5 yo w/ rash

Question 1

itchy and caused by insect bites usually

Answer 1

papular urticaria

Question 2

viral exanthem assoc w/ 3-5 febrile illness,from HHV6

Answer 2

Pityriasis Roseola

Question 3

Sanpaper-like rash more prominent at the skin creases, causes urticarial rash (scarlett fever related)

Answer 3

strep infection

Question 4

hypersensitivity rxn

dusky red macules that turn into well demarcated wheals/target lesions

1-3wk duration

MCC Herpes, but also assoc w/ meds

Answer 4

erythema multiforme

Question 5

slapped cheek, reticular lacy rash on trunk and extremities

Answer 5

Erythema Infectiosum (Fifth disease) parvo B19

Question 6

very itchy, circumscribed, raised erythematous wheal usually w/ central pallor

usually asymmetric

lasts 12-24 hours

Answer 6

Urticaria from Type I hypersensitivity

Question 7

Red papule then expands to annular patch, large and red

assoc w/ borellia burgdorferi

Answer 7

Erythema migrans

Question 8

Ddx rash in infant

Answer 8

Cradle cap (seb derm)–>malessezia tx / oil/small brush, frequent shampooin, low potency steroid

Eczema/atopic dermatitis

Candidal Rash

Psoriasis (assoc w/ fam hx, can be itchy not necessarily)

Question 9

Ddx Pustular rash

Answer 9

Furuncles (staph folloculitis)

Acne vulgaris

Hidradenitis Suppurtiva

Rosacea (worse w/ etoh, spicy food, temp extremes, stress)

Perioral dermatitis

Question 10

Using tretinoin in the tx of acne

Answer 10

• used at night bc of photosensitization
• must be applied to bone dry skin
• inactive by benzoyl peroxide

Question 11

where is the most common site for impetigo

Answer 11

right below the nares

most commonly from Staph aurea and strep pyogenes (GAS)

Question 12

How do you treat mild localized impetigo

Answer 12

topical Abx like mupirocin

must watch for abscess formation

Question 13

topical steroid potency:

Class 6-7

Class 4-5

Class 2-3

Class 1

Answer 13

Class 6-7: hydrocortisone acetate 1% (otc)

Class 4-5: Triamcinolone acetonide 0.1%

Class 2-3: Betamethasonedipropionate 0.05%

Class 1: Clobetasol propionate 0.05% (about 1000x more potent than otc hydrocortisone)

Question 14

SEs of topical steroids

Answer 14

skin atrophy
telangeictasias
hypopigementation
suppression of HPO axis

Question 15

1st line for head lice:

Answer 15

1% permethrin lotion

Question 16

Tx for permethrin resistant lice

Answer 16

Benzyl Alcohol(6mo+) or malathion (2yo+)

DO NOT USE LINDANE

Question 17

tx of scabies

Answer 17

2 applications of permethrin cream 5% one week apart

Question 18

PO tx for scabies/lice

Answer 18

Ivermectin (not approved for kids under 15kg)

Question 19

which systemic illnesses commonly have diaper rash as sxs

Answer 19

zinc deficiency

Langerhans histiocytosis