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Pediatric Outpatient > Derm > Flashcards

Derm Flashcards

1
Q

prodrome of high fever and resp distress followed by red maculopapular rash on trunk that spares face; disappears in 1 to 2 days

A

Roseola (HHV-6)

Self-limiting (just reassure)

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2
Q

clusters of papules or vesicles on red base along w/ fever, malaise and anorexia –> crusted erosions or ulcerations

A

Varicella

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3
Q

How long is someone with varicella contagious?

A

4-5 days after rash appears

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4
Q

mild fever and upper resp symptoms then confluent erythematous macules on face that spares nose and periorbital area which lasts 2-4 days –> lacy, itchy exanthem on trunk and extremities for 1 to 2 w

A

Fifth’s Disease (parvovirus)

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5
Q

Erythematous papular rash from neck to trunk and extremities + strawberry tongue enanthem that all desquamates and fades in 4 to 5 days

A

Scarlet fever (group B strep)

Sand paper like rash

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6
Q

Measles v Rubella

A
  • Measles - Maculopapular from forehead down; prodrome of Koplik spots, fever and malaise
  • Rubella - macular rash from head and neck down; prodrome of fever, sore throat and malaise
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7
Q

macules, papules and pustules at same stage of development w/ fever, myalgias and malaise

A

Variola (smallpox)

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8
Q

vesicles on soft palate, pharynx and tonsils; maculovesicular rash on hands, feet, butt and groin

A

Coxsackie

Herpangina

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9
Q

Maculopapular rash w/o blanching

A

N meningitis

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10
Q

maculopapular rash on lower chest and abdomen (“rose spots”) w/ fever, myalgias, diarrhea, abdominal pain, hepatosplenomegaly

A

Salmonella Typhii (typhoid fever)

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11
Q

abnormal peeling of skin w/ erythematous, edematous and fissured skin underneath

A

Ichthyosis

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12
Q

gray/blue patches esp in darker-skinned infants usually on back or extremities

A

Mongolian Spots

Distinguish from bruises by lack of other colors like red or yellow and no pain

Usually disappear on own

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13
Q

Salmon Patch

A

(nevus simplex or angel kisses)

  • capillary malformation present at birth; often on eyelids or forehead
  • May fade over months to yrs but sometimes outline still present in adulthood
  • If found on nape of neck then called “stork bites”
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14
Q

intense purple/red patches over a large surface area in neonate

A

Port Wine Stain

Discoloration not bad in and of itself but may be associated with underlying syndrome (ex - Sturge Weber)

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15
Q

Milia v. Neonatal Acne

A
  • Milia - white papules; keratin-filled epithelial cysts; present at birth and go away w/in weeks
  • Neonatal Acne - (sebaceous hyperplasia) from maternal hormones/androgens in utero; usually appear after 2 wks of age and spontaneously resolve; more yellow than milia
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16
Q

central yellow papules surrounded by halo of erythema; appear on day 1 or 2 of life then increase in number and resolve within first week or so

A

Erythema toxicum

Very common and no need for treatment

17
Q

hyper pigmented spots with overlying pustules; hyper pigmented spots remain after pustules disappear; starts in utero so can be at any stage at birth

A

Transient Neonatal Pustular Melanosis

  • Pustules only last 1-2 days then hyper pigmented spots also regress
18
Q

Cutis aplasia

A

absence of small patch of skin; associated w/ trisomy 13 or isolated finding

19
Q

Junctional Melanocytic Nevi

Sebaceous Nevi

Epidermal Nevi

A
  • Junctional melanocytic - completely flat and benign
  • Sebaceous nevi - yellow/orange, waxy pebble-like lesion on face or scalp that has no hair follicles; sensitive to androgens in puberty so may elect to remove
  • Epidermal - firm papule w/o any evidence of inflammation; may be associated w/ CNS, bone and eye lesions esp if extensive; may also be benign; becomes more wart-like with time
20
Q

dark erythematous streaking usually on 1 limb

A

cutis marmorata teleangiectasia congenita

Vs. normal transient mottling (lacy); normal mottling is called cutis marmorata

evaluate for associated defects and ulceration

21
Q

Tinea Capitus, Corpis, etc

A
  • Well demarcated annular lesion with raised border and central clearing
  • Usually clinical diagnosis but can do KOH prep or fungal culture if unsure; KOH will show dermatophytes
  • Tx = topical azole (clotrimazole) 2X/day or oral griseofulvin if in scalp or nails (check liver labs)
  • If capitus (in scalp) see broken hairs
22
Q

Tinea Versicolor

A
  • hypo and hyper pigmented lesions in areas w/ inc sweating in humid climate
  • Overgrowth of Malezzia furfur
  • KOH - spaghetti and meatballs
  • Tx = selenium or ketoconazole shampoo
23
Q

Candida Diaper Rash

A
  • beefy red w/ satellite lesions and IN SKIN FOLDS

- Use nystatin cream and if does not resolve then suspect non-albicans species

24
Q

Oral Thrush

A
  • Also Candida
  • common in infants; not as easily scraped as formula; check breastfeeding moms for Candida on breasts
  • Use nystatin swish and treat mom’s breast w/ nystatin cream (safe to still breastfeed)
25
Q

Seborrhoeic Dermatitis

A
  • Flaky erythema in places w/ hair (greasy)

- Tx = selenium shampoo or baby oil w/ soft toothbrush to remove scale

26
Q

Erythema Multiforme

A
  • Presentation - target like lesions
  • More mild and less mucosal involvement than SJS
  • Raised target shaped papules w/ symmetric and wide distribution over body
  • Not transient like urticaria
  • Often triggered by infection
  • Tx - self resolves in about 2 wks; may give anti-histamines if itching
27
Q

SJS/TEN

A
  • Spectrum of drug reaction w/ skin necrosis and sloughing
    • < 10% body surface area = SJS
    • 10-30% = overlap
    • > 30% = TEN
  • Often have fever, malaise, URI prodrome
  • Involvement
    • 90% mucosal - blisters on lips and tongue
    • Ocular - can cause corneal scars
    • Pulmonary - severe form is bronchiolitis obliterates
  • Tx
    • STOP OFFENDING DRUG
    • Treat wound w/ silver products and debridement
    • Fluids and nutrition
    • Analgesia
    • Monitor for super-infection
28
Q

DRESS

A
  • Drug reaction w/ eosinophilia
    • Common w/ phenytoin, carbamazepine, phenobarbital
    • NSAIDs, abx, ACE inhibitor, beta blockers
  • Other manifestations - fever, widespread erythematous macule, lymphadenopathy, elevated LFTs, thyroiditis, pneumonitis, pericarditis
  • Tx - stop offending drug, steroids and support w/ pain control and anti-histamines if pruritic
29
Q

Serum Sickness (pathophysiology, classic triad and tx)

A
  • antigen-antibody complex (type III hypersensitivity reaction) to a drug
  • Classic triad = fever, urticarial rash, later arthralgia
  • Tx - stop drug
30
Q

Eczema Herpeticum

A
  • Herpes infection on top of eczema –> punched out erosions, hemorrhagic crusting and vesicles
  • Important to treat w/ IV acyclovir and eye exam
  • Can be life threatening or vision threatening

Pediatric Outpatient (13 decks)

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