APM Welcome, APM North West Network Conference, Synergies Across Sectors
Paediatric rash
1. Common Pediatric Skin and
Soft Tissue Conditions
Dr.Md.Shahidul Islam
Assistant Professor,Dermatology
CBMCB
2.
3. Erythema Toxicum
Neonatorum
Impressive title - harmless skin condition
Erythematous macule with a central tiny papule, seen
anywhere - except the palms and soles.
The lesions are packed with eosinophils, and there
may be accompanying eosinophilia in the blood
count.
The cause is unknown, and no treatment is required as
the rash disappears after 1-2 weeks.
4.
5. Miliaria
Prickly heat, sweat rash
Many red macules with central papules,
vesicles or pustules are present.
These may be on the trunk, diaper area, head
or neck.
6.
7. Subcutaneous Fat Necrosis
Self limited, benign condition
Sharply demarcated reddish to violaceous
plaques or nodules
Etiology uncertain
Onset first few days- weeks of life
Cheeks, back, buttocks, arms, and thighs
8.
9. Infantile Atopic Dermatitis
Cause is unknown
Red, itchy papules and plaques that ooze
and crust
Sites of Predilection
Face in the young
Extensor surfaces of the arms and legs 8-10 mo.
Antecubital and popliteal fossa , neck, face in
older
12. Eczema- Treatment
Avoidance or elimination of predisposing
factors
Hydration and lubrication of dry skin
Anti-pruritic agents
Topical steroids
13.
14.
15.
16. Seborrheic Dermatitis
Common, generally self-limiting
Its cause remains ill-understood
There is a genetic predisposition
Most frequent between the ages of 1 to 6 mo.
Greasy, salmon-colored scaling eruption
Hair-bearing and intertriginous areas
The rash causes no discomfort or itching
21. Pityriasis Rosea
Mild inflammatory exanthem of unknown
cause, maybe viral
Benign, self limited disorder
Occasionally there are prodromal symptoms
including malaise, headache, sore throat,
fatigue, and arthralgia.
Herald patch- pink in color and scalymimicking tinea corporis
24. Candidal Dermatitis
Starts off in the deep flexures which show
widespread erythema on the buttocks-beefy red
color
There are also raised edge, sharp marginization
and white scale at the border of lesions, with
pinpoint pustulo-vesicular satellite lesions
25.
26.
27. Seborrheic Dermatitis
Salmon-colored greasy lesions with
yellowish scale and predilection for
intertriginous areas
Involvement of the scalp, face, neck, and
post auricular and flexural areas
28.
29. Irritant Dermatitis
Rash confined to the convex surfaces of the
buttocks,perineal area, lower abdomen, and
proximal thighs, sparing the intertriginous
creases
Excessive heat, moisture, and sweat
retention
Harsh soaps, detergents, and topical
medications
34. Smallpox- Variola
Fatality 40 %
First invades upper respiratory tract
From lymph nodes it spreads via
hematogenous spread
Chills, fever, headache, delirium, SZ
Face to upper arms and trunk, and finally to
lower legs
38. Varicella – Treatment
Oral acyclovir- indications
Healthy nonpregnant teenagers and adults
Children > 1 yr with chronic cutaneous or
pulmonary conditions
Patients on chronic salicylate therapy
Patients receiving short or intermittent courses of
aerosolized corticosteroids
Dose: 80 mg/kg/day in four divided doses for
5 days
39. Varicella – Post exposure
VZIG (1 vial/5 kg IM) :
Pts on high dose steroids
Immunocompromised without a history of CP
Pregnant women
Newborns exposed 5 days prior to birth and 2 days
after delivery
Neonates born to nonimmune mothers
Hospitalized premature infants < 28 weeks’
gestation
40.
41.
42. Measles
Rubeola- paramyxovirus
Occurs in epidemics
Incubation 8-12 days
Fever, lethargy, Cough, coryza, conjunctivitis
with clear discharge and photophobia
Koplik spots
Rash begins on the face and spreads to trunk and
extremities
43. Measles – Post Exposure
Immunoglobulin therapy- indications
All susceptible contacts
Infants 5 mo. To 1 year of age
Immunocompromised
Pregnant women
<5 mo. If mother without immunity
Live measles virus vaccine- contraindication
Immunocompromised- excluding HIV
Pregnancy
Allergy to eggs, or neomycin
55. Impetigo
Superficial infection of the dermis
Two types:
Impetigo contagiosa
Bullous impetigo
Etiology
Group A ß hemolytic streptococcus
Coagulase positive S. aureus
Treatment : Keflex, erythromycin, Bactroban
56.
57.
58. Scarlet Fever
Toxin producing strain of group A β-hemolytic
streptococcus
Strep pharyngitis with systemic complaints
Rash from neck to trunk to extremities
Sandpaper feel, erythema, warmth
White and red strawberry tongue
Petechiae in linear form
Complications
Treatment
59.
60. Staphylococcal Scalded-Skin
Syndrome
Generally in less than 5 years of age
Induced by exotoxin produced by staphylococci
Fever, papular erythematous rash starting around
mouth- not involving oral mucosa
Positive Nikolsky’s sign
Diagnosis: Tzanck test, bacterial culture
Treatment
Complications
61.
62. Meningococcemia
Usually sudden onset of fever, chills, myalgia,
and arthralgia
Rash is macular, nonpruritic, erythematous
lesions
Petechial rash develops in 75% of cases
Neisseria meningitides
Fever, rash, hypotension, shock, DIC
Treatment: PCN G
65. Rocky Mountain Spotted
Fever
Most common rickettsial infection in US
Abrupt fever, headache, and myalgia
Rash from extremities towards trunk
Macules→petechiae
Treatment
Tetracycline
Doxycycline
Chloramphenicol
77. Henoch-Schnlein Purpura
No clear etiologic agent, often post viral
2-10 years of age
Palpable purpura over the buttocks and LE
Transient migratory arthritis
Renal and GI involvement
78.
79. Kawasaki Syndrome
Unknown etiology
Peak incidence 18-24 months
Clinical findings:
Fever for at least five days
Conjunctivitis
Polymorphous rash
Oral cavity changes
Cervical adenopathy
