Derm X3 Flashcards
Congenital Melanocytic Nevi
proliferations of benign melanocytes Pres: macules papules or plaques at birth hair may or may no be there appearance changes over time grow in proportion to leasion * correlates with malignancy potential
Mongolian Spots pres
patch of blueish grey pigmentation with irregular border and normal skin texture
- common on butt and back
- increased incidence in darker skin types: asian>black>hisp
- present at birth and usually fades
Mongolian Spots f/u
clinical dx
- consdier further work up in cases of FTT
- tends to fade by age 2 and dis by 10
- may be mistaken for abuse
Nevus Sebaceous
hyperplasia of epidermis, sebaceous glands, hair follicles, apocrine glands
Pres: usually on the scap
“waxy solitary smooth, yellow orange hairless, patch, oval or linear”
- become more pronounced in adolences> bumpy warty or scaly
Nevus Sebaceous dx and tx
Dx: atypical cases me warrant histological evaluation
BCC may arise from lesion
Tx: follow up and refer to derm if we see changes
Aplasia Cutis Congenita
ACC refere to the absence of skin present at birth that can be localized or widespread
Pres: common on midline posterior scalp
- tuft of hair may surroudning defect me indicate neural tibe defect
- may also be a fluid filled bulla
- can be associated with other developmental anomalies
Aplasia Cutis Congenita
gentle cleansing
hypertrophic scar may develope
refereall to neurosurgery for surgical repair may be indicated for large or multiple scalp defects
Cafe-au-lait macules
discrete uniformly pigemted macules
- more common in AA
- present at birth or appear in early childhood
- may be associated with McCune albright syndrome and NF1
Pediatric Vascular Anomalies types
Vascular tumors: neoplasms proliferate and typically require tx to stop growth
Vascular malformations: abnormal blood vessels without rapid proliferation
- static or slow growing
Port Wine stain
cutaneous capillary malformations
pres: present at brith and does not regress.
- pink or dark red patches and may get darker
- can be asssoicated with soft tissue or bony overgrowth, Sturge Weber Syndrome in the V1> congential glaucoma
Port Wine stains Management
depends of size
- no tx needed
- pulse due laser
if widespread or associated with overgrowth refers to vascular surgeon
Infantile Hemangiomas
Common vascular tumore
riskL low birth weight, female, twin
Pres: appears shortly after birth but appears shortly after
superficial: bright red and minimally elevated
deep: larger and more blue
* ulcer is a complication
Nevus Simplex
Faint transient capillary malformation - flat pink red patch - midline of forehead, scalp, upper eyelids, posterior neck and back * most common peds vascular lesion " storke bite" or "angel kiss" usually fad in 1-2 years
Pyogenic Granuloma
Aquired lobular vascular tumor
- can occur at any age
- affects skin prone to trauma ( like hands or face)
- develope rapidly
- extremly friable
- can recur despite treatment
Pyogenic Granulomas
Tx:
Initially biopsy! becuase they show up rapidly we are concerned about other malignant lesions
- surgical excision with primary closure. Curretage or shave removal with electrodessication
* high risk of recurrence is high
Diaper Dermatitis
most cases are irritant/contact dermatitis
- can be caused by underlying skin condition
Pathogensis: excessive moistured, friction, increased pH causing localized skin breakdown
> macerated skin increased suseptible for infection from urine an feces
Diaper Dermatitis Pres
Episodic symptoms
- usually spare the skin folds
persisitant sx can get secondary infections with c. albicans or other microbes
Ex: Candidal superinfections> beefy red plaque and involves skin folds
Impetigo: secondary infection of S aureus
> fragile pustules and honey crusted erosion
Diaper dermatitis Prevention and managment
Frequent diaper changes air exposure gentle cleasing frangrance-free/alc free baby wipes Therap: - barrier preparations - low pot top steroids if more severe > breast milk antiinflamatory topical antifunfals topical vs oral abx+ mupirocin *avoid rash respiratory risk if aspirated
Lice
Pediculus humanus capitis Present: asymptomatic, if allergic reaction to saliva =itching cervical lymphadenopthy if severe Dx: visualized live lice c wet comb nits may persist for months
Lice Tx
Topical pedicullicides: pyrethroids, malathion, benzyl alcohol, sinosad
- rinse in sink after
can use wet combing method > 15-60 min 3x per day for several weeks
Neonatal Acne
not true acne
inflammatory reaction possibly to malassezia colonization
- self limiting and resolves in 6-12months of age
pres: no comodones, foreheads, nose, cheeks
Tx: cleansing with soap and water
- if persistnat can use ketoconazole or hydrocortizone
Infantile acne
@3-4 mo
hyperplasia of the sebaceous glands
-androgenic stimulation
-inflammatory papulaes , comedones, pustules
Tx: to prevents scaring, BP, top ABx, top retinoids
