Dermatology

Question 1

What is a superficial infantile hemangioma?

Answer 1

A superficial infantile hemangioma is a benign capillary tumor of childhood that appears during the first weeks of life and grows rapidly.

Question 2

Treatment:

Superficial hemangioma

Answer 2

1. Observation; most regress spontaneously

2. Beta-blocker

Question 3

Describe the typical population of children affected by staphylococcal scalded skin syndrome (SSSS).

Answer 3

1. Children younger than 10
2. Adults with kidney disease
3. Adults who are immune compromised.

Question 4

Clinical Manifestation:

1. prodrome: fever, irritability, skin tenderness
2. generalized erythema
3. superficial flaccid blisters (Nikolsky sign +)
4. Scaling and desquamation before resolution of disease process.

Answer 4

Staphylococcal scalded skin syndrome (SSSS)

Question 5

What is the Nikolsky sign?

Answer 5

A patient has a positive Nikolsky sign when gentle lateral pressure on the skin surface adjacent to a blister causes slipping and detachment of a superficial layer of skin.

Question 6

Pathogenesis:

Staphylococcal scalded skin syndrome (SSSS)

Answer 6

SSSS is caused by a strain of S. aureus that produces an exfoliative toxin.

Question 7

Pathogenesis:

Henoch-Schonlein purpura (HSP)

Answer 7

IgA-mediated vasculitis

Question 8

Clinical Presentation:

Henoch-Schonlein purpura (HSP)

Answer 8

1. Palpable purpura on lower extremities
2. Abdominal pain
3. Arthralgias
4. Renal involvement

Question 9

How might you distinguish HSP from other causes of purpura?

Answer 9

HSP presents with a normal platelet count.

Question 10

What is the laymen’s name for seborrheic dermatitis?

Answer 10

cradle cap

Question 11

Clinical manifestation:

Palpular, scaly rash on the eyebrows, nasolabial folds, and/or scalp

Answer 11

Seborrheic dermatitis

Question 12

Treatment:

Seborrheic dermatitis

Answer 12

1. Moisterizers
2. Antifungals
3. Topical Steroids

Question 13

Clinical Manifestations:

Atopic dermatitis (eczema) in infancy

Answer 13

1. Pruritus
2. Scaly, erythematous lesions on the face, chest and extensor surfaces of the extremities

• Note, flexural involvement is more common in children and adults.

Question 14

Treatment:

Atopic dermatitis in infancy

Answer 14

1. Topical emollients=first line

Question 15

What are the three main characteristics of deliberate scald injuries?

Answer 15

1. Sharp lines of demarcation
2. Uniform burn depth
3. Spared flexor surfaces

Common features of accidents include: (1) splash marks (2) non-uniform burn depth (3) poorly defined wound margins (4) immediate presentation after injury

Question 16

Clinical Manifestations:

Erythematous, scaly, pruritic rash with central clearing

Answer 16

Tinea (corporis, pedis, etc.)

Question 17

Treatment:

Tinea corporis

Answer 17

1. Topical antifungals (i.e. Terbenafine)

Question 18

Define eczema herpeticum.

Answer 18

Eczema herpeticum is a form of primary herpes simplex virus infection associated with atopic dermatitis. Typically you would see vesicles over the area of atopic dermatitis.

Question 19

Clinical Manifestations:

umbilicated vesicles overlying the erythematous skin of a baby with known atopic dermatitis

Answer 19

Eczema herpeticum

Question 20

Treatment:

Eczema herpeticum

Answer 20

Acyclovir

Note, this is a life-threatening illness and prompt treatment is necessary.

Question 21

Clinical Manifestation:

Scattered, blanching erythematous macules, papules & pustules throughout the body of a nenoate

Answer 21

erythema toxicum neonatorum

Question 22

Treatment:

Erythema toxicum neonatorum

Answer 22

No treatment; usually resolves in 2 weeks

Question 23

What recommendations can you give patients regarding the optimal strength and timing for sun protection.

Answer 23

Patients should apply factor 15-30 sunblock 15-30 minutes before exposure.

Question 24

Which populations are most likely to present with Mongolian spots in infancy?

Answer 24

1. African
2. Asian
3. Hispanic
4. Native American

Question 25

Treatment:

Mongolian spot

Answer 25

No treatment; usually fades spontaneously in during the first decade of life.

Question 26

Clinical Manifestation:

Allergic contact dermatitis

Answer 26

1. erythema
2. edema
3. pruritis
4. tiny vesicles and weepy or crusted lesions

Symptoms occur 24-48 hours after contact with the allergen.

Question 27

What type of hypersensitivity is allergic contact dermatitis?

Answer 27

Cell-mediated hypersensitivity (type IV)