Dermatology Flashcards
Essential features atopic dermatitis
- dermatitis
- pruritis
- chronic or relapsing
- appropriate age-specific distribution
For exam if say axilla or groin do not say AD
Or if older child with new onset do not think AD
Eczema herpeticum management
- swab for HSV PCR for confirmation
- acyclovir x 7-10 day
Use Iv if < 1 yr, if fever/systemic symptoms, severe, poor oral intake - ophtho if V1 area
Pityriasis rosea features
- herald patch
- generalized erythematous plaques/papules with scale
- evolves over 1-3 week
- christmas tree patter
- asymptomatic or pruritic
resolves by 3 months
Psoriasis comorbidities
- arthritis
- obesity
- HTN
- diabetes
- metabolic syndrome
- CVD
- IBD
- depression
- eating disorder
Mid-childhood acne (age 1-7yo)
- pathological until proven otherwise!
Acne treatment guidelines
Mild: topical: retinoid or BPO
Moderate: combined topicals +/- oral tx
Severe: combined topical + oral tx or isotretinoin
Isotretinoin side effects
- teratogenicity
- elevation of lipids, liver enzymes
- change in night vision
- mucocutaneous dryness
- HA, pseudotumor cerebri
- myalgia, arthritis
- depressive sx
Staph scalded skin syndrome management
think well/ non toxic with blisters and erosions
- Admit
- IV cloxacillin/cefazolin and clindamycin
- pain control
Tinea capitis treament
Oral terbinafine x 4-6 weeks (baseline liver enzymes and q4-6 weeks)
Acquired focal alopecia DDX (As and 3Ts)
- alopecia areata
- tinea capitis
- trichotillomania
- traumatic/traction
(secondary syphilis, psoriasis)
Acquired diffuse alopecia DDX
- telogen effluvium (most common)
- anagen effluvium
- androgenetic alopecia
- generalized alopecia areata
- hypothyroidism
- lupus
- iron deficiency anemia
Infantile hemangioma patter of growth
Birth - no lesion or precursor lesion 1-3 months - rapid growth 3-6 month - slow growth 6mo - 1 yr - plateau phase >9mo - 1 yr - slow involution
Hemangiomas require treatment
- ulceration
- disfigurement risk/ cosmetically sensitive areas
- impairment function/vital structures
Hemangioma features associated with systemic disease
- more than 5: risk of visceral IH
- beard area: risk of airway IH
- midline along spine
- large segmental facial lesions: PHACE syndrome
- lumbosacral/perineal: LUMBAR syndrome
PHACE syndrome
- posterior fossa abnormalities
- hemangioma (segmental)
- arterial anomalies
- cardiac abnormalities/aortic abN
- eye abnormalities
Sturge-Weber features
- capillary malformation (forehead)
- glaucoma
- CNS: leptomeningeal CVM, seizures, stroke like episodes, ID
Tuberous sclerosis major criteria
ASSCHLEAFS - Ashleaf spots 3+ - Subependymal nodule, subependymal giant cell astrocytoma + cortical tubers - Heart rhabdomyoma - Lung lymphangioleiomyomatosis - Eye: retinal hamartomas - Angiomyolipoma of renal - Facial angiogribroma OR forehead plaque AND fibromas of ungual or periungual - Shagreen patch = ASS(+C)HLEAFFS
Erythema multiforme features
- grouped, red edematous fixed papules
- may evolve into target lesions
- acrofacial sites
- itchy and burn
- may have shallow mouth ulcers only (no other MM involvement)
Erythema multiforme cause and treatment
HSV = #1 trigger (others = mycoplasma etc)
Treatment: anti-histamines, topical steroids
resolves within 2 weeks, but frequently recurs
Reactive infectious mucocutaneous eruption (RIME)
features
Mucositis with minimal skin involvement/detachment, lackign dusky/purpuric areas think RIME
SJS features
- drug started in previous 6-8 weeks (1-3 weeks as per other notes)
- rapid progression
- acutely unwell
- mucosal erosions/ulcerations and crust
- purpuric patches evolve to blistering
SJS/TEN management
- stop all potentially offending drugs
- supportive therapy
Erythema nodosum etiologies
- # 1 cause = GAS
- viruses: EBV, HBV, mumps, URTI
- fungi
- bacteria: TB, cat-scratch, yersinia, mycopalasma
- Drugs: OCP, sulfonamidse
- other: IBD, SLE, behcet, srcoid etc.
congenital melanocytic nevi
- large and giant
Large > 20 cm
Giant > 40cm
if large 50% will get melanoma before 5 yrs
NF type 1
- CALMs 6+ (0.5cm if prepubertal, 1.5cm if postpubertal)
- axillary/inguinal freckling
- family history - 1st degree relative
- eye: lisch nodules
- skeletal dysplasia
- plexiform neurofibroma
- optic tumor
