Pediatric Dermatology Flashcards
Harlequin Skin Changes in Newborns
etiology
symptoms
diagnosis & treatment
etiology
- a benign abnormal vascualr response of pooling in response to positional changes
- occurs when infant is laying on side
Symptoms
- momentarily; a red colored sharply demarcated at the midline
- can last from about 30 seconds to 20 minutes
- resolves when laying supine/prone
- MC in the low birthweight infants
Diagnosis & Treatment
- it is benign and self limiting
- will resolve on its own
Milia
etiology
symptoms
diagnosis and treatment
Etiology
- small epidermal cysts filled with keratinous material
- can occur at any age, up to 50% seen in newborns as tiny white bumps on teh face
Symptoms
- tiny white bumps on the face, cheeks, nose, chin and forehead
- usually seen in groups
Diagnosis and Treatemnt
- usually resolve spontaneously over a few weeks, no treatment recomennded
- do not pop! they can get infected if skin broken open
- if they occur on the palate : Ebstiens pearls
Miliaria
etiology
symptoms
diagnosis and treatment
Etiology
- also known as “sweat rash or prickyl heat”
- a skin condition in which the eccrine sweat glands get blocked
- two types: mililria crystanllina or miliaria rubra within the infant population
Milriar crystallina
- obstructed sweat glands in the superfiscial portion of the epidermis
- they appear as CLEAR blisters which do not easily break, noninflammatory
- seen on face, head neck and trunk
MIliaria Rubra most common, more bothersome
- obstructed sweat ducts in the mid-epidermal portion
- these are RED papulaes in occluded areas/skin folds
- extremely itchy!! with buring or tingling sensation
Treatment
- cool, dry & loose clothing
- can do antihistamines or low-pot. steroids in severe cases if recurring frequently
Erythema Toxicum Neonatorum
etiology
symptoms
diagnosis and treatment
Etiology
- a benigng slef limiting eruption
- occurs within 1/2 of newborns
- cause is unknown
Symptoms - the leasions becing as poorly defiend **Pink maculres** or **red papules** that are variabel in size - then tehy turn into yellow/pink pustules with a center - **self -resolving over 5-7 days** - occur on face, trunk and extremities
Diagnosis and Treatment
- they usually self-terminate over several days without side effets
- no systemic symptoms: not painful, etc.
- if biopsied: would show eosinophils (but not like ever done)
Transient Neonatal Pustualr Melanosis
etiology
symptoms
diagnosis and treatment
Etiology
- a benging self limiting condition that affects AA babies > whites
- unknonw cause
Symptoms
- lesions are typically present at birth; started in utero
- phase 1: flaccid vesiculopustle with little to no redness for 2 days
- phas e2: collartettes of scales will form
- phase 3: hyperpigmentations macules will form
- can occur anywhere!!!
Diagnosis and Treatment
- self limtiing, no treatment needed
- if biopsied: show neutrophils
Neonatal Acne
etiology
symptoms
diagnosis and treatment
Etiology
- a response to materal hormones causing increased abouts of sebum production in the infant
- being at about 2-4weeks NOT present at birth
Symptoms
- discrete red papuales and pustules on the cheeks
- absent comondones (white and blackheads)
Diagnosis & Treatment
- clincal, can do a culutre if needed
- no treatment needed; will resolve spontaneously in 6 months
Infantile Seborrheic Dermatitis
etiology
symptoms
diagnosis and treatment
Etiology
- also know as “cradle cap”
- occurs in first few months of life
- due to overactive sebatious glands and the irritation of the normal skin bacterial creating the symptoms
Symptoms
- well-circumscribed plaques with a greasy yellow appearance
- on forehead, eyebrows, easr, side of nose, skin folds
Diagnosis and Treatment
- usually go awa y by 8-12 months
- if continue past 12 months:
- plaque removal
- antisebboric shampoo: ketoconazole
- severe or inflammaed cases can warrent steroid use topically
Mongolian Spot
etiology
symptoms
diagnosis and treatment
Etiology
- a congential dermal menalocytosis
- just increased ares of melaoncytes within teh skin
- benign
Symptoms
- a flat, slate grey or blue/black single or mutliple large macualr (flat) lesion
- common in darked skined babies
- commonly at lower spine, shoulders and arms
need to document these because often mistkaend for abuse
usually they fade over the first year of life
Mongolian Spot Variations
Nevous of Ota
Nevous of Ito
Nevous of Ota
- mongolian spot on the trigeminal nerve distribution
Nevous of Ito
- a unilateral lesion over the superclavicualr,deltoid or scapualr region
these tend to persist longer than first year of life because they are from deeper skin layers
a small chance of these two turning into malingnacy: so monitor closely and can be treated with laser!
Cafe au Lait Spots
etiology
symptoms
diagnosis and treatment
Etiology
- a benign conditions of melanocytes in the epidermis
- the birthmark!
- commonly develop in early infancy, full pigmentation appears by about 2 years
Symptoms
- a discrete, light brown oval macule (flat)
those with multiple lesions: > 6 spots are typically seen in neurofibromatosis
Halo Nevus
Halo Nevous
- an area of hypopigmentation surrouding a previously normal appearing nevus (mole)
- due to immune destruction of melaoncytes
- commonly see in those with vitaligo
Symptoms: often a progression
- a rim of pale skin appears arroudn teh mlke
- mole cna become pinker/less pigmented and fade
- the circular oval of depigmentation remains
- then returns to normal color
sometimes this can indicate a skin melanoma elsewhere on the body: so do a full skin check!!
Congenital Nevus
Congential Nevus
- a collection of menlanocytes in teh epidermis which are present at birth or shortly after
- cafe au lait spots are the most common type of congential nevus
Symptoms
- brown macules or patches
- vary in size
- as pt. ages and grows: these do too
careful monitoring of these to ensure there is no abnormal growth, can be malignant
Classifications
- small = 1.5 cm
- medicum: 1.5cm-19.9cm
- large = > 20 cm
can treat with lase or excise: but leads a scar!!
Port Wine Stain
etiology
symptoms
diagnosis and treatment
Etiology
- a congential capillary malformation that presents on the skin as a deep pink or red/purple discoloration
- common on head or neck
Symptoms
- these are well-demarcated areas of a macule which are blanchable
- present from brith and do not fade over time; stay
Sturg-Webber Syndrome: a port wine stain on the trigeminal distrubution
PWS on the back or spine: consider a spinal cord abnormality
Treatmen t
- observe
- pulse-dye laser to remove
Hemiangiomas
etiology
symptoms
diagnosis and treatment
Hemanigomas
Etiolgoy
- “strawberry marks”
- well circumscribed, red, rubber nodule of capillaries
- due to immature angioblascit tissue foramtion
- commonly appear at 3-4 weels
Symptoms
- invoulte over time: years
- 50% will be gone by age 5
Treatment
- if the lesion is obstructiong vision: steroids, propranolol or pulse dye laser
Atopic Dermatitis
etiology
symptoms
diagnosis and treatment
Atopic Derm = Eczema
- chronic cycle of a relasping infalmmatory skin disorder
- “itch scratch cycle”
- a disruption in the normal skin barrier: decreased epidermal lipid content or an increase in transepidermal water loss
Locations in infants: face, elbows and knees
Location in older kids: antecubital and popliteal fossae
Clinical Diagnosis
- acute: red plaques with papules, vesicles and serous exudates
- subacute: red, itched papules
- chornic: thickened skin with attenuated lines
associated with asthma and allergric rhinitis= atpoic triad
