Dermatology Flashcards
What are the five most common organisms of red rash in paediatric patients?
Really Red Munchkins Scare Parents
R: Rubella – fever + 3 day descending rash
R: Roseola – macular rash starting at high fever resolution; starts on trunk
M: Measles – 4Cs: cough, conjunctivitis, corzya and Koplik spots
S: Scarlet Fever – S. pyogenes sandpaper-like rash with strawberry tongue within first 2 days; desquamation on palms and soles afterwards
P: Parvovirus B19 – “slapped-cheek” lacy rash following fever
What are some common infections in paediatric patients associated with rashes?
Really Sick Children Must Take No Exercise
R: Rubella (D1)
S: Scarlet fever (D2)
C: Chickenpox (D3)
M: Measles (D4) + Koplik spots one day before rash
T: Typhus, Rickettsia (D5)
N: Nothing
E: Enteric fever/Salmonella/Typhoid (D7) >> Number of days after fever onset that a rash appears
What are 3 organisms that cause rash specific to palm and soles?
You drive CARS with your palms and soles.
CA: Coxsackie virus A
R: Rickettsia rickettsii
S: Syphilis (secondary)
What is this lesion? What disease is it related with?
Erythema marginatum
- Asosciated with rheumatic fever
What are the presenting features of measles?
Prodrome of the three Cs:
- Cough
- Coryza
- Conjunctivitis
Rash
- ~4 days after start of symptoms
- Erythematous maculopapular rash
- Starts at the hairline and spreads down
- Sparing palms and soles
- Koplik spots in the mucosa ~1 day before rash
What are the presenting features for roseola (6th disease) by HHV-6?
High-grade fever with irritabilty and lymphadenopathy
Rash once fever subsides
- Blanching, pink maculopapular
- Starts at the neck and the trunk
- Spreads to the face and extremities
What is this lesion? What is it associated with?
Erythema multiforme
>> Fixed lesions for at least 7 days
>> Target lesions with damaged skin in the central zone
>> All lesions appear within 72 hours
- Infections: HSV, Orf virus, hisioplasmosis
- Drug reactions
- Non-Hodgkin lymphoma
- Connective tissue disorders
- Vasculitides
>> Severe major erythema multiforme: think toxic epidermal necrolysis
What are the possible causes of generalized itching?
- Anemia
- Iron deficiency
- Polycythemia rubra vera
- Lymphoma
- Hepatic failure
- Thyroid disease
- Drugs
>> Unbearable generalized itching: think malignancy
What is a bulla?
Vesicle (papule that contains clear fluid) >0.5cm
What is a macule?
Flat circumscribed discolouration (think cafe-au-lait spots)
What is a papule?
Elevated solid lesion <0.5cm
What is excoriation?
Linear erosion induced by scratching
What are the differences between erosion and ulcer?
Erosion: partial local loss of epidermis; heals without scar
Ulcer
- FULL thickness focal loss of epidermis and dermis
- Heals with scar
What is the difference between erythema and purpura?
Erythema: blanchable
Purpura: nonblanchable
How does one differentiate between diaper rash and Candida napkin dermatitis?
Candida
- Sharp margin with scaling
- Satellite lesions
- Involvement of intertriginous areas
>> Check oral cavity for oral flush
>> Treat with topical anti-fungal