Pedi Derm Flashcards
Acne Neonatorum
Pustules, papules, comedones. Same as adult acne d/t release of hormones. This is due to the release of maternal hormones. No treatment. Just keep skin dry. Self limiting. Provide reassurance to parents.
Diaper dermatitis assessment
Most common skin disorder in children under 2 years. Variety of kinds. OLDCART. When did it start? Did it spread anywhere - abd, legs. Has anything changed - different wipes, diapers? Anything help it feel better?
Bacterial Diaper Dermatitis
Starts in the deep flexures which show widespread erythema on the buttocks – beefy red in color. Raised edges with sharp marginization and a white scale on the border of lesions. Pinpoint pustulo-vesicular satellite lesions. Encourage abx cream at least once or twice a day. Miserable. Fussing with diaper changes, super uncomfortable. Treat with abx cream alternating with barrier cream.
Candidiasis
Fungal diaper rash. Red, scaly plaques with papules and pustules. Can move up into the suprapubic area and in the folds. Can have satellite lesions.
Treat Candidiasis
Nystatin until 2 or 3 days after it has completely healed 4 times daily. Use barrier cream during the other diaper changes when not using Nystatin
Oral thrush
Same candida of diaper rash can occur in the mouth. White rash that does not scrape off. Oral nystatin 1ml four times a day for 10 days. Disp 60ml. mom can use some on her nipples before and after breast feeding as well. Assess for immunocompromise if chronic candida diaper rash and thrush
Irritant Dermatitis
No open lesions, dry, superficial, found with changing type of diaper, changing diaper creams, wipes. Irritation can –> bacterial or fungal d/t irritated compromised skin. Not frequently changing the diaper can make this worse and progress to bact/fungal rash
Bacterial diaper rash tx
Mupirocin/Polytrim OTC Apply BID to diaper area Disp 30gram tube with refills
Atopic Dermatitis
15-20% of school children, usually starting
Dx Atopic Dermatitis
Itchy skin plus at least 3 of: itching around creases of neck, visible flexural eczema or cheeks/forehead/outer limbs, hx asthma or hay fever or in first degree relative, dry skin, onset first 2 years of life
Lice pediculosis
Pediculosis capitus - head, pediculous corporis - on body. Severe itching. White flecks at nape of neck, behind ears, looks like dandruff but dandruff flakes off this adheres. Can scratch enough to get a secondary infection
Scabies
burrow between fingers complain of severe itching. Erythematous papular and or vesicular eruption that forms a shallow burrow under the stratum corneum. Highly contagious, intensely pruritic. Treat the whole family
Mgmt Lice at home
Live on human scalp, cannot infest pets. Machine wash all items in 130 degree F or place in a plastic bag for 2 weeks. Vaccuum everything to remove infested hair with nits attached dont use bug spray
Lice medication treatment
OTC Meds pyrethins: kills the lice but not approved for children less than 2 years old. Ex RID/NIX. For younger kids can use vaseline overnight and wash next morning. Permethrin lotion 1% is similar which kills adult lice but not nits. Not approved
Mgmt Scabies
Drug of choice is Elimite (permethrin lotion), place on body and bathe after 8-14 hours not for less than 2 months of age. Recheck after 2 weeks. Education on linen treatment. Observe for secondary bacterial infections, post scabies eczema, reaction to scabicide. Use abx soap.
