Dermatology Flashcards by Sam Biniazan

3 wks of life
Clustered or grouped vesicles on erythematous base
Multinucleated giant cells
Eosinophilic intranuclear inclusions

Treatment

Neonatal herpes

IV acyclovir

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Vesicles not on erythematous base
Linear pattern

Incontinentia pigmenti

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Multiple pustules
Brown macules
Vesicles
Non-erythematous base
“Leaving a collarette”
Present at birth

Transient neonatal pustular melanosis

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Yellow pustules
Erythematous macule
Not present at birth
Wright stain with eosinophils

Erythema toxicum neonatorum

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Lichenification with scratching

Atopic dermatitis

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Vesicles
Punched out lesions
Crusted erosions
Inflamed eczema not responding to steroids and antibiotics

Treatment

Eczema herpeticum

Acyclovir

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Greasy yellow patches
Cradle cap

Treatment

Seborrheic dermatitis

Antifungal washes and topical steroids

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Seborrheic dermatitis
Ear discharge
Polyuria

Langerhans cell histiocytosis X

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Prepubertal
Pruritic rash on soles
Minimal scaling
Thickening of skin
Hyper-linearity of distal sole
Normal interdigital skin

Treatment

Juvenile plantar dermatosis

Triamcinolone

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Silvery lesions
Auspitz sign
Erythematous plaques surrounded by thick adherent scales
Pinpoint areas of hemorrhage
Thick scales on scalp
Koebner reaction

Psoriasis

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Psoriasis after strep infection

Guttate psoriasis

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Herald patch
Christmas tree pattern
Exposure to sun/light improves symptoms

Pityriasis rosea

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Nonscaling annular lesions
Nonepidermal involvement
Intact skin

Granuloma annular

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Most likely cause of bullous impetigo and crusted impetigo

Staph aureus

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Very tender
Red
Sheet-like loss of skin
+Nikolosky sign

Staphylococcal scalded skin syndrome

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Target lesion
Mycoplasma pneumoniae
HSV

Erythema multiforme

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Fever, myalgia, arthralgia
Invasive rash
Mucosal involvement
Sulfa, AEDs, NSAIDs
No separation of skin in sheets

Stevens Johnson syndrome

<10% BSA

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Sunburn-like erythema
Sheet-like separation
Widespread bullae
Dunuded necrotic skin
Dermal involvement

Toxic epidermal necrolysis (TEN)

> 30% BSA

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Erythema infectiosum

Parvovirus B19
“Fifth disease”

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Erythema chronicum migrans

Lyme disease

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Erythema nodosum

TB
OCPs
IBD (UC)
Cocci

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Erythema marginatum

Rheumatic fever

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Pruritic linear lesions
Burrows
Between digits
Infants-scalp, palms/soles

Treatment

Scabies

Permethrin 5% cream

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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