Paediatric Dermatology

Dr Olivia O’Gorman Lalor

Atopic eczema

Typical distribution

(face, scalp, neck, flexures, limbs, trunk)

Complication eg infection

Allergen?

Emollients

Topical steroids intermittently

Topical tacrolimus

Chronic lichenified eczema

Atopic eczema

Chronic scratching causing lichenification

Identify any allergens

Emollients

Topical steroids

Wet wraps

Topical tacrolimus

Infected eczema

Secondary bacterial infection eg staph/strep

Swab for MC & S Oral antibiotics Potent topical steroid Emollient

Infected eczema

Eczema herpeticum Herpes simplex Swab: MC & S, viral Oral aciclovir Emollients +/- cover for co-

existing bacterial infection

Topical steroid subsequently

Discoid (nummular) eczema

Tinea corporis

Seborrheic dermatitis

Cradle cap

Generally less itchy than eczema, often at flexures

EmollientsTopical antifungal + mild steroid

Psoriasis

Confluent erythema some scaling clear demarcation extends into skin creases

Irritant dermatitis vs candidiasis

Candidiasis

Irritant nappy dermatitis

sparing of creases

No sparing of creasesSatellite lesions

Impetigo

Usually staphylococcus Swab to confirm/for

sensitivities Oral antiobiotic +/- topical

antibiotic with topical steroid

Repeat antiobiotic course often needed

Antiseptic emollient wash Nasal swab/screen family

for recurrent infections

Scabies

Itchy papulopustular and vesicular eruption

Acral/genital involvement common

Molluscum contagiosum

Eczematous reaction association withMolluscum lesions

Very common skin infectionby pox virus

Lesions spontaneous resolve after months, often following inflammatory phase

Inflammatory linear verrucous epidermal naevus (ILVEN)

Lichen striatus

Capillary haemangioma

Variable size, can be multiple

Spontaneous resolution usual

Treatment for large lesions/if at critical sites

Systemic steroids/ intralesional steroids/laser

Sebaceous naevus

Usually present from birth, more warty with time. Basal cell carcinoma risk in one third

Port wine stain

Cutanous mastocytosis/urticaria pigmentosa