3/03 Pediatric Dermatology Flashcards
What does this baby have?
What do the babies develop?
How would you treat it?
Collodion Membrane aka Lamellar Ichthyosis
- “Saran-wrap” covering at birth due to extensive scaling of the skin
- infants develop respiratory distress, cracks, fissures, and temp instability
Treatment: supportive
What does this baby have?
What do the babies develop?
How would you treat it?
Collodion Membrane aka Lamellar Ichthyosis
- “Saran-wrap” covering at birth due to extensive scaling of the skin
- infants develop respiratory distress, cracks, fissures, and temp instability
Treatment: supportive
What does this baby have?
What do these babies develop?
How would you treat it?
Collodion Membrane aka Lamellar Ichthyosis
- “Saran-wrap” covering at birth due to extensive scaling of the skin
- infants develop respiratory distress, cracks, fissures, and temp instability
Treatment: supportive
What does this baby have?
What is it caused by?
What are other problems that can develop as a result of this?
How do you treat it?
Diaper Dermatitis
- red, itchy rash in diaper area caused by urine and feces (increases moisture comprises the stratum corneum, making it susceptible to friction)
- creases are spared
- 2˚ infections with candida albicans, staph aureus, and strep pyogenes are common
- *Treatment**
- reduce skin wetness
- treat 2˚ infection
What does this baby have?
What is it caused by?
What are other problems that can develop as a result of this?
How do you treat it?
Infantile Seborrheic Dermatitis
- rash/pink to red-inflamed skin with yellow, waxy scales that appear on the scalp, face and body folds (seborrheic areas)
- no established cause, but may be due to Malassezia (a lipid-dependent yeast, U2D); HIV is considered in severe cases
- Begins early in life; improves around 1 yo
Treatment
- gentle removal of scale
- low potency hydrocortisone, pimicrolimus, tacrolimus
What does this baby have?
Atopic Dermatitis
What does this baby have?
Psoriasis
What does this baby have?
What is it caused by?
What are some clinical features of this?
What would labs show?
How would you treat this?
Netherton Syndrome
- AR SPINK5 mutations that results in chronic inflammation of the skin, resulting in a disrupted skin barrier
- atopic diathesis and hair abnormalities: eczema, erythroderma, ichthyosis, short hair, and short stature
- Elevated IgE
- often seen in premature infants and failure to thrive (FTT) patients
Treatment
- systemic tacrolimus and pimicrolimus
What does this baby have?
What is it caused by?
What symptoms do these babies present with?
How do you treat it?
Acrodermatitis Enteropathica
- red scaly serpiginous patches in the skin folds and acral areas, but also happen around the eyes, mouth, and anus
- due to zinc deficiency (can be inherited, AR, or acquired)
- Tetrad of Sx: diarrhea, peri-orificial and acral vesiculobullous dermatitis, alopecia, and apathy
- Irritability and failure to thrive
Treatment:
- oral zinc
What does this baby have?
What is it caused by?
What does the histology show?
How do you treat it?
Erythema Toxicum Neonatorum
- Benign, transient papules and pustular eruptions; “flea bitten” appearance, lesions appear in crops.
- rarely affects palms & soles
- etiology unknown, but it is common in healthy term infants; lasts for first 2-3 weeks of life
- Smear of pustule shows abundant eosinophils
Treatment:
Reassure parents
What does this baby have?
How do you treat it?
Scabies
- intensely pruritic papules, small erosions, and crusted papules; characteristic finding: linear burrows typically on the hands and finger web spaces
Treatment
- Permethrin or Lindane
What does this baby have?
What is it caused by?
What other d/o have this?
How do you treat it?
Cutis Marmorata
- Transient mottling that occurs due to an exaggerated vasomotor response
- infants are usually healthy
- d/o with persistent mottling: Down syndrome, trisomy 18, hypothyroidism, neonatal lupus, septic shock
Treatment
- resolves with warmth
What does this baby have?
What is it caused by?
What are some clinical features of this?
What would labs show?
How would you treat this?
Neonatal Lupus
- pink annular patches with fine scales and central clearing
- usually on the face and scalp; “raccoon-eyes” is characteristic
- immunologic dz acquired through transplacental maternal antibodies
- triad of: cutaneous lesions, irreversible heart block, and thrombocytopenia
- anti-Ro antibodies
- no treatment for the cutaneous lesions (resolves spontaneously), but pacemaker is necessary for the heart block
What does this baby have?
What is it caused by?
Where does it normally affect?
What do these patients norally present with?
What would a biopsy show?
How do you treat it?
Henoch-Schonlein Purpura (HSP)
- Small vessel vasculitis due to IgA immune complexes deposition in post-capillary venules often follows an acute respiratory illness (peak incidence is during the winter)
- purpuric papules commonly affects buttock and lower extremities (gravity dependent areas), but can affect other organs also. Edema around the hands and feet can be prominent.
- Tetrad of: palpable purpura, joint pain, abdominal pain, and glomerulonephritis
- bx: leukocytoclastic vasculitis and IgA complex deposition
Treatment: Systemic corticosteroids for GI and renal complications
What does this baby have?
What is it caused by?
What are other organs can be involved?
How do you treat it?
What drugs must you avoid?
Urticaria Pigmentosa
- cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
- Can involve liver, spleen, GI tract, bones
- Common between 3-9 mo of age, but most resolve by puberty
- Must distinguish from cancer
Treatment
- Anti-histamines
- must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
What does this baby have?
What is it caused by?
What areas are these things commonly found in?
How do you treat it?
Pyogenic Granuloma (misnomer, since it is neither infectious or granulomatous!!)
- exophytic dome-shaped papules made of proliferating capillaries with dense fibers septa
- common on head, neck, and fingers
- Rapid growth, fall off, re-grow
- May be due to trauma and hormones (since this can occur at sites of injury and during pregnancy)
Treatment: electrodessication and curettage (ED&C)
What does this baby have?
What is it caused by?
What is the typical presentation?
What are other problems/sequelae that can develop as a result of this?
Neurofibromatosis Type I (NF1)
- AD, NF1 gene (TSG) mutation
- presentation: café-au-lait macules, axillary freckling, neurofibromas, iris hamartomas
- sequelae: Optic glioma, long bone dysplasia, scoliosis, learning disabilities, hypertension, macrocephaly
What does this baby have?
What is it caused by?
What do these patients normally present with?
What are other organs may be involved?
(fyi - these aren’t the greatest pictures.. but were the only ones provided)
Tuberous Sclerosis Complex
- AD; TSC1 (harmatin) and TSC2 (tuberin) mutations
physical findings
- multiple hamartomas in CNS and skin
- hypopigmented macules (ash leaf spots)
- angiofibromas on face, CT nevi (reddish spots and lumps on face)
- sub/periungual fibromas (weird outgrowths on near the nail plate)
- Involves CNS, eyes, kidneys, heart and lungs.
What does this baby have?
Where is it normally located?
What other syndrome it may be associated with?
Accessory Tragus
- Flesh colored papules with or without cartilage; contains epidermal adnexal structure
- usually located preauricular, but it can be on neck or cheek
- can be unilateral or bilateral
- Isolated lesion, but can be associated with Goldenhar Syndrome, so check hearing
What do these babies have?
cyst
What does this baby have?
What is it caused by?
How is it treated?
Gianotti- Crosti Syndrome
- Papular acrodermatitis - symmetric papular eruptions on the face, buttocks and extremities
- suspect viral etiology (commonly EBV, HepB)
- Usually asymptomatic/mildly itchy
- occurs between 1-6 years
- Self limited 8-12 weeks
What does this baby have?
What is it caused by?
How is it treated?
Gianotti- Crosti Syndrome
- Papular acrodermatitis - symmetric papular eruptions on the face, buttocks and extremities
- suspect viral etiology (commonly EBV, HepB)
- Usually asymptomatic/mildly itchy
- occurs between 1-6 years
- Self limited 8-12 weeks
What does this baby have?
What is it caused by?
What are other organs can be involved?
How do you treat it?
What drugs must you avoid?
Urticaria Pigmentosa
- cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
- Can involve liver, spleen, GI tract, bones
- Common between 3-9 mo of age, but most resolve by puberty
- Must distinguish from cancer
Treatment
- Anti-histamines
- must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
What does this baby have?
What is it caused by?
What are other organs can be involved?
How do you treat it?
What drugs must you avoid?
Urticaria Pigmentosa
- cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
- Can involve liver, spleen, GI tract, bones
- Common between 3-9 mo of age, but most resolve by puberty
- Must distinguish from cancer
Treatment
- Anti-histamines
- must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
What is Collodion Membrane?
What are some features of this disease?
How is it treated?
Collodion Membrane
- “Saran-wrap” covering at birth
- infants develop respiratory distress, cracks, fissures, and temp instability
Treatment: supportive
