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Peds Rotation > Derm part 1 > Flashcards

Derm part 1 Flashcards

1
Q

PE of diaper dermatitis

A

An erythematous scaly diaper area often with papulovesicular or bullous lesions, fissures, and erosions

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2
Q

Causes of diaper dermatitis

A 
Overhydration of the skin
Maceration
Prolonged contact with urine and feces
Retained diaper soaps
Topical preparations
More than 3 diarrheal stools/day
Adverse effects of oral abx
Early sign of biotin deficiency
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3
Q

Tx of diaper dermatitis

A 
Zinc oxide ointment
Acetyl tocopherol
Pure white petrolatum ointment
Aquaphor
1-2-3 paste
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4
Q

Sx of perioral dermatitis

A

Sensation of stinging and burning

H/o long-term use of topical steroids

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5
Q

PE of perioral dermatitis

A

Skin lesions occur as grouped reddish papules, papulovesicles, and papulopustules on an erythematous base with a possible confluent aspect
Primarily a perioral distribution

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6
Q

Causes of perioral dermatitis

A 
Topical steroid preparations
Cosmetics
UV light, heat and wind
Microbiologic factors
Hormonal factors
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7
Q

Tx of perioral dermatitis

A

Therapy similar to that for rosacea

Topical praziquantel

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8
Q

S/sx of lichen planus

A

Insidious lesions that usually develop on flexural surfaces of the limbs
After a week later, generalized eruption.
Pruritis
Papules are violaceous, shiny, and polygonal
Wickham striae

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9
Q

Labs for lichen planus

A

Direct immunofluorescence study in lichen planus

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10
Q

Tx for lichen planus

A

Mild cases: fluorinated topical steroids
Light therapy
Retinoid-like agents

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11
Q

S/sx of pityriasis rosea

A

Herald patch of 2-5 cm that is pink and oval with a central clearing
1-2 wks later, 0.5-2 cm macules with fine, branlike scale arranged parallel to skin tension lines

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12
Q

Where is the herald patch found in pityriasis rosea?

A

Breast
Lower torso
Proximal thigh

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13
Q

Tx of pityriasis rosea

A

Manage any pruritis with oral antihistamines, phototherapy and low-potency topical corticosteroids

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14
Q

PE of erythema multiforme

A

Abrupt onset of round, deep red, well-demarcated macules and papules with a dusky gray or bullous center
Involves <10% of the body

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15
Q

Target lesion of erythema multiforme

A

Three concentric rings:

  • Outermost is red
  • Intermediate is white
  • Center is dusky red or purple
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16
Q

Most common cause of erythema multiforme in children

A

Herpes simplex virus

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17
Q

Tx of erythema multiforme

A

Symptomatic

Oral antihistamines to suppress pruritus, stinging, and burning

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18
Q

What usually precedes SJS or TEN?

A

Prodrome of fever, malaise, and upper respiratory sx 1-14 days before the onset of cutaneous lesions

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19
Q

Presentation of SJS/TEN

A

Red macules that appear suddenly and tend to coalesce into large patches with a predominant distribution over the face and trunk
Lesions evolve rapidly into bullae and areas of necrosis

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20
Q

Difference between SJS, SJS/TEN, and TEN

A

SJS is <10% of body surface area
SJS/TEN is 10-30% of body surface area
TEN is >30% of body surface area

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21
Q

What areas are involved in SJS/TEN?

A

Any mucosal surface may be involved

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22
Q

What are the most common causes of SJS/TEN in children?

A 
Drugs
-NSAIDs
-Sulfonamides
-Anticonvulsants
-Antibiotics
Mycoplasma pneumoniae infections
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23
Q

Tx of SJS/TEN

A 
Discontinuation of offending agent
Supportive care
Meticulous wound care
Parenteral or nasogastric feeding
Careful fluid management and monitoring of electrolytes
24
Q

Contributing factors of acne

A 
Gender
Age
Genetic factors
Environment
Stress
25
Q

Pathogenesis components of acne

A

Increased sebum production
Hyperkeratosis
Bacterial proliferation

26
Q

Location of acne

A

Face
Upper chest
Back

27
Q

What does superficial plugging of the pilosebaceous unit result in?

A

Open (blackhead) comedones

Closed (whitehead) comedones

28
Q

What is the third stage of acne?

A

Inflammatory papules and pustules

29
Q

What is the fourth stage of acne?

A

Cystic acne

30
Q

Diagnostic tests for acne

A

Screening tests if there are signs of PCOS or an underlying androgen-secreting tumor

31
Q

Tx of acne

A 
Topical keratolytic agents
Topical retinoids 
Topical antimicrobials/antibiotics
Combination of topical keratolytic agent and topical antimicrobial
Oral antibiotics
Oral isotretinoin
32
Q

RFs of atopic dermatitis

A

Occurs more frequently in urban areas and in higher socioeconomic classes
FHx of atopy

33
Q

S/sx of atopic dermatitis

A

Xerosis
Pruritis
Erythematous papules or plaques with ill-defined borders and overlying scale or hyperkeratosis
Excoriation and lichenification

34
Q

Locations of atopic dermatitis in infants

A

Face and extensor surfaces of the extremities

35
Q

Locations of atopic dermatitis in children

A

Flexural surfaces

  • Antecubital and popliteal fossae
  • Wrists
  • Ankles
  • Hands
  • Feet
36
Q

What secondary infections are present with atopic dermatitis?

A

S. aureus

Less commonly S. pyogenes

37
Q

Signs of concomitant infection in atopic dermatitis

A

Acute worsening of disease in an otherwise well-controlled patient
Resistance to standard therapy
Fever
Presence of pustules, fissures, or exudative or crusted lesions

38
Q

What are the three components of atopic dermatitis tx?

A

Frequent liberal use of bland emollients to restore the skin barrier
Avoidance of triggers of inflammation
Use of topical anti-inflammatory medication

39
Q

Tx of atopic dermatitis

A

Avoid trigger exposure
Topical corticosteroids- ointments are preferred
Immune modulators
Sedating antihistamines during flares
Short-term administration of systemic corticosteroids
Ultraviolet light therapy

40
Q

Complications of atopic dermatitis

A

Secondary bacterial infections- most common is secondary impetigo
Eczema herpeticum

41
Q

What are the two subtypes of contact dermatitis

A

Irritant

Allergic

42
Q

Irritant contact dermatitis

A

Observed after the skin surface is exposed to an irritating chemical or substance

43
Q

Allergic contact dermatitis

A

A cell-mediated immune reaction (type IV)

44
Q

Characteristics of irritant contact dermatitis

A

Ill-defined, scaly, pink or red patches and plaques

On dorsal surfaces of the hands

45
Q

Characteristics of allergic contact dermatitis

A

Acute lesions are bright pink, pruritic patches, often in linear or sharply marginated bizarre configurations
Within the patches are clear vesicles and bullae

46
Q

Timeline for acute allergic contact dermatitis

A

Could be delayed for 7-14 days after the exposure if the pt has not been sensitized previously

47
Q

Characteristics of chronic allergic contact dermatitis

A

Often mimics atopic dermatitis

48
Q

Labs for contact dermatitis

A

Often clinical dx

Patch testing for difficult cases

49
Q

Tx of contact dermatitis

A

Topical corticosteroids

Oral antihistamines

50
Q

How does seborrheic dermatitis classically present in infants?

A

Cradle cap or dermatitis in the:intertriginous areas of the: -Axillae

  • Groin
  • Antecubital and popliteal fossae
  • Umbilicus
51
Q

How does seborrheic dermatitis present in adolescents?

A

Dandruff

52
Q

Areas prone to seborrheic dermatitis

A 
Scalp
Eyebrows
Eyelids
Nasolabial folds
External auditory canals
Posterior auricular folds
53
Q

Characteristics of cradle cap

A 
Thick
Greasy and waxy
Yellow-white scaling
Crusting
of the scalp
May extend to the face and posterior folds
54
Q

Characteristics of dandruff

A

Fine
White
Dry scaling of the scalp with minor itching

55
Q

Dx of seborrheic dermatitis

A

Fungal cultures and KOH to help differentiate from tinea capitis

56
Q

Tx of seborrheic dermatitis

A

Frequent shampooing
Infants- oil may be gently massaged into the scalp and left on for a few minutes before gently brushing out the scale and shampooing.

Peds Rotation (12 decks)

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