Exam 1

Question 1

Vernix

Answer 1

• Fetal skin
• Covered in uterine with Vernix caseosa
• Greasy, white or yellow material
• Sebaceous glands secretions and exfoliated skin cells
• Water, lipids, and protein
• Present during the 3rd trimester

Question 2

Lanugo

Answer 2

• In utero
• A soft, downy hair
• First appears at 20 weeks
• Covers entire body-including face

Question 3

Acrocyanosis

Answer 3

• Bluish discoloration of the palms and feet
• Presents at birth and lasts up to 48 hours
• Exacerbated by low temperatures
• Benign in the normal, healthy infant

Question 4

Plethora

Answer 4

• Ruddy or red appearance at birth
• indicative of a high level of RBCs
• CBC
• Assess symptoms
• Possibility of polycythemia; can be deadly to the baby. They’re at risk for clots, strokes, etc.

Question 5

TEWL

Answer 5

“Transepidermal Water Loss”

- increased in premature infants (

Question 6

Jaundice in 1st 24 hours

Answer 6

1. Hemolytic disorders

2. TORCH (congenital infection)

Question 7

Jaundice in 2nd day-3rd week

Answer 7

1. Physiological
2. Breast milk
3. Sepsis
4. Polycythemia
5. Cephalohematoma
6. Crigler-Najjar syndrome
7. Hemolytic disorders

Question 8

Jaundice: Appearance or persistence after 3rd week:

Answer 8

1. Breast milk
2. Hypothyroidism
3. Pyloric stenosis
4. Cholestasis

Question 9

Cutis Marmorata

Answer 9

• Bluish mottling or marbling of the skin
• In response to chilling, stress, overstimulation
• Caused by dilatation of the capillaries
• Disappear when the infant is warmed
• Persistent C.M may be seen with Trisomy 21, 18, and Cornelia de Lange syndrome

Question 10

Harlequin color change

Answer 10

• Seen only in the newborn period
• Common in LBW infants
• Lying on one side-sharply demarcated red color on the dependent half of the body
• Pale appearing opposite side
• When rotated the color reverses
• NO PATHOLOGIC SIGNIFICANCE
• Temporary imbalance of the autonomic regulatory mechanism of the cutaneous vessels

Question 11

Erythema toxicum

Answer 11

• Benign rash 70% of newborns
• Small, white or yellow papules, macules, pustules, or vesicles with an erythematous base
• Most common the face, trunk, extremities
• Disappears and reappears on a different part of the body
• Peak incidence is from 24-48 hours
• Cause unknown
• Definitive diagnosis - smear shows numerous eosinophils

Question 12

Milia

Answer 12

• Multiple yellow or pearly white papules ~1mm in size
• Found on the brow, cheeks, nose
• In mouth = Epstein’s pearls
• Epidermal cysts caused by accumulation of sebaceous gland secretions
• Resolve spontaneously during 1st weeks

Question 13

Sebaceous gland hyperplasia

Answer 13

• Numerous tiny (

Question 14

Miliaria

Answer 14

• Prickly heat/heat rash*
• Obstruction on sweat ducts
• Forehead, scalp, creases most common; can be all over
• Three types, depending on severity:
  (1) Crystallina: clear, thin vesicles 1-2mm
  (2) Rubra: appear as small erythematous papules
  (3) Profunda: secondary infection, rare
• Treatment consists of eliminating precipitating factors
• Excessive heat, humidity
• Keep clean and dry
• Resolve within a few hours

Question 15

Sebaceous nevus

Answer 15

• Small yellow papule or plaque
• Scalp and face
• Immature hair follicles, sebaceous glands
• Devoid of hair on the scalp
• Changes at puberty - enlarges & raised
• Small percentage transform into basal cell epithelioma
• Surgical removal

Question 16

Neonatal acne

Answer 16

“Neonatal cephalic pustulosis”

• Benign
• Typically presents 2nd-3rd week of life
• Inflammatory papules and pustules
• Forehead, cheeks and nose
• Can last for 6-12 months

Question 17

Transient Neonatal Pustular Melanosis

Answer 17

[common pigmented lesions]

• Superficial, vesiculopustular lesions
• Rupture within 12-48 hours
• Leaving small pigmented macules
• Surrounded by white scales
• Remain up to 3 months
• Benign
• Aspiration reveals neutrophils, and almost NO eosinophils

Question 18

Pigmented Nevi (Congenital melanocytic nevi, CMN)

Answer 18

[common pigmented lesions]

• Dark brown or black macules
• Proliferation of melanocytes
• Lower back and buttocks most common
• 1cm - 20 cm range
• 20 cm malignant changes
• Observe carefully; laser or surgical excision

Question 19

Tuberous Sclerosis

Answer 19

[common pigmented lesions]

• Hereditary disorder
• Cutaneous & central nervous tumors
• Seizures, delays, and behavioral
• Hypopigmented, white macules
• Ash leaf macules “leaf” shaped
• Trunk & buttocks
• Very light in color!

Question 20

Aplasia cutis congenita

Answer 20

[common pigmented lesions]
"CUTIS APLASIA"
- congenital abnormality
- absence of some layers of skin
- scalp
- trisomy 13 (Patau's syndrome)
- Rx: surgery

Question 21

Identify a rash in this category: Linear

Answer 21

Contact dermatitis (poison ivy)

Question 22

Identify a rash in this category: Annular

Answer 22

Tinea corporis (ring-worm)

Question 23

Identify a rash in this category: Herpetiform

Answer 23

Herpes

Question 24

Identify a rash in this category: Acriform

Answer 24

Erythema multiforme/Erythema marginatum (semi-circular, or arc-like)

Question 25

Identify a rash in this category: Discoid

Answer 25

Discoid lupus erythematous (disk-shaped)

Question 26

Identify a rash in this category: Nummular

Answer 26

Eczema (coin-shaped)

Question 27

Identify a rash in this category: Guttate

Answer 27

Psoriasis