When do you develop the following embryologically? Nails Hair All layers of epidermis Epidermal barrier

Nails: 8-9 wks Hair: 17-19 wks All layers of epidermis: 24 wks Epidermal barrier: 35 weeks

Neonatal rashes Flashcards by Robyn Duffus

When do you develop the following embryologically?

Nails
Hair
All layers of epidermis
Epidermal barrier

Nails: 8-9 wks
Hair: 17-19 wks
All layers of epidermis: 24 wks
Epidermal barrier: 35 weeks

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When is erythema toxicum first noted?

What is a key feature of it?

What type of cells are seen?

What does it resolve?

24-48h post delivery

Spares palms/soles

Eosinophilic

Lesions last <1 day, settles within a week

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Erythema toxicum neonatorum

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When is transient neonatal pustular melanosis first noted?

When do they resolve?

What cells are seen in the pustule?

At birth (5% darker skins, <1% white)

Weeks to months

Neutrophils

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Transient neonatal pustular melanosis

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Miliaria rubra

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What layer of skin does miliaria crystallina occur?

What layer of skin does miliaria rubra occur?

Eccrine sweat ducts

Spinous layer

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Neonatal cephalic pustulosis

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When is neonatal cephalic pustulosis typically seen?

When does it disappear?

2-3 weeks of life

By 3 months

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Congenital candidiasis

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When do lesions present for congenital candidiasis?

What does the rash look like?

Which population is at high risk of disseminated disease?

What is the mortality rate of disseminated systemic candidiasis?

How long do you treat with fluconazole?

At birth or first few days of life

widespread vesiculopustular eruption with fine scale

Premature/low birth weight infants

20%

21 days after microbiological clearance

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Neonatal Candidiasis

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When do lesions present for neonatal candidiasis?

Describe the appearance of lesions.

Where do the lesions tend to be located?

How are they treated?

1 week

Erythematous patches, satellite papules/pustules

Flexures and diaper area

Topical antifungal (imidazole = cannestan)

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List 3 features of congenital HSV?

Which pregnancies are at highest risk?

What type of infection carries a 2% risk?

When are lesions noted with congenital HSV?

Aplasia cutus
Microcephaly
Temporal lobe encephalitis
Chorioretinitis

Primary infection during pregnancy (57%)

Recurrent infection

Birth or within 48h

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What are the 3 types of neonatal HSV?

What is the incubation period for HSV?

What is the recommended treatment?

Mucocutaneous
Disseminated
CNS

4-21 days

IV Acyclovir 14-21 days, prophylaxis x 6 months

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Neonatal lupus

List 3 complications of neonatal lupus

What type of antibodies are seen with this disorder?

Thrombocytopenia
Hepatosplenomegaly
Congenital heart block

Maternal anti-Ro and anti-La

List 3 physical causes of blistering in a neonate

Iatrogenic
Sucking blister
Electrodes from fetal scalp monitoring
Instrumental delivery
Iodine/alcohol burn

List 2 inflammatory causes of blistering in a neonate

Bullous mastocytosis
Urticaria pigmentosis

List 3 autoimmune causes of blistering in a neonate

Bullous pemphigoid
Chronic bullous dermatosis of childhood
Maternal bullous disease

List 3 genetic causes of blistering in a neonate

Epidermolysis bullosa
Incontinentia pigmenti
Epidermolytic ichthyosis

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Staphylococcal scalded skin syndrome

Name the location the exfoliative toxin attacks in SSSS

Desmoglein-1

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What is the deficiency?

List the triad

Acrodermatitis enteropathica

Zinc deficiency

Alopecia
Diarrhea
Periorificial rash/diaper rash

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Incontinentia pigmenti

List the 4 phases of incontinentia pigmenti What gene is implicated? What is the inheritence pattern?

1. Vesicular 2. Verrucal/Crusting 3. Hyperpigmented 4. Hypopigmented IKBKG (NEMO) X-linked dominant

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Epidermolytic Ichthyosis

Where are the mutations located for epidermolytic ichthyosis? Which mutation location is associated with palmoplantar keratoderma?

Keratin 1 and 10 Keratin 1

Where is the mutation located in EB simplex? What is the affected gene in dystrophic EB? What is the affected gene in junctional EB? What is the affected gene in Kindler syndrome?

Keratin 5 and 14 COL7A1 Collagen 17 KIND1

List 3 complications of dystrophic EB What is the expected life expectancy for junctional EB?

* Cardiomyopathy * Contractures * Squamous cell carcinoma * Stenosis of the esophagus 5-6 months

List 3 features of Kindler syndrome

* Acral blisters in infancy * Photosensitivity * Poikiloderma

What is the implicated transporter in infantile hemangiomas? What type of blood flow is present in infantile hemangiomas?

GLUT1+ Fast flow

What associations are seen with PHACES?

* **P**osterior fossa anomalies * **H**emangioma (segmental) * **A**rtery abnormalities * **C**ardiac anomalies/coarctation * **E**ye abnormalities * **S**ternal abnormalities

What associations are seen with SACRAL syndrome?

* **S**pinal dysraphism * **A**nogenital anomalies * **C**utaneous * **R**enal/urological **A**nomalies * **L**umbosacral hemangioma

What is the location that carries the highest incidence of Sturge-Weber syndrome? What are 2 associations of SWS? Where is the mutation?

Forehead * Glaucoma (ipsilateral) * Leptomeningeal angiomas * Seizures * Intellectual delay Somatic mosaic mutation in GNAQ gene

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Sebaceous nevus

What type of cells are found in sebaceous nevi? What can happen in adolescence? What is the recommendation?

Sebaceous glands Proliferate and become warty/lumpy No longer excise. Monitor later in life.

List the classification of congenital melanocytic nevi What do they need to be monitored for? Who is at highest risk? What gene is affected?

* Small (\<1.5 cm) * Medium (1.5-20 cm) * Large (20-40 cm) * Giant (\>40 cm) Melanoma (neurocutaneous and CNS melanoma) Giant CMN and those with satellite lesions NRAS codon 61