Derm, PE Findings, Neonatal Rashes

Question 1

Staphylococcal scalded skin syndrome:
cause?
presentation?
tx?

Answer 1

Staph aureus exfoliatoxins A/B

fever + severe, painful rash that develop into bullae, rupture, and eventually desquamate

abx + supportive

Question 2

Lichen planus:
presentation?
tx?

Answer 2

Purple Polygonal Pruritic Papules (rare in children)

PO steroids

Question 3

Psoriasis:
presentation?
tx?

Answer 3

thick silvery scales that bleed upon removal (Auspitz sign)

- topical steroids + calcipotriene (mild)
- MTX/infliximab/cyclosporine A (severe)

Question 4

impetigo tx?

Answer 4

topical mupirocin > PO erythromycin

Question 5

Asymmetric red reflex is a/w…

Answer 5

• retinoblastoma (AD ∆Rb on chromosome 13)

- juvenile cataracts

Question 6

juvenile cataracts are a/w…

Answer 6

• galactosemia
• congenital rubella syndrome
• neurofibromatosis II
• myotonic muscular dystrophy

Question 7

Cherry-red macula =

Answer 7

• Tay-Sachs disease (AR ∆hexosaminidase A) w/o HSM

- Niemann-Pick disease (AR ∆sphingomyelinase) w/ HSM

Question 8

Pinpoint pupils =

Answer 8

opioids (Tx naloxone)

organophosphates (Tx atropine + pralidoxime)

Question 9

Cholesteatoma:

increased risk a/w…

Answer 9

small whitish debris-containing sac on TM,

recurrent otitis media

**Tx ENT c/s for surgical removal

Question 10

Nasal polyps:

Answer 10

• cystic fibrosis

- triad asthma (aspirin-sensitive)

Question 11

Retained primary teeth:

Answer 11

Job syndrome (hyper-IgE)

Question 12

Single central incisor:

Answer 12

GH deficiency

Question 13

Thyroid nodule: management?

Answer 13

dx = TSH levels, if euthyroid then get FNA

Question 14

Café-au-lait spots:

Answer 14

• neurofibromatosis I

- McCune-Albright syndrome

Question 15

Knuckle-knuckle-dimple-knuckle sign:

Answer 15

brachydactyly of 4th digit = Turner syndrome

Question 16

Knuckle-knuckle-dimple-dimple sign:

Answer 16

brachydactyly of 4th/5th digits = pseudohypoparathyroidism

Question 17

micropenis:

Answer 17

GH deficiency

Question 18

Milia:

Answer 18

benign, tiny white bumps on nose

Question 19

Incontinentia pigmenti:

inheritance?

Answer 19

inflammatory bullae that evolve into hyperpigmented lesions

XR, **lethal in males

Question 20

Neonatal acne tx?

Answer 20

• reassurance (mild)

- topical benzoyl peroxide or tretinoin (severe)

Question 21

Sebaceous nevus:

Tx?

Answer 21

raised, yellow-orange hairless lesion on scalp

resection before adolescence (can undergo malignant degeneration)

Question 22

Seborrheic dermatitis:

tx?

Answer 22

greasy scaly rash, usually on scalp in newborns (“cradle cap”), can result in dandruff

Tx sunlight + mild shampoo

Question 23

Erythema toxicum:

Answer 23

benign, yellow-white papules w/ surrounding erythema, fluid exam shows eosinophils

Question 24

Pustular melanosis:

Answer 24

benign, little pustules that leave a hyperpigmented spot when ruptured

Question 25

Salmon patch (nevus flammeus)

Answer 25

benign, splotchy red rash on forehead, eyelids, or back of neck; more prominent with exercise or emotion