derm Flashcards
dx with wright stain showing multinucleated giant cell and eosinophilic intranuclear inclusions
neonatal herpes
incontinentia pegmenti
vesicles in a linear pattern without an erythematous base
rash present at birth with multiple pustules, brown macule, vesicles, pustules on a non erythematous base
transient neonatal pustular melanosis
“leaving a collarette”
more common in African Americans
gram stain in transient neonatal pustular melanosis
PMNs without organisms
neonatal rash with yellow pustules on an erythematous base
E tox
not present at birth
spares palms and soles
not in premies
fades in ~1wk
neonatal rash with generalized erythematous macules with solitary papules or vesicles in the center
E tox
not present at birth
spares palms and soles
not in premies
fades in ~1wk
gram stain in E tox
eosinophils
neonatal rash with diffuse scaling and erythematous papules and pustules
cutaneous candidiasis
eczema herpeticum
invasion of eczematous skin with herpes virus
-inflamed eczema which is not responding to steroids or abx
-vesicle and punched out or crusted lesions
-usually see on the face
tx w/ acyclovir
eczema with evidence of immunodeficiency
Wiskott Aldrich syndrome & hyperimmunoglobulin E syndrome
young child with seb derm also w/ profuse ear discharge and profuse urine output
histiocytosis x
how is the poison ivy rash contagious?
it isn’t!
fluid from the vesicles does not spread the rash
rash to the soles of the feet that is scaly, thick and has hyperlinearity of the distal soles with nl normal interdigital skin
juvenile plantar dermatosis
type of contact dermatitis
tx with steroids cream-triamcinoloone
erythematous plaques surrounded by thick adherent scales. with pinpoint hemorrhages under the plaques
psoriasis
pinpoint bleeding is called Auspitz sign
round, oozing, crusting, erosions and dry macules with scaly pattern
nummular eczema
small, oval, thick scaling plaques with the long axis lesions parallel to the likes of skin stress
pityriasis rosea
treatment for pityriasis rosea
nothing
but exposure to sun or light improves sx and may hasten resolution
thin scales with pasted on appearance
ichthyosis vulgaris
looks like fish skin
treatment for ichthyosis vulgaris
keratolytic agents- ammonium lactate cream
alpha hydroxy acid
urea containing emollients
non scaling annular lesion without epidermal involvement
granuloma annulare
what is the cause of staph scalded skin syndrome
exotoxin produced by staph aureus
what is the cause of toxic shock syndrome
caused by toxin production either by S aureus or strep- mortality of strep TSS is much higher than staph TSS
what is the cause of scarlet fever
toxin caused by erythrogenic exotoxin produced by GAS- commonly a/w strep pharyngitis
what is the difference of staph scalded skin and TEN
SSSS does not involve the dermis and TEN does
- distinguish by biopsy
- also SSSS often in younger kids and TEN in older kids
what is TEN from
a hypersensitivity rxn
rash with boggy and blue ulcers on a necrotic base
pyoderma gangrenosum
usual a/w systemic dz
erythema infectiousum
fifth disease
slapped cheek
a/w parvo
erythema marginatum
a/w rheumatic fevers Jones criteria Joint involvement w/migratory arthritis O myOcarditis Nodes subq Erythema marginatum Sydenham chorea
treatment for scabies
permethrin 5%
tx all family members bc highly contagious
how long can lice live away from scalp
36 hrs without a blood meal
maculae caeruleae
blue-grey macules on the abdomen or inner thigh
c/w pubic lice
treatment for molluscum
nothing! will clear in mos to yrs
wright stain for molluscum
viral inclusion bodies
pink, excoriated, pruritic lesions with central punctum in clusters on the extensor surfaces of the arms and legs
papular urticarial
occurs typically at night
can last up to 7 days
what is the cause of papular urticaria
delayed hypersensitivity rxn to an insect bite
what causes the black color of blackheads
melanin
adenoma sebaceum
angiofibromas that can appear red/pink/brown
meds that lead to acne
systemic steroids, anticonvulsants
side effects of isoretinoin
- dry lips
- dry eyes
- dry skin
- nose bleeds
- HA
gold standard for dx of tinea capitis
fungal cx
tx of choice for tinea capitis
griseofulvin 6-12 wks
or fluconazole or terbinafine
what is telogen effluvium
loss of large amounts of hair after washing or brushing- triggered by stressful event/illness
pigmented lesions that turn into hives and develop blisters- particularly with rubbing
- also called darier sign
- uticaria pigmentosa
- occurs typically in first 6 mos of life
- worsened by narcotics, NSAIDs, and contrast
how to dx tinea versicolor
KOH prep
how to tx tinea versicolor
astringents and topic antifungals
limit sun exposure as this worsens rash
incontinenentia pigmenti
xlinked dominant- lethal in males
1- erythematous papules and vesicles in crops along the lines of Blaschko that last 1-2 wks
2- swirls of warty growths
3- streaks of hyperpigmentation in marble cake pattenr
4- hypopigmentation
pityriasis alba
post inflammatory hypopigmentation in atopic skin
MRI finding in sturge weber
venous leptomeningeal angiomatosis- a/w port wine stain
tx of port wine stain
tunable dye laser (pulsed dye laser)
where is the port wine stain in sturge weber?
trigeminal distribution
need ophtho referral
what is the inheritance of ichthyosis vulgaris
AD
what is the dx:
child presents in the first year of life with prominent scales over the extensor surfaces with flexor sparing. The rash improves with warm/humid weather. On exam there is noted hyperlinearity of the palms and soles
ichthyosis vulgaris (AD) d/t loss of fxn of filaggrin tx with emollients and keratolytics (lactic acids) avoid salicylates
what are the adverse effects of topical steroids (6)
- folliculitis
- perioral dermatitis
- steroidal acne
- skin atrophy
- telangiectasias
- adrenal suppression
what is the difference between eczema herpeticum and eczema coxsackium
eczema coxsackium is more superficial
what bony deformities are seen with NF1
macrocephaly short stature sphenoid dysplasia cervicothoracic kyphoscoliosis pseudoarthrosis of tibia pectus excavatum genu valgum/varum scoliosis
chromosome __ is involved in NF1
17q11.2
neurofibromin (guanosine diphosphate-activating protein GAP) = tumor suppressor
chromosome __ is involved in NF2
22
what is mccune albright syndrome (5)
large segmental cafe au lait also a/w... - accelerated linear growth - precocious puberty - skeletal defects- polyostotic fibrous dysplasia with bowing of arms - endocrine abnormalities
what is PHACES
Posterior fossa malformation Hemangioma (segmented, cervicofacial) Arterial anomalies (intracerebral) Cardiac anomalies/coarc Eye abnormalities Sternal defects
what do you need to investigate in children with lumbosacral hemangiomas
spinal cord or GU abnormalities
what do you need to investigate in children with beard-like hemangiomas
airway compromise
what do you need to investigate in children with multiple (>5) hemangiomas
internal/visceral hemangiomas (live, lung, GI, eyes, CNS)
what is the dose of griseofulvin for tinea capitits
20 mg/kg/d with fatty foods to increase absorption
tx 6-8 wks
what is the dx
2 week old infant with bullous rash
noted to have staph colonization of the umbilical stump
bullous impetigo
how long does pustular melanosis last
present at birth-several mos
gram stain findings with:
miliaria rubia (heat rash)
many PMN
no bacteria
gram stain findings with:
e tox
many eos
maybe some PMN
no bacteria
gram stain findings with:
transient neonatal pustular melanosis
many PMNs
no bacteria
gram stain findings with:
bullous impetigo
any PMN
gram pos cocci in clusters
name the dx
child with many 0.2-1 cm scaly papules and plaques distributed symmetrically over the trunk and proximal extremities following GAS
guttate psoriasis
what is the concern in an infant with a large congenital melanocytic nevi
neurocutaneous melanosis, melanoma, spinal dysraphism, dandy walker
what is the diagnostic criteria of juvenile dermatomyositis (5)
skin signs plus 3
- cutaneous featurs (heliotrope, gottons sign)
- progressive symmetrical weakness of proximal mm
- elevated muscle enzymes
- myopathy on EMG or MRI
- biopsy evidence of myositis and necrosis
what further work up must be done in a child with a midline facial dermoid cyst
need MRI to look for CNS comminication
what bug is usually a/w necrotizing fasciitis
GABHS
how do you transmit molluscum
skin to skin and autoinnoculation
what do you need to worry about in the future for children d/w lichen sclerosis
increase risk of lesional squamous cell carcinoma in affected adults
what is the inheritance of hidrotic ectodermal dysplasia
AD
what is the inheritance of hypohidrotic ectodermal dysplasia
x linked R
name the dx
child with nail dystrophy, hyperkeratosis of the alms and soles, and hair defects
of note there are NO abnl facies
hidrotic ectodermal dysplasia
name the dx
young boy with absent/reduced sweating, hypotrichosis, defective dentition
hypohidrotic ectodermal dysplasia
