Infectious and Non-Infectious Pediatric Rashes Flashcards
varicella zoster virus:
Distribution: starting on __ and progressing __.
Rash: __, then __ then umbilicated and crusted. Appears in __.
Symptoms: pruritic vesicular rash with central __, on erythematous base with mild fever. __ signs.
Distribution: starting on trunk and progressing outwards.
Rash: papules, then vesicles then umbilicated and crusted. Appears in crops.
Symptoms: pruritic vesicular rash with central umbilication, on erythematous base with mild fever. URTI signs.
symptoms of roseola. What virus is it caused by?
Etiology: human herpes virus 6 and 7
“Baby measles”
Symptoms: high fever >39.5 for 3-7 days followed by rash, febrile seizures with 10-15% of first presentation. MAy have URTI, GI or otitis media signs. Incubation period is 9-10 days.
Erythema Infectiosum
Etiology:____
Prodrome: fever, malaise, myalgia, headache 7-10 days prior
May have no recollection of prodrome
Rash: red __ rash over cheeks, often __ pallor. Symmetric, maculopapular, lacklike and often pruritic rash starting on __ and spreading to the periphery. Rash my fluctuate with __
Etiology: parvovirus B19
Prodrome: fever, malaise, myalgia, headache 7-10 days prior
May have no recollection of prodrome
Rash: red macular rash over cheeks, often perioral pallor. Symmetric, maculopapular, lacklike and often pruritic rash starting on trunk and spreading to the periphery. Rash my fluctuate with temperature
Impetigo
Rash: polymorphic __, erythematous, __,excoriated, __ crusting.
Microbiology:__s and __
Treatment: topical __, __. __ or __ if oral
Rash: polymorphic patches, erythematous, pustular,excoriated, yellow crusting.
Microbiology: S. Aureus and S. pyogenes.
Treatment: topical bacitracin, mupirocin. Cephalexin or cloxacillin if oral
d. Scarlet fever
Microbio: ___ (group __ __ strep)- pyrogenic (__ toxin)
Symptoms: __ onset of fever, __ +/- abdo pain, headache toxicity, pharyngitis with __ and chills
Rash: generalized erythematous, punctate/finely papular rash. May have __ line on _, neck or axillae. __ tongue and __ on palate. May have __ of hands and feet after a week.
DDx: __, scarlet, streptococcal __, roseola, measles, drug eruption, EBC
Diagnosis and treatment: isolation of S. pyogenes. Treat with __ V or __, __/__/___ if allergic to pen.
Microbio: S. pyogenes (group A betahemolytic strep)- pyrogenic (erythorogenic toxin)
Symptoms: acute onset of fever, vomiting +/- abdo pain, headache toxicity, pharyngitis with exudate and chills
Rash: generalized erythematous, punctate/finely papular rash. May have pastia’s line on groin, neck or axillae. Strawberry tongue and petechiae on palate. May have desquamation of hands and feet after a week.
DDx: kawasaki’s, scarlet, streptococcal TSS, roseola, measles, drug eruption, EBC
Diagnosis and treatment: isolation of S. pyogenes. Treat with penicillin V or amoxicillin, cephalosporin/macrolide/clinda if allergic to pen.
Key symptoms of kawasaki disease
WARM CREAM
Warm= fever
C= conjunctival symptoms
R= red skin rashes
E= edema
A= adenopathy
M= mucosal changes *strawberry tongue)
Rash: generalized maculo-papular rash. Starts often on forehead, spreading over three days to the trunk and extremities. Rash more confluent over the head and upper extremities than lower body.
Prodrome: cough, coryza, conjunctivitis, koplik spots are pathognomonic, fever 40-40.5, lymphadenopathy including mesenteric
Complications: otitis media, pneumonia, encephalitis, subacute sclerosing panencephalitis, GI bleeding, DIC, mild liver involvement, blindness, death.
Incubation: 10-12 days
MEASLES
Rash: clusters of pearly papules with umbilicated centers. Cheese contents localized to trunk. May accompany STD’s in sexually active individuals. Asymptomatic generally speaking. May disseminate in immunocompromised
Incubation: 2-7 weeks, replicates in host epithelial cell.
Spread: direct contact, fomites, auto-inoculation
Treatment: usually self limited disease. May use liquid nitrogen or mechanical removal
MOLLUSCUM
Epi: common in full term infants
Rash: small, yellow-white, firm, occasionally, vesiculopustular papules on an erythematous base. Face, trunk and extremities. Sterile with eosinophils.
1-3 days after birth, lasts 1 week.
Sparing of palms and soles.
Erythema Toxicum
- Evanescent superficial pustules, ruptured with fine collaret of fine scale, hyperpigmented macules
- Lesions present at birth, pustular phase lasts 2-3 days, hyperpigmentation up to 3 months
- Anterior neck, forehead, lower back • Sterile, no eosinophils
Transient Pustular Melanosis
Epsteins’ pearls:
small, white or gray lesions on the mucosa, alveolar ridge and hard palate. All asymptomatic and are usually shed within the first three months of life.
tiny yellow macules or papules at the opening of each pore over the nose and cheeks of term newborns
Sebaceous Hyperplasia:
caused by swear retention resulting from pore closure. Mild erythema or vesicles, patches of erythema studded with tiny vesicles. Often misdiagnosed as contact dermatitis.
Miliaria Crystallina
nevus of ota
compare and contrast salmon patch with port wine stain
Salmon patch: midline capillary malformation, often on forehead. Extremely common and often progresses over time. DIFFERENT THAN PORT WINE STAIN BECAUSE SALMON PATCH IS NOT DISFIGURING. Does not need treatment. If on nape of neck, it persists into adulthood (hard to see)
Trigeminal PWS is associated with __, __, and __ involvement (sturge-weber syndrome)→ can cause __ because the venous malformation is __, leading to neural impairment.
Trigeminal PWS is associated with leptomeningeal, ocular, and CNS involvement (sturge-weber syndrome)→ can cause seizures because the venous malformation is intracranial, leading to neural impairment.
PWS may occur on the trunk and extremities, with extremity lesions occasionally developing progressive lymphectasia and soft-tissue hypertrophy–? what’s this called
kipple trenaunay weber
port winee stain:
Cosmetically __ due to congenital capillary and __ malformation
At birth, lesions are first noted as subtly, light pink patches, commonly appearing on the face and often in a __ dermatomal distribution.
Cosmetically disfiguring due to congenital capillary and venular malformation
At birth, lesions are first noted as subtly, light pink patches, commonly appearing on the face and often in a trigeminal dermatomal distribution.
atopic dermatitis is associated with __ __ and ___. also associated with elevated serum __ levels and a fmaily history.
treatment: dry skin measures, sedating antihistamines, topical anti inflammatoryies like topical steroids or ___ inhibitors. Use emollients.
atopic dermatitis is associated with allergic rhinitis_ and asthma. also associated with elevated serum __ levels and a fmaily history.
treatment: dry skin measures, sedating antihistamines, topical anti inflammatoryies like topical steroids or calcineurin inhibitors. Use emollients.
T/f generic steroids are the same as brand name products
false. generic topical steroid preparations do not duplicate the vehicle of the brand-name product
T/F: when a stronger steroid is needed, consider switching to another steroid in the same class of steroid potency rather than increase the percentage of the same drug
true
d. Seborrheic dermatitis
differentiate between primary and irritant diaper dermatitis
Primary dermatologic diaper dermatitis: seborrheic dermatitis, psoriasis, candida, histiocytosis → involves folds.
Irritant diaper dermatitis: spares folds because it only involves the surfaces in contact with diaper → higher suspicion with reusable diapers.
__-related erythema multiforme, characterized by ___ lesions and a predominantly inflammatory histopathologic pattern
HSV-related erythema multiforme, characterized by target lesions and a predominantly inflammatory histopathologic pattern
SJS-TEN complex, primarily ___-related and characterized by atypical or no target lesions at all and a predominantly __ histopathologic pattern.
SJS-TEN complex, primarily drug-related and characterized by atypical or no target lesions at all and a predominantly necrotic histopathologic pattern.
what virus causes this?
erythema multiforme is caused by HSV
EBV can cause ___ ___ ___, aka gianotti-crosti syndrome
infantile papular acrodermatitis
NOT pruritic and may be accompanied by splenomegaly, hepatitis, lymphadenopathy.
