Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DRT > Dermatological Disorders > Flashcards

Dermatological Disorders Flashcards

1
Q

Peds Derm - Burns - Categories

A

-First degree: Red, no blisters, involves epidermis only - sunburn
-Second degree (partial thickness): Moist, blisters, extends beyond epidermis
-Third degree (full thickness): Dry, leathery, black, pearly, waxy, from epidermis to dermis, to underlying tissues, fat, muscle, and/or bone - do not feel pain because it burns through the nerve cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Peds Derm - Burns - Rule of Nines

A

-For adolescents >14 years old
-Estimates total body surface area (TBSA) burned

*9% each: head, front upper torso, back upper torso, front lower torso, back lower torso, front right leg, back right leg, front left leg, back left leg
*4.5% each: Right arm, left arm
*1%: groin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peds Derm - Burns - <14 TBSA Burns

A

-Front and back of head and neck: 21%
-Front and back of each arm and hand: 10%
-Chest and stomach: 13%
-Back: 13%
-Buttocks: 5%
-Front and back of each leg and foot: 13.5%
-Groin: 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Peds Derm - Burns - Primary Management

A

-Assess ABCs - priority
-Prophylactic intubation if they have singed nares or eyebrows - evaluate nares/mouth for soot/mucous
-Drench the burn in cool (not iced) water to prevent damage
-Remove all burned clothing
-Do not cover with lotion, toothpaste, butter, etc - this traps in the heat
-If area is limited, immerse in cold water for 30 minutes to reduce pain, then apply a clean, dry wrap
-If area is large, after dousing in cold water, apply clean, dry wrap to prevent systemic heat loss and hypothermia
-Hypothermia is particularly a risk in young children
-The first 6 hours following the injury are critical - transport patients with severe burns to the hospital immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Peds Derm - Skin Disorders - Primary vs. Secondary

A

-Primary lesion: lesion in previously unaltered skin
-Secondary lesion: lesion that either changes impression over time or occurs when a primary lesion is scratched (i.e. excoriation), it may become infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Peds Derm - Skin Disorders - Macule Morphology

A

-Macule: flat discoloration, usually <1 cm - freckles, petechiae, flat nevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Peds Derm - Skin Disorders - Patch Morphology

A

-Patch: flat discoloration, usually >1 cm, tiny pigment changes - Mongolian spot, cafe au lait spot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Peds Derm - Skin Disorders - Nodule Morphology

A

-Nodule: elevated, firm lesion >1 cm - xanthoma, fibroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Peds Derm - Skin Disorders - Tumor Morphology

A

-Tumor: firm, elevated lump - benign or malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Peds Derm - Skin Disorders - Papule Morphology

A

-Papule: small (<1 cm), elevated, firm skin lesions - ant bite, elevated nevus (mole), verruca (wart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peds Derm - Skin Disorders - Plaque Morphology

A

-Plaque: scaly, elevated lesion - classic psoriasis lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Peds Derm - Skin Disorders - Vesicle Morphology

A

-Vesicle: small (<1 cm) lesion filled with serous fluid - herpes simplex, varicella (chicken pox)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Peds Derm - Skin Disorders - Bulla Morphology

A

-Bulla: serous fluid-filled vesicles >1 cm - burns, superficial blister, contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Peds Derm - Skin Disorders - Wheal Morphology

A

-Wheal: lesion raised above the surface and extending a bit below the epidermis - allergic reaction, OOD test, mosquito bites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Peds Derm - Skin Disorders - Pustule Morphology

A

-Small (<1 cm), pus-filled lesion - acne, impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Peds Derm - Skin Disorders - Abscess Morphology

A

-Pus-filled lesion, >1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Peds Derm - Skin Disorders - Cyst Morphology

A

-Large, raised lesions filled with serous fluid, blood, and pus - has a sack that needs to be removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Peds Derm - Skin Disorders - Solitary or Discrete Configuration

A

-Individual or distinct lesions that remain separate - warts, ringworm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Peds Derm - Skin Disorders - Grouped Configuration

A

-Linear cluster - herpes simples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Peds Derm - Skin Disorders - Confluent Configuration

A

-Lesions that run together - measles, urticaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Peds Derm - Skin Disorders - Linear Configuration

A

-Scratch, streak, line, or stipe - contact dermatitis, scratching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Peds Derm - Skin Disorders - Annular Configuration

A

-Circular, beginning in the center and spreading to the periphery - tinea corporis, erythema multiforme

23
Q

Peds Derm - Skin Disorders - Polycystic Configuration

A

-Annular lesions merge - erythema multiforme, lupus erythematosus

24
Q

Peds Derm - Skin Disorders - Acne Causes & S/S

A

-Polymorphic skin disorder characterized by comedones, papule, pustules, and cysts

-Causes/Incidence:
*Can be activated by androgens
*Can be exacerbated by steroids or anticonvulsants
*Food has not been demonstrated to be a contributing factor
*More common and severe in males
*Exacerbate before menses in women

-S/S:
*Open comedones: blackheads - opening in the skin capped with blackened mass of skin debris
*Closed comedones: whiteheads - obstructed opening which may rupture, causing low-grade local inflammatory reaction
*Depressed or hypertrophic scars: seen with cystic acne

25
Q

Peds Derm - Skin Disorders - Acne Non-Pharmacological Management

A

-Avoidance of topical, oil-based products
-Use of oil-free, mild soaps, cleansers, and moisturizers

26
Q

Peds Derm - Skin Disorders - Acne Pharmacological Management

A

-Mild acne:
*Topical BPO (2.5%-10%)
*If not responsive with BPO, retinoid acid (0.025%-0.1%) cream or gel - pregnancy category C
*Tretinoin - inactivated by UV light, and oxidized by BPO, so apply Tretinoin at night and BPO in the morning
*Most common side effects of mild tx: dryness, redness, and irritation - educate to not stop, just decrease strength or duration of application
*Salicylic acid (Neutrogena 2% wash)
*Topical antibiotics: Erythromycin or clindamycin lotions or pads

-Moderate acne (or severe pustular acne) requires systemic antibiotics (-cyclines should be tried followed by macrolides)
*Doxycycline
*Minocycline
Erythromycin - only for patients who cannot use tetracyclines (pregnant patients or <8 years old)
**Tetracycline stains the teeth - do not give to patients <8 years old

-Severe acne that does not respond to above tx, refer to derm

-Patients may need double contraceptives if taking Tretinoin, due to risk of defects if they get pregnant while taking it

27
Q

Peds Derm - Skin Disorders - Fungal Infections

A

-Fungal organisms: Trichophyton (most common), or microsporum

-Disorders:
*Tinea capitis (scalp) - babies, cradle cap - Hallmark is a bald spot
*Tinea corporis (body ringworm) - person that goes to the gym and sweats a lot - Hallmark is raised border with central clearing with pruritus
*Tinea curries (jock itch)
*Tinea manuum
*Tinea pedis (athlete’s foot)
*Tinea versicolor (hypo/hyperpigmentation macules on limb) - pigmentation change can be more long-term in darker-skinned people

28
Q

Peds Derm - Skin Disorders - Fungal Infections S/S & Labs/Dx

A

-S/S:
*May be asymptomatic
*Severe itching (cruris and pedis)
*Erythematous rings (corporis)
*Hypo/hyperpigmentation (versicolor)

-Labs/Dx:
*“Spaghetti and meatballs” hyphae microscopically when treated with potassium hydroxide (KOH)

29
Q

Peds Derm - Skin Disorders - Fungal Infections Management

A

-Keep dry and air out
-Depending on the surface area:
*> surface area: oral tx
*< surface area: topical tx

-Tinea capitis: Primary management with griseofulvin - topical tx does not work on capitis because it can go into hair follicles
-Tinea corporis: Topical antifungals - miconazole 2%, ketoconazole 2%
-Tinea cruris: Topical antifungals - terbinafine cream, griseofulvin for severe cases
-Tinea manuum and pedis:
*Macerated: aluminum subacetate solution, soak 20 minutes BID
*Dry, scaly stage: topical antifungals (terbinafine)
*Severe cases: oral therapy
-Tinea versicolor: Selenium sulfide shampoo for 5-15 minutes daily for 7 days - for persistent cases or larger areas, 200mg itraconazole every day PO for 5 days

30
Q

Peds Derm - Skin Disorders - Varicella Zoster Virus (Chickenpox)

A

-Transmitted by direct contact with lesions or airborne
-Contagious for 48 hours before outbreak until lesions have crusted over
-Most common in children <10 years old
-Risk greatly decreased with vaccination

-S/S:
*“Dew drop on a rose petal”
*Erythematous macules, with papule developing over macule
*Vesicles erupt usually first in the trunk, and then scalp and face
*Intense pruritus
*Generalized lymphadenopathy
*Low-grade fever

-Management:
*Supportive care: calamine lotion, antihistamine, acetaminophen
*Healthy children <12 years: self-limiting - can return to school once lesions have crusted over
*At risk kids: oral acyclovir, given hint he first 24 hours to reduce magnitude and/or duration of symptoms (give as soon as possible)

31
Q

Peds Derm - Skin Disorders - Molluscum Contagiosum

A

-Benign viral skin infection
-Very small, firm, pink- to flesh-colored discrete papule, which become umbilicate papule with a cheesy core - hallmark is dimpling in the middle, looks like a donut (umbilicated)
-Children who are sexually active or with a hx of sexual abuse can have grouped lesions in the genital area
-Children with eczema or immunosuppression can have severe infections

32
Q

Peds Derm - Skin Disorders - Molluscum Contagiosum S/S & Labs/Dx

A

-S/S:
*Most common in the face, axillae, antecubital fossa, trunk, crural fascia, and extremities
*Itching at site of infection - teach to not scratch

-Labs/Dx:
*Clinical dx
*History of exposure to molluscum

33
Q

Peds Derm - Skin Disorders - Molluscum Contagiosum Management

A

-Resolves spontaneously if left alone
-Mechanical removal of central core prevents spread and autoinoculation
-Curretage

-Pharmacological agents:
*Tretinoin cream at bedtime
*Salicylic acid at bedtime
*Podophyllotoxin cream - not recommended for pregnant women due to presumed toxicity to fetus
*Liquid nitrogen
*Trichloroacetic acid peel
*Silver nitrate, iodine
*Cantharidin (beetle juice) - avoid on facial lesions
*Imiquimod

-Prevent scratching and touching lesions to stop spreading
-Spontaneous resolution may office within 6-9 months in some immunocompetent patients
-Extensive lesions or if diagnosis is unclear, refer to derm

34
Q

Peds Derm - Skin Disorders - Atopic Dermatitis

A

-Chronic, characterized by intense itching
-Remission and exacerbation pattern

-Triad:
*Atopic dermatitis
*Asthma
*Allergic rhinitis

-Elevated IgE and eosinophils

35
Q

Peds Derm - Skin Disorders - Atopic Dermatitis S/S & Labs/Dx

A

-S/S:
*Intense itching - antecubital and popliteal folds
*Dry scaly skin
*Acute flare-ups: red, shiny, or thickened patches
*Inflamed and/or scabbed: diffuse erythema and scaling
*Dry, leathery, lichenified (thick & leathery) skin - if not well controlled

-Labs/Dx:
*Radioallergosorbent test (RAST)
*Serum IgE
*Eosinophilia

36
Q

Peds Derm - Skin Disorders - Atopic Dermatitis Management

A

-Dry skin management (hallmark treatment): moisturizing lotion immediately after bathing, must BLOT dry
-For flare-ups: topical steroids - starts with low %, hydrocortisone - adverse effects of hydrocortisone: bladder dysfunction, hyperglycemia, hypopigmentation/scarring - use topical steroid first and then seal with emollient cream
-Systemic steroids in severe cases: prednisone taper
-In acute weeping:
*Saline or aluminum subacetate solution
*Colloidal oatmeal baths
*Bleach bath - 1/4-1/2 cup bleach in 40-gallon bathtub with warm water, apply moisturized afterwards
-Dupilumab for moderate-severe cases - prescribed by derm

37
Q

Peds Derm - Skin Disorders - Allergic Contact Dermatitis

A

-Direct skin contact with chemicals or allergens

-S/S:
*Redness, pruritus, scabbing
*Tiny vesicles and weepy
*Lichenification in chronic phase
*Affected areas are hot and swollen

-Management:
*Compresses locally, avoid scrubbing with soap and water
*High potency topical steroids locally
*If severe and systemic, prednisone taper

38
Q

Peds Derm - Skin Disorders - Irritant (Diaper) Dermatitis

A

-Skin irritation in genital-perianal region
-Most common type of diaper rash, caused by prolonged contact with urine and/or feces
-Peaks at 9-12 months: babies are walking with their diapers on and causes friction

-S/S:
*Fiery red rash
*Irritable infant

-Management:
*Mild cases - barrier emollients (Desitin)
*With erythema/papules - 1% hydrocortisone
*Burow’s (Domeboro) compresses for severe erythema and vesicles
*Secondary bacterial infection - topical antibiotics
*Secondary fungal infection - topical antifungals
*Prevention
*Allow diaper area to air out several times per day

39
Q

Peds Derm - Skin Disorders - Psoriasis

A

-Common benign hyperproliferative inflammatory skin disorder
-Epidermal turnover time is reduced from 14 days to 2 days
-Immature nucleated cells
-Immunologically mediated

-S/S:
*Can be asymptomatic
*Itching
*Red, sharply defined plaques with silvery scales in extensor surfaces
Auspitz sign: droplets of blood when scales are removed ** Hallmark

-Management:
*Topicals for the scalp: tar/salicylic acid shampoo, topical steroid oil
*Topical steroids for the skin: topical steroids twice daily for 2-3 weeks
*UVB light if more than 30% of the body is involved
*Moisturizers - emollient and unscented

40
Q

Peds Derm - Skin Disorders - Pityriasis Rosea

A

-Mild, acute inflammatory disorder, self-limiting, lasts 3-8 weeks
-More common in spring and fall
-Most common after URI
-More common in females

-S/S:
*Itchy
*Initial lesion (“herald patch”)
*Pruritic rash in a Christmas tree pattern in the trunk

-Labs/Dx:
*Serologic tests for syphilis if the rash does not itch, or if the palmar surfaces, genitalia, or mucous membranes are involved

-Management:
*Daily sunlight exposure, UVB daily x3-5 days
*Oral erythromycin

-Management: If pruritic
*Hydroxyzine (1st generation antihistamine - sedating)
*Oral antihistamines
*Topical antipruritic
*Cool compresses, baths
*Topical steroids

41
Q

Peds Derm - Skin Disorders - Scarlet Fever

A

-Caused by group A beta-hemolytic streptococci (GABHS)
-Contracted through contact with infected respiratory droplets or skin exudate
-Complication of strep throat
-More common in children 5-15 years

-S/S:
Initial presentation (days 1-2)
-Fever (101F or higher)
-Exudative pharyngitis
-Swollen tongue with white exudate and/or red papillae (strawberry tongue)
Rash presentation (typically 12-48 hours after fever onset)
-Sandpaper-like papillae
-*Appear on neck, armpits, and groin, before spreading to trunk and extremities

-Dx:
*Throat cx for strep

-Management:
*10-14 day course of PCN or amoxicillin - should see improvement 24-48 hours
*Emollients or oral antihistamines for desquamating rash
*Check urine for RBC 14 days after completing antibiotic to check for secondary glomerulonephritis

42
Q

Peds Derm - Skin Disorders - Impetigo

A

-Bacterial (strep or staph)
-Usually involves the face, but can occur anywhere
-Summer, fall
-Highly contagious

-S/S:
*Inflammation
*Pain, swelling, warmth
*Regional lymphadenopathy
*Classic honey-crusting lesions - hallmark sign

-Management:
*Topical antimicrobials for minor infections - Bactroban
*Systemic treatment, only if severe - Augmentin
*Clindamycin
*Abstain from school or community events until 48 hours of treatment
*Apply Burrow’s (Domeboro) solution to clean lesions
*Avoid sharing towels, clothing, kitchen utensils, communal surfaces
*Trim fingernails to avoid transmission

43
Q

Peds Derm - Skin Disorders - Scabies

A

-Highly contagious
-Parasitic mite that burrows into the skin
-incubation 4-6 weeks
-Direct or indirect contact with personal items

-S/S:
*Intense itching
*Linear or curved burrows
Infants: red-brown vesiculopapular lesions on head, neck, palms, or soles **
*Older children: skin folds, umbilicus, or abdomen
*Regional adenopathy
*Interdigital lesions

-Labs/Dx:
*Skin scrapings show mites, ova, and/or feces

-Management:
*Permethrin 5% rinse - leave on for 8-14 hours, repeat in one week
*Ivermectin (not to be used if mother is pregnant, lactating, or for children <15 kg)
*Wash all washable items
*Store non-washable items for 1 week
*Antihistamine for itching

44
Q

Peds Derm - Skin Disorders - Pinworms

A

-Roundworm that lives in colon and rectum
-Common in school-aged children and younger
-Spread by fecal-oral route

-S/S:
*Itching in perianal area
*Appear nocturnally around the anus and may be seen visually

-Labs/Dx:
*“Tape test”: press clear tape to skin around any, place on a slide and look under at microscope

-Management:
*Symptomatic - Benadryl for itching
*Anthelmintics - pyrantel, mebendazole or albendazole

45
Q

Peds Derm - Skin Disorders - Lyme Disease

A

-Spirochetal disease
-Most-common vector-borne disease in the US
-Northeast, Upper Midwest, and Pacific Coast
-Mice and deer tick
-Borrelia burgdorferi (spirochete)
-Tick must feed for more than 36 hours to transmit ***

46
Q

Peds Derm - Skin Disorders - Lyme Disease S/S

A

-Stage 1:
Erythema migrant - bull’s eye rash ** Hallmark
*50% have flu-like symptoms
*Joint pain

-Stage 2:
*Headache
*Stiff joints
*Cardiac symptoms
*Bell’s palsy
*Peripheral neuropathy

-Stage 3:
*Subacute encephalopathy (Lyme meningitis)
*Acrodermatitis chronic atrophicans: bluish red discoloration of the distal extremity with edema

47
Q

Peds Derm - Skin Disorders - Lyme Disease Labs/Dx & Management

A

-Labs/Dx:
*ELISA screening
*Western blot confirms

-Diagnostic criteria:
Exposure to tick habitat within the last 30 days with:
-Erythema migrans, or
-One late manifestation, and
-Lab confirmation

-Management:
*Under 8 years: Amoxicillin or cefuroxime axetil
*Over 8 years: Doxycycline

48
Q

Peds Derm - Skin Disorders - Rubeola

A

-Ordinary measles
-Virus
-Koplik spots ***

49
Q

Peds Derm - Skin Disorders - Rubella

A

-3-day measles
-Virus
-Erythematous maculopapular rash
-Starts on face, spreads to extremities, trunk; gone in 72 hours
-Teratogenic

50
Q

Peds Derm - Skin Disorders - Erythema Infectiosum

A

-Fifth disease
-5-15 years
-Human parvovirus B19
-“Slapped cheek”
-Fetal aplastic crisis - hydrops fetalis
-Not contagious after fever breaks

51
Q

Peds Derm - Skin Disorders - Roseola Infantum

A

-Sixth disease
-6 months-2 years
-Herpesvirus 6
-High fever, then abruptly stops when rash appears *** Hallmark sign

52
Q

Peds Derm - Skin Disorders - Coxsackie Virus (Hand-Foot-and-Mouth-Disease)

A

-Highly contagious
-Ulceration and inflammation of the soft palate (herpangina) and papulovesicular exanthema in the hands/feet
-Affects children <10 years old
-Resolves spontaneously in less than a week
-Peeling/loss of nails is common
-Spread by contact with unwashed hands or contaminated surfaces, or respiratory droplets

-S/S:
*Drooling
*Papulovesicular rash
*Poor oral intake

-Management:
*Acetaminophen
*Topical applications for comfort

53
Q

Peds Derm - Skin Disorders - Mumps

A

-Highly contagious
-Infection primarily affecting salivary glands
-“Chipmunk appearance”
-Resolved within 2 weeks
-Can cause complications: oophoritis, mastitis, pancreatitis, encephalitis, meningitis, and deafness

-S/S:
*Swollen salivary glands (parotitis) causing puffy cheeks

-Labs/Dx:
*Mumps IgM

-Management:
*Rest and isolation
*NSAIDs
*Warm or cold compresses for swollen glands
*Sugar-free lemon drops to increase flow of saliva

DRT (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions