derm Flashcards

1
Q

dx with wright stain showing multinucleated giant cell and eosinophilic intranuclear inclusions

A

neonatal herpes

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2
Q

incontinentia pegmenti

A

vesicles in a linear pattern without an erythematous base

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3
Q

rash present at birth with multiple pustules, brown macule, vesicles, pustules on a non erythematous base

A

transient neonatal pustular melanosis
“leaving a collarette”
more common in African Americans

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4
Q

gram stain in transient neonatal pustular melanosis

A

PMNs without organisms

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5
Q

neonatal rash with yellow pustules on an erythematous base

A

E tox

not present at birth
spares palms and soles
not in premies
fades in ~1wk

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6
Q

neonatal rash with generalized erythematous macules with solitary papules or vesicles in the center

A

E tox

not present at birth
spares palms and soles
not in premies
fades in ~1wk

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7
Q

gram stain in E tox

A

eosinophils

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8
Q

neonatal rash with diffuse scaling and erythematous papules and pustules

A

cutaneous candidiasis

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9
Q

eczema herpeticum

A

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

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10
Q

eczema with evidence of immunodeficiency

A

Wiskott Aldrich syndrome & hyperimmunoglobulin E syndrome

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11
Q

young child with seb derm also w/ profuse ear discharge and profuse urine output

A

histiocytosis x

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12
Q

how is the poison ivy rash contagious?

A

it isn’t!

fluid from the vesicles does not spread the rash

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13
Q

rash to the soles of the feet that is scaly, thick and has hyperlinearity of the distal soles with nl normal interdigital skin

A

juvenile plantar dermatosis

type of contact dermatitis
tx with steroids cream-triamcinoloone

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14
Q

erythematous plaques surrounded by thick adherent scales. with pinpoint hemorrhages under the plaques

A

psoriasis

pinpoint bleeding is called Auspitz sign

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15
Q

round, oozing, crusting, erosions and dry macules with scaly pattern

A

nummular eczema

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16
Q

small, oval, thick scaling plaques with the long axis lesions parallel to the likes of skin stress

A

pityriasis rosea

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17
Q

treatment for pityriasis rosea

A

nothing

but exposure to sun or light improves sx and may hasten resolution

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18
Q

thin scales with pasted on appearance

A

ichthyosis vulgaris

looks like fish skin

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19
Q

treatment for ichthyosis vulgaris

A

keratolytic agents- ammonium lactate cream
alpha hydroxy acid
urea containing emollients

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20
Q

non scaling annular lesion without epidermal involvement

A

granuloma annulare

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21
Q

what is the cause of staph scalded skin syndrome

A

exotoxin produced by staph aureus

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22
Q

what is the cause of toxic shock syndrome

A

caused by toxin production either by S aureus or strep- mortality of strep TSS is much higher than staph TSS

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23
Q

what is the cause of scarlet fever

A

toxin caused by erythrogenic exotoxin produced by GAS- commonly a/w strep pharyngitis

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24
Q

what is the difference of staph scalded skin and TEN

A

SSSS does not involve the dermis and TEN does

  • distinguish by biopsy
  • also SSSS often in younger kids and TEN in older kids
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25
what is TEN from
a hypersensitivity rxn
26
rash with boggy and blue ulcers on a necrotic base
pyoderma gangrenosum usual a/w systemic dz
27
erythema infectiousum
fifth disease slapped cheek a/w parvo
28
erythema marginatum
``` a/w rheumatic fevers Jones criteria Joint involvement w/migratory arthritis O myOcarditis Nodes subq Erythema marginatum Sydenham chorea ```
29
treatment for scabies
permethrin 5% | tx all family members bc highly contagious
30
how long can lice live away from scalp
36 hrs without a blood meal
31
maculae caeruleae
blue-grey macules on the abdomen or inner thigh | c/w pubic lice
32
treatment for molluscum
nothing! will clear in mos to yrs
33
wright stain for molluscum
viral inclusion bodies
34
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
35
what is the cause of papular urticaria
delayed hypersensitivity rxn to an insect bite
36
what causes the black color of blackheads
melanin
37
adenoma sebaceum
angiofibromas that can appear red/pink/brown
38
meds that lead to acne
systemic steroids, anticonvulsants
39
side effects of isoretinoin
- dry lips - dry eyes - dry skin - nose bleeds - HA
40
gold standard for dx of tinea capitis
fungal cx
41
tx of choice for tinea capitis
griseofulvin 6-12 wks or fluconazole or terbinafine
42
what is telogen effluvium
loss of large amounts of hair after washing or brushing- triggered by stressful event/illness
43
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
44
how to dx tinea versicolor
KOH prep
45
how to tx tinea versicolor
astringents and topic antifungals | limit sun exposure as this worsens rash
46
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
47
pityriasis alba
post inflammatory hypopigmentation in atopic skin
48
MRI finding in sturge weber
venous leptomeningeal angiomatosis- a/w port wine stain
49
tx of port wine stain
tunable dye laser (pulsed dye laser)
50
where is the port wine stain in sturge weber?
trigeminal distribution | need ophtho referral
51
what is the inheritance of ichthyosis vulgaris
AD
52
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 ```
53
what are the adverse effects of topical steroids (6)
- folliculitis - perioral dermatitis - steroidal acne - skin atrophy - telangiectasias - adrenal suppression
54
what is the difference between eczema herpeticum and eczema coxsackium
eczema coxsackium is more superficial
55
what bony deformities are seen with NF1
``` macrocephaly short stature sphenoid dysplasia cervicothoracic kyphoscoliosis pseudoarthrosis of tibia pectus excavatum genu valgum/varum scoliosis ```
56
chromosome __ is involved in NF1
17q11.2 neurofibromin (guanosine diphosphate-activating protein GAP) = tumor suppressor
57
chromosome __ is involved in NF2
22
58
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 ```
59
what is PHACES
``` Posterior fossa malformation Hemangioma (segmented, cervicofacial) Arterial anomalies (intracerebral) Cardiac anomalies/coarc Eye abnormalities Sternal defects ```
60
what do you need to investigate in children with lumbosacral hemangiomas
spinal cord or GU abnormalities
61
what do you need to investigate in children with beard-like hemangiomas
airway compromise
62
what do you need to investigate in children with multiple (>5) hemangiomas
internal/visceral hemangiomas (live, lung, GI, eyes, CNS)
63
what is the dose of griseofulvin for tinea capitits
20 mg/kg/d with fatty foods to increase absorption | tx 6-8 wks
64
what is the dx 2 week old infant with bullous rash noted to have staph colonization of the umbilical stump
bullous impetigo
65
how long does pustular melanosis last
present at birth-several mos
66
gram stain findings with: miliaria rubia (heat rash)
many PMN | no bacteria
67
gram stain findings with: e tox
many eos maybe some PMN no bacteria
68
gram stain findings with: transient neonatal pustular melanosis
many PMNs | no bacteria
69
gram stain findings with: bullous impetigo
any PMN | gram pos cocci in clusters
70
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
71
what is the concern in an infant with a large congenital melanocytic nevi
neurocutaneous melanosis, melanoma, spinal dysraphism, dandy walker
72
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
73
what further work up must be done in a child with a midline facial dermoid cyst
need MRI to look for CNS comminication
74
what bug is usually a/w necrotizing fasciitis
GABHS
75
how do you transmit molluscum
skin to skin and autoinnoculation
76
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
77
what is the inheritance of hidrotic ectodermal dysplasia
AD
78
what is the inheritance of hypohidrotic ectodermal dysplasia
x linked R
79
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
80
name the dx young boy with absent/reduced sweating, hypotrichosis, defective dentition
hypohidrotic ectodermal dysplasia