Multidisciplinary Examination of the Skin Promoting multiprofessional education

Multidisciplinary Examination of the Skin Promoting multiprofessional education and development in Scottish maternity care Quality Education for a Healthier Scotland

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 Multidisciplinary

Examination of the Skin • • • 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

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 • • Multidisciplinary Jaundice Pallor Plethora Cyanosis central, peripheral or acrocyanosis Bruising Harlequin Mottling cutis marmorata. Quality Education for a Healthier Scotland

Content • • • 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

Content • • • Examination of the skin Colour Rashes Naevi Infections Miscellaneous. Quality Education for a Healthier Scotland Multidisciplinary

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

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

Multidisciplinary Infection Skin Sepsis may suggest systemic infection requiring full septic screen and vigorous use of antibiotics. Quality Education for a Healthier Scotland

Miscellaneous Skin Conditions Multidisciplinary 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

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 Multidisciplinary

Icthyosis. Quality Education for a Healthier Scotland Multidisciplinary

Multidisciplinary Any Questions? Quality Education for a Healthier Scotland

Examination of the Skin Summary Multidisciplinary • 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