Download Skin Lesions

Multidisciplinary
Examination of the Skin
Promoting multiprofessional
education and development
in Scottish maternity care
Quality Education for a Healthier Scotland
Content
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Examination of the Skin
Colour
Rashes
Naevi
Infections
Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
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Easily visible including parents
Need to inspect entire body
Undress the baby
Integrate with systems examination.
Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
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Trauma
Infection
Developmental abnormalities
Congenital conditions
Endocrine and metabolic
Retention of secretions.
Quality Education for a Healthier Scotland
Multidisciplinary
Multidisciplinary
Examination of the Skin
• Huge number of abnormalities seen!!!
• If in doubt … ask someone more
experienced
• Atlas of dermatology or
www.dermatlas.org
• Dermatologist.
Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
• IMPORTANT … Examination of the skin
may reveal clues to a more general
problem.
• For example … A blue baby or a white
baby.
Quality Education for a Healthier Scotland
Multidisciplinary
Content
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Examination of the Skin
Colour
Rashes
Naevi
Infections
Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Colour
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Jaundice
Pallor
Plethora
Cyanosis central, peripheral or acrocyanosis
Bruising
Harlequin
Mottling cutis marmorata.
Quality Education for a Healthier Scotland
Content
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Examination of the skin
Colour
Rashes
Naevi
Infections
Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Rashes
Multidisciplinary
Milia
White papules are hyperplastic
sebaceous glands, the effect of
the transplacental hormones.
They disappear with
desquamation.
Quality Education for a Healthier Scotland
Rashes
Multidisciplinary
Erythema neonatorum
•Is a maculo-papular rash
which occurs in 30-70 %
of normal term neonates.
•It is very rare in the preterm.
•The rash fades by the
end of the first week and
no treatment is required.
Quality Education for a Healthier Scotland
Multidisciplinary
Content
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Examination of the skin
Colour
Rashes
Naevi
Infections
Miscellaneous.
Quality Education for a Healthier Scotland
Naevi
Multidisciplinary
Stork Mark is the light
colour capillary dilatation
commonly seen at the
back of neck.
It may appear along the
midline of the face.
Gradually fades within the
first two years.
Quality Education for a Healthier Scotland
Multidisciplinary
Naevi
Capillary haemangioma
(Port Wine Stain)
Present at birth, flat or slightly
raised.
Caused by dilated, mature
capillaries in the superficial
dermis.
These do not regress.
Quality Education for a Healthier Scotland
Naevi
Multidisciplinary
Port Wine Stain
Treatment:
Until recently only
cosmetic cover could
be offered but good
results are now being
achieved with the
pulsed dye laser.
Quality Education for a Healthier Scotland
Strawberry Naevus
It is a cluster of dilated
capillaries which appears
within the first month
after birth.
Raised and bright red,
with discrete edges,
occurring in any part of
of the body.
Usually regresses after
one year of age.
Quality Education for a Healthier Scotland
Multidisciplinary
Naevi
Multidisciplinary
Mixed Haemangioma
There is a deep vascular
component here.
Because the vision in the R eye
is under threat this will
require treatment.
More unusual presentation the
lesion on the heal began
spontaneously involute
after about 6 months of age.
Quality Education for a Healthier Scotland
Multidisciplinary
Naevi
Mongolian blue
spots
blue-grey pigmentations often
over the lower back and
buttocks owing to an
accumulation of
melanocytes.
Very common in infants of
races with pigmented skin.
They become less obvious as
the skin darkens.
Quality Education for a Healthier Scotland
Multidisciplinary
Giant Melanocytic Naevus
Large area of
pigmentation often
becoming hairy later.
Long-term concern
about malignant
change though rare.
Quality Education for a Healthier Scotland
CAFE AU LAIT
Quality Education for a Healthier Scotland
Multidisciplinary
Multidisciplinary
Content
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Examination of the Skin
Colour
Rashes
Naevi
Infections
Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Infection
Skin Sepsis may
suggest systemic
infection requiring
full septic screen and
vigorous use of
antibiotics.
Quality Education for a Healthier Scotland
Multidisciplinary
Miscellaneous Skin Conditions
Petechial rash
Fairly common and not usually significant if only
a few lesions and baby is otherwise well.
Quality Education for a Healthier Scotland
Miscellaneous Skin Conditions
Vernix caseosum
Foetal product of
sebaceous glands, shed
cells and hair.
In most full-term babies at
the time of birth.
It dries and flakes off
within a few hours.
Not seen in post-term
babies.
Quality Education for a Healthier Scotland
Multidisciplinary
Multidisciplinary
Miscellaneous Skin Conditions
Accessory Nipple
Not uncommon, and
the number may vary.
Refer for removal
Quality Education for a Healthier Scotland
Multidisciplinary
Miscellaneous Rare Conditions
• Incontinentia pigmenti
• Blistering disorders … epidermolysis bullosa
• Hypopigmentation … Albinism, ash leaf
patches
• Hyperpigmentation … Café-au-lait spots
• Icthyosis.
Quality Education for a Healthier Scotland
Multidisciplinary
Miscellaneous Rare Conditions
Incontinentia
pigmenti
• X-linked,
dominantly inherited
disorder often
associated with
other abnormalities.
Quality Education for a Healthier Scotland
Multidisciplinary
Miscellaneous Rare Conditions
Epidermolysis
bullosa
An inherited
blistering
disorder.
Quality Education for a Healthier Scotland
Icthyosis.
Quality Education for a Healthier Scotland
Multidisciplinary
Multidisciplinary
Any Questions?
Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
Summary
• Undress your baby fully.
• Parents want to know what is
temporary and what is likely to be
permanent.
• Remember associations with other
conditions.
• ASK someone more experienced if you
don’t know.
Quality Education for a Healthier Scotland