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Flashcards in Special Problems In Children Deck (35)
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1
Q

What’s the most common lesion in neonates?

A

The Mongolian blue spot

(AKA Congenital dermal melanocytosis)

2
Q

How do you treat a mongolian blue spot?

A

You don’t.

They usually regress over time.

3
Q

What is this called?

A

Naevus of Ota

It is over the 1st or 2nd branch of the trigeminal nerve.

4
Q

At what age peaks does the Naevus of Ota form?

A

1st peak = <1 year old

2nd peak = puberty

5
Q

What is this?

A

Naevus of Ito

(Involves the supraclavicular, scapular or deltoid region)

6
Q

Does a naeuvs of ito or a naevus of Ota spontaneously resolve?

A

No

Q-Switched Ruby Lasers have been successfull in the past.

7
Q

What is this and how do you treat it?

A

Erythema Toxicum Neonatorum

Affects 50% of neonates

Usually begins on the face

Resolves spontaenously over a week or two.

8
Q

What is this

At what age does it start?

How do you treat it?

A

Infantile Acne

About 3 months

Topical BPO & Topical Erythromycin.

Can consider Topical Tretinoin or Adapelene.

9
Q

What are the two types of vascular birthmarks?

A

Infantile Haemangiomas

Vascular Malformations

10
Q

What is this?

Who does it occur in?

Does it spontaneously resolve?

A
  • Infantile Haemangioma (Strawberry naevus)
  • More common in girls and premature infants.
  • It usually involutes leaving a hypopigmented patch:
    • 30% by 3
    • 90% by 9
11
Q

When should an infantile haemangioma be referred?

A

Refer if there is:

  • Ulceration
  • Recurrent bleeding
  • Large facial haemangiomas
  • Significant areas - perioral, periocular etc.
12
Q

What is the treatment for infantile haemangiomas by the specialist?

A
  • Propranolol is first line. (2 to 3 times daily until the child is 12-15 months)
13
Q

What is this?

A

A port wine stain

It is the most common type of vascular malformation.

14
Q

In which condition do port wine stains occur and when should you refer?

A

Sturge-Weber Syndrome

10% of neonates with SWS will have a port wine stain.

Refer all port wine stains involving the opthalmic branch of the trigeminal nerve due to risks of eye abnormalities.

15
Q

Name the 6 common skin tumours in children.

A
  1. Naevus Sebaceous
  2. Becker’s Naevus
  3. Epidermal Naevus
  4. Epidermal Naevus syndrome
  5. Pilomatricoma
  6. Juvenile Xanthogranuloma (JXG)
16
Q

What is this?

A

A Naevus Sebaceous

10-15% become cancer (Usually BCC)

Excise when in teenage years if possible.

17
Q

What is this and how is it treated?

A

Becker’s Naevus

IPL and Lasers to reduce pigmentation.

18
Q

What condition is this?

A

Epidermal Naevus Syndrome

19
Q

What 2 other syndromes can Epidermal Naevus Syndrome be associated with?

A
  • CHILD syndrome (females, hemidysplasia, limb defects, ichthyosiform naevus)
  • Proteus syndrome (overgrowth of tissues in skin, fat, blood vessels, kidneys, lungs and other organs)
20
Q

What is this?

A

Pilomatricoma

Benign bluish hard nodule of calcium deposits.

21
Q

What is this?

A

Juvenile Xanthogranuloma (JXG)

Majority flatten in 3-5 year

22
Q

What is this and in what condition is it seen?

A

Cafe au lait spot

Neurofibromatosis

23
Q

What are these?

A

Angiofibromas of Tuberous Sclerosis

24
Q

What is this?

A

Shagreen patch and an ash leaf macule

Both seen in Tuberous Sclerosis.

25
Q

What is this?

A

Periungual Fibromas - seen in tuberous sclerosis

26
Q

What is this and how do you treat it?

A

Tinea Capitis

  • 1st line Griseofulvin or oral terbinafine.
  • 1nd line Itraconazole.

1% of children will have residual scarring.

27
Q

How do you treat scabies?

A
  • Permethrin ceam inlcuding face and scalpe
  • Leave for 8 hours.
  • Repeat after 1 week.
  • Treat all family members.
28
Q

What is this?

A

Gianotti-Crosti Syndrome

Monomorphic papules on extensor surfaces.

Usually clears in 8 weeks.

Asociated with Hep B and other viral infections.

29
Q

What is this and tell me about it?

A

Henoch Schonlein Purpura

  • IgA Vasculitis of the skin
  • 4-7 years old
  • Boys more than girls.
  • Associated with abdominal pain.
30
Q

What is the most common complication of HSP?

A

Nephritis

31
Q

What is this?

A

Mastocytoma

(Mast cells go into the skin)

  • Occurs in the first 3 months oflife.
  • Urticates on stroking (Darier’s Sign)
32
Q

What is this and how is it treated?

A

Urticaria Pigmentosa

  • The most common form of mastocytosis.
  • Develops between 3-9 months.
  • Darier’s sign positive.
  • 50% of cases resolve by adolescence.
33
Q

How is urticaria Pigmentosa treated?

A

Antihistamines

(Although rarely patients can collapse due to systemic histamine release)

34
Q

What can precipiate urticaria pigmentosa?

A
  • Aspirin
  • Opiates
  • D-tubocurarine
  • Iodine-containing radiological dyes
  • Bee stings
  • Shellfish
35
Q
A