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Summary Essential Notes: Paediatrics: Dermatology
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Neonatal skin disordersDermatology Birthmarks
Milia Vascular birthmarks
White pimples on the nose + cheeks Often red/purple/pink + caused by abdominal blood
From retention of keratin + sebaceous material in the vessels in/under the skin
pilosebaceous follicles Eczema
Occur commonly in the head + neck area
Miliaria A genetic deficiency of skin barrier function
Clinical features
Salmon patch (stork mark)
Common disorder of sweat glands
Infants = face/scalp + trunk Flat red/pink patches that can appear on a baby’s
Occurs in conditions of increased heat + humidity
Blockage of the sweat ducts leakage of sweat into Younger children = extensor surfaces eyelids, neck/forehead @ birth
epidermis/dermis Older children = flexor surfaces, creases of the face Mx Fade completely after a few months
3 types + neck Forehead 4 years to heal
Miliaria crystalline (superficial- stratum Rashes may itch (pruritus) = main symptom More noticeable when a baby cries- fills w/ blood +
corneum layer) Scratching + exacerbation of rash excoriated areas becomes darker
Miliaria rubra (epidermis- pruritic, become erythematous, weeping + crusted lichenification Infantile haemangioma (strawberry mark)
erythematous papules) (accentuation of normal skin) Appear anywhere, if they occur deeper= appear
Miliaria profonda (dermo-epidermal junction) Complications blue/purple
Erythema toxicum (baby acne) Can become infected by: S. aureus (release super Ags + Common in females
o Common rash, occurring @ 2-3 days worsen eczema), strep, herpes simplex eczema Grow rapidly in size in the 1st 6 months + disappear by 7
o White pinpoint papules at the centre of an herpeticum years
erythematous base Mx Capillary malformation (port wine stain)
o Fluid contains eosinophils 1. Avoid irritants e.g. soap, biological detergents, cut
Only affect one side of the body + usually occur on the
o Concentrated on the trunk come + go @ nails short
face, chest or back
different sites 2. Simple emollients e.g. moisturising + softening skin
3. Topical steroids Sensitive to hormones seen during puberty,
Capillary haemangioma (‘stork bites’) pregnancy, menopause
o Pink macules on the upper eyelids, mid- 4. Occlusive bandages/wet wraps (zinc paste/tar
paste) Permanent
forehead + nape
o Distension of dermal capillaries Pigmented birthmarks
o Those on eyelids disappear after a year Nappy Rash
Usually brown + caused by clusters of pigment cells
o Those on neck covered by hair
Irritant Nappies infrequently changed; infant has Café au lait spots
o White, girls, mothers who underwent CVS diarrhoea, irritant effect of urine on the skin
(contact) Coffee-coloured skin patches
Cavernous haemangioma (‘strawberry naevus’) Urea-splitting organisms in faeces increase the
dermatitis Many children have ½, but >6 by 5 years requires GP
o Usually not present @ birth, but develop alkalinity + likelihood of a rash
referral (? Neurofibromatosis)
rapidly in the 1st month of life Convex surfaces of buttocks, perineal region,
(Most lower abdomen, tops of thighs, creases are Mongolian spots (Congenital dermal
o More common in preterm infants
common) spared, erythematous rash + scalded melanocytosis)
o Rx Topical propranolol speeds regression
appearance Blue-grey/bruised-looking birthmarks that are present @
Mx Emollient, topical steroids birth
Lower back, buttocks
First 3 months of life, starts on scalp (cradle Disappear by 4 years
cap) thick yellow, adherent layer spread to Congenital melanocytic naevi (congenital moles)
face, axiallae + napkin area Large brown/black moles
Infantile
Unlike atopic eczema it is NOT itchy Overgrowth of pigment cells in the skin
seborrhoei
Mx Craddle cap = ointment containing low
c Become darker, bumpier, hairy w/ age/ during puberty
Henoch-Schonein Purpura dermatitis
[sulphur + salicylic acid]
Is an IgA- mediated small vessel vasculitis with a degree of Topical corticosteroid + antibacterial/antifungal
e.g. 1% hydrocoristone Rx of birthmarks
overlap w/ IgA nephropathy (Berger’s disease) 1. Corticosteroids- directly injected/taken orally to
Mild = baby shampoo + baby oils
HSP is usually seen in children, following a URTI, common shrink (e.g. hemangioma)
in boys + in Winter Candida 2. Interferon alpha- 12- If corticosteroids doesn’t
Rash: symmetrically distributed over the buttocks, Erythematous, skin flexures + satellite lesions
infection work
extensor surfaces or arms + legs + ankles, trunk spared 3. Laser therapy- for port win stains
A less common cause, erythematous scaly rash
(First clinical feature = 50% of cases) Psoriasis
also present elsewhere on the skin 4. Surgery
Joint pain: knees + ankles, symptoms resolve before the
rash goes
Colicky abdo pain: haematemesis/malaena Atopic Other areas of the skin will also be affected
Renal involvement: 80% have micro/macroscopic eczema
haematuria
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