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Paediatrics > demr and exanthems > Flashcards

demr and exanthems Flashcards

1
Q

Acne Neonatorum

A

Closed comedones on face

- self resolves in 4 mo

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2
Q

erythema toxicum neonatorum

A

pustules on face, trunk, proximal limbs, “flea bitten”. Spares palms and soles.

Resolves in 1 week, up to several weeks.

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3
Q

infantile hemangioma

A

benign vascular tumour

may grow then resolve, most gone by age 7

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4
Q

milia

A

1-2mm pearly papules, forehead, cheeks, nose, chin

self resolve in 1-3mo

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5
Q

transient neonatal pustular melanosis

A

vesicopustular rash, more common in black babies.

Pustules + erythema. Can be anywhere.

Self limiting – collarette + scale, pigmented macule fades in 3-4 weeks.

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6
Q

Diaper Contact Dermatitis Description

A

shiny, erythematous rash, +/- maceration. Spares folds.

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7
Q

Diaper contact dermatitis treatment

A

barrier cream, zinc oxide +/- 1% hydrocortisone. Increase diaper changes.

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8
Q

diaper candidiasis description

A

beefy red plaques, satellite papules + pustules with confluent lesions. Involves skin folds. Fine scale.

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9
Q

Diaper candidiasis treatment

A

1% clostrimazole or nystatin.

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10
Q

Infantile psoriasis

A

sharply demarcated red plaques + papules, involving folds. No treatment.

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11
Q

Scabies

A

Macules, pustules, excoriations, nodules. Burrows in webs. ++ pruritic. Spares face.

tx: Permethrin 5% for whole family, 2 applications 1 wks apart.

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12
Q

Impetigo

A

honey coloured crusts, face, extremities. S. Aureaus (or GA strep).
Tx: PO cephalexin or erythromycin. IV if severe.

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13
Q

Tinea

A

capitis, corporis, onychomycosis. Annular lesions, maceration in folds. Tx: topical anti-fungal for skin (azoles, terbinafine, tolnaftate), oral for nails or scalp (terbinafine). Don’t use nystatin.

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14
Q

Urticaria

A

tx: stop offending agent. Antihistamine (eg loratidine)

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15
Q

Molluscum Contagiosum

A

pox virus infection. Domed, pearly, flesh coloured to transluscent, umbilicated. Face, trunk, limbs. +/- pruritic.
Tx: self-resolving. Curretage, cryotherapy, cantharidin possible.

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16
Q

Measles

A

incubate 8-13d. Contagious 4d before + after rash.

rash starts at hairline, goes down. Conjunctivitis, cough, coryza. Koplik spots (white buccal)

Tx: vitamin A, supportive.
Contacts: Ig + MMR vaccine.
Complications: pneumonia, AOM, encephalitis, myocarditis (rare).

17
Q

Rubella

A

Incubate 14-21d. Infectious 7d before and after rash.

Pink, maculopapular rash on face/neck/trunk. Occipital + retroauricular nodes. Low fever.
Petechiae on soft palate.

Complications: STAR - sore throat, arthritis, rash. Congenital anomalies in preg.

18
Q

Roseola

A

HHV-6 + HHV-7

incubate 5-15d

pink, maculopapular on neck, arms, trunk. After fever breaks.
Red papules on soft palate + uvula.

complications: febrile seizures.

19
Q

erythema infectiosum

A

fifth’s disease. Parvovirus b19.
Incubates 4-14d.
“slapped cheek”, maculopapular lacy rash (may appear later /w heat).
petechai in mouth.

Complications: STAR, PPGSS glove + sock, aplastic crisis (esp sickle cell)

20
Q

chicken pox

A

varicella zoster virus
incubate 10-21d, infectious 2d before + 5d after rash
airborne + contact

tichy, vesico-bullous, macules, papules, crusts, new lesions q2-3d, “dew drop on a rose petal”.

Prevention: VZ-Ig within 96hrs of contact, vaccine

complications: bacterial super-infection, nec fasc, encephalitis, cerebellar ataxia, hepatitis, DIC

21
Q

Herpes Simplex

A

HSV1,2
grouped vesicles on erythma +/- erosions in anterior mouth.
Herpetic whitlow = on finger.

tx: topical or oral anti-virals
complications: secondary infection, keratitis, gingivostomatitis, encephalitis, hepatitis, DIC

22
Q

hand-foot-mouth disease

A

coxsackie virus

vesicles + pustules on red base, tongue + posterior pharynx

atypical: generalized vesicobullous, excema, petechia, or gianotti-crosti like
complications: dehydration, nail shedding

23
Q

Gianotti-crosti syndrome

A

EBV, HBV, coxackie, parvo
asymptomatic papular acrodermatitis, viral prodrome. Cheeks + extensors, pseudovesicles.
Self limiting but lasts 3-12wks

24
Q

Scarlet Fever

A

Group A Strep

generalized red papules, sandpaper. Flexural accentuation (pastia’s lines). Strawberry tongue, palatial petechia.

Tx: pen V, amp, amoxil x10d.

Complications: pneumonia, pericarditis, meningitis, hepatitis, glomerulonephritis, rheumatic fever.

25
Q

Unilateral laterothoracic exanthem

A

aka asymmetric periflexural exanthem
unknown etiology
prodrome fever, URTI/GI
erythematous, papular eruption, flexural area (“statue of liberty”), then spreads to other side

can last 6 weeks

26
Q

Kawasaki Disease

A

vasculitis, unknown etiology

fever 5d and 4/5 of:

  • rash
  • hand/foot edema/erythema
  • lymphadenopathy (usually unilateral)
  • oral lesions: strawberry tongue, dry cracked lips
  • conjunctivitis - non-purulent

labs supportive: WBC high, anemia, ESR + CRP high, plt high, transaminases up, low albumin, sterile pyuria

tx: high dose ASA, IVIG, baseline echo + repeat in 6 weeks. No live vaccines until 1 year.
complications: coronary artery aneurysm. Need cardiac f/u longterm if occurs.

27
Q

atopic dermatitis

A

plaques, papules, poorly defined, red, lichenified, dry, pruritic

baby: face, extensors
kids: flexural
adults: face, feet+hand, eyelid

tx: emollients, topical steroids (high potency, then low for maintenance), calcinurin inhibitors

28
Q

eczema herpeticum

A

small punched out, monomorphic grouped erosions
HSV on eczema
emergency, blindness/organ failure, death
high dose PO or IV acyclovir
optho consult if near eye

29
Q

seborrheic dermatitis

A

greasy, yellow, scale + red plaques. Scalp, diaper, folds. Not itchy.
etiology ?malassezia
tx - antifungals (eg ketoconazole), steroids. Selenium or zinc pyrithione shampoo.

30
Q

Nummular dermatitis / discoid eczema

A

coin shaped plaques, edema, erythema, crusting
lower legs, pruritic
tx - similar to AD. PRevemt trauma

31
Q

allergic contact dermatitis

A

red, papules, plaques, vesicles, bullae Localized.
erosions, crusting, superinfection.
pruritic.

32
Q

pityriasis rosea

A

large herald patch –> christmas tree. Central scale.

HHV7?

33
Q

HSP

A

IgA complex deposition, small vessel vasculitis.
Purpura, abdo pain, arthritis, arthralgia.
Ix: Cr, lytes. U/A (blood, prot). Coags (r/o bleed disorder), CBC (r/o ITP, plt N in HSP).

skin or renal bx can show IgA deposits.

tx: supportive, anti-inflammatories, steroids, immunosuppressants depending on severity.

34
Q

HSP complications

A
  • glomerulonephritis, hemorrhagic cysts, nephrotic syndrome, renal failure, obstruction, HTN
  • bowel infarction/perf, obstruction, intussusception
  • alveolar hemorrhage, infiltrates, pulm effusion
  • seizures, CNS bleed, blind, neuropathy
  • orchitis, test torsion, scrotal edema
  • anterior uveitis
  • myocarditis, myositis

Paediatrics (23 decks)

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