Se ha denunciado esta presentación.
Utilizamos tu perfil de LinkedIn y tus datos de actividad para personalizar los anuncios y mostrarte publicidad más relevante. Puedes cambiar tus preferencias de publicidad en cualquier momento.
OSCE PAEDIATRIC
DERMATOLOGY
RASHES
Dr S FISH
Terminology
• Macule – flat lesion ,usually a circumscribed change of colour
• Papule – small , solid, elevated lesion
• N...
Summary of Paediatric Skin Rashes: Adapted from Paediatric Handbook
6th Ed. Royal Children's Hospital, Melbourne
SLIDE 1
SLIDE 1
1-Name condition and causative organism
2-Describe what you see
3-How would you treat it
SLIDE 2
SLIDE 2
1-Name the condition
2-What are typical causative organism
3-describe typical features
4-How would you treat it
SLIDE 3
SLIDE 3
1-Name the rash and the associated
syndrome
2-name infective and drug causes
3-describe typical features
SLIDE 4
SLIDE 4
• Name this disease ,what is its cause.
• Name the features
• Name a major complication of this disease
• treatment
SLIDE 5
SLIDE 5
• Name this condition
• What is the causative organism
• How do you treat it
SLIDE 6
SLIDE 6
• What is this rash
• Describe features
SLIDE 7
SLIDE 7
• What is this called
• What is the causative organism
• Describe features
• treatment
SLIDE 8
SLIDE 8
• What is the broad term used to describe
this condition
• Name the subset of conditions which
cause it.
• How do ...
SLIDE 9
SLIDE 9
• Name this condition
• What is the cause of it
• How do you treat it
SLIDE 10
SLIDE 10
• What is this called
• What organism causes it
• treatment
SLIDE 11
SLIDE 11
• Name the condition
• What causes this condition
• Describe the features
• How do you treat it
SLIDE 12
SLIDE 12
• Name the rash
• What causes this condition
• Name 2 types of this condition
• How do you treat this condition
References
• Pictures – Derm atlas
• Oxford Handbook of Dermatology for
primary care ,Saxe ,Jessop
• Topics in Paediatrics...
SLIDE 1
1-Chicken-pox , Varicella zoster virus
2-Crops of vesicles mainly on the trunk and head.
-Pass through various sta...
SLIDE 2
• 1-Impetigo
• 2-staph areus and streptococcal pyogenes
• 3-Thin–roofed vesicles or bullae surrounded by
narrow ma...
SLIDE 3
1-Erythema Multiforme
Steven-Johnson Syndrome (mucous membrane involvement)
2-Drug
most commonly associated-Allopu...
SLIDE 4
1-Kawasaki Disease, systemic vasculitis
2- Classical features of Kawasaki disease
• Fever lasting ≥5 days
• Marked...
SLIDE 5
1-Scabies
2-Mite –sarcoptes scabeii
3 -Clothes, towels, and bed linen should be machine-washed (at 50
degrees Cels...
SLIDE 6
1-Measles
2-single stranded RNA Morbillivirus from the paramyxovirus family.
3- Symptoms
• Prodrome - lasts 2-4 da...
SLIDE 7
1- erythema infectiosum, slapped cheek disease, slapped cheek syndrome, fifth
disease, Parvovirus B19 (PV-B19), St...
SLIDE 8
1-Napkin /Daiper dermatitis
2- Contact dermatitis
prolonged exposure to urine and faeces, friction
mild erythemato...
SLIDE 9
• 1- tinea capitis
• 2- fungal infection by a group of organisms
called dermatophytes
• 3-griseofulvin for 6 weeks...
SLIDE 10
• Meningococcal meningitis
• Neisseria meningitidis
• Cefotaxime
SLIDE 11
1-Molluscum contagiosum
2-From direct innoculation of pox virus
3-tend to heal spontaneously within 6 months – 1
...
SLIDE 12
1-Miliaria
2-Miliaria is a common disorder of the eccrine sweat glands that often occurs in
conditions of increas...
Próxima SlideShare
Cargando en…5
×

Rsh

11.417 visualizaciones

Publicado el

  • Holistic Candida Secrets, Eliminate Yeast Infection Fast. Candida cure e-book reveals all  http://ishbv.com/index7/pdf
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • I am so thankful and thrilled to know that someone had found a solution to such a disturbing problem in this country! There are too many women and men that are suffering from this horrendous disease! Before I ordered your program, I used to itch and scratch constantly sometimes all night long. Above all the annoyance it was very embarrassing, especially at work. Since I started your system, I don't use drugs or creams anymore to bring me through the nightmare of yeast infections that was my reality for too long! The constant itching and rashes that sometimes continued for mouths are completely gone. Additionally, the lack of energy and heartburn which I now know were caused by candida overgrowth have also disappeared in a matter of weeks. I feel so rejuvenated and lucky to have found your system. I am also amazed and thankful that your product worked so fast and well. ♥♥♥ http://ishbv.com/index7/pdf
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • I Cured My Yeast Infection. Top ranked Candida plan for download Unique holistic System. ◆◆◆ https://tinyurl.com/y3flbeje
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • I was searching for a way to explain my recently frequent yeast infections and other related conditions stumbled upon your program on the internet. I suffered from chronic mouth thrush (with creamy white lesions on my tongue and inner cheeks). My baby daughter had the same problem in her mouth and your program was the only thing that helped us! I highly recommend your book to anyone who is perceptive about their health, and for those who are tired of being told that it's all in their heads. I feel so rejuvenated and lucky to have found this system.  https://tinyurl.com/y3flbeje
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • Unique Yeast Infection System, How to get lasting Candida freedom, Candida Cure e-book Reveals All ■■■ http://scamcb.com/index7/pdf
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí

Rsh

  1. 1. OSCE PAEDIATRIC DERMATOLOGY RASHES Dr S FISH
  2. 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. 3. Summary of Paediatric Skin Rashes: Adapted from Paediatric Handbook 6th Ed. Royal Children's Hospital, Melbourne
  4. 4. SLIDE 1
  5. 5. SLIDE 1 1-Name condition and causative organism 2-Describe what you see 3-How would you treat it
  6. 6. SLIDE 2
  7. 7. SLIDE 2 1-Name the condition 2-What are typical causative organism 3-describe typical features 4-How would you treat it
  8. 8. SLIDE 3
  9. 9. SLIDE 3 1-Name the rash and the associated syndrome 2-name infective and drug causes 3-describe typical features
  10. 10. SLIDE 4
  11. 11. SLIDE 4 • Name this disease ,what is its cause. • Name the features • Name a major complication of this disease • treatment
  12. 12. SLIDE 5
  13. 13. SLIDE 5 • Name this condition • What is the causative organism • How do you treat it
  14. 14. SLIDE 6
  15. 15. SLIDE 6 • What is this rash • Describe features
  16. 16. SLIDE 7
  17. 17. SLIDE 7 • What is this called • What is the causative organism • Describe features • treatment
  18. 18. SLIDE 8
  19. 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. 20. SLIDE 9
  21. 21. SLIDE 9 • Name this condition • What is the cause of it • How do you treat it
  22. 22. SLIDE 10
  23. 23. SLIDE 10 • What is this called • What organism causes it • treatment
  24. 24. SLIDE 11
  25. 25. SLIDE 11 • Name the condition • What causes this condition • Describe the features • How do you treat it
  26. 26. SLIDE 12
  27. 27. SLIDE 12 • Name the rash • What causes this condition • Name 2 types of this condition • How do you treat this condition
  28. 28. References • Pictures – Derm atlas • Oxford Handbook of Dermatology for primary care ,Saxe ,Jessop • Topics in Paediatrics ,Basson& Ginsberg
  29. 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. 30. SLIDE 2 • 1-Impetigo • 2-staph areus and streptococcal pyogenes • 3-Thin–roofed 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. 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. 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. 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 <2 months -5% sulphur ointment
  34. 34. SLIDE 6 1-Measles 2-single stranded RNA Morbillivirus from the paramyxovirus family. 3- Symptoms • Prodrome - lasts 2-4 days with fever, runny nose, mild conjunctivitis and diarrhoea. Koplik spots are pathognomic and appear on the buccal mucosa opposite the second molar teeth as small, red spots each with a bluish-white speck (sometimes compared to a grain of rice) in the centre.6 They occur in 60-70% of patients during the prodrome and for up to 2-3 days before the onset of the rash. • Rash - (morbilliform = measles-like) first seen on forehead and neck and spreads, involves trunk and finally limbs over 3-4 days. It may become confluent in some areas. Rash then fades after 3-4 days in the order of its appearance. It leaves behind a brownish discoloration sometimes accompanied by fine desquamation. 4-Uncomplicated measles is usually self-limiting and treatment is mainly symptomatic with paracetamol or ibuprofen and plenty of fluids. Patients should remain at home to limit disease spread. It is a notifyable disease
  35. 35. SLIDE 7 1- erythema infectiosum, slapped cheek disease, slapped cheek syndrome, fifth disease, Parvovirus B19 (PV-B19), Sticker's disease 2- Parvovirus B19 3- After 3-7 days, the classic 'slapped cheek' rash appears as erythema on the cheeks, sparing the nose, peri-oral and peri-orbital regions.6 This disappears after 2- 4 days. • About 1-4 days after the facial rash appears, an erythematous macular/morbilliform rash develops on the extremities, mainly on the extensor surfaces.7 It is usually not itchy in young children, but may be itchy in older children and adults. This gradually fades over the next 3-21 days, but may recur in reaction to various stimuli such as exercise, heat and sunlight 4- It is usually mild and self-limiting in healthy people. It may also cause fetal loss or fetal hydrops, reactive arthritis in adults, and severe anaemia in those with haematological conditions or immunocompromise.Detection in pregnancy is important for monitoring and possible treatment.
  36. 36. SLIDE 8 1-Napkin /Daiper dermatitis 2- Contact dermatitis prolonged exposure to urine and faeces, friction mild erythematous ,glazed appearance -Seborrhoeic dermatitis salmon coloured greasy lesions and a predilection for intertriginous areas. - Candidiasis beefy red in colour with pin point pustulo-vesicular satellite lesion 3- frequent daiper changes barrier cream zinc and caster oil apply hydrocortisone 1% in aqueous cream bd if candidiasis suspected -10% steriod and nystatin 20% in zinc cream
  37. 37. SLIDE 9 • 1- tinea capitis • 2- fungal infection by a group of organisms called dermatophytes • 3-griseofulvin for 6 weeks ,10mg/kg
  38. 38. SLIDE 10 • Meningococcal meningitis • Neisseria meningitidis • Cefotaxime
  39. 39. SLIDE 11 1-Molluscum contagiosum 2-From direct innoculation of pox virus 3-tend to heal spontaneously within 6 months – 1 year -liquid nitrogen 2-3 weeks -express contents with sharp curette -benzoyl peroxide cream apply daily
  40. 40. SLIDE 12 1-Miliaria 2-Miliaria is a common disorder of the eccrine sweat glands that often occurs in conditions of increased heat and humidity. It is thought to be caused by blockage of the sweat ducts, which results in the leakage of eccrine sweat into the epidermis or dermis. 3-Two types • -miliaria crystallina-clear superficial pinpoint vesicles • -miliaria rubra –(prickly heat )-small discrete red papules,vesicles,papulovesicles 4-No compelling reason to treat miliaria crystallina exists because this condition is asymptomatic and self-limited. he prevention and treatment of miliaria primarily consists of controlling heat and humidity so that sweating is not stimulated. Measures may involve treating a febrile illness; removing occlusive clothing; limiting activity; providing air conditioning. • Topical treatments that have been advocated involve lotions containing calamine

×