missed rosh review - DERM Flashcards
This condition is a toxin-mediated bacterial skin disorder that primarily affects young children ages 0-6. Characteristics include erythroderma and blisters in area w/ high mechanical stress
staph scalded skin syndrome (SSSS)
what is the clinical characteristic of SSSS
- diffuse skin pain, erythema, superficial blisters, and desquamation
- prodrome of low-grade fever, irritability, poor oral intake, impetiginous lesions and bacterial conjunctivitis
- + Nikolsky sign
- blisters in areas of mechanical stress
what is the classic sign known as SSSS sad face?
thick perioral crusting with a dried oatmeal appearance that can develop around the mouth, nose, and sometimees eyes
what is a significance of difference between SSS and SJS/TEN
SSSS typically does NOT have mucous membrane involvement
what is the first line tx of SSSS
IV abx: penicillinase-resistant penicillin (oxacillin, nafcillin)
what is the most common type of psoriasis in children?
chronic plaque psoriasis
is psoriasis typically on EXTENSOR or FLEXOR surfaces
EXTENSOR - elbows and knees
what are the key clinical features of plaque psoriasis?
- well demarcated, erythematous placques with a overlying silvery-white scaling
- elbows and knees are most common site
- SYMMETRIC
- children - involvement of face, scalp, and intertriginous areas
what is the treatment for plaque psoriasis?
< 10% BSA - topical corticosteroid (dexamethosone, indamethasone)
> 10% BSA - systemic or phototherapy (methotrexate, biologics)
intreginous - calcinerin inhibitors
what is the cause of lesions presentign as small erythematous papules with linear tracts/burrows on the pals, soles, wrists, axillae, waist, genitalia, and buttock?
scabies
what is the treatment for scabies
1st line in kids (>2mo) = topical permethrine
infancts < 2 mo and pregnant patients = topical sulfur
oral ivermectin is effective, but not recomended for children < 5y/o
what is different in estimating the BSA% of burns in infants < 1 y/o?
- head - 19%
- arm - 7% ea.
- ant. trunk - 13%
- post. trunk - 13%
- leg - 13% ea.
only partial-thickness and full thickness burns are included in the estimation
Excess of what hormone leads to androgenic alopecia?
**dihydrotestosterone (DHT)
**
* why? –> high a-5 reductase levels, which promotes conversion of testosterone to DHT
* high DHT levels result in shortening of anagen (growth) phase -> follicular miniaturization and loss of terminal hair fibers
clinical characteristics of androgenic alopecia?
- follicular miniaturization (shorter, thinner, vellus hairs)
- loss of terminal hair fibers
- ASYMPTOMATIC –> no itching, burning, or tenderness of the scalp
- NO inflammation or scarring present
- Location: midfrontal scalp, temporal scalp, or VERTEX
treatment of androgenic alopecia? how do they work?
1st line agents: topical minoxidil and oral finasteride
* minoxidil - promotes duration of anagen phase and enlarges miniaturized follicles by vasodilation
* finesteride - 5-alpha-reductase inhibitor, lowers serum and scalp levels
definitive: surgical hair transplant
which exanthem is tetarogenic if maternal infection occurs (esp in 1st tri)
Rubella
what are the clinical manifestations of congenital rubella syndrome?
*** decreased hearing
* cataracts
* cardiac dz **
* fetal growth restriction
* infantile glaucoma
* petechiae and purpura that appears as a blueberry muffin rash
* hemolytic anemia
Which congenital condition is Hutchinson teeth, or peg-like incisors or molars, associated with?
Congenital syphilis
what is the first line self-administered vs. clinician-administered treatment for warts?
self - salicylic acid (painless, best for younger children)
clinician - cryotherapy (painful, better for older children and adults)
causes of cutaneous and genital warts?
soles and palms - HPV 1
common warts - HPV 2 & 4
genital - HPV 6 & 11
how are TEN and SJS differentiated
Toxic epidermal necrolysis and Stevens-Johnson syndrome are differentiated by the percent of total body surface area involved, with the former including > 30% and the latter including < 10%. These conditions overlap in patients with skin detachment of 10–30% of total body surface area.
treatment for SJS/TEN
stop the offending agent, supportive care and crystalloid administration, transfer to specialized center
* high risk for electrolyte imbalance and infection!!!
clinical manifestations of SJS/TEN
- widespread blistering and sloughing of the skin and mucous membranes
- begins with diffusely red, sunburn-like tender skin with scattered target lesions and bullae
- Bullae coalesce as the disease progresses
- full-thickness epidermal necrosis and detachment –> skin sloughing
- **lesions typically originate on the face and trunk before spreading to distal extremities **
