Common Pediatric Dermatoses in OPD

Question 1

Honey colored crusts caused by Staphylococcus, Streptococcus, MRSA

Answer 1

Impetigo Contagiosa

Question 2

treatment of Impetigo Contagiosa

Answer 2

Systemic antibiotics

cloxacillin, cephalexin, mupirocin

Question 3

Caused by Mycobacterium leprae transmitted via inhalation/droplets

Hypopigmented or reddish skin lesion with sensory loss

History of Chronicity

Answer 3

Hansen’s disease

Question 4

Treatment for Hansen’s disease

Answer 4

Multidrug therapy (rifampicin, clofazimine)

dapsone, clofazimine

Question 5

Pearly smooth firm nodule. Nodule is non-itchy, flesh colored with central umbilication

Answer 5

Molluscum contagiosum

Question 6

Koebner phenomenon

Answer 6

Spreading by trauma like scratching

Question 7

treatment of Molluscum contagiosum

Answer 7

Imiquimod (topical)

0.05% tretinoin

Remove by curretage

Cryotherapy

Question 8

Elevated rough graying papule increasing in size every time nicked out. Itchy when perspiring

Answer 8

Verruca vulgaris

Question 9

Salient features of Verruca vulgaris

Answer 9

Papilloma
Slow growing, chronic
HPV types 1-4

Question 10

Dx clincher for verruca vulgaris

Answer 10

tiny punctate black dots on wart surface representing thrombosed capillaries

Question 11

Treatment for Verruca Vulgaris

Answer 11

Light cryotherapy
Topical Slicylic acid
Imiquinod
Electrodessication

Question 12

Multiple Vesicular lesions (prodrome - low grade fever, malaise, headache)

Answer 12

Varicella

-raindrop on a rose petal

Question 13

Differentiate Measles vs Varicella

Answer 13

Measles: TOP -> DOWN

Varicella: CENTRAL ->OUTWARDS

Question 14

Treatment of Varicella

Answer 14

Neonatal varicella - acyclovir 500mg q8 x 10 days

child - acyclovir 20mg/kg qid x 5 days or symptomatic tx

Question 15

Grouped vesicles following a dermatomal distribution, Unilateral

Painful (burning, tingling sensation)

papules and plaques of erythema in a dermatome followed by development of blisters within hour

Answer 15

Herpes Zoster

Illness lasts 2-3 weeks, 6 weeks

Question 16

Treatment for herpes zoster

Answer 16

Golden Period: 3-4 days after appearance of vesicles to optimize efficacy

Acyclovir 800mf 5x/daily
Valcyclovir 1000mg
Famciclovir 500 mg 3x/daily for 7 days

Question 17

Papules with central punctum appear on exposed areas and arms and legs.

Answer 17

Mosquito bite

-Excoriations can give rise to secondary bacterial infection and prurigo nodularis

Question 18

Pruritic erythematous papules distributed in soft, warm and moist area, wrist area, armpit, inframammary area, umbilical, inner thigh, scrotal and buttock areas

NOCTURNAL PRURITUS

Answer 18

Scabies

-Sarcoptes scabiei

Question 19

Treatment for Scabies

Answer 19

Permethrin 5% lotion
(leave 8-12 h) -> repeat after 7 days

Crotamiton 10% apply for 3-5 days

Prevention: Take care of the fomites. (Scabies die in heart or seal in airtight bag for 7 days)

Question 20

Broken off stumps of hairs in rounded erythematous patches where there are scales, crust, or pustules and few hair

Answer 20

Tinea Capitis

Question 21

Black dot

Answer 21

endothrix (trichophyton tonsurans)

Question 22

Gray patch

Answer 22

Ectothrix (microsporon)

Question 23

Inflammatory tinea capitis

Answer 23

Kerion/favus or scutula, bluish white fluorescence

Question 24

Treatment for tinea capitis

Answer 24

systemic treatment

Oral antifungals:
Ultramicronized griseofulvin
Terbinafine
Itraconazole
Ketoconazole

Question 25

Chronic, inflammatory, lloos, dry, moist, greasy scales (Seborrheic Dermatitis)

Answer 25

Seborrheic dermatitis Scalp - Most common form manifesting as dry flaky desquamation in infants, the scalp may be covered by a greasy dirty crust

Question 26

Treatment for Seborrheic dermatitis

Answer 26

Low potency corticosteroid cream For scalp - selenium sulfide shampoo, tar, zinc, pyrithione In auditory meatus - low potency cortisone and 2 % acetic acid allylamines - dermatophytic infection

Question 27

Primary lesions are discrete coin-shaped erythematous, vesicular or crusted plaques Legs are favored areas Chronic and relapsing

Answer 27

Nummular eczema

Question 28

Treatment for nummular eczema

Answer 28

If infected, topical antimicrobials may be given If not infected, may use potent corticosteroid creams, oral antihistmines, moisturizers.