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Pediatrics Exam 2 > Derm > Flashcards

Derm Flashcards

1
Q

Macules

A

< 1 cm; circumscribed and flat

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2
Q

Patch

A

flat, >1 cm

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3
Q

Papules

A

raised, < 1cm

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4
Q

nodules

A

papules > 1 cm, in dermis or subcutatneous area

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5
Q

Plaques

A

well defined elevated confluence of papules > 1cm

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6
Q

Vesicles

A

circumscribed, fluid containing epidermal elevations < 1 cm

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7
Q

Bulla

A

vesicle > 1 cm

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8
Q

Pustules

A

circumscribed, small elevations with purulent exudate

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9
Q

Wheals

A

plateau-like edematous elevations, pink or red

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10
Q

Scale

A

dry or greasy flakes of stratum corneum

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11
Q

Crust

A

dried serum, blood or pus with debris on skin surface

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12
Q

Excoriation

A

shallow, hemorrhagic linear excavation

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13
Q

Erosions

A

loss of all or portions of epidermis from physical abrasions, vesicles, or bullae

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14
Q

Ulcer

A

rounded or irregular shaped excavations into dermis or deeper

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15
Q

Fissure

A

linear deep skin split through epidermis or into dermis

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16
Q

lichenification

A

thickened skin with accentuated skin markings

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17
Q

atrophy

A

decreased skin thickness

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18
Q

Congenital Melanocytic Nevi (CMN)

A

macules, papules or plaque AT BIRTH, +/- hair, lesions grow in proportion to individuals size

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19
Q

CMN Risk of malignancy

A

increased size of CMN = increased risk of malignant potential; risk of melanoma

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20
Q

Most common pigmented lesion in infants

A

Mongolian spot

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21
Q

Mongolian Spot other name

A

Congenital dermal melanocytosis (CDM)

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22
Q

Mongolian spot

A

bluish-grey patch with irregular border and normal texture

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23
Q

Mongolian spot dx

A

clinical; further work up if FTT or not meeting developmental milestones

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24
Q

Mongolian spot prognosis

A

fades by age 2 and disappears by age 10

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25
Q

may be mistaken for abuse

A

CDM (mongolian spot)

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26
Q

Nevus sebaceous

A

hyperplasia of epidermis, sebaceous glands, hair follicles, apocrine glands

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27
Q

Nevus sebaceous clinical presentation

A

usually on scalp or face; waxy solitary, smooth, yellow-orange hairless patch, often oval or linear; more pronounced in adolescence (bumpy, warty or scaly)

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28
Q

Goes away with age

A

Mongolian spot

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29
Q

Grows with age

A

CMN

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30
Q

More pronounced in adolescence

A

Nevus Sebaceous

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31
Q

nevus sebaceous dx

A

some may need histological evaluation; BCC or other malignancy may arise from lesions

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32
Q

Nevus sebaceous tx

A

f/u, refer to derm if concerning changes are observed

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33
Q

Malignant potential

A

CMN, Nevus Sebaceous

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34
Q

Aplasia Cutis Congenita (ACC)

A

absence of skin present at birth

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35
Q

ACC presentation

A

most commonly found midline posterior scalp (may have tuft of hair = neural tube defect), may be associated fluid-filled bulla, well demarcated

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36
Q

ACC tx

A

gentle cleaning and ointment, hypertrophic scar may develop, refer to neuro for surgical repair if large or multiple scalp lesions

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37
Q

ACC imaging

A

done if atypical/large or hair tuft

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38
Q

Cafe-au-lait Macultes (CALM)

A

uniformly pigmented macules/patches; most common in african americans; present at birth OR in early childhood

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39
Q

CALM lesions are associated with what conditions

A

McCune-Albright syndrome or NF1

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40
Q

Neurofibromatosis

A

autosomal dominant (50% new mutations)

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41
Q

Sx of NF1

A

cafe-au-lait, axillary or inguinal freckling, neurofibromas, lisch nodules, optil gliomas, skeletal abnormlaities

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42
Q

Kids with NFI need what

A

yearly ophthalmology exams starting at 1 year

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43
Q

Types of vascular anomalies

A
  1. Tumors: neoplasms proliferate and typically require tx to stop growth
  2. Malformations: abnormal blood vessels without rapid proliferation (static/slow growing)
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44
Q

Vascular Tumors

A

infantile hemangioma, congenital hemangioma, pyogenic granuloma

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45
Q

Vascular malformations

A

capillary malformations (CM), port-wine stain, nevus simplex

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46
Q

Port-Wine Stain (PWS)

A

cutaneous capillary malformation; present at birth and DOES NOT REGRESS; pink/dark red patch (may darken/thicken)

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47
Q

PWS associated with

A

soft tissue or bony overgrowth, Sturge Weber Syndrome in V1 distribution (congenital glaucoma concerns if patch affects eyelid)

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48
Q

Sturge Weber Syndrome

A

PWS in V1 distribution; concern for congenital glaucoma

49
Q

PWS tx

A

No tx needed; Pulse dye laser, widespread/extremity overgrowth = refer to vascular specialist

50
Q

Pulse dye laser

A

tx for PWS; causes intravascular coagulation in abnormal vasculature without damaging surrounding structures (do early before it progresses)

51
Q

Most common benign vascular tumor

A

Infantile hemangiomas

52
Q

Risk factors for infantile hemangiomas

A

LBW, female, twin gestation and fair-skin

53
Q

Clinical presentation of infantile hemangiomas

A

NOT PRESENT AT BIRTH but appear shortly after, can be superficial (bright red and minimally elevated), deep (large with bluish color) or mixed; ulceration is common complication

54
Q

Infantile hemangiomas stages

A

Proliferative:
1. Early- rapid growth during first 3 months of age (max: 5–7 weeks)
2. Late- less rapid but still ongoing; completed @ 9 mo
Involution: Color darkens and tumors softens, ultimate residual skin changes vary

55
Q

Completed growth of infantile hemangioma

56
Q

Max growth period of infantile hemangioma

A

5-7 weeks of age (grows rapidly first 3 mo)

57
Q

Nevus simplex is also known as…

A

Salmon Patch

58
Q

Nevus Simplex presentation

A

faint, TRANSIENT capillary malformation; flat, pink/red patch typically midline of forehead, scalp, upper eyelids, posterior neck and back

59
Q

Most common pediatric vascular lesion

A

Nevus simplex (salmon patch)

60
Q

NS on nape of neck

A

stork bite

61
Q

NS on eyelid

A

angel’s kiss

62
Q

Time period for NS

A

fade within 1-2 years

63
Q

Pyogenic Granuloma

A

acquired (not born with) lobular vascular tumor; occurs at any age and affects skin prone to traums (hands, fingers, face and mucous membrane); develop rapidly (days to months); FRIABLE, can recur despite treatment

64
Q

Pyogenic granuloma tx

A

biopsy to confirm dx (surgical excision with primary closure, curettage or shave remove w/ electrodessication, pulsed dye laser); risk of recurrence is high; tx is traumatic (viscious cycle)

65
Q

When to refer hemangiomas to emergent ENT

A

mandibular hemangioma with stridor or hoarseness; evaluate for airway compromise

66
Q

Diaper dermatitis causes

A

irritant/contact; seborrheic dermatitis, atopic dermatitis or other underlying skin conditions

67
Q

Diaper derm presentation

A

episodic with varying severity, persistnec = secondary infection with C. albicans, etc

68
Q

Candidal superinfecton

A

beefy red plaques (involves skin folds); dx with KOH

69
Q

impetigo

A

secondary infection of S. aureus or S. pyogenes; fragile pustules and honey crusted erosions

70
Q

Honey crusted erosions

71
Q

Bacteria behind impetigo

A

S. aureus and s. pyogenes

72
Q

Diaper dermatitis therapeutic options

A

EDUCATE; barrier cream (paste/ointment), low-potency topical steroid if severe or not resolving; breast-milk (anti-inflammatory and anitmicrobial); DON”T USE POWDERS

73
Q

Tx for diaper derm candida infection

A

Topical antifungal

74
Q

Tx for diaper derm bacterial superinfection (impetigo)

75
Q

Lice

A

Pediculus humanus capitis

76
Q

Clinical presentation of lice

A

asymptomatic; itching if allergic to saliva, cervical LAD, febrile w/ secondary staph infection

77
Q

Dx for Lice

A

visualize live lice (wet-combing); nits may persist for months and does not indicate active infection

78
Q

Tx for lice

A

topical pediculicides (pyrethroids, malathion, benzyl alcohol, spinosad)- rinse in sink to avoid skin irritation; wet combing (mechanical removal) w/ conditioner, 15-60 minutes every 3-4 days for several weeks

79
Q

Prophylactic tx for lice

A

only bedmates

80
Q

Topical pedicullices

A

pyrethroid, malathion, benzyl alcohol, spinosad

81
Q

Neonatal cephalic pustulosis (Neonatal acne)

A

not true acnes; inflammation due to Malassezia; self-limited; presents first 2-3 weeks and resolves by 6-12 months

82
Q

Neonatal acne presentation

A

first 2-3 weeks

83
Q

Neonatal acne resolution

A

by 6-12 months (usually by 4 months without scarring)

84
Q

Not true acne

A

neonatal acne

85
Q

Clinical presentation of neonatal acne

A

inflammed papules/pustules on forehead, nose and cheeks; no comedones

86
Q

Tx for neonatal acne

A

self-limiting
Mild- cleanse w/ mild soap and water
persistent acne: ketoconazole or hydrocortisone to expedite clearance

87
Q

Infantile Acne

A

hyperplasia of sebaceous glands; inflammatory papules, comedones, pustules

88
Q

Presentation of infantile acne

A

3-4 months

89
Q

Resolution of infantile acne

90
Q

Tx for infantile acne

A

benzoyl peroxide, topical abx, topical retinoids; oral tx only in severe cases

91
Q

“true acne”

A

infantile acne

92
Q

“the itch that rashes”

A

atopic dermatitis

93
Q

Atopic dermatitis presentation

A

infants: cheeks, trunk and extensor surfaces
Adults: neck, flexors, hands and feet

94
Q

Tx for atopic derm

A

petroleum (vaseline) AAA 2x daily; topical steroids, topical calcineurin inhibitors (elidel, protopic), antihistamines

95
Q

Cradle cap

A

seborrheic dermatitis

96
Q

yellow, greasy adherent scales on vertex of scalp (may also effect diaper area and axilla)

A

cradle cap

97
Q

herald patch

A

pityriasis rosea

98
Q

Pityriasis rosea

A

benign, viral skin exanthem, mild pruritis, large salmon colored herald patch with colarrette scale followed by smaller lesions; christmas tree patern

99
Q

Vitiligo

A

acquired skin depigmentation via autoimmune process against melocytes

100
Q

Vitiligo presentation

A

milk-white macules with homogenous depigmentation and well-defined border, slowly progressive; tx with topical steroids

101
Q

Measles (rubeola)

A

highly contagious; clinical stages: 1. incubation (2-3 weeks), asymptomatic

  1. Prodrome (anorexia, malaise, fever >105
  2. Enanthem (koplik spots- bluish white papules (48 hours prior to rahs)
  3. exanthem: blanching, maculopapular rash starting on face and spreading head to toe (spares palms and soles)
102
Q

Erythema infectiosum also known as…

A

Fifth’s disease

103
Q

Etiology of Erythema infectiosum

A

Parvovirus B-19

104
Q

Erythema infectiosum presentation

A

Stages:

  1. Incubation 7-14 days
  2. Prodrome: flue like 2-3 days (mild fever, malaise, coryza)
  3. Facial rash: slapped cheek
  4. Body rash: 2-3 days after face rash/ lacy, pink macular rash of trunk and xtremitites
105
Q

Lacy pink rash

A

Fifth’s disease

106
Q

Slapp Cheek

A

Fifth’s disease

107
Q

Hydrops fetalis

A

fifth’s disease

108
Q

Blueberry muffin

A

Congenital rubella syndrome (lethal)

109
Q

Roseola Infantum

A

caused by HHV-6; peak 7-13 months; high fever, resolves, rash appears (blanchable, pink macules), starts on neck /trunk then spreads to face

110
Q

Measles symptoms (prodrome)

A

3 C’s: cough, coryza, conjunctivitis

111
Q

Etiology of hand, foot, mouth

A

coxsackie A16 virus

112
Q

Etiology of molluscum

113
Q

Clinical presentation of molluscum

A

flesh colored, pearly, papules with umbiliciation; not on palms or soles; resolve 6-12 months

114
Q

Verruca Vulgaris etiology

115
Q

Varicella presentation

A

Pruritic, lesions at different stages (papule, blister, ulcer) over 4 days and crust over in 6 days

116
Q

Herpes Zoster (shingles)

A

neuritic pain (throbbing, stabbing, burning), grouped vesicles on erythematous base in dermatomal distribution (unilateral)

117
Q

Etiology of tinea versicolor

A

Malassezia

118
Q

Etiology of thrush

A

candida albicans

119
Q

Thrush

A

mouth pain; creamy-white patches/plaques with underlying erythematous mucosa; thrush will brush

Pediatrics Exam 2 (3 decks)

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