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Dermatology Flashcards

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1
Q

what drugs commonly cause Toxic Epidermal Necrolysis?

A

sulfa abx

phenytoin

phenobarbital

carbamazepine

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2
Q

what would you see with these lesion on a smear?

A

erythema toxicum neonatorum (ENT)

filled with eosinophils

not seen in premies

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2
Q

what infection is this rash associated with?

A

guttate psoriasis

strep infections (pharyngitis or perianal strep)

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3
Q
A

neonatal acne

birth-3 weeks

self-resolving

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3
Q

over what body parts should you be concerned about large congenital nevi?

A

neurocutaneous melanosis

scalp, midline neck, spine - may have leptomeningeal involvement

verterbral colum - may have spina bifida

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3
Q

what diseases/syndromes are associated with cafe-au-lait spots?

A

NF1

NF2

McCune-Albright

tuberous sclerosis

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4
Q

what is erythrodermic psoriasis?

A

exfoliative reaction

entire body is warm, red, scaly

cannot control body temperature

causes: sunburn, drugs (antimalarials, betablockers, lithium), infections (strep, viruses)

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5
Q

in what locations should you worry about hemangiomas?

A

beard distribution (airway involvement)

ocular (eye involvement)

midline lumbosacral (spinal dysraphism)

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6
Q

if you have bilateral facial port-wine stains, what workup do you need?

A

optho and radiology imaging

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6
Q

what infections (other than bacterial superinfection) are children with eczema at higher risk of?

A

widespread molluscum

or

widespread herpes (eczema herpeticum)

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8
Q

what is the difference between neonatal and infantile acne?

A

neonatal: birth-3wks, self-resolve
infantile: 3-4 months later, has comedones, may require trreatment, may be related to other conditions that cause androgen excess (tumor, CAH, etc)

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9
Q

what is this caused by?

A

Koebner phenomenon

psoriasis outbreak in the area of an abrasion

usually linear

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10
Q

what do you need to be worried about if you have more than 5 hemangiomas?

A

visceral involvement

at risk for heart failure, liver failure

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10
Q

what are some of the conditions associated with this painful rash?

A
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12
Q
A

Milia:

tiny, pinhead size

yellow-white

tiny, epidermal inclusion cysts

no treatment

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14
Q

what are the skin findings in zinc deficiency?

A

red, irritated, eczematous rash

around nose/face

in perianal area (burned diaper rash)

also can cause alopecia

commonly seen in children with diarrheal diseases

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15
Q

what is a shagreen patch?

A

plaque of thickened skin with a cobblestone or orange-peel texture often seen on the dorsal aspect of the trunk

seen with tuberous sclerosis

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16
Q

what is the underlying defect of oculocutaneous albinism

A

tyrosine deficiency

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16
Q
A

pitariasis rosea

herald patch

christmas tree pattern

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17
Q

where does the rash of measles start?

A

forehead and then goes down

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18
Q

what are patients with oculocutaneous albinism at higher risk of?

A

basal cell and squamous cell cancers

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18
Q

what drug causes hypertrophied gums?

A

phenytoin

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19
Q

what drug can cause necrotic skin patches 3-10 days after starting it?

A

warfarin

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19
Q

what happens if you try to remove a psoriatic plaque?

A

will have bleeding from capillaries underneath (auspitz sign)

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19
what physical findings are associated with dermatomyositis?"
heliotrope rash Gottron's papules (eruptions over the knuckles) rash over knees/elbows nailbed teleangiectasias tx with steroids +/- immunosuppresives
20
koplik spots seen with measles (appear before rash) small white papules on erythematous base
21
what medicine is used for severe psoriasis?
acitretin (TNF-alpha inhibitor) has black box warning: increased risk of leukemia and other cancers can also use methotrexate or cyclosporine (esp if arthritis)
22
what should you look for in a patient with x-linked icthyosis?
undescended testicles underdeveloped penis or testicles
23
what can this be associated with?
polyglandular syndrome! autosomal recessive look for: diabetes graves addison/adrenal insufficiency hyper/hypo thyroidism pernicious anemia
24
congenital herpes simplex common around fetal scalp monitor or presenting part more likely to happen if primary infection for mom or vesicles present
25
what can this sometimes be associated with
psorasis
26
what other physical findings are associated with psoriasis?
nail pitting and onycholysis (painless separation of the nail from the nail bed)
28
sebaceous hyperplasia in differential of milia concentrated around nose/lips due to increased exposure to adrogens in utero self-resolving
28
what is erythrasma
well-defined redding lesion with some scaling found in axillae, under breasts, in between toes, and in groin chronic infection will fluoresce RED with woods lamp tx with erythromycin and -azole cream
29
hyperpigmented gingivia
addison's disease
31
how is this disease inherited?
incontinenia pigmenti x-linked (thought to be fatal in males) also associated with delayed eruption of teeth teeth often cone shaped alopecia blindness
32
what ANA pattern is associated with cutaneous lupus?
speckled have SS-A or SS-B (Ro/La) antigens
33
what is PHACES syndrome?
P: posterior fossa abnormalities H: hemangioma (usually involve trigmeninal distribution) A: arterial anomalies (intracerebral arteries) C: cardiac defects (coarct) E: eye abnormalities S: sternal clefting
34
what is this rash seen on a well-appearing baby?
cutis marmorata reticular lacy pattern seen when baby is cold skin returns to normal when warm usually goes away by 6 months of age
35
what is associated with ash leaf spots?
tuberous sclerosis
36
what is the Nikolsky sign?
seperation of skin with minimal pressure seen in SSSS, TEN, and pempigus vulgaris
37
does the Ro (SS-A) or La (SS-B) antigen cause heart block in neonates?
Ro (SS-A) - can cross the placenta number one cause of neonatal heart block usually don't have skin findings (periorbital erythema, round/annular patches)
38
what causes this type of alopecia? | (focus on second picture)
tinea capitis breakage at the scalp with "salt and pepper" apperance
39
what is the underlying defect in x-linked icthyosis?
sulfatase deficiency
40
what else should you look for in a patient with this finding?
hearing loss (Wardenberg syndrome) or other neurologic deficits (Wolf-Hirschorn)
42
what other condition do you need to worry about with a port-wine stain?
if in opthalmic branch of trigeminal nerve (V1) then worry about Sturge-Weber syndrome ipsilateral cerebral vascular malformation (seizures, MR, contralateral hemiplegia, glaucoma)
43
peutz-jeghers syndrome (multiple intestinal haramtomas/polyps)
45
what is the risk of melanoma with congential nevi?
yes. very small for small to medium nevi 5-15% for large nevi large nevi often in dermatome distribution
46
what would you seen on smear of these pustules?
transient pustular melanosis pustules that turn to pigmented macules neutrophils on smear
48
what is associated with lower extremity port-wine stains?
Klippel-Trenaunay syndrome vascular malformation of limb associated soft tissue overgrowth or limb overgrowth varicose veins
50
miliaria rubia caused by sweat retention/overheating often on head and neck miliaria crystallina: similar but clear fluid filled vesicles
51
what is the natural course of infantile hemangiomas?
may or may not be present at birth grow rapidly stabilize for 6-10 months then begin to involute around age 2 50% gone by age 5
52
NF1 6 or more spots and axiallary/groin freckling is diagnostic for NF1!
53
what is the medical term for port-wine stain?
nevus flammeus
54
erythema multiforme palms and soles frequently involved fixed lesions associated with HSV, mycoplasma,
55
what infection is this rash associated with?
congenital rubella | (also CMV)
56
Incontinentia pigmenti. A, Linearly distributed vesicles on an erythematous base are seen on the legs of this neonate. B and C, Subsequently, lesions evolve into warty papules, which can have thick overlying crusts. D, Splotchy hyperpigmented patches replaced the warty lesions by 8 months of age. E, In many cases the hyperpigmentation appears in swirls and streaks. F, These hypopigmented reticulated lesions on the leg of an affected child's mother represent old scars in areas of prior hyperpigmentation.
57
how is oculocutaneous albinism inherited?
autosomal recessive
58
what syndrome consists of basal cell carcinoma in childhood dysmorphic facies palmoplantar pits skeletal defects jaw cysts ovarian tumors
Gorlin Syndrome autosomal dominant
60
what causes erysipelas?
group A strep infection rapidly enlaring cellultiis with clear borders culture the leading edge
61
what other physical finding may you find in a child with this disease?
pitted fingernails occasionally associated with autoimmune diseases if total hair loss - less likely to grow back topical steroids can be tried but not super effective
62
Cutis Aplasia Congenita abscence of skin 25% have underlying abnormalities multiple spots: trisomy 13 midline defect: spinal dysraphia
63
name some of the side effects of isotretinoin
pseudotumor cerebri depression psychosis pancreatitis hypertriglyceridemia hearing loss vision loss skeletal abnormalities
64
what other nutritional deficiency can result in symptoms similar to zinc deficiency?
biotin can also have CNS symptoms common in kids on hyper al

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