PED- DERM BENIGN KEY POINTS

Question 1

Management of Insect Bites/Stings?

Answer 1

• Addressing significant itching and discomfort with appropriate treatments such as oral antihistamines when over-the-counter creams are ineffective.
  
  • Ensuring environmental protection against further bites.

Question 2

Sunburn Prevention and Management?

Answer 2

• Importance of using broad-spectrum sunscreen with at least SPF 30.
  
  • Recommending protective clothing and seeking shade to prevent sunburns.

Question 3

Acne Management in Adolescents:

Answer 3

• Adhering to and intensifying topical treatments when initial treatments are not effective.
  
  • Considering adding a topical retinoid for better results.

Question 4

Acne Vulgaris and Psychological Impact:

Answer 4

• Addressing severe acne issues with potential oral antibiotics or isotretinoin therapy.
  
  • Screening for depression and providing counseling due to the emotional impact of severe acne.

Question 5

Erythema Toxicum (newborn rash)

Answer 5

• Affects 50% of full-term infants.
• Appears 24-48 hours after birth, resolves in 1-2 weeks.
• Blotchy, erythematous macules with central papules, usually 2-3 cm in diameter.
• Seen on chest, face, extremities but not palms or soles.
• No treatment necessary; educate parents to leave it alone

Question 6

Acne Neonatorum (newborn acne)

Answer 6

• Due to sebaceous gland sensitivity to maternal hormones.
• Begins at 2-4 weeks, may last until 4-6 months.
• No treatment needed; avoid baby oils and ointments.

Question 7

Transient Neonatal Pustular Melanosis

Answer 7

Black/brown or red bumps on dark skin; yellow/white on light skin.
- Common in black babies; sometimes seen in white babies.
- No erythema at the base, can cluster, resolves in 3-4 weeks.
- Seen on palms and soles, unlike erythema toxicum.

Question 8

Sebaceous Gland Hyperplasia

Answer 8

• Prominent yellow papules on face (nose), caused by maternal hormones.
• Resolves in a few weeks to 4-6 months without treatment.

Question 9

Milia

Answer 9

• Tiny white bumps from blocked skin pores.
• Found on the face of 40% of newborns, disappear by 1-2 months.
• No treatment needed.

Question 10

Mongolian Spots/Dermal Melanocytosis

Answer 10

• Blue-gray, flat, and irregular, mostly on back and buttocks.
• Common in Asian, Native American, African, and Hispanic newborns.
• Fade by age 2-3, not related to bruising.

Question 11

Sucking Blisters

Answer 11

• From vigorous sucking in utero or after birth.
• Found on forearms, wrists, thumbs, upper lip.
• Resolve within a week.

Question 12

Nevus Flammeus / Stork Bite / Salmon Patch

Answer 12

• Dilated capillaries, flat and pink.
• Seen on face and nape of neck, fade by 18 months.
• Redness increases when baby is hot or upset.

Question 13

Vascular Birthmarks: Hemangiomas

Answer 13

• Benign tumors formed by rapidly dividing blood vessels.
• Not present at birth, appear 2-4 weeks after and grow rapidly initially.
• More common in light-skinned infants, especially females.
• Most disappear by age 2-3, max regression by 5 years.
• Large or complicated ones may require pediatric dermatology referral.

Question 14

Port Wine Stains

Answer 14

• Capillary malformations, persist over time.
• Pink/purple, often unilateral and follow a dermatomal distribution.
• May need laser therapy; can be associated with neurocutaneous syndromes (e.g., Sturge-Weber syndrome).
• Early treatment creates better results.

Question 15

Cafe au Lait Spots

Answer 15

• Uniform brown macules, indicative of potential neurofibromatosis if multiple.
• Present in 25-35% of children aged 4-18.
• Diagnostic criteria for neurofibromatosis include six spots >0.5 cm before puberty or >1.5 cm after.
• Close monitoring required; referral to pediatric neurologist if criteria met.

Question 16

Freckles and Lentigines

Answer 16

• Freckles: Small, flat, brown due to sun exposure, common in fair skin.
• Lentigines: Larger, flat, brown spots, not necessarily sun-related.