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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
SJS affects _______% of body surface area
< 10%
26
TEN affects ______% of body surface area
> 30%
27
Prodrome of fever, malaise, myalgias followed by lesions on face and trunk. Bullous and vesicle formation begins days after
SJS/TEN
28
Gentle pressure to the skin causes sloughing
Nikolsky Sign | Seen in SJS/TEN
29
Main cause of death in SJS/TEN
Sepsis and shock secondary to infection
30
Treatment for SJS/TEN
Admit to hospital, preferably to burn unit | Supportive care is mainstay
31
Most common cause of erythema multiforme
Secondary to herpes simplex infection
32
Multiple target-like lesions that spares the mucosa
Erythema Multiforme | Minor
33
Multiple target-like lesions that includes mucosal involvement
Erythema multiforme | Major
34
Treatment of erythema multiforme
Typically resolves after 2 weeks | Can give topical steroids and antihistamines
35
Intense itching, especially in the occipital area, papular urticaria may be seen
Lice
36
White oval-shaped egg capsules at the base of the hair
Nits Lice
37
Management of lice
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
Second line management of lice and S/E
Lindane Neurotoxic: headaches, seizures Do not use after showering
39
Scabies cannot survive off the human body for ______ days
> 4
40
Intensely pruritic papules, vesicles and linear burrows
Scabies
41
Commonly found in the intertriginous zones including web spaces between fingers/toes and scalp
Scabies
42
Increased intensity of rash at night
Scabies
43
Diagnosis of scabies
Clinical diagnosis | Can scrape burrows with mineral oil to identify mites or eggs under microscopy
44
Treatment of scabies
Permethrin topical Apply topically from neck to soles of feet for 8-14 hours before showering. Repeat application after 1 week is recommended
45
Second line treatment for scabies
Lindane (cheaper) Do not use after bath/shower May cause seizures Teratogenic, not used in breastfeeding women or children < 2 y/o
46
Key androgen leading to androgenetic alopecia
Dihydrotestosterone
47
Management of androgenetic alopecia
``` Minoxidil Oral finasteride (decreased libido, sexual or ejaculatory dysfunction) ```
48
HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum - papule formation
Verrucae (warts)
49
Firm, hyperkeratotic papules between 1-10 mm with red-brown punctuations. Thrombosed capillaries are pathognomonic
Common and plantar warts (verrucae)
50
Numerous, small, discrete, flesh-colored papules measuring 1-5 mm in diameter.
Flat warts (verrucae)
51
Management of verrucae (warts)
Most resolve spontaneously within 2 years if immunocompetent May use OTC salicylic acid and plasters Can do cryotherapy (liquid nitrogen)
52
Characteristics of second degree burn - superficial partial thickness
Erythematous, pink, moist, weeping Blistering Most painful! Blanches with pressure
53
Characteristics of second degree burn - deep partial thickness
``` Red, yellow, pale white, dry Blistering Not usually painful Absent capillary refill May need skin graft ```
54
Characteristics of third degree burn - full thickness
Waxy, white, leathery, dry Painless Absent cap refill
55
Characteristics of 4th degree burn
Black, charred, eschar, dry Painless Absent cap refill Into underlying muscle, fat, bone
56
Mast cells release histamine causing vasodilation of venules and edema of dermis and SQ tissue
Urticaria
57
Blanchable, edematous pink papules, wheals or plaques (oval, linear or irregular)
Urticaria
58
Localized urticaria where the skin is rubbed (urticaria pigmentosa)
Darier's sign
59
Management of urticaria
Oral antihistamines treatment of choice | Topical or oral steroids
60
What is included in the atopic disease triad?
1. Eczema 2. Allergic rhinitis 3. Asthma Usually starts in childhood
61
Altered immune reaction in genetically susceptible people when exposed to certain triggers - causes an increase in IgE production
Atopic dermatitis (Eczema)
62
Triggers for atopic dermatitis
Heat perspiration Allergens Contact irritants (wool, nickel, food)
63
Hallmark of atopic dermatitis
pruritus
64
Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales
Atopic dermatitis
65
Atopic dermatitis is most commonly found on:
Flexor creases | Antecubital folds and popliteal folds
66
Special characteristics of atopic dermatitis
Dermatographism - localized development of hives when the skin is stroked
67
Sharply defined discoid/coin shaped lesions found on the dorsum of the hands, feet, and extensor surfaces (knees, elbow)
Nummular eczema
68
Management of atopic dermatitis
1. Topical corticosteroids, antihistamines for itching | 2. Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus) are alternatives for steroids
69
Annual, scaling lesions and broken hair shafts. Inflamed plaques with multiple pustules with scarring and alopecia
``` Tinea capitis (fungal) Ringworm ```
70
Treatment for tinea capitis
PO griseofulvin, terbinafine, itraconazole
71
Pruritic, scaly eruption rash between toes
Tinea pedis (athlete's foot)
72
Management for tinea pedis
Topical antifungals | PO griseofulvin in uneffective
73
Diffusely red rash on the groin or on the scrotum
Tinea cruris (jock itch)
74
Management of tinea cruris
Topical antifungal | PO griseofulvin if ineffective
75
Erythematous plaques (circular rash with clear center and defined borders), scaling, cracking and vesicles
Tinea corporis
76
Management of tinea corporis
Topical antifungal | PO griseofulvin if ineffective
77
Diagnosis of fungal infections
KOH smear | Wood's lamp
78
Overgrowth of the yeast Malassezia furfur
Tinea versicolor
79
Management of tinea versicolor
Topical antifungals - selenium sulfide, sodium sulfacetamide, zinc pyrithione, azoles PO (itraconazole or fluconazole if widespread)
80
Highly contagious superficial vesiculopustular skin infection that typically occurs at site of superficial skin trauma
Impetigo
81
Impetigo occurs primarily on exposed surfaces of the
Face and extremities
82
Risk factors for impetigo
Warm, humid conditions | Poor personal hygiene
83
Vesicles, pustules that have a characteristic honey colored crust
Nonbullous impetigo
84
Most common causes of impetigo
Staph aureus
85
Vesicles form large bullae (rapidly), which rupture and leave thin "varnish-like crusts," fever and diarrhea also
Bullous impetigo
86
Management of impetigo
1. Mupirocin (Bactroban) topical drug of choice TID x 10 days. 2. Wash area gently with soap and water
87
Management of impetigo if extensive disease or systemic symptoms (fever)
Systemic abx - cephalexin, dicloxacillin, clindamycin, erythromycin, azithromycin

Pediatric EOR (10 decks)

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