history

infantile haemangioma - what can speed up evolution?

bet blockers

infantile haemangioma - treatment

typical - Timollol 5% gel - oral - propranolol (can cause drop in bp and blow sugar)

infantile haemangioma - when is treatment indicated?

- enlarging - central face - ulcerating - - bum and genitals - posterior shoulder

Phaces - is due to abnormality with?

- pituitary fossa abnormality - haemangioma - arterial anomalies - cardiac anomalies or coarctation of aorta - eyes - sternal cleft

treatment of Phaces?

low dose propranolol - can improve segmental haemangioma

Paediatric dermatology Flashcards

(79 cards)