Dermatology Flashcards
- clustered or grouped vesicles on an erythematous base
- MC on butt or scalp where pH probe was
- Dx: Wright stain: multinucleated giant cells and eosinophilic intranuclear inclusions
- Tx: IV Acyclovir
HSV
-vesicles in a linear pattern without an erythematous base
Incontinentia pigmenti
- multiple pustules, brown macules, vesicles and pustules on a non-erythematous base
- Tzank smear: sheets of NEUTROPHILS
- No Tx
Neonatal Pustular Melanosis
- yellow pustules with an erythematous base, erythematous macules, IN THE CENTER a solitatry papule, or occasional vesicle
- frequently not present at birth
- Wright stain: EOSINOPHILS
- rash is benign and will fade within 5-7 d
- does not appear on palms and soles
Erythema Toxicum Neonatorum
-diffuse scaling and erythematous papules and pustules
Cutaneous Candidiasis
-rash that involves erythema, edema, vesicle formation, exudate, and scaling
Eczema
- lichenification with scratching
- behind he knees and elbows (extensor surfaces)
- associated with asthma, allergic rhinitis, and FHx
- high IgE level in the cord blood
- flares with food allergies
- prevention: breastfeeding x6mo
Atopic dermatitis
- inflammed eczema not responding to antibiotics
- vesicular lesions and crusted erosions
- Dx: Tzank smear
- Tx: acyclovir
Eczema herpeticum
- coin shaped plaques on the extensor surfaces due to dry skin
- round, oozing, crusting erosions, and dry macules with a fine scaly pattern
- Tx: topical steroids
Nummular ezcema
-ezcematous rash but appears on palms and soles and other family members are affected
Scabies
- greasy yellow patches on the scalp, face, and skin folds during the first 2 mo of life
- Tx: topical antifungals
Seborrheic dermatitis
- delayed hypersensitivity reaction
- requires multiple exposures
- red, vesicular, crusting rash
- jewelry and poison ivy
Allergic contact dermatitis
- silvery lesions on the elbows or knees
- scaly lesions on the scalp or groin
- Auspitz sign: bleed when picked
- erythematous plaques surrounded by thick adherent sclaes, pinpoint areas of hemorrhage, thick scales on the scalp
Psoriasis
- oozing rash with honey colored crusting
- Strep or Staph
- Tx does NOT prevent PSGN
Impetigo
- small oval thick scaling plaques
- long axis of the lesion parallel to the lines of skin stress
- herald patch
- palms and soles are spared
- winter and early spring
- Christmas tree pattern
Pityriasis rosea
-thin scaly lesions with central clearing and elevated border
Tinea corporus
- fever and generalized LAD
- rash that involves the palms and soles
Secondary syphilis
- hyper or hypo pigmented scaling macules
- get worse with exposure to the sun
- Dx: KOH prep
- Tx: astringents or topical antifungal
Tinea versicolor
- thin scales that have a pasted on appearance
- during preschool years
- Tx: keratolytic agents: ammonium lactate, alpha hydroxy acid and ures-containing emollients
- 50% will also have atopic dermatitis
Icthyosis vulgaris
- papular lesion on the sole of the foot in a child walking barefoot
- atypical mycobacteria
Swimming pool granuloma
- pruritic rash on the soles of the feet
- minimal scaling, thickening of the skin, with hyperlinearity of the distal soles
- interdigital skin is normal
- form of contact dermatitis from occlusive shoes and synthetic socks
- Tx: topical steroid
Juvenile plantar Dermatosis
- annular lesions without epidermal involvement
- NO SCALING
- benign inflammatory condition
Granuloma annulare
- preschooler with very tender and red rash that sperads to become a sheet-like loss of skin
- involves only the epidermis (appears white)
- caused by a toxin
- Tx: Abx
Staph Scalded Skin Syndrome
- hypersensitivity reaction in response to a variety of triggers
- MC trigger is HSV
- rash abruptly appears as edematous macules on extremities and spreads to trunk
- Tx: stopping the offending agent
Erythema multiforme minor
- rash preceeded by fever, muscle aches, and joint aches
- discrete bullous or target lesions
- mucous membrane involvement (conjunctiva, oral mucosa, and anogenital mucosa)
- MC triggers: sulfas, AEDs, NSAIDs
- Tx: infection and dehydration
Stevens Johnson Syndrome
- sunburn-like erythema and sheet-like separation of skin (erythematous peeling skin)
- widespread bullae and denuded necrotic skin
- hypersensitivity reaction
- Dx: biopsy will show invelement of the dermis
Toxic Epidermal Necrolysis
- teenage girl with sepsis-like picture and a rash
- fevers, hypotension, sunburn-like rash
- Cause: either Staph or Strep
- Tx: Abx and supportive care
Toxic Shock Syndrome
- boggy, blue ulcers with a necrotic base
- usually associated with a systemic disease
Pyoderma Gangrenosum
- febrile child with a tender, well-demarcated area of erythema and induration containing several bullae
- Tx: 1st gen Cephalosporin
Cellulitis
- linear lesions that are papular or pustular and do not respond to Abx tx
- erythematous papules, some crusted, on the volar aspects of the wrists, axillae, groin, and in between the digits
- S-shaped burrow track on the skin
- can be on the palms and soles in infants
- Tx: all family members with Permethrin 5%
Scabies
- maculae caerulae (blue gray macules) on the abdomen or inner thigh
- suggest sexual abuse in children
- can last 36 hrs without a blood meal
- the eggs can hatch 10 days later
- can exist on other hair (facial)
- slower moving
- Tx: permethrin 1%
Pubic Lice
- pearly papules with central dimpling
- Tx: none
- Wright stain: viral inclusion bodies
Molluscum contagiosum
- pruritic lesions “pink and excoriated” on the extensor surfaces of the arms and legs
- episodic and erupt at night
- clustered erythematous papules with central punctum
- recurrent papules lasting up to 10 d
- no family members affected
- delayed hypersensitivity rxn to an insect bite
Papular Urticaria
- perioral dermatitis with alopecia
- Zinc deficiency
- autosomal recessive
- no lichenification
Acrodermatitis Enteropathica
- oral rash
- alopecia
- ataxia
Biotin defieincy
- whiteheads
- follicles that are plugged but covered with epithelium
Closed comedones
- blackheads
- no epithelial covering
- color comes from melanin
Open comedones
- acne with papules, pustules, and cysts
- Tx: topical Abx, po Abx
Inflammatory acne
- antibacterial
- reduces sebum production
- anti-inflammatory
- destroys comedones
- side effects: dry lips, skin, eyes, nosebleeds, and HA
- pregnancy prevention
Isotretinoin
- black dots or broken hairs
- inflammation and bogginess of the surrounding tissues
- Tx: po griseofulvin for 6-12 wks
Tinea capitis
- areas of complete hair loss with no other scalp lesions
- no inflammation
- may have nail pitting
- Tx: steroids
Alopecia Areata
-hair loss in a girl with tight braids
Traction alopecia
- round, well defined patches of complete hair loss
- sudden loss of large amounts of hair during routine activities such as washing and brushing the hair
- triggered by stressful events
- no inflammation
- telogen bulbs on microscopic exam
Telogen Effluvium
-irregular patches of incomplete hair loss
Trichotillomania
- pigemented lesions that turn into hives and develop blisters particularly with rubbing (Daier Sign)
- avoid narcotics, radiocontrast material, and NSAIDs
- infant in the first 6 mo of life
Urticaria Pigmentosa
- autosomal recessive
- UV damaged DNA is not repaired
- vulnerable to skin cancer and mets
- Tx: avoidance of sunlight
Xeroderma Pigmentosum
- cafe au lait spots (6 or more)
- Lisch nodules (iris harmatomas)
- neurofibromas
- optic gliomas
- inguinal and axillary freckling
- bony defects
- family Hx (Autosomal Dominant) Xsome 17
- at risk for Pheo and renal artery stenosis (monitor for HTN)
NF 1
- hearing loss or tinnitus from acoustic neuroma
- ocular symptoms from cataracts or harmatomas
- schwannomas, neurofibromas, meningiomas, gliomas, or juvenile cataracts
- FHx: Xsome 22
- Dx: MRI for CNVIII masses
NF 2
- more than 3 ash leaf spots (hypopigmented skin)
- periventricular/cortical tumors (seizures)
- sebaceous gland hyperplasia (adenoma sebaceum)
- Shagreen patch (Cobblestone appearing skin)
- sub/periungual fibroma
- cardiac rhabdomyoma
- retinal nodular harmatomas
- renal angiomyolipoma
Tuberous Sclerosis
- capillary hemangioma in the upper dermis
- present at birth and gradually gets larger, resolves after 1 yr
- Tx if interfering with vision, breathing, eating, hearing
- Tx: steroids and lasers
Strawberry hemangioma (superficial)
- hemangiomas located in the lower dermis, fat, and muscles
- will often be blue
Deep/Cavernous hemangioma
- rapidly growing progressive hemangioma
- sequestration of plts into the lesion
- thrombocytopenia and bleeding
Kasabach-Merritt Syndrome
- rash associated with SJS
- oral lesions and other mucous membranes
- hands and feet can be involved
Erythema multiforme
- Fifth’s disease, slapped cheek rash
- Parvo B19
Erythema infectiosum
- bullseye rash associated with Lyme Disease
- Carditis, Arthritis, Neuritis
Erythema Chronicum Migrans
- painful bluish lesions on the shin
- associated with TB, OCPs, IBDs, and fungal infx
Erythema Nodosum
- -erythematous macule on the trunk which clears centrally
- one of the major Jones criteria associated with Rheumatic fever
Erythema Marginatum