3 Derm Flashcards
parvovirus erythema infectiosum
- where is rash other than face
- what other sxs
- time duration
- also on reticular, extensor surfaces
- also trunk/flexors
- arthralgias, ha, myalgias
self resolves 3-7 days
eczema–how to think of treatment options?
Think of severity:
- dry skin -> emollient/moisterizer
- itchy - antihistamine–benadryl or hydroxyzine
- inflamed - topical steroid bid. start with hydrocortisone, can go stronger with triamcinolone. (also calcineurin inhibitors like tacrolimus if steroid resistant and older than 2)
- superinfection - can be both staph or even herpes virus. might need even IV acyclovir and vanc if really bad
peds rashes: what are these 2 and their tx?
note: both scaly and itchy
Numular eczema–note: steroid resistant
tinea corporis–antifungal
eczema:
if itchy, inflamed. If topical steroid resistant, try what?
go to calcineurin inhibitor eg tacrolimus. age>2
Peds rashes
What happened to this kid with eczema
Superinfection:
Eczema herpeticum, MRSA?
tx both herpes and mrsa. may even need iv acyclovir and vanc
This kid:
- what complications to think about?
- vaccine?
- tx
- what precautions?
chickenpox
- vaccine at 1 y, live vaccine
- check eyes! keratoconjunctivitis
- also rare things: pna, stroke, cerebellar ataxia
tx: start with antihistamines and calamine lotion - consider acyclovir for very young children, severe dz, ADULTS
precautions: avoid pregnant women, immunocompromised including elderly, very young!
14y old with this scaly, itchy on head. you feel a lump, feels boggy
-what is this, tx?
- Kerion. not an abscsess
- griseofulvin 6 weeks
what is this? making ceviche
tx?
phytophotodermatitis
- citrus, sunlight. other things too
- tx: topical steroids, sunblock
impetigo
-give what abx cream?
- Use bactroban (mupirocin), not bacitracin
- this covers mrsa, other does not
Toddler has this, hurts.
what is this
Herpes stomatitis. tx is just pain control, hydration
-obviously consider SJS if rash elsewhere, toxic
Pediatric wound care:
extremity neurovascular exam, 2 tricks that Hippo recommends
- place child’s extremity into glass of water. denervated skin will not wrinkle
- run plastic part of ballpoint pen across child’s skin involving injury: wlil slide easliy if slightly sweaty (normal). will not slide easily if denervated
What sutures to use for young kids?
- face
- hand
- fingers
- scalp
Vicryl Rapide, or fast acting gut. NOT REGULAR VICRYL
face: 6-0. want in place x5 days. can tell parents to moisten gauze at 5 days to remove
hand/finger/scalp, go with 5-0
Finger amputations:
-what to know
- distal tuft fractures will regrow–if no bone involvement. Don’t even need to call ortho
- if partial amputation, irrigate clot and reattach part
if worse, irrigate, ortho consult, reattach if possible, consider abx
