Presentations
- Birthmarks
-
Eruptions:
- papulonodular
- papulosquamous
- pustular
- Erythroderma
- Hair and nail disorders
- Hyperpigmentation
- Hypopigmentation
- Petechiae and purpura
- Photosensitivity
-
Vascular:
Conditions
- Acne
- Albinism
-
Alopecia, including:
- alopecia areata
- scarring alopecia
- tinea capitis
- Autoimmune bullous disorders
-
Benign neonatal cutaneous conditions, including:
- cradle cap
- eczema
- erythema toxicum
- napkin dermatitis
- psoriasis
- seborrhoeic dermatitis
-
Birthmarks, including:
- cafē-au-lait macules
- congenital melanocytic naevi
- cutis aplasia
- epidermal naevi
-
Cutaneous examthems, including signs of:
- neglect and abuse
- nutritional deficiencies
- Drug eruptions
- Hidradenitis suppurativa
-
Inflammatory conditions, including:
-
connective tissue disease:
- dermatomyositis
- lupus erythematosus:
-
cutaneous vasculitis:
- Henoch–Schonlein purpura
- Kawasaki disease
- eczema and seborrheic dermatitis
- granuloma annulare
- lichen sclerosus
- morphoea
- psoriasis
- urticaria
- Pyogenic granuloma
-
Vascular:
-
anomalies, including:
- capillary malformation
- infantile haemangioma
- lymphatic malformations
- venous malformations
- malformations
- tumours
- Vesicobullous conditions
- Vitiligo
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Abnormal development and growth in association with skin conditions
-
Birthmarks:
- collodion
- extensive
- syndromic
- Blueberry muffin syndrome
-
Cutaneous presentations of:
- primary immunodeficiencies
-
systemic diseases, such as:
- autoinflammatory diseases
- cutaneous vasculitis
- cystic fibrosis
- endocrine
- metabolic
- rheumatic syndromes
- vasculitis syndromes
-
Cutaneous:
- presentations of primary immunodeficiencies
- tumours
- Developmental anomalies of the skin
- Ichthyosis
- Infections:
- Keratoderma
- Neonatal erythroderma
Conditions
- Cutaneous infections in immunocompromised children
-
Genodermatoses, including, but not limited to:
-
disorders of keratinisation, such as:
- ichthysosis
- keratodermas
- Netherton syndrome
- ectodermal dysplasia
- epidermolysis bullosa
- incontinentia pigmenti
- malignancy predisposition syndromes
- neurofibromatosis
- RASopathies
- tuberous sclerosis
- Graft-versus-host disease in children
-
Haematological and other malignancies:
- fibromatoses
-
histiocytic disorders:
- juvenile xanthogranuloma (JXG)
- Langerhans cell histiocytosis (LCH)
- mastocytosis
- melanoma
- skin tumours
- transplacentally acquired conditions
-
Inflammatory dermatoses, complex, including:
- severe eczema and psoriasis requiring systemic treatment
- Mosaic disorders, including:
- congenital melanocytic naevus (CMN) syndrome
- epidermal naevus syndromes
- proteus and mosaic overgrowth syndrome
- Mosaic presentations of skin disorders, such as segmental neurofibromatosis (NF) / vitiligo
- Photosensitivity disorders:
- polymorphic light eruption
- porphyrias
- Rheumatological diseases, including:
- juvenile dermatomyositis
- juvenile idiopathic arthritis
- systemic lupus
- Vascular malformations and tumours, complex, including:
- kaposiform haemangioendothelioma
- LUMBAR / SACRAL syndrome
- PHACE syndrome
- PIK3CA-related overgrowth spectrum (PROS) disorders
- Sturge–Weber syndrome
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Differences in drug pharmacodynamics and pharmacokinetics in childhood and adolescence, and the related impacts of medication efficacy and safety
- Impact of dermatological disease on normal growth and development of children
- Incidence and prevalence of cutaneous disorders during the neonatal period, childhood, and adolescence, compared to adults
Clinical assessment tools
- Collateral history from wider family members
-
Disease severity and quality of life scores, such as:
- Children’s Dermatology Life Quality Index (CDLQI)
- Eczema Area and Severity Index (EASI)
- Patient Oriented Eczema Measure (POEM)
- Global developmental assessment
Investigations
- Blood and serological investigations
- Histopathology and immunohistochemistry
- Trichoscopy
- Wood’s lamp
Procedures
- Approach to the paediatric patient for procedures
- Dermoscopy
- Skin biopsy
- Skin scraping for mycology
Vascular abnormalities
- Radiological investigations
- Tissue biopsies for histology and genetic evaluation
- Assessment and recommended management of associated food allergies with complex inflammatory dermatoses
- Assessment of children’s ability to give consent
- Awareness of child safety in home environments, including when necessary to raise concerns with relevant personnel / organisations
- Home, Education / employment, Eating / exercise, Activities, Drugs and alcohol, Sexuality and relationships, Suicide and depression, Safety (HEEADSSS) assessment
- Impact on the wider family of having a child with a dermatological condition
- Multidisciplinary approach for management, including vascular anomalies multidisciplinary teams
- Normal paediatric and adolescent development, and how this is impacted by dermatological disease
- Treatment modalities, including laser therapy and sclerothera
