Pediatric Dermatology Flashcards
1
Q
- causes orolabial, genital and congential infections
- transmission occurs during asymptomatic and symptomatic periods of viral shedding
- majority of seropositive individuals report having no history of genital herpes infection
- prodrome of tender LAD, malaise, fever, localized pain, tenderness and burning
- symptoms appear 3 to 7 days after exposure
- usually presents as gingivostomatitis in children or pharyngitis and a mononucleosis-like syndrome in YA
A
Herpes simplex virus
HSV 1
- primarily associated with oral and labial lesions
- largely a childhood disease of oral mucosa, pharynx, lips and occasionally eyes
HSV 2
- primarily associated with anogenital lesions
- commonly spread via a sexual contact or neonates by passage through an infected birth canal
2
Q
- ooccurs in atopic dermatitis
- often acute worsening of the eczema (widespread eruption of monomorphic vessels and erosions, especially in areas of active eczema
- often with fever, adenopathy, irritability
- treatment: IV antivirals typically
A
HSV: Eczema herpeticum
3
Q
HSV treatment
A
Primary Orolabial
- self-limited but may treat if poor intake and dehydration
- most effective when started early (within 72 hrs of onset)
- acyclovir, valacyclovir for recurrent treatment
4
Q
- prodrome of mild fever, malaise and myalgia
- pruitic, erythematous macules and papules–> vesicles surrounded by red halos (dew drops on a rose petal–> pustules and crusts
- starts on the scalp and face then spread to the trunk and extremities. often involvement of the oral mucosa
- heals within 7 to 10 days
- lesions in all stages of development is the hallmark
- usually benign and self limited
A
Varicella
5
Q
complications of varicella?
A
- secondary bacterial infection with subsequent scarring is the most common complication
- reye’s syndrome, encephalitis and acute cerebellar ataxia are rare
- primary varicella in adults often more severe with more complications
- Congenital: low birthweight, cicatrical lesions, ocular abnormalities, cortical atrophy, psychomotor retardation and hypoplastic limbs
6
Q
- 3 c’s: cough, coryza and conjunctivitis
- prodrome of fever, cough, nasal congestion and rhinoconjunctivitis and koplik spots (gray- white papules on the buccal mucosa
- erythematous macules and papules begin on the forehead, hairline and behind the ears then spreads downward onto the trunk
- on 5th day exanthem starts to fade in the same order that it happened
tx: supportive, two dose vaccine
A
measles
7
Q
complications of measles?
A
- otitis, pneumonia, gastroenteritis, enecephalitis and myocarditis
- subacute sclerosing panencephalitis (delayed neurodegenerative disorder may occur many years later)
8
Q
- Aka Erythema infectiousum
- caused by parvovirus B19, a single stranded DNA virus
- transmission by respiratory secretions, blood products and vertical
- peak incidence during winter and spring
- most common in school-aged children
- may begin with mild prodrome of headaches, fever, chills or respiratory symptoms
- 2-3 days after prodrome, bright red macular erythema of the cheeks (slapped cheeks) spares nasal bridge and perioral areas
- 1-4 days after facial rash, erythematous macules and papules which progress to a lacy, reticulate pattern
A
fifth disease
9
Q
- Aka exanthem subitum or sixth disease
- causes by human herpes virus (HHV) 6 or 7
- transmission: saliva, horizontal
- most common in ages 6mon-3yrs
- peak incidence is 6-7 months
- high fever in infant who otherwise appears well
- diffuse rash appears after abrupt defervescence –> rose-pink macules and papules on the trunk, neck, proximal extremities and ocassionally face
tx: supportive, antipyretics
A
Roseola
10
Q
- caused most frequently by cosackie A16 (enterovirus)
- peak incidence is later summer and fall
- incubation is 4-6 days
- 1-2 day prodrome of fever, malaise, sore throat
- gray oral vesicles on red or flesh colored base on hands, feet (can also occur on buttocks, trunk face, and extremities: usually burn or pruritic)
- Vesicles rapidly ulcerate in mouth to leave erosions on tongue, buccal mucosa, posterior pharynx
- tx: supportive; usually clears in < 1 week
A
Hand-foot-mouth diseae
11
Q
types of diaper dermatitis?
A
- infant dermatitis
- candidiasis
- seborrheic dermatitis
12
Q
- due to moisture, feces, urine, bacteria,
- erythematous patches +/-blisters and erosions
- buttocks, vulva, perianal area, lower abdomen and proximal thighs
- spares skin folds
A
irritant contact dermatitis
13
Q
- c.albicans
- beefy red erythema
- erythematous papules that involve skin folds, with pinpoint pustulovesicular satellite lesions
- atopic dermatitis typically spares the groin and diaper area during infancy due to increased hydration/moisture
A
candidiasis
14
Q
- salmon colored greasy plaques with yellowish scale
- hypersensitivity to overgrowth of normal lipophilic yeast
- areas with the highest concentration of sebaceous glands- namely the scalp, face, postauricular, presternal and intertriginous areas
- erythematous, yellowish greasy scale or crusting eruption
- “cradle cap”
- tx: self limited- ketoconazole shampoo, topical corticosteroid to treat the infammation
A
seborrheic dermatitis
15
Q
- most commonly due to C. albicans followed by C. Trpicalis
- tongue, soft and hard palate and buccal and gingival mucosae
- white, friable patches or plaques overlying reddened mucosa
- predisposing factors in children and adults (diabetes mellitus, xerostomia, occlusion, hyperhidrosis, the use of corticosteroids and broad spectrum antibitotics and immunosuppresion, including HIV infection
A
Thrush
DX: clinical, KOH shows budding yeast, fungal culture
tx: nystatin oral suspension
