Dermatology Flashcards
3 wks of life
Clustered or grouped vesicles on erythematous base
Multinucleated giant cells
Eosinophilic intranuclear inclusions
Treatment
Neonatal herpes
IV acyclovir
Vesicles not on erythematous base
Linear pattern
Incontinentia pigmenti
Multiple pustules
Brown macules
Vesicles
Non-erythematous base
“Leaving a collarette”
Present at birth
Transient neonatal pustular melanosis
Yellow pustules
Erythematous macule
Not present at birth
Wright stain with eosinophils
Erythema toxicum neonatorum
Lichenification with scratching
Atopic dermatitis
Vesicles
Punched out lesions
Crusted erosions
Inflamed eczema not responding to steroids and antibiotics
Treatment
Eczema herpeticum
Acyclovir
Greasy yellow patches
Cradle cap
Treatment
Seborrheic dermatitis
Antifungal washes and topical steroids
Seborrheic dermatitis
Ear discharge
Polyuria
Langerhans cell histiocytosis X
Prepubertal
Pruritic rash on soles
Minimal scaling
Thickening of skin
Hyper-linearity of distal sole
Normal interdigital skin
Treatment
Juvenile plantar dermatosis
Triamcinolone
Silvery lesions
Auspitz sign
Erythematous plaques surrounded by thick adherent scales
Pinpoint areas of hemorrhage
Thick scales on scalp
Koebner reaction
Psoriasis
Psoriasis after strep infection
Guttate psoriasis
Herald patch
Christmas tree pattern
Exposure to sun/light improves symptoms
Pityriasis rosea
Nonscaling annular lesions
Nonepidermal involvement
Intact skin
Granuloma annular
Most likely cause of bullous impetigo and crusted impetigo
Staph aureus
Very tender
Red
Sheet-like loss of skin
+Nikolosky sign
Staphylococcal scalded skin syndrome
Target lesion
Mycoplasma pneumoniae
HSV
Erythema multiforme
Fever, myalgia, arthralgia
Invasive rash
Mucosal involvement
Sulfa, AEDs, NSAIDs
No separation of skin in sheets
Stevens Johnson syndrome
<10% BSA
Sunburn-like erythema
Sheet-like separation
Widespread bullae
Dunuded necrotic skin
Dermal involvement
Toxic epidermal necrolysis (TEN)
> 30% BSA
Erythema infectiosum
Parvovirus B19
“Fifth disease”
Erythema chronicum migrans
Lyme disease
Erythema nodosum
TB
OCPs
IBD (UC)
Cocci
Erythema marginatum
Rheumatic fever
Pruritic linear lesions
Burrows
Between digits
Infants-scalp, palms/soles
Treatment
Scabies
Permethrin 5% cream
Intense scalp itching
Excoriations
White dots that cannot be removed
Treatment
Head lice
Permethrin cream
Nits do not have to be removed before return to school
Macula ceruleae
(Blue-gray macules on the abdomen or inner thigh)
Pubic lice
Think sexual abuse
Central dimpling
Viral inclusion bodies
Molluscum contagiosum
(Pox virus)
Pink, excoriated pruritic lesion
Extensor surfaces
Clustered erythematous papules
Central punctum
Recurrent
No one else affected
Papular urticaria
Delayed hypersensitivity reaction to insect bite
Comedomes
Non-inflammatory acne
Think precocious puberty If seen before 8 yo
Acne
Whiteheads - follicles that are covered with epithelium
Closed comedomes
(Non-inflammatory)
Acne
Blackheads - no epithelial covering
Open comedomes
(Non-inflammatory)
Acne
Papules
Pustules
Nodules
Later in life
Inflammatory acne
“Acne”
Angiofibromas
Pink, red, or brown
Tuberous sclerosis
Adenoma sebaceum
Salicylic acid
Good for comedomal acne
Reduces formation of obstructive lesions
Benzoyl peroxide
Bactericidal
Controlling inflammatory acne
Best treatment for no inflammatory acne
Tretinoin
Halts the process that plugs hair follicles
Adverse effect of isotretinoin (accutane)
Teratogenic
Dry lips, skin, eyes
Nosebleeds
Headaches
Elevated TG or liver enzymes
Black dots
Broken hairs
Salt and pepper appearance
Kerions - tender boggy areas of induration
Occipital adenopathy
Treatment
Tinea capitis
PO griseofulvin x 6-12 weeks
Exclamation point hair follicles
No inflammation
Nail pitting
Treatment
Alopecia Areata
Intralesional corticosteroids
Sudden loss of large amounts of hair
Stressful events
Round patches, well defined, complete areas of hair loss
Telogen effluvian
Irregular or incomplete patches of hair loss
Hair shafts of different lengths
Tight pulling
Traction Alopecia
Pigmented lesions
Red-brown
Flush or turn into hives
Blisters
Darier sign
1st 6mo of life
Urticaria pigmentosa
Avoid narcotics, radiocontrast material, NSAIDs
Scalp or diaper seborrheic rash
Chronic ear drainage or mastoiditis
Lytic lesions in skull or vertebra
Excessive urination
Langerhans cell histiocytosis
Hypopigmented patches
Get worse with sun exposure
Fungal
Treatment
Pityriasis (Tinea) versicolor
Astringents
Topical antifungal
Avoid sun exposure
Blaschko crops
Warty growths
Hyperpigmentation in marble cake pattern
Hypopigmentation
X-linked dominant
Lethal in males
Incontentia pigmenti
Post inflammatory hypopigmentation
Pityriasis alba
Autoimmune destruction of melanocytes
Complete depigmentation
Treatment
Vitiligo
Topical steroids
tacrolimus/pimecrolimus
Port wine stain - venous leptomeningeal angiomatosis
Development delay
Seizure - Contralateral to stain
Hemiplegia
Vision problems
Glaucoma - ipsilateral to stain
Serpentine-like intracranial calcifications
Sturge Weber m
Ophtho referral if stain is alone branches of trigeminal nerve
Chance an affected parent can pass on Neurofibromatosis
50%
Autosomal dominant
Complications of neurofibromatosis
Pheochromocytoma
Renal artery stenosis
Hypertension
Acoustic neuroma
Schwannoma
Neurofibromatosis type 2
Chromosome 22
Clinical criteria for Tuberous sclerosis
> 3 ash leaf spots (hypopigmented skin)
Periventricular/cortical tuber (seizures)
sebaceous gland hyperplasia (adenoma)
Shagreen patch (cobblestone)
Sub/periungual fibroma
Cardiac rhabdomyo
Retinal nodular hamartomas
Renal angiomyolipoma
Abnormal development of skin, teeth, nails, hair, sweat glands
Peg shaped or pointed teeth
Defective enamel
Dentures as early as 2 yo
Ectodermal dysplasia
Recurrent blisters After minor trauma
Nail changes
Epidermolysis bullosa
First line treatment for complicated infantile (strawberry) hemangiomas
Propranolol
Rapidly enlarging hemangioma
Platelet sequestration
Thrombocytopenia
Bleeding
Kasabach-Merritt syndrome
Amelanotic - pink or red
Bleeding, bump
Color uniformity
New
< 6mm
Melanoma
Psoriasis
Strep infection
Guttate psoriasis
Erythema of nose, mid-cheeks
Papulopustular component
Triggered by temperature change, sun, exercise, alcohol
Rosacea
Topical Metronidazole
