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EOR 3 - Peds > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Cradle cap

A

dz: Seborrheic dermatitis
path: malassezia furfur

CP: itchy, flaky/scaly, greasy, yellowish

tx: mineral oil to scalp (infants)
selenium sulfide shampoo (teens)

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2
Q

What is the treatment for seborrheic dermatitis?

A

infants: mineral oil
teens: selenium sulfide shampoo

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3
Q

Diaper dermatitis

A

contact dermatitis

CP: SPARES inguinal folds (DDx: Candida - affects inguinal folds)

Tx: avoid irritant, keep skin surface dry, use emollients

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4
Q

What is the DDx for diaper dermatitis?

A

Candida

CP: satellite lesions, “beefy red” rash, affects inguinal folds

Tx: TOP antifungal (fluconazole, nystatin)

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5
Q

Perioral dermatitis

A

eti: can be triggered by steroid creams/ointments, cosmetics

CP: small red bumps around mouth +/- nose, cheeks, eyes

tx: TOP Abx, +/- top steroids

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6
Q

What is the treatment for perioral dermatitis?

A

avoid triggers/cosmetics

topical abx +/- top steroids

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7
Q

What is the most common type fo cutaneous drug reactions?

A

exanthematous eruptions (delayed)

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8
Q

What does the rash look like for drug eruptions?

A

starts on trunk, spreads to face/extremities

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9
Q

What is the treatment for drug eruptions?

A

stop drug

rash will clear 2-3 days after drug is stopped

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10
Q

5Ps

A

lichen planus

purple, pruritic, polygonal, planar, papules/plaques

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11
Q

What is the treatment for lichen planus?

A

top steroids (mod - strong)

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12
Q

White, lacy, reticular lesions

A 
oral lesions (Wickham striae) 
lichen planus of the mouth
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13
Q

Herald patch

A

seen with pityriasis rosea

typically on trunk w/ scaling

follows langer’s lines (Christmas tree)

lasts between 4-10 weeks

rare in children <3-4 yo

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14
Q

SATAN

A

high risk drugs seen with SJS/TENS

sulfa drugs
allopurinol
tetracyclines
AEDs (carbamazepines, lamotrigine, pheytoin) 
NSAIDs
Nevirapine
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15
Q

SJS/TEN

A

mucocutaneous reaction
type 4 HSR

<10% BSA = SJS
>30% BSA = TENs

CP:
onset within 8 weeks - rapid progression
prodrome (fever, malaise, flu-like sxs)
Begins on face/trunk, spreads outward
Nikolsky sign - sloughing - detachment of epidermis
Mucosal membrane involvement in >90% of cases

sub-epidermal cleavage –skin biopsy

tx: supportive treatment

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16
Q

Which type of HSR is SJS/TENs?

A

4

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17
Q

CP of SJS/TENS?

A

onset within 8 weeks - rapid progression
prodrome (Fever, malaise, flu-like sxs)
begins on face/trunk – spreads outward
Nilkolsky sign - sloughing - detachment of epidermis
Mucosal membrane involvement in >90% of cases

Sub-epidermal cleavage - skin biopsy

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18
Q

SSSS

A

path: exotoxin in staph aureus causes breakdown in desmosomes and detachement within epdiermal layer

CP: exofloiative rash, flaccid bullae, skin desquamation

Recent URI
starts on face (perioral), neck, spreads to axillae and groan

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19
Q

Erythema mutliforme

A

eti: thought to be hypersensitivity to virus (HSV, mycoplasma)

half of all cases occur <20yo

CP: target lesion (3 zones = dark center, pale inner ring, red outer ring)
exanthem - starts on distal extremities and spreads proximally

EM minor: confined to extremities and face (no mucous membrane involvement)

EM major: affects extensive surface area, bullous lesions

self limited: resolves in 2 weeks

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20
Q

What is the most common etiology of erythema multiforme?

A

HSV

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21
Q

Erythema multiforme rash and distribution

A

Target or Iris lesions - round shape with 3 concentric zones
dark center, pale inner ring, red peripheral outer zone

distal extremities and spreads proximally

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22
Q

What is drug induced hypersensitivity syndrome?

A

skin eruption with systemic sxs + internal organ involvement

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23
Q

What is serum sickness?

A

immune complex (type 3) occurs after animal proteins or serum or drugs

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24
Q

How does serum sickness present?

A

rash, joint pain, fever

erythema occurs on sides of fingers, toes, hands

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25
Q

Black dot alopecia

A

tinea capitis

infection of scalp and hair shafts

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26
Q

What is the treatment for tinea capitis?

A

griseofluvin

selenium sulfide shampoo

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27
Q

T. Rubrum

A

tinea corporis

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28
Q

What is the tx for tinea corprois?

A

local miconazole or clotrimazole

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29
Q

Tinea cruris

A

jock itch
spares the scrotum

tx: local miconazole or clotrimazole

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30
Q

Tinea unguium

A

onchyomycosis

peeling of distal nail plate

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31
Q

What is the tx for onchyomycosis?

A

oral ketoconazole or griseofluvin

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32
Q

Spaghetti and meatballs

A

tinea versicolor on KOH prep

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33
Q

M. furfur

A

tinea versicolor

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34
Q

How can you tell the difference b/w diaper dermatitis and candida infection?

A

skin fold are only involved in candida infections
should suspect is > 3 days
beefy red erythema with satelite lesions

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35
Q

What is the treatment for diaper dermaititis?

A

open air exposure
topical zinc oxide
1% hydrocortsione (use < 2 weeks)

36
Q

How do you tx perioral dermatitis?

A

topical metronidazole or erythromycin

spares vermillion border

37
Q

Atopic triad

A

Eczema + allergic rhinitis + asthma

T cell mediated immune reaction

38
Q

Where is atopic dermatitis in infancy?

A

on the face

as opposed to adolesence where its on flexor surfaces

39
Q

Milia

A

keratin filled papules found on the face - without erythema

often confused with sebaceous hyperplasia

40
Q

Sebaceous gland hyperplasia

A

maternal androgen - similar to neonatal acne
regression occurs when hormone levels decline

“hormones leaving the body”

41
Q

Neonatal acne

A

sebaceous gland blockage

peaks around 2 weeks of age and resolves with a decline in maternal hormones in 3-4 months

42
Q

M. furfur

A

tinea versicolor
AND
seborrheic dermatitis

CRADLE CAP - yellow/pink greasy appearing scales on scalp and erythematous scaling on neck and face

43
Q

What is the treatment for cradles cap?

A

ketoconazole 2% cream/shampoo 2x/wk

44
Q

When does SJS or TEN present?

A

within 8 weeks of exposure to drug

45
Q

What is the difference between SJS and TEN?

A

SJS <10% of BSA

TEN >30% of BSA

46
Q

What is the treatment for acne in adolescence?

A

Mild: Topical ABX and benzoyl peroxide

Moderate: benzoyl peroxide + tretinoin + topic ABX

Severe: Oral ABX or accutane (isotretinoin)

47
Q

What is the most common cause of hair loss in men?

A

androgenic alopecia

anagen phase = 2-6 years (80-90% of hairs on scalp_

48
Q

What is the treatment for androgenic alopecia?

A

Minoxidil (Rogaine)

Finasteride (lowers scalp DHT - inhibits 5alpha reductase)

49
Q

Exclamation point hairs

A

alopecia areata

T cell mediated inflammation disrupts hair cycle
non-scarring hair loss

onset < 30yo

50
Q

What is the treatment for alopecia areata?

A

intralesional triamcinolone

51
Q

Telogen effluvium

A

diffuse hair loss
possibly secondary to zinc deficiency or drug use?
positive hair pull sign - follicles are easily extracted

52
Q

What is impetigo?

A

superficial bacterial infection of the epidermis

MC s. aureus and Group A strep

53
Q

Who gets impetigo?

A

< 6yo MC

54
Q

How does impetigo present?

A

honey colored crusts MC on face and extremities

55
Q

Bullous impetigo vs ecthyma?

A

bullous impetigo: toxins from S. Aureus - MC on trunk and in folds, less common on face

Ecthyma: deeper into dermis - MC on distal extremities

56
Q

What is the treatment for impetigo?

A

Mupirocin (bactroban) - covers MRSA - topical

systemic: cephalexin (keflex)

57
Q

What is the first line treatment for verrucae?

A

common warts

salicylic acid

58
Q

Target or IRIS lesions

A

erythema multiforme

MC etiology: HSV

59
Q

Who gets erythema multiforme?

A

M > F

20-40yo

60
Q

How does erythema multiforme present?

A

typically an acute, self limited reaction (1-3 weeks)

prodrome: fever, malaise, myalgia, sore throat, cough
Rash: evolve over days - sharply demarcated
target and IRIS lesions - 3 concentric zones

distal extremities –> usually spread proximally to palms, soles, elbows, and knees

may demonstrate koebner phenomenon

61
Q

What is the difference b/w erythema multiforme minor and major?

A

Minor: little or no mucosal involvement
Major: ALWAYS has mucosal involvement - bullous lesions +/- Nikolsky sign

62
Q

What is the treatment for erythema multiforme?

A

usually resolves spontaneously within 3-5 weeks

oral antihistamines and topical steroids for sx relief
oral prednisone for severe cases

63
Q

What causes lichen planus?

A

mucocutaneous dermatosis

associated with Hep C

64
Q

How does lichen planus present?

A

papulosquamous exanthem
6Ps: purple, polygonal, prurutic, planar, papules, plaques
Wickham striae - orally

+/- koebner’s phenomenon

65
Q

Who gets lichen planus?

A

1% of the population
30-60yo
majority spontaneously remit in 1-2 years

66
Q

Oral lichen planus is associated with what?

A

SCC

67
Q

What is the treatment for lichen planus?

A

Topical corticosteroids - clobetasol, betamethasone, deproprionate

intralesional injections of triamcinolone for resistance lesions

68
Q

What is pityriasis rosea?

A

etiology is unknown
possibly viral

age of onset: adolescents through adults

spring or fall MC

69
Q

How does pityriasis rosea present?

A

Prodrome phase: malaise, HA, mild constitutional sxs

Herald patch: Trunk is MC location

Exanthem - christmas tree distribution

70
Q

Pediculosis

A

lice

pediculosis capitis (head lice) 
pediculosis pubic (pubic lice) 
pediculosis corpora (body lice) -- can transmit trench fever and typhus
71
Q

What is the treatment for head lice?

A

1% permethrin (NIX) and repeat in 1 week

72
Q

What is the treatment for pubic lice?

A

1% lindane shampoo for 5 minutes

ALL sexual partners should be treated

FULL sexual workup must be done

73
Q

Sarcoptes saciei

A

mite causes scabies

74
Q

What do you tell a family that is being treated for scabies in regards to expected recovery?

A

itching may persist for 7-14 days after successful treatment

75
Q

What is the treatment for scabies?

A

12 hour application of permethrin 5% location

76
Q

How can you dx scabies?

A

apply topical tetraycline and examine skin with wood’s lamp

77
Q

What is molluscum contagiosum?

A

a poxvirus (wart like - umbilicated)

78
Q

Who gets molluscum contagiosum?

A

rare under 1 yo

MC < 5yo or young adults

79
Q

How does molluscum contagiosum present?

A

umbilicated papules 2-5mm skin colored

self limited - takes about 2 months for a single lesion to heal

80
Q

Urticaria is what type of reaction?

A

IgE mediated

81
Q

A pt with urticaria also has arthritis and a fever, what should you be concerned for?

A

serum sickness

82
Q

What is the difference between 1st, 2nd, and 3rd degree burns?

A

1st: epidermis
2nd: dermis
3rd: hypodermis (subcutanous tissue)

83
Q

Rule of 9s

A 
BSA burns 
adults: 
head 9% 
trunk: 36% 
arms: 18%
legs: 36%
perinum: 1%
84
Q

Parkland formula

A

LR (fluid of choice)
4ml x BSA burn x weight (kg) = total fluid amount

replace 1/2 in first 8 hours
replace 2nd 1/2 in next 16 hours

85
Q

Mongolian Spots

A

dermal melanosis

benign persistence of dermal melanocytes in neonates
blue color is caused by melanocytes

More common in non-caucasian races

MC locations: sacrum and shoulders

gradually fades during first 2 months of life

86
Q

What is the course of mongolian spots?

A

gradually fades during first 2 months of life

EOR 3 - Peds (9 decks)

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