DERM- EXTRA IMPORTANT Flashcards
What is the most common skin disease treated by medical providers?
Acne
Warts
Molluscum Contagiosum
Eczema
Keratosis Pilaris
Impetigo
Moles
? (ask)
What is the most common chronic pediatric skin disorder?
eczema? (ask(
List a few of the differentiating signs between irritant diaper dermatitis and candida diaper dermatitis
Which pediatric infection presents with a lacy rash and can be harmful to a fetus if contracted by a pregnant woman in their first half of their pregnancy?
FIFTH DISEASE (erythema infectiosum)
If you’re pregnant and develop fifth disease (parvovirus B19 infection), it can spread to the fetus and cause complications, including:
Miscarriage.
Stillbirth (intrauterine fetal demise).
Hydrops fetalis (when large amounts of fluid build up in a fetus’s tissues and organs).
These complications are rare, however. Most adults and pregnant people have already been infected with parvovirus B19, so they’re protected. The risk of fetal loss when you get a parvovirus B19 infection while pregnant is approximately 2%.
Pregnant people in their second trimester are at the greatest risk of developing complications from parvovirus B19, but complications can happen at all points of pregnancy.
If you’re pregnant and have been exposed to someone with fifth disease, contact your healthcare provider.
What is this skin condition?
Scabies
Scabies occurs when human itch mites bite and burrow into the skin, laying eggs. Someone may learn how to identify scabies through the appearance and location of its symptoms, which includes an extremely itchy rash.
This is scabies
What is this skin condition?
A scabies rash is extremely itchy. Typically, the itching will be worse at night.
Appearance: Scabies bites cause a rash that often presents as small blisters, which doctors call vesicles. Some people may think that it resembles pimples. Itching the vesicles can cause them to turn into open skin sores, making a person more vulnerable to infection.
Pattern: Scabies mites tend to burrow or tunnel under the skin, which can create a distinct pattern.
The pattern consists of lines that are flesh-toned or, sometimes, gray and white. In some cases, the tunnels may be very hard to see.
Location in adults: The most common scabies sites in adults include the buttocks, elbows, waist, wrists, and skin between the fingers. Sometimes, a person may find mite burrows under a ring, watchband, or fingernail.
Location in children: The most common scabies bite locations in infants and children are the face, neck, palms of the hands, and soles of the feet.
Timing: According to the American Academy of Dermatology, if a person has not had a scabies infection before, their symptoms may not appear until about 2–6 weeks after the initial infestation.
However, if a person has had scabies before, they will usually develop symptoms within 1–4 days.
In some instances, scabies bites may crust over. Once crusted, scabies may not itch. However, crusting could indicate a significant and highly contagious infection.
What are some differential dx for this disease?
Several rashes and bites may closely resemble scabies. These include the following:
- Atopic dermatitis: Also known as eczema, this condition causes dry, itchy patches.
- Contact dermatitis: This allergic reaction to a chemical or another irritant can cause an itchy rash.
- Folliculitis: This condition occurs when hair follicles become inflamed, often due to a bacterial infection. It typically presents as papules or pustules.
- Insect bites: Bites from other insects, such as bed bugs, chiggers, fleas, mites, and mosquitoes, can cause itching.
- Papular urticaria: This condition is an allergic reaction to insect bites. It causes bumps that may appear similar to scabies.
A doctor will consider all of a person’s symptoms when making a diagnosis.
Treatment for this condition? (scabies)
permethrin (Elimite) cream to treat scabies.
A person must apply this cream to all skin surfaces, not just where the rash appears. Usually, they will apply the cream at night before bed.
Key areas to which people should apply the cream include:
-between the fingers and toes
-in the bellybutton
-on the buttocks
-on the waistline
The immediate side effects of the cream include a mild burning, itching, or stinging sensation.
When a person wakes up, they can shower to remove the permethrin cream, if they wish.
A person should also keep their nails short and trimmed, as this keeps the mites from hiding under the fingernails.
How to prevent transmission of scabies?
While scabies usually spreads via skin-to-skin contact, its transmission is possibleTrusted Source through contact with clothing or linens.
In addition to applying topical treatments to the skin, it is important that people take steps to clean their home and soft materials to prevent reinfestation or the transmission of the condition to another person.
Ways to accomplish this include washing any clothing, linens, and towels that people with scabies have worn or used within the past 3 days. The mites cannot survive washing at any temperature.
Most mites cannot live beyond 3–4 days without being on a human host.
How does this condition spread?
A scabies infection is the result of a bite from Sarcoptes scabiei var. hominis. These mites are microscopic, so a person cannot see them.
Scabies spreads through close and sometimes intimate contact.
Examples include:
in facilities where people are often in close contact, such as child care centers, nursing homes, and prisons
sexual contact
sharing bedding, clothing, or towels with someone who has the infection
sleeping on sheets that have mites on them
Any time a person has direct, close, and sometimes prolonged contact with a person who has scabies, they are at risk of getting it.
However, a person does NOT usually get scabies from short interpersonal interactions, such as a brief handshake or hug.
When would someone need to see a Dr. for scabies?
A person should see their doctor if they experience the
following symptoms:
itchy areas of skin
vesicles that appear on the skin
discolored areas of irritated skin that do not go away
A doctor can dx scabies by visually inspecting the rash and noting any accompanying symptoms. If a doctor still needs to confirm that the rash is scabies, they can perform skin scraping to get a sample for analysis under a microscope.
What is this skin condition?
Café-Au-Lait Macules and Macrocephaly in a 19-Month-Old
CALMs are common in children (sample photo above), and they most often present as one or two brown spots in an otherwise healthy child.
However, the presence of multiple CALMS without other cutaneous anomalies should raise the possibility of an associated syndrome. Of these syndromes, NF1 is the most common
Clinical diagnosis requires the presence of at least two criteria to confirm the presence of neurofibromatosis type 1 (NF1) 1.
These diagnostic criteria can be remembered with the mnemonic:
CAFE SPOT
C: café-au-lait spots (greater than six seen during one year)
A: axillary or inguinal freckling
F: fibromas (neurofibroma (two or more) or plexiform neurofibroma (one))
E: eye hamartomas (Lisch nodules)
S: skeletal abnormalities, e.g. sphenoid wing dysplasia, leg bowing
P: positive family history
OT: optic tumor (optic nerve glioma)
Café au lait spots are a type of pigmented skin lesions which are classically described as being light brown in color.
Conditions associated with them include:?
I. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is a multisystem neurocutaneous disorder, the most common phakomatosis, and a RASopathy. Additionally, it is also one of the most common inherited CNS disorders, autosomal dominant disorders, and inherited tumor syndromes.
-Neurofibromatosis type 1 (NF1 with smooth borders which have been likened to the coast of California, a western state in the USA
II. McCune-Albright syndrome (MAS) (also known as McCune-Albright-Sternberg syndrome) is a genetic disorder characterized by the triad:
endocrinopathy: precocious puberty
polyostotic fibrous dysplasia: more severe than in sporadic cases
cutaneous pigmentation: coast of Maine ‘café au lait’ spots
MAS
typically irregular spots which have been likened to the coast of Maine, a far northeastern state in the USA
What is this skin condition?
Port-Wine Stain
Incidence
< 1% of newborns
Demographics
commonly involves newborns
most common vascular malformation of the skin
Location:
face and neck
Risk factors
family history
caused by ectatic superficial papillary dermal capillaries characterized by vascular dilatation and no proliferation
thought to result from
neural deficiency of sympathetic innervation of the blood vessels
↑ vascular endothelial growth factor (VEGF) inducing vasodilation
Port Wine Stain
What is the presentation of the port wine stain?
Symptoms
persistent purple or dark red birth mark present on face since birth
asymptomatic
Physical examin childhood:
pink, red, or purple flat macular patch with well-demarcated borders
blanches somewhat with external pressure
in adulthood, lesion may
progress to deep-red or purple
become raised and papular with cobblestone-like surface
location
most lesions are in one of the divisions of the trigeminal nerve
typically unilateral
Differential dx for port wine stain?
Capillary hemangioma
These are more red & raised & look more like blobs
Treatment for a port wine stain?
Conservative
cosmetic cover-up
if lesions are a source of psychological stress for patients
Procedural
pulsed dye laser therapy
indications
first-line treatment
if lesions are a source of psychological stress for patient can lighten port-wine stain without any scarring
Prognosis for port wine stains?
Port-wine stains are present at birth and do not spontaneously resolve
Lesions become thicker and darker with increasing age
A 5-week-old girl is brought into the pediatrician’s office for evaluation of a birth mark. According to her mom, this red birthmark has been present since birth and has not really changed.
Physical exam shows that she has a pink-to-purple macular patch involving the left cheek. The lesion is unilateral with a sharply demarcated border along the facial midline.
Her parents are counseled about the fact that this lesion may persist for her entire life. A referral is made to a pediatric dermatologist for potential pulsed dye laser therapy
What is this condition?
Port-Wine Stain
What is the clinical definition of this condition?
a type of benign capillary malformation that presents as a purplish “port-wine” colored birthmark on the face and neck
also known as nevus flammeus
Genetics
Sturge-Weber syndrome
inheritance pattern
autosomal dominant
mutations
GNAQ
activating mutation
Associated conditions
Sturge-Weber syndrome, also known as encephalotrigeminal angiomatosis
glaucoma
especially with periorbital port-wine stains
eczematous dermatitis
What is this skin condition?
Molluscum contagiosum
appears as small pearly, skin-colored, wart-like lesions on the body.
It is caused by a common virus and is spread by direct contact with other affected children or adults, or by touching objects that have been handled by infected people
Molluscum contagiosum
is painless and typically harmless; it usually disappears in 6-9 months on its own but could last for a few years
. Children who are affected with molluscum contagiosum can spread the rash to other areas of their body by itching or rubbing the lesions.
face, eyelids, neck, underarms, and thighs are the most commonly affected areas.
Infants with atopic dermatitis (eczema) may be more commonly affected
molluscum contagiosum.
One or more small (1-5 mm) pink, white, or skin-colored, smooth papules (solid bumps), often with a tiny dot or depression in the center
occur in clusters
sometimes in a straight line from scratching (self-inoculation).
In darker skin colors, the lesions may appear skin-colored or purple.
In individuals with an immune system deficiency, the bumps can be larger than a thumbnail.
molluscum contagiosum
This is a benign poxvirus infection that typically has a central depression
What is this skin condition?
Roseola Infantum
A 9-month old girl presents to the pediatrician for a rash on her trunk. She had a high-grade fever for 3 days, and she has been receiving ibuprofen for the fever. She has been more irritable but has been eating and having sufficient diapers. This morning, she no longer had a fever but developed a pink rash over her chest and back. On physical exam, there is a blanching, light pink rash with macules and papules on the trunk and back. She also has erythematous papules on her soft palate. Her mother is reassured that this disease is self-limited and has no complications.
What condition is this?
Roseola Infantum
human herpesvirus-6 (HHV-6)
an enveloped, linear, double-stranded DNA virus
a picornavirus and enterovirus
transmission via respiratory secretions
causes roseola infantum (exanthem subitum)
Prevention
no vaccines are available
roseola infantum (exanthem subitum)
Symptoms
high fever for 3 days
may have febrile seizures
no upper respiratory symptoms
temporally separated by rash
Physical exam
light pink, morbilliform rash that develops after the fever resolves blanching
discrete, irregular macules and papules
lasts 2 days
Nagayama spots
erythematous papules on the mucosa of soft palate and uvula
Roseola Infantum
Treatment for roseola infantum?
Management approach
mainstay of treatment is supportive care!
all patients
antipyretics
hydration
At risk for seizures
What is this skin condition?
erythema multiforme
Erythema multiforme is an immune-mediated reaction that causes a raised, red, target-like rash on the skin or mucous membranes. It often resolves on its own but may require medical treatment.
Its name combines the Latin “erythema” (redness), “multi” (many), and “forme” (shapes) and describes its main symptom.
Erythema multiforme minor is usually a mild condition that causes a rash on the skin. .
Erythema multiforme major can be severe, affecting the mucous membranes, and typically requires more extensive treatment.
Widespread erythema multiform rash. The erythema multiforme rash usually appears over 3 to 5 days and gets better in about 2 weeks.
Erythema multiform
Erythema multiforme minor presents as a bulging, rash-like lesion that is red, pink, or purple. It may look like a hive or a somewhat round bull’s-eye target. The center of the lesion is typically darker with lighter pink edges.
The lesion is often circular and less than 3 centimeters (cm) in size, though it may be larger or smaller.
The outermost circle has a well-defined border, while the center may be a blister. The condition almost always involvesTrusted Source the palms of the hands.
What is this skin condition?
Impetigo
Impetigo is a common bacterial skin infection that typically affects young children
It is most often caused by a bacteria called Staphylococcus aureus or Streptococcus pyogenes. Affected individuals present with sores that break open leading to honey-colored crusts and scabs.
Where are the lesions of impetigo found?
Though lesions can be found anywhere, the face (around the nose and mouth) and extremities (hands and feet) are favored locations. The condition can be self-limited and resolve without therapy
How do you treat impetigo?
Impetigo is a common infection of the superficial layers of the epidermis
highly contagious and most commonly caused by gram-positive bacteria.
It most commonly presents as erythematous plaques with a yellow crust and may be itchy or painful. The lesions are highly contagious and spread easily.
Diagnosis is typically based on the symptoms and clinical manifestations alone. Treatment involves topical and oral antibiotics and symptomatic care. This activity reviews the cause, pathophysiology and presentation of impetigo and highlights the role of the interprofessional team in its management.
Bullous impetigo begins with small vesicles that become flaccid bullae. The exfoliative toxin A produced by S. aureus causes loss of cell adhesion in the superficial epidermis. The bullae contain a clear or yellow fluid which eventually progresses to become purulent or dark. Surrounding erythema and edema are typically absent. Once the bullae rupture, an erythematous base with a rim of scale remains.
Bullous impetigo does not form a honey-colored crust. Lesions most commonly form in the intertriginous regions and on the trunk and, unlike nonbullous impetigo, may occur in the buccal membranes. There are typically fewer lesions present than in non-bullous impetigo. Regional lymphadenopathy is absent. Systemic symptoms, such as fever, are more common than in nonbullous impetigo.
It most commonly presents as erythematous plaques with a yellow crust and may be itchy or painful. The lesions are highly contagious and spread easily.
Impetigo is a disease of children who reside in hot humid climates. The infection may be bullous or nonbullous. The infection typically affects the face but can also occur in any other part of the body that has an abrasion, laceration, insect bite or other trauma.
Diagnosis is typically based on the symptoms and clinical manifestations alone. Treatment involves topical and oral antibiotics and symptomatic care
Impetigo
It is most prevalent in children aged 2-5 years old but can occur at any age. The peak incidence is during summer and fall. Bullous impetigo is more common in infants. Children younger than two account for 90% of cases of bullous impetigo
Nonbullous impetigo often starts as a vesicle or a pustule. Multiple vesicles often coalesce and rupture after which the purulent exudate forms the characteristic honey-colored crust. An erythematous base is also present.
There are often multiple lesions on the face and extremities, especially in areas in which disruption of the skin barrier has occurred.
The rapid spread and satellite lesion formation follow self-inoculation, often in areas with no apparent break in the skin barrier.
Mild regional lymphadenopathy is a common associated finding. Systemic symptoms such as fever are typically absent in nonbullous impetigo.
What is this skin condition?
FIFTH DISEASE
Fifth disease tends to have threeTrusted Source overlapping stages:
STAGE 1
Within 2 weeksTrusted Source of exposure to the virus, a person feels unwell, possibly with a fever, muscle aches, headache, vomiting, or diarrhea.
STAGE II
A face rash appears and lasts 4–5 daysTrusted Source. When the rash is present, the person can no longer pass on the virus.
STAGE III
A body rash may appear and usually lasts around a weekTrusted Source. It may be itchy in adults.
Joint symptoms may last beyond the rash and other symptoms. A person with joint symptoms cannot pass on the virus.
Treatment for fifth disease ?
There is no specific treatment for fifth disease, and it will usually resolve alone within around 2 weeksTrusted Source. However, home and over-the-counter treatment can help manage symptoms and discomfort.
Options include:
staying hydrated
using a moisturizer on dry skin
asking a pharmacist about antihistamine options if the rash is itchy
acetaminophen or ibuprofen for pain or a fever
getting plenty of rest
known medically as erythema infectiosum, results from infection with the parvovirus B19. It is one of the five most common viral diseases in children, along with measles, rubella, chicken pox, and roseola.
FIFTH DISEASE
What is this skin condition?
What is this skin condition?
BABY ACNE
Many newborns have baby acne (also called newborn acne or neonatal acne). Less often, babies develop acne as infants (infantile acne).
Yeast that normally live on the skin, called Malassezia, flourish when sebum production increases in newborns. The yeast, in turn, creates inflammation that results in neonatal acne,
It may start when hormones passed on from the mother just before she gives birth stimulate the glands that produce sebum, the oily substance that can clog pores.
How to care for this condition?
Wash the affected area daily.
Use plain water, or alternate between plain water and a gentle, unscented cleanser. Don’t scrub. Lightly pat the skin dry with a towel instead of rubbing it dry.
Don’t use oily or greasy skin care products on areas with acne. These could make the acne worse.
Refrain from picking at the acne. Picking at or popping pimples can aggravate the acne and lead to infection.
What is this skin condition
Mongolian spots!
- more properly called slate grey nevi – are very common birthmarks.
They are flat and bluish-gray, almost bruise-like. You might be concerned if such a mark show up on your baby, but there’s often little reason to worry.
Mongolian spots don’t hurt, and they won’t get any worse as a child gets older. In fact, they often fade over time.
Nobody knows what causes mongolian spots. Any baby can be born with them, but they are most common in babies with dark skin, including babies of Asian, African, or Native American heritage.
usually the lower back but also possibly the buttocks, arms, and legs
location of Mongolian spots
