D1 Flashcards
<p>the major cause of pediatric burn?</p>
<p>scaled injury</p>
<p>characteristics of scaled burn-in child abuse?</p>
<p>mainly due to immersion to hot liquid
Clear demarcation with no splash mark
Involvement of back, buttock, and leg
sparing of the flexural part(ankle, knee, and hip flexure)
lesion inconsistent with the history
Delay in presentation
Uniform burn degree especially in case of severe burn</p>
<p>what action should be taken?</p>
<p>contact with childhood protective service immediately</p>
<p>unentational burn caracter?</p>
<p>Mainly spillage from upper Proximal upper extremity, face, and proximal trunk Presence of splash mark non-uniform burn depth asymmetric lesion</p>
epidemiology of tinea capitis
transmitted by direct contact or fomite
dermatophyte(Trichophyton and microsporidium)
CM?
scaly, erythematous skin lesion with hair loss
+-black dote on the site of lesion
+- Tender LDP
scaring and pruritis may be there
managment?
oral grisofulvin/terbinafin
treat contact with selinium selfide or ketokonazol shampo
alopecia areata?
Due to autoimmune
Clear area of hair loss w/o scaling
Discoid rash
Seborrheic dermatitis?
scaley, oily erythematous rash(dandruff)
around the hairline, ears, or nose; or in the center of the chest or back.
High risk of hair breaking
keratosis pilaris?
Characterized by retained hair b/n the hair follicle
Small painless papules
rough skin texture
mottled perifollicular erythema
exacerbated by dry and cold weather
commonly affect the posterior surface of the upper arm
Treatment when necessary?
use when necessary
emollient
topical keratolytic(salicylate, uric acid)
Pathogenesis of henock-schonlein purpura pathogenesis?
IgA mediated leukocytoclastic vasculitis
CM?
Triads(Palpable purpura,Arthritis/Arthralgia
and Abdominal pain,intususuption)
A renal disease similar to IgA nephropathy
Laboratory?
Normal platelet
Normal coagulation
Nephritic syndrome sign
Managment?
suportiv(RHD and NSAID)
IV glucocorticoid in sever case
Infectious complications of atopic dermatitis?
Impetigo
Eczema herpeticum
Molluscum Contagiousum
Tinea corporis
Impetigo CXS?
S.A and S.P(can progress to cellulitis and abscess)
Painful
nonpruritic
Hoony crust lesion
Eczema herpeticum CXS?
HSV Painful Vesicular Punched out hemorrhagic crusting
Molluscum Contagiousum CXS?
PV
Flesh-colored papule with central umbilication
Tinea corporis CXS?
trichophyton rubrum Pruritic erythematous Central clearing raised and erythematous border
Eczema herpeticum treatment?
acyclovir indicated in children
Atopic dermatitis presentation?
In young children
Dry, scaly, and erythematous lesion in chicks and extensor surface
In older children
Dry, thickened skin in antecubital fossa and popliteal area
Tinea pedis etiology?
Trichopytone(MCC;TP.rubrum)
CM?
Acute: Pruritic, burning pain erythematous vesicle/bulla
Chronic: erythematous, pruritic, Interdigital scale/fissure with an extension around.
treatment?
Topical antifungal
Azoles(miconazol)/terbinafine
Systemic(fluconazole, terbinafine) in severe case: for the patient did not respond to topical
Keep feet dry
What about scabies
Papule,pustule and burrow
treat with permethrin
effect of UV exposure?
Sunburn
Photoaging
Skin cancer
Sunburn symptom?
Changes in skin tone, such as pinkness or redness.
Skin that feels warm or hot to the touch.
Pain and tenderness.
Swelling.
Small fluid-filled blisters, which may break.
Headache, fever, nausea, and fatigue,
if the sunburn is severe.
Eyes that feel painful or gritty.
prevention?
exposure
sunscreen
clothing
exposure reduction?
Avoid all if you can
Avoid age < 6 mont
Avoid exposure 10:AM to 4:PM
sunscreen?
Use SS cream protecting power 30-50
15-30 min before exposure
reapply every 2 hours and after swimming
Clothing?
Long sleeves
Broad hat
Dark color
Tight weav
Alopecia areata pathogenesis?
Genetic predisposition
Autoimmune hair bulb distraction
CM?
painless, nonscary patchy hair loss
narrowing of hair shaft near the surface
positive hair pulling test(extract 5-5 hair at once)
recur but regrow during TX
It May be associated with AID(SLE, Autoimmune thyroid disease and vetiligo)
mild/moderate hair loss?
Mild/Moderate:topical or intralesional CS
Sever: Topical immunosuppressant (diphenylcyclopropenone) with oral CS
What about discoid SLE involving hair?
The lesion is erythematous and scaring
Another site SLE lesion
Allergic contact dermatitis pathogenesis?
Require previous exposure(Immune sensitization)
Due to T cell RXN(Type IV)
Ethology are(URUshiol(from the plant(Poison ivy, oak, and sumac), nickel and neomycin)
CM?
Start after 12 hr Pruritis Erythematous rash with a streak(especially in uroshiol) Develop edema and vesicle weeping drainage and crusting usually, resolve in 1-3 week
managment?
avoid exposure
removed exposed cloth
topical and oral corticosteroid
Scabies pathogenesis?
Infection bay Sacrobitis scabi bite
Spread by direct person to person contact
CM?
extremely pruritis
burrow/small erythematous papule/vesicle
wave space, flexor wrist, extensor elbow, axilla, umbilicus, and genitalia
Treatment?
Topical permetrin or oral Ivermectine
Perianal streptococcal infection sign?
Caused by S.Pyogenes Sharpley demarcated, erythematous and painful perianal rash Constipation due to the pain Bloody stool Contact in recent day
Managment?
Oral BLA
Staphylococcal scalded skin syndrome pathogenesis?
Caused by exfoliativ toxin-producing S.A infection
The source is usually the umbilicus/circumcision site in the neonate
But in adult nares and skin
Toxin damage keratinocyte attachment within the epidermis
CM?
Prodrom: Fever eriteblity and skin tenderness
Then, generalized erythema,
flaccid bullae/blister dominate in the flexural area
spare mucosa
Niklisky sign
Scaled skin lesion due to epidermal peeling
Managment?
Naficiline/vancomycin
Supportive(wound care)
Diagnosis?
clinical
Bulle is sterile
Bullous impetigo?
The localized form of SSSS
Seborrheic dermatitis pathogenesis?
associated with colonization by Malassezia furfur
Affect part of the body that have a sebaceous gland
CM?
A peak in infancy/adulthood
Erythematous plaque/yellow gressy scale
Located on the scalp, face(eyebrows/eyelid.nasolabial fold and posterior ear), umbilicus and diaper area.
pruritis and pain is not typical
Tx?
Mild: gentle emollient and non-medical shampo
severe: Glucocorticoid cream and topical ketoconazole
Bullous and non-bullous impetigo D/C?
Etiology
CM
TX
Etiology?
B: S.A
NB: SA & GAS
CM?
B: enlarged flaccid bullous lesion with yellow fluid
—raptured lesion with a collarette of scale at the periphery
NB:Papules with pustule with honney crust lesion
Treatment?
NB:Topical/if extensive :oral
B: Oral
common childhood pigment disorder?
Cafe-au-laits spots
Congenital dermal melanocytosis
Congenital melanocytic nevus
Cafe-au-laits spots?
Flat,hyperpigmented patches Associated MAS(McCune Albright syndrome)/NF
Congenital dermal melanocytosis?
Blue-gray patches
more common in African American
Common in lower back and buttock
Fades away with decades(no treatment require)
Due to the presence of melanocytes in the dermis
Congenital melanocytic nevus?
Benign melanocyte proliferation
Increase density of hair lesion
5 % risk of melanoma
Infantile hemangioma managment?
Also known as strawberry hemangioma
Can present with a patch of telangiectasia at birth
Proliferate age 0-1, bright red raised nodule
Involution: age 1-9,Deeper red/violet,regretion in size
Is capillary tumor due to endothelial proliferation
managment?
observation
topical beta-blocker(at site complication will be anticipated)
Complication?
Ulceration/scaring
Vision impairment if near eye
Life-threatening if the near airway
cherry hemangioma?
common benign vascular tumor in adult
Dilation of capillary and PCV
usually widespread at trunk and face
enlarge with age
Pathogenesis of T.Versicolour?
Malaysia globosa
exposure to the skin to hot and humid air
CM?
Hypo/Hyperpigmented lesion may have mild erythema face in children trunk and UE in above \+- fine-scale and pruritis
Diagnosis?
KOH: hyphae and yeast(spaghetti in metaball)
Tx?
Topical ketoconazole, Terbinafine or selenium sulfide
Generally nystatin not treat dermatocyte
Pityriasis rosea?
viral prodrome
classically begin by single salmon colourd macule
then multiple lesions in trunk and extremity(Christmas tree)
erythematous
eventually, desquamate
Pruritis
managment?
usually self-limited
antihistamine and topical steroid for pruritis
erythema toxicum neonatorum?
asymptomatic erythematous papule and pustule full-term neonate in first 2 week spare hand and palm not need treatment(resolve by itself)
bed bug skin lesion?
pruritic
small puncture
maculopapular in linear group
on close free rea
spider bite?
solitary
papule/pustule
weal/+-pruritis
managment?
suportive(CS and anti histamin)
decontamination
