Pediatric Dermatology Flashcards
Treatment of tinea capitus and other severe cases of tinea
griseofulvin 20mg/kg/day for six weeks
monitor LFTs
Varicella zoster
- pruritic, vesicles, “dew drop on a rose petal”, fever, adenopathy
- back to school 48 hours after last lesion dries
- acetaminophen, antihistamine, caladryl lotion, oral acyclovir
Molloscum contagiousum
pruritic, umbilicated, flesh-colored papules with a cheesy core
Atopic triad
Personal or family history of asthma, allergic rhinitis, atopic dermatitis
Atopic dermatitis/eczema
- dry, red, itchy patches (“the itch that rashes”)
- elevated IgE, eosinophilia, allergy testing
- dry skin management, topical steroids
Allergic contact dermatitis
- red, vesicles, warm, swollen, pruritic
- poison ivy, nickel
- high potency topical steroids, Prednisone taper
Treatment of irritant (diaper) dermatitis
- Barrier emollient in mild cases (zinc oxide)
- for erythema/papules: Burow’s/Domeboro, hydrocortisone
- fungal co-infection: topical antifungal
- bacterial co-infection: topical antibiotic (bactroban/mupirocin)
- keep open, clean, and dry as much as possible
Psoriasis
- hypoproliferative disorder
- skin cell turnover reduced from 14 (normal) to 2 days
- immature nucleated cells are seen on the horny layer
- “sharply defined plaques with silvery scales”
- Auspitz’ sign
- refer to derm, topical steroids, tar shampoo
Pityriasis Rosea
- may be related to virus/recent URI
- more common in spring and fall
- herald patch, Christmas tree pattern, pruritic
- EEC x2 weeks, oral antihistamines, sunlight exposure
- check for syphilis if non-pruritic, or on palms/soles/mouth
Impetigo
- bacterial infection, staph or strep
- “honey colored crusts”
- topical (bactroban) for minor cases
- oral antibiotics: dicloxacillin, cephalexin (Keflex), EEC, clindamycin
- Domeboro solution to clean
Lyme disease
- Borrelia burgdorferi, tick must feed 24hr to transmit
- screen with ELISA, confirm with Western blot
- Treat with doxycycline (amoxicillin or cefuroxime under age 7)
- Refer stage 2 or 3 Lyme disease
Lyme disease stages
Stage 1: erythema migrans (bulls eye rash), flu symptoms
Stage 2: cardiac dysrhythmias, aseptic meningitis, Bell’s palsy, peripheral neuropathy
Stage 3: joint pain, subacute encephalopathy, bluish-red discoloration and edema of extremity distal to bite
Measles: Rubeola
- ordinary measles
- fever, rash, URI symptoms, Koplik’s spots
Measles: Rubella
- “3-day measles”
- rash gone in 72 hours, malaise, joint pain, fever, adenopathy
- teratogenic
Measles: Roseola Infantum
- “Sixth disease”
- Herpesvirus 6
- URI symptoms, rash, high fever for up to 8 days that comes to abrupt end when rash develops
Measles: Erythema infectiosum
- “Fifth disease”
- human parvovirus B19
- “slapped cheek” appearance, lacy reticular exanthem
- may return to school after fever breaks
- Fetal aplastic crisis
First, Second, and Third Degree Burns
First- dry, red
Second- “partial thickness”, moist, blisters
Third- “full thickness”, black, waxy, deeper
Hand-Foot-and-Mouth disease (Coxsackie Virus)
- viral, resolves spontaneously in less than 1 week
- papulovesicular rash on hands/feet/mouth, fever, malaise, vomiting, drooling
Biggest risk of burns
Hypothermia (heat loss) and dehydration
Prophylactic intubation for singed eyebrows/nares/mouth
First 6 hours are critical
Calculating burns
Head- 6 to 10% Upper and lower arm- 2% Hand- 1% Chest and back- 13% Genitals- 1% Thigh- 3-5% Calf- 2-3% Foot- 2%
Calculating burns >9 years old
Head- 4.5% Arms- 4.5% Chest and back- 18% Legs- 9% Genitals- 1%
Treatment of tinea manuum and pedis
Macerated stage- aluminum subacetate soak for 20 minutes BID
Dry stage- topical antifungals
Treatment of tinea versicolor
Selenium sulfide 2.5% shampoo topically for 15min daily x7 days
