Pediatric Dermatology Flashcards
Atopic dermatitis (eczema) in children/adults usually appears on […] surface.
Atopic dermatitis (eczema) in children/adults usually appears on flexor surfaces
e.g. antecubital fossa
Atopic dermatitis (eczema) in infants usually manifests as pruritic, scaly, erythematous lesions on the […], chest, and extensor surfaces.
Atopic dermatitis (eczema) in infants usually manifests as pruritic, scaly, erythematous lesions on the face, chest, and extensor surfaces.
Do strawberry hemangiomas typically regress spontaneously?
Yes (after an initial period of rapid growth)
Intentional scald injuries in children are characterized by sharp lines of demarcation and uniform burn depth with sparing of […] surfaces.
Intentional scald injuries in children are characterized by sharp lines of demarcation and uniform burn depth with sparing of flexor surfaces.
accidental injury is typically characterized by splash marks, poorly defined wound margins, and non-uniform burn depth
Staphylococcal scalded skin syndrome is caused by […] toxin-producing strains of S. aureus.
Staphylococcal scalded skin syndrome is caused by exfoliative toxin-producing strains of S. aureus.
Staphylococcal scalded skin syndrome usually affects children, but may also be seen in adults with immunocompromise or […] insufficiency.
Staphylococcal scalded skin syndrome usually affects children, but may also be seen in adults with immunocompromise or renal insufficiency.
Sunscreen with SPF 15 - 30 or higher should be applied […] - […] minutes prior to sun exposure to allow time for development of a protective film.
Sunscreen with SPF 15 - 30 or higher should be applied 15 - 30 minutes prior to sun exposure to allow time for development of a protective film.
sunscreen should be reapplied at least every 2 hours; the best form of photo-protection is sun avoidance
The targetoid appearance of erythema multiforme is due to central epidermal […], surrounded by erythema.
The targetoid appearance of erythema multiforme is due to central epidermal necrosis, surrounded by erythema.
What demographic is typically affected by Tinea capitis?
African American children
What dermatologic condition is more common in patients with a family history of asthma and/or allergic rhinitis?
atopic dermatitis (eczema)
What is the first-line treatment for atopic dermatitis (eczema)?
topical emollients
treatment also includes trigger avoidance to minimize irritation (e.g. using hypoallergenic cleansers)
What is the first-line treatment for tinea corporis?
Topical antifungals (e.g. clotrimazole, terbinafine)
more severe/extensive cases may require systemic therapy
What is the likely diagnosis in a child that notices multiple, mildly pruritic hypopigmented skin lesions on the face and trunk after beginning summer camp?
Tinea versicolor (pityriasis versicolor)
typically noticed after sun exposure as the surrounding skin gets darker
What is the likely diagnosis in a child that presents with an erythematous, sharply demarcated perianal rash that is associated with pruritus and pain?
Streptococcal perianal dermatitis
treatment is with oral beta-lactam antibiotics
What is the likely diagnosis in a child that presents with generalized erythema, fever, and superficial flaccid bullae with a positive Nikolsky sign?
Staphylococcal scalded skin syndrome
typically a self-resolving process that only requires supportive care; the Nikolsky sign is positive if gentle lateral pressure on the skin surface causes detachment of the superficial skin
What is the likely diagnosis in a child that presents with linear streaks of erythematous vesicles a few days after returning from a camping trip?
Contact dermatitis
likely secondary to urushiol exposure in poison ivy
What is the likely diagnosis in a child that presents with pruritic, erythematous plaque on the scalp that resulted in patchy hair loss with residual “black dots”?
Tinea capitis
What is the likely diagnosis in a healthy-appearing newborn that presents with scattered blanchable erythematous papules that spare the palms/soles?
Erythema toxicum neonatorum
benign neonatal rash that resolves spontaneously within 2 weeks after birth; common in full-term infants
What is the likely diagnosis in a vaccinated child that presents with intensely pruritic small, erythematous papules and burrows involving the hands?
Scabies
often involves the interdigital web spaces; spread by person-to-person contact, therefore asking about contacts with similar symptoms is important
What is the likely diagnosis in an African-American infant that presents with flat blue-gray patches on the lower back and buttock?
Congenital dermal melanocytosis (“Mongolian spot”)
What is the likely diagnosis in an athlete that presents with a scaly, erythematous, pruritic plaque with a raised border and central clearing on their leg?
Tinea corporis (ringworm)
What is the likely diagnosis in an infant that presents with erythematous plaques with yellow, greasy scale on the scalp?
Seborrheic dermatitis (“cradle cap”)
What is the likely diagnosis in an infant that presents with the lesion below?
Superficial infantile (strawberry) hemangioma
What is the likely diagnosis in an infant with a history of atopic dermatitis that presents with fever and multiple painful vesicles in the distribution of the eczema? Gram stain of the lesions is negative.
Eczema herpeticum
due to superimposed HSV-1 infection; requires systemic acyclovir treatment
What is the likely diagnosis in an infant with an erythematous rash in the diaper region that spares skin folds?
Irritant (contact) diaper dermatitis
What is the likely diagnosis in an infant with an erythematous rash in the diaper region with satellite lesions and involvement of skin folds?
Candidal diaper dermatitis
What is the likely diagnosis in an infant with an isolated, hyperpigmented patch with numerous dark, coarse hairs?
Congenital melanocytic nevus
What is the likely diagnosis in an infant with blanchable, pink patch involving the glabella?
glabella: the smooth part of the forehead above and between the eyebrows.
Nevus simplex
What is the next step in management for a newborn with suspected erythema toxicum neonatorum?
Reassurance
What is the recommended management for strawberry hemangiomas that are disfiguring, disabling, or life-threatening?
Beta blockers (e.g. propanolol)
What is the recommended management of pityriasis rosea?
Reassurance
may use antihistamines for symptomatic relief of itching if necessary
What is the recommended treatment for scabies?
topical permethrin or oral ivermectin
What is the recommended treatment for seborrheic dermatitis in infants?
emollients and non-medicated shampoos
spontaneous remission is common
What is the recommended treatment for tinea capitis?
oral griseofulvin or terbinafine
What microorganism is involved in the pathogenesis of tinea versicolor?
Malassezia
grows best in hot and humid environments
What microorganism is most commonly involved in the pathogenesis of tinea capitis?
Trichophyton tonsurans
other dermatophytes, such as Microsporum canis, can also cause tinea capitis
What type of hypersensitivity reaction is contact dermatitis (e.g. poison ivy, nickel allergy)?
Type IV HSR (delayed-type hypersensitivity)
Which skin disorder begins as a “Herald patch” followed days later by other scaly, erythematous plaques in a “Christmas tree” distribution on the trunk?
Pityriasis rosea
may be associated with a viral prodrome; self-resolving in 6 - 8 weeks
Erythema multiforme is a blistering skin disorder most commonly associated with […] infection.
Erythema multiforme is a blistering skin disorder most commonly associated with HSV infection.
less commonly associated with Mycoplasma pneumonia infection; may also be seen with drugs (e.g. penicillin, sulfonamides), autoimmune disease, and malignancy
[…] is a blistering skin disorder most commonly associated with HSV infection.
Erythema multiforme is a blistering skin disorder most commonly associated with HSV infection.
less commonly associated with Mycoplasma pneumonia infection; may also be seen with drugs (e.g. penicillin, sulfonamides), autoimmune disease, and malignancy
Bullous impetigo has bullae and is usually caused by […] infection.
Bullous impetigo has bullae and is usually caused by S. aureus infection.
