Fully comprehensive Paediatric dermatology notes. Includes ALL the notes you will need for Paediatric dermatology thought medical school with pictures.
Dermatology can be difficult therefore these notes were developed to make your life easier by providing you with all the important conditions in ...
Primary skin lesions (arise de novo in the skin)
• Macule
o A small flat area of altered colour or texture
o Example - freckles, measles, rubella, roseola, café-au-lait macule of tuberous
sclerosis
• Patch
o Larger flat area of altered colour or texture
o Example - depigmented patch of vitiligo
• Papule
o A small raised lesion
o Example - allergic, inflammatory papules of acne
• Maculopapular
o Combination of macules and papules
o Example - measles, scarlet fever, parvovirus B19 (erythema infectiosum, fifth
disease)
• Plaque
o A larger raised lesion
o Example - scaly plaque of psoriasis
• Nodule
o A larger raised lesion with a deeper component (involvement of the dermis or
subcutaneous fat)
o Example - nodular lesion of erythema nodosum
• Vesicle
o A small clear blister
o Example - varicella
• Bulla
o A large clear blister
o Example - skin trauma, bullous impetigo
• Wheal/weal
o A transient raised lesion due to derma oedema
o Example - urticaria (hives)
• Pustule
o A pus containing blister
o Example - acute paronychia
• Purpura
o Bleeding into skin or mucosa. Small areas are petechiae, whereas large areas are
ecchymoses. Do not blanch on pressure
o Example - Meningococcal septicaemia, Henoch-Schnlein purpura, Immune
thrombocytopenia, Disseminated intravascular coagulation (DIC)
Secondary skin lesions (evolve from primary lesions or from scratching of primary lesions by
patient)
• Excoriation
o Stretch mark, loss of epidermis following trauma
o Example - atopic dermatitis (from acute rubbing)
• Lichenification
o Roughening of the skin with accentuation of skin markings
o Example - atopic dermatitis (from chronic rubbing)
• Scales
o Flakes of dead skin
o Example - cradle cap in seborrhoeic dermatitis
• Crust
o Dry mass of exudates consisting of serum, dried blood, scales and pus
o Example - impetigo
, • Scar
o Formation of new fibrous tissue post wound healing
o Example - acne
• Erosion
o Loss of epidermis and dermis (heals with scarring)
o Example - epidermolysis bullosa
• Ulcer
o Loss of epidermis and dermis (heals with scarring)
o Example - ulcerating haemangioma
Skin function
• Protection against chemicals and particles - Horny layer
• Preservation of balanced internal environment: water, electrolytes, macromolecules - Horny
layer
• Protection against ultraviolet radiation - Melanocytes
• Protection against invasion - Langerhans cells (large white cells)
• Shock absorber - Dermis and Subcutaneous fat
• Temperature regulation - Dermal blood vessels
• Insulation - Subcutaneous fat
• Sensation - Nerve fibres, specialised nerve endings, Merkel cells (produce neurosecretory
granules)
• Lubrication - Sebaceous glands
• Protein and Prising - Nails
• Calorie reserve - Subcutaneous fat
• Vitamin D synthesis - Keratinocytes
• Body odour/pheromones - Apocrine sweat glands
• Psychosocial, display - Skin, lips, hair and nails
Skin anatomy
Epidermis:
• Closely packed layers of Keratinocytes (85%) adherent to eachother by desmosomes and
dermis through basal membrane called Lamina densa
• Horny layer consists of dead cells bound by lipid
• 60 day transit time from basal layer to the surface
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