Pediatric Derm Flashcards
Mongolian Spot
What are Mongolian spots
Collection of melanocytes in the dermal layer
Also known as congenital dermo-melanocytosis
What are the signs and symptoms of Mongolian spots
Flat blue or gray lesions with well-defined margins
Commonly found in the presacral region
More common dark skinned races
Often confused with bruises
Will fade with time
Erythema toxicum
What are the signs and symptoms of erythema toxicum
Small papules/pustules on an erythematous base
Usually appear after first day of life
Lesions will contain mostly eosinophils
Seborrheic dermatitis
“Cradle Cap”
What are the signs and symptoms of seborrheic dermatitis
Erythematous, try, crusting lesions on the face, scalp, perineum, postauricular and intertrigenous Areas
less pruritic than eczema
What are intertrigenous ares
Area where two surfaces of skin touch or rub together
What is the treatment first of seborrheic dermatitis
Baby oil
Dandruff shampoo (Hypersensitivity to yeast)
Hydrocortisone for severe cases
Milia
What is Milia
Small inclusions cyst
Epstein’s pearls in the mouth are common
Self-limited, benign
Cutis Marmorata
What is cutis marmorata
Lacy pattern on skin
Represents is a vasomotor response to cold stress
Persistent form is seen with trisomy 21 and trisomy 18
Usually decreases with warmth to the child
Neonatal Acne
What is neonatal acne
Comedomes caused by an excess in circulating androgenic hormones
No treatment usually required
Salmon Patch
Stork Bite
What is a salmon patch
Flat vascular lesion commonly seen over the eyelids, glabella, the nucal areas, symmetric
Usually disappears time
Distinguish from Portwine stains (permanent, unilateral, more intensely colored)
Capillary Hemangioma
What is a capillary hemangioma
Macular strawberry colored lesions
Grow quickly in the first your life
99% regressed completely by age 9 with no treatment
When is treatment indicated for capillary hemangioma
Becomes Caverness (Kasabach merrit)
Is in the airway (suggested by cutaneous lessions in a beard distribution)
Threatens vision
What is kasabach merrit syndrome
Hemangioma with thrombocytopenia
Vascular tumor leads to decrease in platelets
May become cavernous
Portwine stain
Cafe Au Lait spots
What are the signs and symptoms of cafe au lait spots
Sharply demarcated tan or light brown flat lesions
Occur anywhere
Variable and size
Associate with neurofibromatosis
Acne Vulgaris
What is that Acne Vulgaris
Skin disorder caused by:
- Abnormal characterization of the follicular epithelium
- Increase sebum
- Inflammation from bacteria growth (Propionibacterium acnes)
All these changes are stimulated by pubertal hormonal changes
What is the treatment for acne vulgaris
Keep skin cleaned
No special diet
Abnormal keratin: benzyl peroxide’s (topical)
Bacterial Overgrowth: topical (clindamycin) or Systemic antibiotics (tetracyclines)
Increased Sebum: topical or systemic retinoids
What side effects are associated with systemic retinoid therapy
Photosensitivity
birth defects
Atopic Dermatitis
What is atopic dermatitis
Chronic relapsing remitting inflammatory skin reaction with a strong genetic predelection
What are the signs and symptoms of atopic dermatitis
Pruritic your erythematous papulovesicular reaction that progresses to scaling, hypertrophy and lichenification
Less than two years: extensors, face, scalp, sparing of diaper
Older: flexor, neck, wrist, ankles
What is the treatment for atopic dermatitis
Emoillents, decreased irritants
Topical corticosteroids
Topical immunosuppressants (tacrolimus, pimectrolimus)
What complications are associate with atopic dermatitis
Bacterial or herpetic superinfection
Staph, strep, HSV
Psoriasis
What is psoriasis
Chronic inflammatory disease with strong genetic predisposition that affects 1 to 3% of the population
What are the signs and symptoms of psoriasis
Plaques and papules with silver scale mostly on extensor surfaces
Nail Findings: pitting, oncholysis, and yellow discoloration
What is the treatment for psoriasis
Emollients, topical steroids, tar and phototherapy
Tinea Corporis
What pathogens are associated with tinea corporis
Trichophyton tonsurans
Microsporum canis
What are the signs and symptoms of tinea corporis
Annular lesion with raised order, scaling and central clearing
What is included in the differential for tinea corporis
Erythema migrants (lime disease)
nummular eczema
Psoriasis
Erthema Multiforme
What is the treatment for tinea corporis
Topical antifungal (such as clotrimazole)
Tinea Capatis
Kerion
What pathogens are associated with tinea capitis
Trichophytum tonsurans,
Microsporum Canis
What are the signs and symptoms of tinea capitis
Hair loss, scalp pruritus, (black dot sign), occipital adenopathy
What is the treatment for tinea capitis
Griseofulvin for 4 to 6 weeks
What is a kerion
Allergic reaction to the fungus causing a buggy granulomatous mass. They often resolve on their own; some require steroids
What causes the “black dot sign”
broken hairs at the base that looks like black dots
Staphylococcal Scalded skin syndrome
What are the signs and symptoms of staphylococcal scalded skin syndrome
Ill peering infant with inflamed maculopapular rash with purulent discharge
What is the treatment for staphylococcal scalded skin syndrome
Fluid resuscitation, intravenous antibiotics
Impetigo
What is impetigo
Superficial skin infections staph aureus or group A beta-hemolytic strep
Where the signs and symptoms of impetigo
Nonbullous: vesicles, papules, plus shows that rupturing leave a honey colored crust over a shallow ulcerated base
Bullous: red macules the progress to bullous reactions on an erythematous base
What is the treatment of impetigo
Bactroban: Mupirocin tropical
Oral antibiotics if extensive
Pityriasis Rosea
What are the signs and symptoms of pityriasis rosea
Herald patch: annular, raised boarder with fine adherent scales
5 to 10 days later, widespread symmetric eruption: oval, round, less than 1 cm, may have scale, “Christmas tree pattern” - follow skin folds; pruritic
May persist for 4 to 6 weeks
What is the treatment for pityriasis rosea
Emoilents
Antihistamines
Trial of steroids, but this is yet to be proven
Cellulitis
What are the signs and symptoms of cellulitis
Erythema, warm, paint
It’s an infection of the deeper layers of the skin caused by group A beta-hemolytic strep or staph aureus
Erythema multiforme
What are the signs and symptoms of erythema multiforme
Hypersensitivity reaction associated with viral infections, mycoplasma infection, drug ingestion, immunizations and food reactions
Signs and symptoms: symmetric distribution of lesions evolving through multiple morphological stages including target lesions
What is the treatment of erythema multiforme
Symptomatic
Steven Johnson syndrome
What is Stevens-Johnson syndrome
Severe form of erythema multiforme
Signs and symptoms: inflammatory Bullae on two or more mucous membranes
What is the treatment for Stevens-Johnson syndrome
Supportive care, especially fluid management
Associated with a 10% mortality
