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Peds > Dermatology > Flashcards

Dermatology Flashcards

1
Q

terminology primary lesion

A 
flat: macule/ patch: cutaneous color
raise:
1. papule/patch
2. vesicles/bulla- fluid filled
3. pustules
4. wheals- cutaneous elevation caused by dermal edema
dermal lesion
1) nodule/tumor
2) cyst- nodule with expressible material
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2
Q

secondary lesion

A 
scaling-desquamation of stratum corner
crusting-dried exudate
pigmentation changes
exoriations-linear erosions caused by fingernail scratches
scars-thicked fibrotic dermis
 ulcer-lack of epic/some of dermis
atrophy-thinning of epic/dermis
fissue-linear crack through dermis
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3
Q

configuation

A

linear, annular, acuate (semi-circle), grouped, discrete

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4
Q

acral

A

hands, feet buttock

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5
Q

woods light

A

pigmentary changes dermatophytes

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6
Q

scraping

A

fungus-10% KOH exudate hyphae
look for mites eggs feces-scabies
base of vesicle scraped for HSV

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7
Q

hyperkeratosis

A

need keratolytics like salicylic acid, urea, acids

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8
Q

topical corticosteroid SE

A

systemic- only if potent and on damaged skin. adrenal suppression,
local SE- more common- w/in days of tx: arena, hirsutism, folliculitis, striae, hyper/hypopigmentation, atrophy, ecchymoses, telangiectasias, tachyphylaxis

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9
Q

antiinflam agents

A

steroids, tracrolimus ointment (for atopic dermatitis), 1-5% sulfer for acne. tar- eczema, psoriasis

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10
Q

inflammatory D

A

contact dermatitis, atopic dermatitis, seborrheic dermatitis, pityriasis rosea, psoriasis, miliaria rubra (heat rash)

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11
Q

contact dermatitis

A

sensitizing agent cause infm of epidermis and superficial dermis

1) allergic contact dermatitis: direct T cell mediated: initial sensitization then rechallenge, not dose dep- poison ivy/oak, jewelry, cream. see: erythematous papule and vesicles. tx- corticosteroid and avoidance
2) primary irritant contact dermatitis: caustic substance irritate skin, dose dep, no sensitization. ex- diaper dermatitis. erythema papules. tx- clean + no moisturizers, change diaper. low potency corticosteroid

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12
Q

seborrheic dermatitis

A

infant and adolescents. unknown et-maybe hypersensitive to yeast. P: red scales and crusts in area with sebaceous gland= scalp, face, chest, groin. greasy skin lesion
infant- limit to scalp= cradle cap
low potency corticosteroid, ulcer, zine or salicylic acid shampoo, topical anti fungal med

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13
Q

pityriasis rosea

A

uncommon

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14
Q

psoriasis

A

3% in kids. 30% first sign in childhood.
etio: if in kid likely auto dom inheritance caused by immune dysregs –> epi prolif
P: scaling papuls, plaques. scalp, nongreasy, hair loss, ears, elbow,. silvery scale. koebner phenomenon- new lesion dev at trauma sites
nail involvement common= pits, distal thickening, lifting of nail med/ destruction
arthritis uncommon in kids
manage- mod-high pot CS, UV light, bit D, 3% salicylic acid, retinoids, anthralin

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15
Q

miliaria rubra (heat rash)

A

disrupted sweat ducts near upper dermis- occlusion or friction. sweat into skin –> inflm –> more sweat -> more occlusion –> rash
small erythematous pruritic papule or vesicles in rubbed area-inguinal, axilla, chest, neck
tx: no med, avoid occlusive clothes- decr sweating

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16
Q

hypersensitive D

A

urticaria, serous sickness, erythema multiform, toxic epidermal necrolysis

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17
Q

serum sickness

A

~urticaria, systemic sign=fever, arthralgia, = organ injury. cause med meds~ cephalosporin

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18
Q

erythema multiform

A

HS to multi stimuli, drug, viruses etc
EM minor, EM major, steven johnson. all has target lesion= fixed, dull red, oval macule with dusky center containing a papule or vesicle.

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19
Q

toxic epidermal necrolysis

A

drug rxn. widespread epidermal neurosis, sloughing >30% skin loss.. no target lesion. Nikolsky sign- skin peal with lateral pressure. 10-30% mortality bc sepsis, dehyration, electrolyte abn

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20
Q

skin infection

A

fungal, bacterial, viral, ectoparasites

21
Q

fungal

A

etio- child, urban, humid, crowded

category: hair, skin nails
dx: KOH scraping, wood light

22
Q

tinea capitis

A

fungal hair loss cause by trichophyton tonsuring from human-human contact.
P: patchy cair loss -black dot ringworm. scales and pustules, kerio= boggy nodule red, occipital posterior cervical lymphadenopathy
tx- systemic oral antifungal. topical bad.

23
Q

tinea corporis/pedis/cruris

A 
infect body, foot, groin. et: M canis
corporis- ringwarm= oval scaly circal erythematous patches with partial central clearing
pedis- athlete's foot, can have vesicles
cruris- scales and erythema
tx: topical antifungal
24
Q

tinea unguium (onychomyocisis)

A

fungal nail infection. yellow

25
Q

tinea versicolor

A

pityrosporum oribularea= yeast invade stratum corneum. scaly macule on trunk, proximal arm, face. hypo/perpig. more prominent with sun.
dx- circular spore or hyphae on koh. spaghetti and meatball appearance
slenium sulfid

26
Q

viral exanthem

A

skin associated with viral infection. morbilliform- measles like. scarlatiniform- scarlet fever like- papular, vesicular, petechial

27
Q

erythema infectious (fifth disease)

A

fifth grade= school age.
etio: parvovirus B19- respiratory secretion
also see aplastic crisis, prolong anemia, fetal hydrous, miscarriage
P: begin with URI then 1-2 wk bright red macular rash on cheeks = slapped cheek= not contagious. lacy reticular rash, arthralgia
tx: supportive

28
Q

roseola infantum

A
29
Q

gianotti crosti= papular acrodermatitis

A
30
Q

varicella

A

dew drop on rose petal= vesicle on red background. crops of lesions –> crust. fever common. if at risk for complication give acyclovir

31
Q

herpes simplex 1/2

A

neonatal. 2/3 by 2. gingivostomatitis - most common HSV in infancy alway by 1. on lip, mouth, tongue. pain on swelling, drooling, fever
grouped vesicles on erythematous base
newborn- scalp contact with mom lesion- sepsis, meningoencephalitis.= emergency
herpetic whitlow- oral lesion + finger sucking= finger lesion
latent in dorsal ganglia- retrigger by sunlight, fever, stress, trauma
dx: tzanck preparation= microscope with direct fluorescent ab or culture base of lesion, pcr if test csf

32
Q

hand-foot-mouth disease and herpangina

A

coxsackievirus A16. vesicle papule, pustule. if only oral lesion= herpangina. fever. supportive tx

33
Q

warts

A

HPV. ireg, discrete flesh colored papules, smooth or rough. contagious. condylomata acuminata= multiple in genital
spontaneously resolve in 1-2y. liq Nitrogen, recurrence high

34
Q

molluscum contagiosum

A

poxvirus. fresh colored papule with central umbilication. on haired skin though face, extremity trunk. contagious. HIV associated. self resolve

35
Q

ectoparasites

A

louse infestation or scabies

36
Q

louse infestation

A

lice in head/body (pedicures humanus), groin (phthirus pubis). ingest blood. nits- eggs on hair shaft- white oval.
body- papule and pustules
pubic- nits and black crusted papule or blue macule
1% permethrin shampoo, comb
12hr application of 1% benzene hexachloride lotion

37
Q

scabies

A

sarcoptes scabiei. pruritic papules or vesicles. itching severe. S shaped burrows. tx- 5% permethrin lotion or 1% lindane. highly contagious

38
Q

pigmentation D

A

hypopig, neurocutaneous D, nevocellular nevi

39
Q

hypopig

A

postinflm hypopig, pityriasis alba (atopic dermatitis, cheeks), vitiligo (complete loss of pig in patchy area cause by melanocyte destruction, no tx), oculocutaneous albinism- genetic defect in melanin synthesis (photophobia, nystagmus, blue eyes, white skin/hair)- no tx.

40
Q

Tuberous sclerosis

A

ash-leaf, angiofirboma= adenoma sebaceum. shagreen patch- orange peel appearance. ungual fibroma. infantile spasm, #1 cuase of neonatal cardiac tumor

41
Q

NF I

A

cafe au lait. lis nodules (iris hamartoma)

42
Q

Nevocelular nevi

A

congenital: any color papule or plaque detected btw birth-6mo - all have incr risk of ca. giant nevi (>6cm) = high risk of melanoma= excision + observe other nevi
acquired nevi: peak 2-3/11-18. most junctional nevi. risk of ca lower than congenital.

43
Q

hair disorder

A

alopecia areata, tinea capitis (common cause of hair loss), traumatic alopecia, telogen effluvium

44
Q

alopecia areata

A

AI injury to follicle. complete hair loss in well remarked scalp areas w/o inflm. sudden with smooth skin. pitting nail in 40%. most regrow in 1y. topical CS or minoxidil speed it up.

45
Q

traumatic alopecia

A

trichotillomania: perifollicular petechiae and excoriations

traction alopecia: due to friction/ traction of tight hair braids, curlers etc. thinner but few broken hair

46
Q

telogen effluvium

A

2nd most common alopecia after male pattern baldness. due to acutely stressful event ~ preg. convert hair from growing phase (anagen) to resting phase (telogen) lose>100/d. spontaneous regrow.

47
Q

acne vulgaris

A

most common skin disease. androgen stimulate sebum production - obstructed = comedones –> inflm bc bacteria- propionibacterium acne. benzoyl peroxide good for both inflm and noninfm (black/white heads). systemic isotretinoin (actuate) good for all. but test for preg bc incr teratogenic

48
Q

atopic dermatitis

A

eczema. itch that rashes. irritation- scratch- rash

tx: lubricate skin, use anti-inflm in bursts, tx associated skin infection

Peds (21 decks)

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