Management of Sucking blisters
These are common on upper lip. Reassure these will settle.
These are common on upper lip. Reassure these will settle.
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Management of Miliaria
This is related to overheating and appears as two types: • ‘crystallina’—beads of sweat trapped under the forehead, scalp, face and trunk • ‘rubia’ or ‘heat rash’ mainly on forehead, scalp, face and trunk Appears to be a type of folliculitis due to Pityrosporum orbiculare. It is a benign condition that disappears after a few wks (usually clears by age of 6 mths). If problematic: • keep skin dry and cool (e.g. fan, air conditioner) • dress in loose-fi tting cotton clothing • reduce activity • avoid frequent bathing and overuse of soap Rx: salicylic acid 2%, menthol 1%, chlorhexidine 0.5% in alcohol Prevention: Ego Prickly Heat Powder Management of Milia
Blocked sebaceous glands, esp. on the face, are present in 50% of neonates. The fi rm white papules are ~1–2 mm in diameter and differ from the yellowish papules of sebaceous hyperplasia. Also disappear after several weeks. Management of Benign juvenile melanoma
Brown pigmented lesions on face are usually surgically excised because of rapid growth and family concerns. Management of Congenital naevi
These have to be treated on an individual basis. If giant naevi, they can be dermabraded at ideally < 6 wks. Management of Naevus sebaceous
This is a variation of sebaceous hyperplasia usually found on the head or neck as a yellow-orange coloured circumscribed or linear lesion. Leave it to resolve. Management of Sebaceous hyperplasia
Hyperplastic sebaceous glands appear as tiny yellow-white papules on the nose at birth, esp. at the tip. Disappear in several wks. Management of Cavernous haemangioma (strawberry naevus)
Usually on head and neck. Starts as a pinpoint red lesion at birth and grows up to the age of 6–12 mths, then slow involution up to 5–10 yrs. Reassure parents and show how to stop any bleeding. Worst complication is ulceration (use dressings with Duoderm or Intrasite gel). Lasers can promote healing but treatment usually unnecessary. Refer lesions on eyelids. Management of Capillary malformation (port wine stain)
Present from birth—surgery inadvisable. Assessment for underlying vascular abnormalities advised if the lesion is in the area supplied by the ophthalmic or maxillary divisions of the trigeminal nerve. Consider the Sturge–Weber syndrome—associated intellectual disability and epilepsy. The stains can be considered for pulsed dye laser therapy—probably best in fi rst 2 yrs or when the colour changes to bluish-red, usually in early adulthood. Cosmetic camoufl age useful. Management of Naevus flammeus (salmon patch)
Dilated capillaries form on face and eyelids (~50% of babies) and nape of neck (almost 100%). Fades over 6–12 mths but neck patches may persist into adult life. No treatment required. |
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May 2021
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