Derm SCE

Paediatric dermatology for the Dermatology SCE: high-yield topics and classic traps

A high-yield revision guide to paediatric dermatology for the UK Dermatology SCE: the conditions examiners love, the key genodermatoses and the classic traps.

Editorial illustration of a young child's arm with gentle skin patches beside a teddy bear and a magnifying glass

Paediatric dermatology sits squarely on the Dermatology SCE blueprint, and it rewards candidates who have read around the children they see in clinic rather than those who have only revised adult disease. The questions tend to cluster around a predictable set of areas: common inflammatory disease in children, the birthmarks and vascular lesions, the infections, and the genodermatoses that examiners return to year after year. This guide maps out the high-yield territory and the traps to avoid. Treat it as revision support and confirm current management against NICE, the BNF for Children and the British Association of Dermatologists.

The bread-and-butter inflammatory disease

  • Atopic eczema. The single most important paediatric topic. Know the NICE stepwise approach built on generous emollients, topical corticosteroids matched to severity and the place of topical calcineurin inhibitors, and be ready for eczema herpeticum as an emergency.
  • Napkin dermatitis. Separate irritant dermatitis, which spares the skin folds, from candidal infection, which involves the folds with satellite lesions.
  • Infantile seborrhoeic dermatitis and infantile acne. Common, usually self-limiting, and useful for questions that test reassurance and simple management.

Birthmarks and vascular lesions

  • Infantile haemangioma. Understand the proliferation then involution course, and know that propranolol is first-line for problematic lesions. Be alert to PHACE syndrome with large facial haemangiomas and to airway or periocular lesions that need urgent referral.
  • Capillary malformation (port wine stain). A persistent vascular malformation, not a haemangioma. A stain in the trigeminal distribution should prompt thoughts of Sturge-Weber syndrome.
  • Cafe au lait macules. Six or more, above a size threshold, raise the possibility of neurofibromatosis type 1, especially alongside axillary freckling.

The infections examiners love

  • Viral exanthems. Hand, foot and mouth disease, chickenpox, measles and the parvovirus B19 slapped-cheek pattern all appear as image or vignette questions.
  • Molluscum contagiosum. Common, self-limiting, and a test of appropriate reassurance rather than aggressive treatment.
  • Staphylococcal scalded skin syndrome. A toxin-mediated blistering illness in young children with a positive Nikolsky sign, which the exam likes to contrast with SJS/TEN.
  • Scabies. Know the distribution in infants, which includes the palms, soles and scalp, and that the whole household is treated.

Genodermatoses worth knowing cold

  • Neurofibromatosis type 1. Cafe au lait macules, axillary and inguinal freckling, neurofibromas and Lisch nodules.
  • Tuberous sclerosis. Ash-leaf macules, angiofibromas, a shagreen patch and periungual fibromas, often with neurological features.
  • Epidermolysis bullosa. A group of inherited blistering disorders classified by the level of skin cleavage; the exam tests the broad subtypes and their inheritance.
  • Incontinentia pigmenti. An X-linked condition with blistering that evolves through verrucous and pigmented stages along the lines of Blaschko, largely in girls.
  • Ichthyoses. Recognise the common ichthyosis vulgaris and the more severe congenital forms.

How to revise paediatric dermatology efficiently

Paediatric disease is intensely visual, so revise it with images and questions rather than prose. Keep a short list of the must-know genodermatoses and their signs, drill the haemangioma versus malformation distinction until it is automatic, and use image-based practice for the infections and exanthems. Pair this with our guide to the highest-yield SCE topics and the dermatopathology spot diagnosis approach, since children feature heavily in both.

Get the common inflammatory disease solid, learn the birthmarks and the headline genodermatoses cold, and practise the infections by sight. Do that and paediatric dermatology becomes one of the most predictable and rewarding parts of the paper. You can practise paediatric questions across the full blueprint on our question bank.

Sources & further reading

For educational use only. Check current official guidance.

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