- 1. OSCE PAEDIATRIC DERMATOLOGY RASHES Dr S FISH
2. Terminology Macule flat lesion ,usually a circumscribed
change of colour Papule small , solid, elevated lesion Nodule a
large , solid , palpable and elevated lesion Plaque a lesion
slightly raised over a larger area Blister an elevated lesion
,fluid filled Ulcer depressed lesion with loss of surface
epithelium Atrophy a depressed lesion with intact surface
epithelium Crust a mixture of scale and serum yellowish accretions
on the surface of a lesion Petechiae non raised red-brown non
blanchable lesions 3. Summary of Paediatric Skin Rashes: Adapted
from Paediatric Handbook 6th Ed. Royal Children's Hospital,
Melbourne 4. SLIDE 1 5. SLIDE 1 1-Name condition and causative
organism 2-Describe what you see 3-How would you treat it 6. SLIDE
2 7. SLIDE 2 1-Name the condition 2-What are typical causative
organism 3-describe typical features 4-How would you treat it 8.
SLIDE 3 9. SLIDE 3 1-Name the rash and the associated syndrome
2-name infective and drug causes 3-describe typical features 10.
SLIDE 4 11. SLIDE 4 Name this disease ,what is its cause. Name the
features Name a major complication of this disease treatment 12.
SLIDE 5 13. SLIDE 5 Name this condition What is the causative
organism How do you treat it 14. SLIDE 6 15. SLIDE 6 What is this
rash Describe features 16. SLIDE 7 17. SLIDE 7 What is this called
What is the causative organism Describe features treatment 18.
SLIDE 8 19. SLIDE 8 What is the broad term used to describe this
condition Name the subset of conditions which cause it. How do you
treat this condition ? 20. SLIDE 9 21. SLIDE 9 Name this condition
What is the cause of it How do you treat it 22. SLIDE 10 23. SLIDE
10 What is this called What organism causes it treatment 24. SLIDE
11 25. SLIDE 11 Name the condition What causes this condition
Describe the features How do you treat it 26. SLIDE 12 27. SLIDE 12
Name the rash What causes this condition Name 2 types of this
condition How do you treat this condition 28. References Pictures
Derm atlas Oxford Handbook of Dermatology for primary care ,Saxe
,Jessop Topics in Paediatrics ,Basson& Ginsberg 29. SLIDE 1
1-Chicken-pox , Varicella zoster virus 2-Crops of vesicles mainly
on the trunk and head. -Pass through various stages of papule,
vesicle, pustule and crust. 3-Symptomatic :analgesia paracetamol
for discomfort and pyrexia. -pruritis antihistamine or calamine
lotion - acyclovir only for those at risk of complications or
immunocompromised. 30. SLIDE 2 1-Impetigo 2-staph areus and
streptococcal pyogenes 3-Thinroofed vesicles or bullae surrounded
by narrow margin of erythema. The vesicles /bullae rupture to
release thin cloudy yellow fluid. This fluid dries to form thick
yellow crusts. 4-topical-bactroban(mupirocin) ointment/betadine
cream - antibiotics flucloxacillin or erythromycin 31. SLIDE 3
1-Erythema Multiforme Steven-Johnson Syndrome (mucous membrane
involvement) 2-Drug most commonly associated-Allopurinol5 Recent
drugs- Nevirapine, lamotrigine, sertraline, pantoprazole, tramadol
Antibiotics- Sulphonamides, including co-trimoxazole, penicillin
cephalosporins, fluoroquinolones, vancomycin NSAIDs- Piroxicam,
fenbufen, ibuprofen, ketoprofen, naproxen, tenoxicam, diclofena c,
sulindac Anti-TB- Rifampicin, ethambutol, isoniazid, pyrazinamide
Anticonvulsants- Barbiturates, carbamazepine, phenytoin, valproate,
lamotrigine - Infective herpes simplex 3-target lesion round
,erythematous papules contain central blister or darker area of
necrosis 32. SLIDE 4 1-Kawasaki Disease, systemic vasculitis 2-
Classical features of Kawasaki disease Fever lasting 5 days Marked
irritability of the child Erythema, swelling and desquamation
affecting the skin of the extremities Bilateral conjunctivitis Rash
Inflammation of the lips, mouth and/or tongue Cervical
lymphadenopathy 3- coronary artery aneurysms 4 -Intravenous Immune
Globulin 2g/kg x1 Aspirin: 80-100 mg/kg/day until fever x 14 day,
then 3-5mg/kg/day x 6-8 weeks echocardiograms 33. SLIDE 5 1-Scabies
2-Mite sarcoptes scabeii 3 -Clothes, towels, and bed linen should
be machine-washed (at 50 degrees Celsius or above) to prevent
re-infestation and transmission. Items that cannot be washed can be
kept in plastic bags for at least 72 hours to contain the mites
until they die. -benzyl benzoate lotion ,apply for 24hours ,may be
repeated in 1 week -permethrin cream Antiscabial soap alone is not
an effective treatment Babies
