Dermatology Flashcards
what are kertain filled papules without erythema found on the face of infants?
milia
what is sebaceous hyperplasia?
maternal androgens cause hyperplasia of sebaceous cells leading to “pimples” esp. on nose
declines with maternal hormones
when does neonatal acne present?
around 2 weeks
resolves with decline in maternal hormones at 3 months
what’s the treatment for neonatal acne?
nothing - resolves on its own without scarring
can wash with soap or benzoyl peroxide
what is the causative organism for “cradle cap”
Malessezia furfur
greasy, erythematous scale
(older kids an adults get around eyebrows and on face)
what’s the RX for cradle cap?
Ketoconazole 2% cream/shampoo 2x/week
– OR topical Hydrocortisone 1% cream (if mostly erythematous)
what is this?
Harlequin color change
benign
due to vasomotor instability
(associated with prostaglandins and prematurity)
ddx with port wine stain - this is transient
what is the formal name for mottling?
cutis mammorata
triggered by cold expsosure
what do you suspect if you see mottling that is not transient with warming?
cutis mammorata telangiectasia congenita - in one extremity
sepsis or shock if capillary refill >3 sec.
what is erythema toxicum?
a benign skin condition that appears in 50% of newborns on days 2-5 of life
believed to be eosinophilic
*not grouped or vesicular like HSV
how long does it take pustular melanosis to go from pustules to hyperpigmented spots?
hours to a few days
how do you distinguish pustular melanocytes from HSV?
p.m. not grouped, non-erythematous base, and not on a presenting part
what’s the treatment for irritant contact dermatitis?
avoid irritant contact
keep area dry
for diaper, use barrier creams (zinc oxide)
hydrocortisone 1 or 2.5% (face/severe diaper)
mometasone (trunk or extremities)
what are the characteristics of diaper rash?
- satellite lesions
- beefy red
- affects folds/creases
how do you treat candidal diaper rash?
topical nystatin
what # and distribution of cafe au lait spots supports a diagnosis of neurofibromatosis?
>6 spots >5mm anywhere
what is infantile hemangioma?
vascular overgrowth due to dysregulation of endothelial stem cells - grows rapidly during first 6-12 months of life and then starts to involute
when do you treat infantile hemangioma?
- when they can interfere with breathing or eating
- when they are very large and can ulcerate and get infected
- if they are midline over the sacrum (need u/s to rule out spinal dysraphism)
what is a port wine stain?
blanchable capillary congenital lesions
usually isolated, but can be affiliated with genetic conditions
when should you consider Sturge-Weber syndrome in a child with a port wine stain?
If 1st and 2nd segments of the trigemminal nerve are affected (upper and lower eyelid)
when do you refer a child for further work up with port wine stain?
evidence of glaucoma
seizures
1st and 2nd segment of trigemminal nerve involvement
what is the change that a large or giant congenital melanocytic nevus will transform to melanoma? What about a small one?
3-5%
1%
What is the causative organism of bullous impetigo?
S. aureus
what is bullous impetigo?
bacterial infection, often around nose and mouth, that begins as red macules and progress to bullae on an erythematous base that eventually rupture with varnish on top as coating.
what causes non-bullous impetigo?
Group A beta-hemolytic strep
and S. aureus
what does non-bullous impetigo look like?
papules —> vesicles —-> pustules
rupture, leaving honey-colored crust over shallow ulcerated base
can have local lymphadenopathy with strep.
Definition of urticaria (hives)?
raised, pale pink pruritic wheals that involve the upper layers of dermis
urticaria with fever and arthritis suggests what?
serum sickness = treatment is to withdraw offending agent and treat symptoms (NSAIDs, etc.)
what is the treatment for hives?
antihistamines, H2 blockers first line
low dose corticosteroids, low dose cyclosporin 2nd line
when are hives considered chronic?
when they last for more than six weeks
What is erythema multiforme?
acute, self-limited hypersensitivity reaction
can be due to drugs, viruses, foods, immunizations
what are the lesions of erythema multiforme?
symmetrical, evolving, often on dorsum of hands and extensor surfaces of extremities - can spread to trunk
evolution is over days - erythematous maculues, papules, plaques, vesicles, target lesions
what are the systemic manifestations of erythema multiforme?
- itching
- fever
- arthralgias
- malaise
What is Stevens-Johnsons Syndrome?
Most severe form of erythema multiforme
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