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Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
Promoting multiprofessional education and development in Scottish maternity care
Quality Education for a Healthier Scotland
Multidisciplinary
Content • Examination of the Skin• Colour• Rashes• Naevi• Infections• Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Examination of the Skin
• Easily visible including parents• Need to inspect entire body• Undress the baby• Integrate with systems examination.
Quality Education for a Healthier Scotland
MultidisciplinaryExamination of the Skin
• Trauma• Infection • Developmental abnormalities• Congenital conditions• Endocrine and metabolic• Retention of secretions.
Quality Education for a Healthier Scotland
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
• Examination of the Skin• Colour• Rashes• Naevi• Infections• Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Colour• Jaundice • Pallor• Plethora• Cyanosis central, peripheral or
acrocyanosis• Bruising• Harlequin• Mottling cutis marmorata.
Quality Education for a Healthier Scotland
Multidisciplinary
Content
• Examination of the skin• Colour• Rashes• Naevi• Infections• Miscellaneous.
Quality Education for a Healthier Scotland
MultidisciplinaryRashes
Milia White papules are hyperplasticsebaceous glands, the effect of the transplacental hormones.They disappear with desquamation.
Quality Education for a Healthier Scotland
MultidisciplinaryRashes
Erythema neonatorum
•Is a maculo-papular rash which occurs in 30-70 % of normal term neonates.•It is very rare in the pre-term. •The rash fades by the end of the first week and no treatment is required.
Quality Education for a Healthier Scotland
Multidisciplinary
Content
• Examination of the skin• Colour• Rashes• Naevi• Infections• Miscellaneous.
Quality Education for a Healthier Scotland
MultidisciplinaryNaevi
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
MultidisciplinaryNaevi
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
Multidisciplinary
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 ofof the body. Usually regresses after one year of age.
Quality Education for a Healthier Scotland
MultidisciplinaryNaevi
Mixed HaemangiomaThere 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 spotsblue-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
Multidisciplinary
CAFE AU LAIT
Quality Education for a Healthier Scotland
Multidisciplinary
Content
• Examination of the Skin• Colour• Rashes• Naevi• Infections• Miscellaneous.
Quality Education for a Healthier Scotland
Multidisciplinary
Infection
Skin Sepsis may suggest systemic infection requiringfull 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
Multidisciplinary
Miscellaneous Skin Conditions
Vernix caseosumFoetal 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
Miscellaneous Skin Conditions
Accessory NippleNot 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
MultidisciplinaryIcthyosis.
Quality Education for a Healthier Scotland
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.
