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Pediatric EOR > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Management of diaper rash

A 
Frequent diaper changes
Open air exposure
Topical zinc oxide or petroleum jelly
1% hydrocortisone
May need topical antibiotics
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2
Q

Perioral dermatitis is most commonly seen in:

A

Young women - may have history of topical corticosteroid use

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3
Q

Papulopustules on an erythematous base, which may become confluent into plaques with scales. May have satellite lesions. Classically spare the vermillion border

A

Perioral dermatitis

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4
Q

Management of perioral dermatitis

A

Topical metronidazole or erythromycin
Oral: tetracycline
Avoid topical corticosteroids!

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5
Q

Most common type of drug reaction/skin eruption

A

Exanthematous / Morbilliform Rash

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6
Q

Generalized distribution of “bright-red” macules and papules that coalesce to form plaques - typically begins 2-14 days after medication initiation

A

Drug eruption

Exanthematous/Morbilliform Rash

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7
Q

2nd most common type of drug eruption

A

Urticaria

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8
Q

3rd most common type of drug eruption

A

Erythema multiforme

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9
Q

Most common offending drugs with urticaria

A

Antibiotics and NSAIDs

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10
Q

Management of drug induced exanthematous/morbilliform rash

A

Oral antihistamines

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11
Q

Management of drug induced urticaria/angioedema

A

Systemic corticosteroids, antihistamines

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12
Q

Management of drug induced erythema multiforme

A

Topical steroids, oral antihistamines

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13
Q

Has an increased incidence with Hepatitis C

A

Lichen planus

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14
Q

The 5 P’s of lichen planus

A

Purple, polygonal, planar, pruritic papules

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15
Q

Lichen planus most commonly seen on:

A

Flexor surfaces, skin, mouth, scalp, genitals, nails and mucous membranes

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16
Q

Koebner’s phenomenon

A

New lesions at site of trauma

Seen in psoriasis and lichen planus

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17
Q

Fine white lines on the skin lesions or on the oral mucosa, nail dystrophy

A

Wickham Striae

Seen in lichen planus

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18
Q

Management of lichen planus

A

Topical corticosteroids
Antihistamines for pruritus
Rash will usually spontaneously resolve in 8-12 months

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19
Q

Associated with Human Herpes Virus 7

A

Pityriasis Rosea

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20
Q

This rash can mimic syphilis, so an RPR should be ordered if the pt is sexually active

A

Pityriasis Rosea

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21
Q

Solitary solman-colored macule on the trunk, followed by general exanthem 1-2 weeks later

A

Herald Patch

Pityriasis Rosea

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22
Q

Very pruritic salmon-colored papules with collarette scaling along cleavage lines in a christmas tree pattern

A

Pityriasis Rosea

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23
Q

Management of pityriasis rosea

A

None needed PO
Antihistamines, topical corticosteroids as needed.
Can use UVB phototherapy if severe and started early

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24
Q

Most common medications causes SJS and TEN

A 
Allopurinol
Sulfonamides
Lamotrigine 
NSAIDs
Anticonvulsants
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25
Q

SJS affects _______% of body surface area

A

< 10%

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26
Q

TEN affects ______% of body surface area

A

> 30%

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27
Q

Prodrome of fever, malaise, myalgias followed by lesions on face and trunk. Bullous and vesicle formation begins days after

A

SJS/TEN

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28
Q

Gentle pressure to the skin causes sloughing

A

Nikolsky Sign

Seen in SJS/TEN

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29
Q

Main cause of death in SJS/TEN

A

Sepsis and shock secondary to infection

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30
Q

Treatment for SJS/TEN

A

Admit to hospital, preferably to burn unit

Supportive care is mainstay

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31
Q

Most common cause of erythema multiforme

A

Secondary to herpes simplex infection

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32
Q

Multiple target-like lesions that spares the mucosa

A

Erythema Multiforme

Minor

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33
Q

Multiple target-like lesions that includes mucosal involvement

A

Erythema multiforme

Major

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34
Q

Treatment of erythema multiforme

A

Typically resolves after 2 weeks

Can give topical steroids and antihistamines

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35
Q

Intense itching, especially in the occipital area, papular urticaria may be seen

A

Lice

36
Q

White oval-shaped egg capsules at the base of the hair

A

Nits Lice

37
Q

Management of lice

A

Permethrin topical drug of choice
Safe in children > 2 y/o
If lice in hair: permethrin shampoo (leave on 10 minutes)
If pubis/body: permethrin lotion at least 8-10 hours

38
Q

Second line management of lice and S/E

A

Lindane
Neurotoxic: headaches, seizures
Do not use after showering

39
Q

Scabies cannot survive off the human body for ______ days

A

> 4

40
Q

Intensely pruritic papules, vesicles and linear burrows

A

Scabies

41
Q

Commonly found in the intertriginous zones including web spaces between fingers/toes and scalp

A

Scabies

42
Q

Increased intensity of rash at night

A

Scabies

43
Q

Diagnosis of scabies

A

Clinical diagnosis

Can scrape burrows with mineral oil to identify mites or eggs under microscopy

44
Q

Treatment of scabies

A

Permethrin topical
Apply topically from neck to soles of feet for 8-14 hours before showering.
Repeat application after 1 week is recommended

45
Q

Second line treatment for scabies

A

Lindane (cheaper)
Do not use after bath/shower
May cause seizures
Teratogenic, not used in breastfeeding women or children < 2 y/o

46
Q

Key androgen leading to androgenetic alopecia

A

Dihydrotestosterone

47
Q

Management of androgenetic alopecia

A 
Minoxidil
Oral finasteride (decreased libido, sexual or ejaculatory dysfunction)
48
Q

HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum - papule formation

A

Verrucae (warts)

49
Q

Firm, hyperkeratotic papules between 1-10 mm with red-brown punctuations. Thrombosed capillaries are pathognomonic

A

Common and plantar warts (verrucae)

50
Q

Numerous, small, discrete, flesh-colored papules measuring 1-5 mm in diameter.

A

Flat warts (verrucae)

51
Q

Management of verrucae (warts)

A

Most resolve spontaneously within 2 years if immunocompetent
May use OTC salicylic acid and plasters
Can do cryotherapy (liquid nitrogen)

52
Q

Characteristics of second degree burn - superficial partial thickness

A

Erythematous, pink, moist, weeping
Blistering
Most painful!
Blanches with pressure

53
Q

Characteristics of second degree burn - deep partial thickness

A 
Red, yellow, pale white, dry
Blistering
Not usually painful
Absent capillary refill
May need skin graft
54
Q

Characteristics of third degree burn - full thickness

A

Waxy, white, leathery, dry
Painless
Absent cap refill

55
Q

Characteristics of 4th degree burn

A

Black, charred, eschar, dry
Painless
Absent cap refill
Into underlying muscle, fat, bone

56
Q

Mast cells release histamine causing vasodilation of venules and edema of dermis and SQ tissue

A

Urticaria

57
Q

Blanchable, edematous pink papules, wheals or plaques (oval, linear or irregular)

A

Urticaria

58
Q

Localized urticaria where the skin is rubbed (urticaria pigmentosa)

A

Darier’s sign

59
Q

Management of urticaria

A

Oral antihistamines treatment of choice

Topical or oral steroids

60
Q

What is included in the atopic disease triad?

A
  1. Eczema
  2. Allergic rhinitis
  3. Asthma
    Usually starts in childhood
61
Q

Altered immune reaction in genetically susceptible people when exposed to certain triggers - causes an increase in IgE production

A

Atopic dermatitis (Eczema)

62
Q

Triggers for atopic dermatitis

A

Heat perspiration
Allergens
Contact irritants (wool, nickel, food)

63
Q

Hallmark of atopic dermatitis

A

pruritus

64
Q

Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales

A

Atopic dermatitis

65
Q

Atopic dermatitis is most commonly found on:

A

Flexor creases

Antecubital folds and popliteal folds

66
Q

Special characteristics of atopic dermatitis

A

Dermatographism - localized development of hives when the skin is stroked

67
Q

Sharply defined discoid/coin shaped lesions found on the dorsum of the hands, feet, and extensor surfaces (knees, elbow)

A

Nummular eczema

68
Q

Management of atopic dermatitis

A
  1. Topical corticosteroids, antihistamines for itching

2. Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus) are alternatives for steroids

69
Q

Annual, scaling lesions and broken hair shafts. Inflamed plaques with multiple pustules with scarring and alopecia

A 
Tinea capitis (fungal)
Ringworm
70
Q

Treatment for tinea capitis

A

PO griseofulvin, terbinafine, itraconazole

71
Q

Pruritic, scaly eruption rash between toes

A

Tinea pedis (athlete’s foot)

72
Q

Management for tinea pedis

A

Topical antifungals

PO griseofulvin in uneffective

73
Q

Diffusely red rash on the groin or on the scrotum

A

Tinea cruris (jock itch)

74
Q

Management of tinea cruris

A

Topical antifungal

PO griseofulvin if ineffective

75
Q

Erythematous plaques (circular rash with clear center and defined borders), scaling, cracking and vesicles

A

Tinea corporis

76
Q

Management of tinea corporis

A

Topical antifungal

PO griseofulvin if ineffective

77
Q

Diagnosis of fungal infections

A

KOH smear

Wood’s lamp

78
Q

Overgrowth of the yeast Malassezia furfur

A

Tinea versicolor

79
Q

Management of tinea versicolor

A

Topical antifungals - selenium sulfide, sodium sulfacetamide, zinc pyrithione, azoles PO (itraconazole or fluconazole if widespread)

80
Q

Highly contagious superficial vesiculopustular skin infection that typically occurs at site of superficial skin trauma

A

Impetigo

81
Q

Impetigo occurs primarily on exposed surfaces of the

A

Face and extremities

82
Q

Risk factors for impetigo

A

Warm, humid conditions

Poor personal hygiene

83
Q

Vesicles, pustules that have a characteristic honey colored crust

A

Nonbullous impetigo

84
Q

Most common causes of impetigo

A

Staph aureus

85
Q

Vesicles form large bullae (rapidly), which rupture and leave thin “varnish-like crusts,” fever and diarrhea also

A

Bullous impetigo

86
Q

Management of impetigo

A
  1. Mupirocin (Bactroban) topical drug of choice TID x 10 days.
  2. Wash area gently with soap and water
87
Q

Management of impetigo if extensive disease or systemic symptoms (fever)

A

Systemic abx - cephalexin, dicloxacillin, clindamycin, erythromycin, azithromycin

Pediatric EOR (10 decks)

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