Dermatology Flashcards
Pustules of erythema toxicum contain
Eosinophils (reassurance)
Pustules of transient neonatal pustular melanosis contain
Neutrophils (reassurance)
Newborn with white papules on the hard palate
Epstein pearls (reassurance)
Newborn with pinhead white papules on the face
Milia (reassurance)
Newborn with white papules on the upper gums
Bohn nodules (reassurance)
An infant with small papules and pustules on the forehead, nose, and cheeks and an absence of comedones.
Neonatal acne (resolves without treatment)
Newborn with blistering and erosions of the skin. May have mucous membrane and nail involvement. Infection has been ruled out
Epidermolysis bullosa
What is the best diagnostic test for epidermolysis bullosa?
Skin biopsy of an induced blister or genetic testing
Well-defined erythematous plaques on the knees and elbows, covered with silvery scales, bleed when removed, pitting of the nails
Psoriasis
Child with ulcerative colitis presents with bright red, tender nodules on the anterior leg
Erythema nodosum
Erythematous, scaly plaques in periorificial and acral areas, alopecia, and diarrhea
Acrodermatitis enteropathica (zinc deficiency)
A 2-year-old boy with fever, fragile blisters, and denuded skin, predominantly affecting the flexures and perioral skin
Staph scalded skin syndrome (SSSS)
Adolescent boy with a history of cold sores presents with targetoid papules, distributed acrally, and hemorrhagic crusting of the lips
Erythema multiforme
Child is taking penicillin for a dental abscess, developed macules, papules, vesicles, bullae, and ulcerations on 8% of the body surface area. Sloughing, blistering, and ulceration around the lips, eyes, and genitalia are also present
Stevens–Johnson syndrome
Most common virus that triggers erythema multiforme
Herpes simplex virus (HSV)
Poorly defined, hypopigmented rough macules and patches on the cheeks
Pityriasis alba
Adolescent with oval scaly papules and plaques on the trunk that run parallel to skin cleavage lines
Pityriasis rosea
Adolescent boy with hypopigmented scaly lesions on the neck, chest, and back that worsen with sun exposure
Tinea versicolor
What is the cause of tinea versicolor?
Malassezia furfur
Child with an itchy rash affecting both feet. Exam shows scaling, fissuring, and maceration in the interdigital spaces. What is the best treatment?
Topical antifungal cream, e.g., terbinafine cream
Child with one bald spot on the scalp with scale and “black-dot” hairs (the remnants of broken hairs within follicles). What is the best treatment?
Oral antifungal
Child with one bald spot on the scalp with no associated scale or redness. What is the best treatment?
Reassurance or topical steroids (alopecia areata)
A young child with diffuse thinning of the hair on the scalp after undergoing major surgery 3months prior
Telogen effluvium
Condition with pegged-shaped teeth, prominent ears, small chin, frontal bossing, absence of sweating with associated overheating
Hypohidrotic ectodermal dysplasia
Female neonate with blistering and/or hyperpigmentation of the skin in a blaschkoid distribution. May be associated with eye and neurologic abnormalities
Incontinentia pigmenti (X-linked dominant)
Fish-like scaling of the body, sparing flexural areas, with corneal opacities and history of cryptorchidism
X-linked recessive ichthyosis
Extremities are covered with fine, irregular, polygonal scales, hyperlinear palms; worse with dry weather and during winter, family history of “dry skin”
Ichthyosis vulgaris
Erythematous, scaly, itchy plaques in the antecubital and popliteal fossae, older brother with asthma
Atopic dermatitis
A 3-year-old boy was exposed to poison ivy while playing in the garden. He developed itchy linear streaks of vesicles on both arms. What is the best treatment?
Topical steroids (Rhus dermatitis)
What is the most important recommendation for all cases of contact dermatitis?
Avoidance of triggering agents
Folliculocentric papules with central keratinous debris on the upper arms and thighs
Keratosis pilaris
Unilateral, irregular brown to blue-gray pigmentation of the neck, shoulder, supraclavicular, deltoid, and/or upper arm skin. May darken at puberty
Nevus of Ito
Unilateral, irregular, blue-gray discoloration in the periorbital area and sclera (Ocular)
Nevus of Ota
A nevus of Ota involving the sclera requires monitoring by ophthalmology due to increased risk of
Glaucoma >ocular melanoma
Large congenital nevi likely carry an increased risk of what type of cancer?
Melanoma
Child is going to the beach for swimming and parents are concerned about sunburn. How would you counsel the family about sunscreen use?
Apply SPF 30 or greater sunscreen 15–30min before sun exposure, reapply every 2h
Large facial port-wine stain involving V1, seizures, and glaucoma
Sturge–Weber syndrome
Posterior fossa malformations (Dandy–Walker), hemangiomas, arterial anomalies, cardiac defects (e.g., coarctation of the aorta), and eye abnormalities
PHACE syndrome
An infant with a large hemangioma on the upper eyelid is at risk for
Amblyopia
What is the best treatment for a hemangioma on the upper eyelid that obstructs the visual axis?
Oral propranolol
Annular plaque without scale not responding to topical antifungals
Granuloma annulare
An infant with orange to brown macules and papules that become red and swollen when stroked
Urticaria pigmentosa (cutaneous mastocytosis)
An infant with a 4-month history of seborrheic dermatitis-like rash on the scalp, behind the ears, and in the diaper area not responsive to topical antifungals or steroid cream
Langerhans cell histiocytosis
A 12-year-old boy with learning disabilities and seizure disorder presents with persistent papules on the face despite acne treatment. He is also found to have hypopigmented skin lesions on the exam
Tuberous sclerosis
A 10-month-old with light brown macules and small patches on the body. How many café-au-lait macules should raise concern for neurofibromatosis?
Six
What is the treatment for head lice?
Permethrin 1% liquid; 2 treatments spaced 1week apart
What is the treatment for scabies?
Permethrin 5% cream; 2 treatments spaced 1week apart
