🚀 Regular Tickets for our Pharmacy OSCE Conference — Register Now for £10 →
  Search Files
Career Hub
Login
Medicine Scenarios Idea Info Capsules Video Chat Videos Article Articles
Home
Account Settings
osce toolbox
Login



timer-icon
Paediatric Rash 1

View all notes

This feature is unavailable on mobile device 😔
note-icon

Scenario Tabs

All products and content are protected and may not be duplicated, reproduced, or redistributed without written permission.

Report a problem
Scenarios

Paediatric Rash 1
By Amina Adnan • July 28, 2024 • Last reviewed: 24/09/24 •

Ready to dive into this scenario?

Log in or sign up to add it to your favourites and show your support

curved-arrow  Add to Favourites



Summary

In this scenario, a parent complains of a rash on their son's head. The student must take a history, make a diagnosis and suggest an appropriate course of action. 

 Please ensure that this scenario and mark scheme aligns with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment. 

You will need a student pharmacist and an actor for this OSCE station.  

Revision Topics
Be aware, this may reveal any answers!

Cradle Cap 

Student Instructions

You are a pharmacist working in a community pharmacy. The patient is a 2-month-old boy brought in by his parent. The parent is complaining of a rash on their child's head. You have been asked to take a history, make an appropriate diagnosis and advise the patient on an appropriate management plan. 

To do:  

  1. Assess the patient's symptoms, develop an appropriate treatment plan, and provide relevant medical or lifestyle advice as needed. 

You have 10 minutes.  
You have access to the BNF. 

 

The patient:

A close-up of a baby's head Description automatically generated

Actor AI 🤖 (Beta)
Actor Instructions

You are Avery Hudson (Ay-var-ree, Hud-son) - You can be the mother, father or guardian.

 

Opening statement: ‘My son has a rash on his head. Can you help me figure out what is going on?’ 

Patient information: 

Provide this information when prompted. 

  • Name: Phillip Hudson 

  • Age: 2 months 

  • Medication History: 

    • "None." 

 

  • Past medical history: 

    • "My baby was born prematurely via Caesarean section due to pre-eclampsia. Other than that, everything else was fine." 

 

  • Allergies: 

    • "None." 

  • Symptoms: 

    • "My baby has patches of white/yellow, greasy scales on red skin, but it’s only on the scalp.”  

    • “I first noticed it last week.  

    • “He’s generally well and playful, with no fever.” 

    • “I don’t think it’s itchy because he’s not scratching or rubbing his head on anything.” 

    • “There’s also no bleeding or leaky fluid." 

  • Treatments: 

    • "I haven’t tried anything to help with it yet." 

 

At this point, the student should inform you that your child has seborrhoeic dermatitis/cradle cap. 

 

  • Query for the pharmacist when prompted:
    • "I don’t want to use any medications if there’s an alternative solution I can try at home." 

The student should mention things you can do at home to help with the symptoms. If they do not, prompt them by asking: 

 “Is there anything I can do at home to help my son with this?” 

“Is there anything I should avoid using on his head while he has this?” 

Mark Scheme

Introduction 
0 / 2
Introduce yourself with an appropriate greeting
+1
Confirm patient details: Name and age
+1
History
0 / 11
Asks about patients’ symptoms:
Areas of white/ yellow scales on a background of erythematous skin
+1
Localised to the scalp
+1
1 week history
+1
Generally well and playful
+1
Enquires if the patient has used anything to relieve symptoms or make them worse
+1
Important negatives
No pyrexia
Not pruritic
No bleeding or fluid
These symptoms may indicate that the skin is infected and could require antibiotics.
Confirms patient past medical history:
Premature birth via Caesarean section 
+1
This is an important risk factor as it could indicate impaired immune function
Confirms medication history including dose, frequency, indication, including any over-the-counter products and herbal remedies 
+1
Check for allergies
+1
Diagnosis
0 / 3
Makes a correct diagnosis: Seborrhoeic Dermatitis/Cradle Cap
+1
Explain the diagnosis in a patient-friendly manner
This is a harmless condition that happens to a lot of children.
+1
It is not contagious and normally resolves on its own within a few months.
+1
Management and Advice 
0 / 5
Self-care management:
A topical emollient can loosen the scales, then remove them gently using an infant brush or a fine tooth comb.
+1
Do this before washing the head with a fragrant-free/baby shampoo.
+1
Sometimes the baby's hair can come away with the scales, but it will grow back soon, so it is not something to worry about.
+1
Things to avoid (Maximum 2 marks awarded):
Do not use olive oil as it may not be suitable/safe to use on the baby's head scalp or skin.
Do not use peanut oil because of the risk of allergy/anaphylaxis.
Do not use adult soaps/shampoo.
Do not pick the crusts because you can increase the risk of infection.
Safety netting
0 / 2
The patient should take their son to the GP or call 111 if (Maximum 2 marks):
Response to treatment is poor or symptoms worsen
There are signs of infection e.g. bleeding, crusting, oozing, swelling. 
If the patient shows signs of irritation such as changes in feeding or sleeping patterns
Communication
0 / 6
Knowledge and understanding of the topic is apparent
+1
Demonstrates appropriate empathy
+1
Ensure the patient’s understanding
+1
Signposts to further resources (e.g. NHS website, British Association of Dermatologists leaflet, National Eczema Association website)
+1
Concludes the conversation well by asking if there are any further questions
+1
The student did not say anything that could harm the patient  
+1
This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.
Time Management
0 / 1
Completed the scenario in time and achieved 70% of marks
+1

Any criteria marked in red must be met to pass this station.  




Referral Criteria

Referral Criteria for Cradle Cap  

 

Refer to A&E if: 

The baby has high fever, redness, swelling, or rapidly spreading patches: 
These could indicate a severe infection requiring immediate care. 

 

Refer for an urgent GP appointment if: 

  • The cradle cap doesn’t improve with home treatments: Persistent symptoms might need professional evaluation. 

  • The patches are spreading or worsening: This could signal a secondary infection or other issues needing medical attention. 

  • There are signs of infection, like increased redness, swelling, or oozing: These symptoms suggest an infection that requires treatment. 

  • The baby seems unusually irritable or distressed: Discomfort or distress not explained by visible symptoms may need further investigation. 

References

Wikimedia Commons, 2024.Baby with cradle cap. [online] Available at:https://upload.wikimedia.org/wikipedia/commons/5/50/Baby_With_Cradle_Cap.jpg[Accessed 23 August 2024]. 

NHS, 2024.Cradle cap. [online] Available at:https://www.nhs.uk/conditions/cradle-cap/[Accessed 22 August 2024]. 

 

Did this scenario help you?

Log in or sign up to add it to your favourites and show your support

curved-arrow  Add to Favourites
Comments(1)

Mary

You need to be logged in with an active subscription to post a comment.

© OSCE Toolbox. All rights reserved.

CRN: 15724937

Work with Us Privacy Policy Disclaimer

This website uses cookies to ensure you get the best experience
Learn more