Childhood Integumentary Disorders

Question 1

Impetigo

Answer 1

• Caused by Staphylococcus
• *Crust is honey colored
• Highly contagious
• Treat with topical Bacitracin ointment

Question 2

Dermatophytoses

Answer 2

• Fungal Infections
• Tinea (Corporis( body), Cruris (groin) , Pedis (foot), Capitis (head))
  — Ring worm

Question 3

Dermatophytoses treatment

Answer 3

• Topical anti-fungal: Ketoconozole
• Griseofulvin- for up to 6 weeks (stronger)(take full course)
• Do not exchange towels or clothes or grooming products
• Can be spread on any surface

Question 4

Scabies

Answer 4

• Mite
• Contact transmission
• Severe pruitis- mite burrows under skin where eggs and feces are deposited.
• Treat with *5% permethrin wash with Lukewarm water for 3 days and prophylaxis for close contacts since incubation period can be up to 60 days.
• Can not be used when pregnant

Question 5

Pediculosis Capitis Lice

Answer 5

• Infestation of hair & scalp by pediculosis louse
• Transmitted by direct contact or contact with hair accessories or hats
• *Nits(eggs) are layed on hair shaft and hatch in 7-10 days
• They like warm and dark environments (behind ears/ back of neck)

Question 6

Lice
Clinical manifestations:

Answer 6

• Severe itching, especially at base of neck and behind ears
• Scratch marks
• Nits and lice

Question 7

Lice treatment 

Answer 7

• *Permethrin 1% cream
• Pyrethrin
• Shampoo on dry hair and rinse in 10 minutes; repeat 7-10 days later to treat hatching nits
• Avoid hot water
• Launder, clothes, and bedding
• Spray furniture and items that are not washable for 2 weeks

Question 8

Eczema/atopic dermatitis
Infantile: time/ s/s

Answer 8

2 months - 2years
- exudative
- crusty
- papulovesicular
- bright/raw erythematous
- pruritic lesions; more on the face

Question 9

Eczema/atopic dermatitis
Infantile: outcome

Answer 9

50% resolve by age 2-3 years

Question 10

Eczema/atopic dermatitis
Childhood: time period/ signs and symptoms

Answer 10

2 years- puberty
- erythematous
- dry, scaly, papular
- more thickened
not on face; instead on elbows/ knees/ scapula/fingers

Question 11

Eczema/atopic dermatitis
Childhood: outcome

Answer 11

75% have no recurrence after adolescence

Question 12

Eczema/atopic dermatitis
Puberty to adult: time/ s/s

Answer 12

Puberty to adult:
- same as childhood
- *large plaques
- *thickened, lichenified

Question 13

Eczema/atopic dermatitis
Puberty to adult: outcome

Answer 13

may occur often, more often a chronic form

Question 14

Eczema/atopic dermatitis

DX

Answer 14

Diagnosis by history & clinical manifestations
- asthma HX is almost always accompanied by eczema

Question 15

Eczema/atopic dermatitis

Treatment

Answer 15

• hydrate and lubricate skin; petroleum jelly
• Reduce pruritus; may need antihistamine
• Minimize inflammatory changes
• May give steroids
• Determine what triggers flare ups
• Prevent infection