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X Pediatrics Exam 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is congenital melanocytic nevi (CMN)?

A

Proliferations of benign melanocytes

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2
Q

Clinical presentation of congenital melanocytic nevi

A

Macules, papules or plaques at birth
Hair may or may not be present
Appearance may change with time
Lesions grow in proportion to individuals size

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3
Q

When does congenital melanocytic nevi have a risk of malignancy?

A

Larger and giant lesions are at a much higher risk than small and medium sized

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4
Q

What is the most common pigmented lesion in infants?

A

Mongolian Spot (congenital dermal melanocytosis)

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5
Q

Clinical presentation of Mongolian Spot

A

Patch of bluish-grey pigmentation with irregular border and normal skin texture
Most commonly on butt and low back
Increased incidence in darker skin types
Usually present at birth/first weeks of life

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6
Q

What is the difference between CMN and Mongolian Spots?

A

CMN grows with the patient while Mongolian Spots fade by age 2 and often disappear by 10

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7
Q

What is nevus sebaceous?

A

Hyperplasia of the epidermis, sebaceous glands, hair follicles of apocrine glands

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8
Q

Clinical presentation of nevus sebaceous

A

Primarily on scalp or face
Waxy, solitary, smooth, yellow-orange hairless patch that is often oval or linear in shape
Usually becomes more pronounced in adolescence (bumpy, warty, scaly)

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9
Q

What might occur with a nevus sebaceous?

A

BCC or other malignancy may arise from the lesion (damaged tissue)

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10
Q

What is aplasia cutis congenita?

A

Absence of skin present at birth that can be localized or widespread

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11
Q

Clinical presentation of aplasia cutis congenita

A

Most commonly on midline posterior scalp
May have fluid-filled bulla
Can be isolated or have other developmental anomalies
Lesions well demarcated

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12
Q

What is signified by a tuft of hair in aplasia cutis congenita?

A

Hair surrounding the defect may indicate a neural tube defect

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13
Q

Clinical presentation of Cafe-au-lait macules (CALM lesions)

A

Discrete uniformly pigmented macules or patches
Present at birth or appear in early childhood
Most common in African American but seen in others

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14
Q

What conditions are associated with cafe-au-lait macules?

A

McCune-Albright syndrome or neurofibromatosis type 1

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15
Q

Signs and symptoms of NF1

A

Cafe-au-lait macules, axillary or inguinal freckling, neurofibromas, lisch nodules, optic gliomas, skeletal abnormalities
Need yearly ophthalmology exams
Autosomal dominant disease

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16
Q

2 types of vascular anomalies

A 
Vascular tumors (neoplasms proliferate and typically require tx to stop growth)
Vascular malformations (abnormal blood vessels without rapid proliferation)
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17
Q

Types of vascular tumors

A

Infantile hemangioma, congenital hemangioma, pyogenic granuloma

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18
Q

Types of vascular malformations

A

Capillary malformations like Port wine stain and nevus simplex

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19
Q

What is a port-wine stain?

A

Cutaneous capillary malformation

20
Q

Clinical presentation of port-wine stain

A

Presents at birth and does not regress

Pink or dark red patches (may darken or thicken)

21
Q

What might be associated with Port-Wine Stain?

A

Soft tissue or bony overgrowth

Sturge Weber syndrome in V1 distribution (concern for congential glaucoma if affects eyelid)

22
Q

What is a pulse dye laser?

A

Used for PWS and causes intravascular coagulation in abnormal vasculature without damaging surrounding structures (use in isolated areas)

23
Q

Risk factors for infantile hemangioma

A

Low birth weight, female gender, twin gestation and fair skin

24
Q

Clinical presentation of infantile hemangiomas

A

Majority not present at birth but appear shortly after
Superficial: bright red and minimally elevated
Deep: larger with a bluish color
Ulceration is common complication

25
Q

Phases of infantile hemangiomas

A

Proliferative:
Early is rapid growth during first 3 months and max growth at 5-7 weeks of age
Late is less rapid but still ongoing and completed typically by 9 months
Involution:
Color darkens and tumors softens, ultimate residual skin changes vary

26
Q

Other names for nevus simplex

A

Salmon patch, stork bite at nape of neck, angel kiss on eyelid

27
Q

Clinical presentation of nevus simplex

A 
Faint, transient capillary malformation
Flat, pink/red patch
Typically midline of forehead, scalp, upper eyelids, posterior neck and back
Smooth appearance like surrounding skin
Typically fade within 1-2 years
28
Q

Presentation of pyogenic granuloma

A 
Acquired lobular vascular tumor
Occurs at any age
Affects skin particularly prone to trauma (hands, fingers, face) and mucous membranes
Develop rapidly (days to months)
Friable
29
Q

Why is the risk of recurrence high after treatment of pyogenic granulomas?

A

Treatment is traumatic and these happen in areas of trauma

30
Q

Preferred tx of pyogenic granuloma

A

Surgical excision with primary closure

31
Q

Why do you need a biopsy to confirm dx of pyogenic granuloma?

A

Because they may mimic malignant lesions

32
Q

What is important with mandibular hemangiomas with stridor or hoarseness?

A

Need emergent ENT referral to evaluate for airway compromise

33
Q

Most common cause of diaper dermatitis (rash)

A

Irritant/contact dermatitis (some are seborrheic dermatitis, atopic dermatitis, or other skin conditions)

34
Q

Pathogenesis of diaper dermatitis

A

Excessive moisture, friction, increased pH causing localized skin break-down (macerated skin increasingly susceptibility for infection)

35
Q

What do you suspect with persistent symptoms of diaper dermatitis?

A

Secondary infection with C. albicans or other microorganisms

36
Q

Candidal superinfection

A

Beefy red plaques (involves skin folds)
Dx is clinical or KOH prep/fungal culture
*classic dermatitis does not involve skin folds

37
Q

Impetigo

A

Secondary infection of S aureus or S pyogenes

Hallmark: fragile pustules and honey crusted erosions

38
Q

Therapeutic options for diaper dermatitis

A

Barrier preps (OTC pastes and ointments)
Low-potency topical corticosteroids
Breast as just as effective as steroids (anti-inflammatory and antimicrobial)
Topical antifungals or topical/oral antibiotics for super infections
*Avoid powders

39
Q

What is responsible for head lice in kids?

A

Pediculus humanus capitis (head louse)

40
Q

When is there itching with kids that have lice?

A

When they are allergic to the saliva

Might see cervical LAD

41
Q

How do you diagnose lice?

A

Visualize live lice (wet combing)

Nits may persist for months and might not be an active infection

42
Q

Treatment of lice

A 
Topical pediculicides (pyrethroids, malathion, benzyl alcohol, spinosad), skin irritation is side effect, don't use in kids under 2
Wet combing is mechanical removal of lice (15-60 every 3-4 days for several weeks)
43
Q

Why is neonatal acne (neonatal cephalic pustulosis) not true acne?

A

It is an inflammatory rxn that might be due to Malassezia colonization
Self-limiting and resolves by 6-12 mos (presents first 2-3 wks of life)

44
Q

Clinical presentation of neonatal acne

A

Inflammatory papules and pustules on forehead, cheeks and nose
No true comedones

45
Q

What do you use when neonatal acne persists?

A

Ketoconazole or hydrocortisone

46
Q

Presentation of infantile acne

A

Presents at 3-4 mos of age and commonly resolves by 2-3 yrs of age (true acne)
Hyperplasia of sebaceous glands (androgenic stimulation)
Inflammatory pustules, comedones, pustules

47
Q

Tx for infantile acne

A

Tx to prevent scarring
Benzoyl peroxide, topical abx, topical retinoids
Oral only in severe cases

X Pediatrics Exam 2 (3 decks)

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