Dermatology

Question 1

Cutis aplasia associations and care

Answer 1

Congenital absence of skin (dermis and epidermis)
No need for antibiotics
Lesions will re-epithelialize over months
Can be associated with T13
If large, then check head because may be associated with neuro abnormalities

Question 2

Characteristics of Staph scalded skin syndrome

Answer 2

Caused by exotoxin
Erythema that evolves into diffuse, flaccid bullae
May slough off (Nikolsky’s sign)
Accompanied by fever, irritability, conjunctivitis
Culture nasopharynx, conjunctivae, skin, blood
Not helpful for culture the lesions, fluid is sterile
Rx with anti-Staph antibiotics, fluid management
Full recovery without scarring

Question 3

When should infantile hemangiomas be treated?

Answer 3

When large, ulcerate, secondarily infected, or compromise the airway or vision
Propranolol or topical steroids may be used, interferon if life threatening

Usually grow till 6-8 months and then involute

Question 4

Difference between Bohn nodule and Epstein pearl?

Answer 4

Bohn nodule is on maxillary alveolar ridge, Epstein pearls are located on the hard palate

Question 5

White plaques on umbilical cord should make you think about?

Answer 5

Candida or Listeria (early onset)

Question 6

Bullous pemphigoid

Answer 6

Autoimmune condition
Abs against dermoepidermal junction
Tense blisters on hands and feet

Question 7

Sucking blisters

Answer 7

Because of infant sucking wrist

Present at birth, typically on fingers and wrist

Question 8

Bullous impetigo

Answer 8

Due to Staph epidermolytic toxins
Non tender, flaccid bullae
Scaly crust when ruptured
Fluid can be cultured (as opposed to SSSS which has sterile fluid)

Question 9

Epidermolysis Bullosa

Answer 9

3 types
Gene mutation in basement membrane zone
Can present within first few days, fragile skin
There can be congenital localized absence of skin
1. Simplex: superficial blisters within epidermis, no scarring
2. Junctional: junction of epidermis and dermis, most severe form is fatal
3. Dystrophic: deeper bullae, has scarring and have mitten hand deformities

Question 10

Most important clinically significant difference between preterm and term skin?

Answer 10

Difference in the structure of the stratum corneum

Question 11

Where is the cleavage plane in EB simplex?

Answer 11

At or above the basal cell layer within the epidermis

Question 12

Where is the cleavage plane in junctional EB?

Answer 12

Within the lamina lucida of the dermoepidermal junction

Question 13

Where is the cleavage plane in dystrophic EB?

Answer 13

Below the lamina densa within the papillary dermis