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DRT PEDS > Pediatric Dermatology > Flashcards

Pediatric Dermatology Flashcards

1
Q

Type of burns

A

First degree
-dry, red, no blisters, insoles EPIDERMIS only

Second degree
-(PARTIAL THICKNESS), moist, blisters, extends beyond epidermis

Third Degree
-(FULL THICKNESS), dry leathery, black, pearly, waxy, extend from epidermis,is to dermis to underlying tissues, fat, MUSCLE and/or BONE

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2
Q

how do you measure burn injuries in pediatrics

A

“rule of nines”
9%-head, front upper torso, back upper torso, front lower torso, back lower torso, front right leg, front left leg, back right leg, back left leg

4.5% each right arm, left arm

1% groin

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3
Q

Primary Management for burns in pediatrics

A

Assess ABCs, might require intubation if
-singed nares or eyebrows
-evaluate nares/mouth for soot/mucous

-DRENCH the burn w/ cool (NOT ICE) water

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4
Q

Evaluation of Skin Disorders 3 types

A

-morphology
-configuration
-distribution

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5
Q

lesion that developes on previously unaltered skin

A

primary lesion

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6
Q

Secondary skin lesion

A

lesion that either changes impression over time or occurs when a primary lesion is scratched (excoriation) it may become infected

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7
Q

flat discoloration skin lesion

A

Macule
ex. ephelides (freckles)
petechiae
flat nevi (moles)

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8
Q

Flat discoloration that looks as though it is a collection of multiple, tiny pigment changes, may be some subtle surface changes

A

Patch
ex. mongolian spot
-cafe au lait spot

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9
Q

elevated firm lesion >1cm

A

nodule
ex. Xanthoma
fibroma

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10
Q

Firm elevated lump

A

Tumor
ex-benign or malignant

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11
Q

small <1cm, elevated, firm skin lesion

A

Papule
example, ant bite
-elevated nevus (mole)
-verruca (wart)

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12
Q

Scaly, elevated lesion

A

Plaque
ex. classic psoriasis

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13
Q

Small <1cm lesion filled with serious fluid

A

Vesicle
ex. herpes simplex
varicella (chicken pox)

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14
Q

Serous fluid-filled vesicles >1cm

A

Bulla
ex. Burns
-superficial blister (sports runners)
-contact dermatitis

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15
Q

Lesion raised above the surface and extending a bit below the. spiders, many times and allergic reaction.

A

Wheal
ex. PPD test
-mosquito bites

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16
Q

Small <1 cm pus filled lesion

A

Pustule
ex: acne and impetigo

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17
Q

A pus filled lesion >1cm

A

Abscess

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18
Q

Large, raised lesions with serous fluid, blood, and pus

A

cyst

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19
Q

configuration of skin lesions

A
  1. solitary or discreet
    -individuale or distinct lesions
    ex. warts, ringworm
  2. grouped
    -linear cluster
    ex. herpes simplex
  3. confluent
    -lesiomn that run together
    ex. measles, urticaria

4.linear
-scratch, streak, line or stripe
ex. contact dermatitis, scratching

  1. annular
    -circular, beginning in the center and spreading to the periphery
    ex. tina corporis, erythema multiforme
  2. Polycyclic
    -annular lesions merge
    ex. erythema ,multiforme, lips erythematosus
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20
Q

Distribution of a lesion?

A

where the lesion appear on the body

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21
Q

Acne

A

polymorphic skin disorder characterized by comedones, papule, pustules, and cysts

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22
Q

Open comedones

A

blackheads

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23
Q

Closed comedones

A

whiteheads
-obstructed opening which may rupture, causing low-grade local inflammatory reaction

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24
Q

Mild Acne Tx

A
  1. benzoyl peroxide (2.5%-10%)
  2. Tretinoin
    -applied at night and not used concomitantly w/ benzoyl peroxide
    -too much can burn skin
    -decreases bacteria on skin
  3. may need to decrease strength or duration of application for excess redness/ irritation
    *do not stop but decrease
  4. salicylic acid preparations
  5. Topical ABX, Erythromycin or clindamycin lotions or pads
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25
Q

Moderate Acne Tx

A

-cyclines first then macrocodes

  1. Doxycycline 50-100mg BID or 100mg QD
    -Minocycline 50-100mg BID
    *teeth discoloration
    *DO NOT GIVE TOP <8year olds
  2. Erythromycin (Macrolide)
    -tends to upset stomach
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26
Q

Severe Acne Tx

A

refer to Dermatology

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27
Q

Fungal Infections in pediatrics

A

AKA Yeast, Candida, Fungus

most common Trichophyton
other Microsporum

28
Q

Round bald spot, fungal infection

A

tine capitis (scalp)

29
Q

Body ringworm, fungal infection

A

Tinea corporis
-raise border
-central clearing
*no bullseye

30
Q

Jock itch

A

Tinea Cruris

31
Q

fungal infection of hands and Athletes foot

A

Tinea manuum and *Tinea pedis

32
Q

Tinea Versicolor

A

fungal infection causing hyper/hypo pigmentation macules on limbs

33
Q

Skin Scrappings lab test

A

“spaghetti and meatballs” hyphae microscopically when treated w/ potassium hydroxide (KOH)

34
Q

Tinea Capitis Tx

A

-griseofulvin 20-25mg/kg/day for 6-8 weeks

35
Q

Tinea Corporis Tx

A

Miconazole 2%, Ketocconazole 2%

36
Q

Tinea Versicolor Tx

A

Selenium Sulfide Shampoo

37
Q

Chicken Pox/ Varicella Zoster Virus

A

acute contagious disease caused by herpes virus, transmitted by direct contact with lesions or AIRBORNE

*Dew Drop on a Rose Petal

-infected individuals are CONTAGIOUS FOR 48HOURS BEFORE outbreak and until lesions have crusted over

38
Q

S/S of Varicella Zoster Virus

A

*Papules develop over macule
*intense pruritis
*generalized lymphadenopathy
-Vesicules erupt: usually distributes on the trunk, then scalp and face

39
Q

Varicella Zoster VIrus Tx

A

*oral acyclovir 20mg/kg 5 times a day
-calamine/caladryl lotion (pink lotion)
-antihistamine
-acetaminophen

*return to school after lesion have crusted over

40
Q

flesh colored discrete papules, which become UMBILICATED PAPULES with a CHEESY CORE

A

Molluscum Contagiousum
-viral skin infection
-resolves few weeks to a few month

*autoinoculated, more where skin rubs together
*do not pop lesions, more will appear

41
Q

Molluscum Contagiousum management

A

Resolves spontaneously if left alone

42
Q

Atopic Dermatitis aka?

A

Eczema
-chronic skin condition characterized by intense itching along with a typical pattern of distribution with periods of remission and exacerbation

*destroys 1st layer of skin, watch for secondary infections

43
Q

Management for Atopic dermatitis (eczema)

A

Dry skin management (hallmark Tx)
-moisturizing lotion immediately after bathing
-must blot dry
-need lotion from a jar, lotions must be scooped out
-Topical Steroids (hydrocortisone)
*Adverse effects of hydrocortisone: Bladder dysfunction, hyperglycemia, hypopigmentation/ scarring. etc

44
Q

Allergic Contact Dermatitis

A

acute or chronic dermatitis that results from direct skin contact with chemicals or allergies

45
Q

Irritant (diaper) dermatitis

A

common skin irritation of the genital-perianal region

46
Q

Psoriasis

A

common bench hyper proliferative inflammatory skin disorder
*think snake skin
-normal keratinization is faulty

*Ausptiz sign: Droplets of blood when scales are removed

47
Q

Acute inflammatory disorder, usually self-limiting lasting 3-8weeks

A

Pityriasis Rosea

48
Q

Hark the Harold Patch, Christmas tree rash pattern
(patch/pattern)

A

Pityriasis Rosea
*Christmas from fall to spring

*“harold patch”- initial lesion 2-10cm

49
Q

Pityriasis Rosea LAB/Dx

”” Treatment

A

serologic test for syphilis should be performed
-if rash is not itchy this is worrisome

Treat pruritis
-hydroxazine (sedating)
-certirizine (non sedating)
-Topical steroids
-UVB daily x3-5 days
*Oral erythromycin (2 week course)

50
Q

Scarlet Fever

A

Group A beta-hemolytic streptococci (GABHS)

S/S
*swollen tongue with white exudate and/or red papillae
*strawberry tongue
-confined, bright red, flat blotches that progress into WIDESPREAD SANDPAPER-LIKE PAPILLAE

Management
*10-14day course of penicillin or amoxicillin
-consider checking urine 14days after ABX Therapy for red blood cells with may suggest secondary glomerulonephritis

51
Q

Impetigo

A

skin infection. by…
-Gram Positive Streptococcus
-Staphylococcus (S. aureus)

*classic honey-crusting lesions

Management
*Mupirocin

*apply Burow’s (Domeboro) solution to clean lesions

52
Q

Scabies

A

High contagious
parasitic mite
burrows into stratum corneum

S/S
*infants
-red brown vesiculopapular lesions on head, neck, palms, or soles
*older children
-red papules on skin folds, umbilicus, or abdomen

TX
-Permetherin (Nix) 5% rinse (1st treatment-leave on for 8-14hours) repeat in week

53
Q

Pin worms

A

“Tape Test”
-press clear tape to skin around anus, place on slide and look at under microscope

Tx
-Pyrantel (Pin-X) -OTC

54
Q

Mice or DEER ticks cause this disease?

A

Lyme disease

These ticks must feed for more than 36 hours to transmit the infecting organism

55
Q

Lyme disease is cause be which organisms and found where?

A

-Spirochetal

-Northeast, Upper Midwest, and Pacific Coast

56
Q

S/S or stages of Lyme disease

A

stage 1
-Erythema migrans, flat or slight red lesion that expands over several days but has central clearing, “bulls eye” rash
-Joint pain

Stage 2
-Headache, stiff joints
-Bells palsy

Stage3
Joint and periarticular pain

57
Q

Lyme disease Dx

A

ELISA screening (checks of antibodies)

*Western Blot is confirmatory

Dx criteria
1. erythema migrains or
2 one late manifestation and
3. laboratory confirmation

58
Q

Tx for Lyme Disease

A

under 8: Amoxicillin or Cefuroxime axetil
Over 8: Doxycycline

59
Q

Rubeola (measles)

A

koplik Spots

60
Q

Rubella (3 day measles)

A

teratogenicity

61
Q

Erythema infectiosum

A

Fifth disease

*slapped cheek appearance

62
Q

Roseola Infantum

A

Sixth disease (herpesvirus 6)

*trunk rash then extremities
*high fever, abrupt end when rash develops

63
Q

Coxsackie Virus

A

Hand Foot Mouth Disease

-resolves spontaneously in less than 1 week
-peeling/ loss of nails is common
-spread by contact w/ unwashed hands or contaminated surfaces as well as respiratory droplets

64
Q

Mumps

A

S/s
-swollen salivary glands (ex. parotitis) causing puffy cheeks, and a tender, swollen jaw

Lab tests
-Mumps IgM

Tx
Lemon drops (sugar free) to increase flow of saliva

65
Q
A

DRT PEDS (11 decks)

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