Common Pediatric Lesions

Question 1

definition

primary morphology

secondary morphology

etiology

symptoms

treatment

Answer 1

definition: infantile hemangioma. COMMON INFNATILE Benign endothelial cell neoplasm characterized by early proliferation and then spontaneous involution (grey/purple) patch.

primary morphology: can vary in size

secondary morphology

etiology: girls, preemies, low birthweight, older mothers who had villus sampling
symptoms: most self resolved, but periocular hemangiomas can lead to blindness.
treatment: most are self resolved but severe IHs can be managed with propranolol

Question 2

an infantile hemangioma is a

COMMON INFNATILE Benign ____ cell neoplasm characterized by early proliferation and then spontaneous involution (grey/purple) patch.

Answer 2

endothelial

Question 3

Answer 3

vascular malgormation (port wine stain)

• wine-red colored lesion with sharp midline demarcation secondary to vascular malformation. present at birth and grows proportionately and persists into adulthood.

Question 4

complications of vascular malformation

Answer 4

1. struge-weber syndrome: vascular malformation in trigeminal distribution can lead to a seizure disorder.
2. soft tissue hypertrophy causing growths and swelling.

Question 6

Definition: small firm white papules with keratin Epi: 40-50% of infants will have milia, usually on the face. Management: resolves within 1 st 4wk of life (infants), resolves spontaneously (children)
What is this?

Answer 6

milia

Question 7

How does miliaria come up?

Answer 7

miliaria is a heat rash. small vesicles of retianed sweat trapped under a swollen stratum corneum due to occlusion of sweat duct.

• can happen at any age group

Question 8

Definition

• what is the general form of the childhood version of this disease?

Answer 8

mastocytosis

• excessive collection of normal mast cells. in children, limited to skin. but in adults, can involve BM, liver, spleen and LN.

the childhood version of mastocytosis is URTICARIA PIGMENTOSA.1+ tan-brown papules/plaques. Large lesions in children–>excessive histamine–>diarrhea/wheezing

Question 9

darier’s sign

Answer 9

urtication of mastocytosis lesion

Question 10

what is this lesion associated with?

Answer 10

this is a halo nevi. it’s a mole surrounded by white ring/halo

• epi: incidence rate of <20 yo is 1%. average age is 15.
• 20% of patients have VITILIGO. They are also more likely to have melanocytic nevi.

Question 11

management?

Answer 11

dermal melanosis (mongolian spot)

• grey-blue spots present at birth usually on lumbosacral region
  management: self-resolve in early childhood

Question 12

definition

etiology

investigation

complications

Answer 12

Alopecia Areata

Definition: non-scarring patterned alopecia, usually presenting with circular areas of alopecia

Epi: 1.7% lifetime risk, 1-in-5 pt have a FHx

Etiology: organ-specific autoimmune disease (T-cell mediated) Investigation: exclamation point hair which narrows proximally as it exits the hair follicle

Complications: chronic relapse, alopecia totalis (complete baldness)