other childhood skin disorders

psoriasis
1. familial disorder
2. rarely presents before 2 years old
3. guttate type
  1. common in children
  2. often follows strep or viral sore throat or ear infection
  3. DCM
    1. small, raindrop-like, round or oval erythematous scaly plaques
    2. on trunk & upper limbs
  4. attack resolves over 3-4 months
    1. but recurrence within next 3-5 years
  5. Rx
    1. bland ointments
4. chronic psoriasis
  1. plaques or annular lesions
  2. less common in children
  3. nail pitting
    1. unusual in kids
  4. psoriatic arthritis
  5. effect on quality of life
5. Rx
  1. for plaque psoriasis & scalp involvement
    1. coal tar preps
  2. plaque psoriasis in > 6 years
    1. calcipotriol (vit D analogue)
pityriasis rosea
1. acute, benign self-limiting condition
2. of viral origin
3. presentation
  1. 1. starts as a single round or oval scaly macule (herald patch) 2-5 cm diameter
    1. on trunk, upper arm, neck or thigh
    2. 2. after few days, macules develop on trunk, upper arms & thighs
      1. rash tends to follow line of ribs posteriorly (fir tree pattern)
  2. sometimes itchy
4. No Rx needed. Rash resolves within 4-6 weeks
Alopecia areata
1. common form of hair loss in kids
2. presentation
  1. hairless, single or multiple non-inflamed smooth areas of skin (usually over scalp)
  2. remnants of broken-off hairs (exclammation mark hairs) @ edge of active patches of hair fall
3. prognosis
  1. more guarded in kids w/ atopic disorders
  2. the more extensive the hair loss, the poorer the prognosis
4. regrowth often occurs within 6-12 months in localised hair loss
granuloma annulare
1. DCM
  1. annular w/ raised flesh-coloured non scaling edge
    1. edge differentiates it from ringworm
  2. over bony prominences, esp hands & feet
    1. but can be anywhere
  3. single or multiple lesions, 1-3 cm diameter
2. subcutaneous form exists
acne vulgaris
1. acne may start 1-2 years before onset of puberty
  1. ff androgenic stimulation of sebaceous glands & increased sebum excretion rate
    1. obstruction to flow of sebum in sebaceous follicle starts process of acne
2. DCM
  1. open comedones (blackheads) or closed comedones (whiteheads)
    1. progressing to papules, pustules, nodules & cysts
      1. more severe cystic & nodular lesions -> scarring
  2. face, back, chest & shoulders
3. exacerbations assoc w/
  1. menstruation
  2. emotional stress
4. usually resolves in late teens, but may persist
5. Rx
  1. topical Rx aimed to encourage skin to peel
    1. keratolytic agent e.g. benzoyl peroxide
      1. applied 1-2x/daily after washing
    2. sunshine in moderation
    3. topical Abx
    4. topical retinoids
  2. more severe acne
    1. oral Abx
      1. tetracylines
        for > 12 year olds only
        discolour teeth in younger kids
      2. erythromycin
    2. isotretinoin (oral retinoid)
      1. severe acne in teens unresponsive to other Rx

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other childhood skin disorders

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	Created by v.djabatey almost 11 years ago