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PEDS exam 2 > Pediatric Dermatology > Flashcards

Pediatric Dermatology Flashcards

1
Q

distinguish between a macule and a patch

A
  • macule: circumscribed area of change in skin color without elevation or depression (flat); < 1 cm
  • Patch: macule that is larger than 1 cm
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2
Q

circumscribed, solid superficial elevations < 1 cm

A

papule

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3
Q

papule > 1cm

A

plaques

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4
Q

distinguish between a vesicle and a bulla

A
  • vesicle < 1 cm
  • bulla > 1 cm
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5
Q

rounded or irregular shaped excavations into the dermis or deeper

A

ulcer

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6
Q

thickened skin with accentuated skin markins

A

lichenification

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7
Q

shallow, hemorrhagic linear excavations

A

excoriations

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8
Q

what are congenital melanocytic nevi?

A

proliferations of benign melanocytes

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9
Q

clinical presentation

  • macules, papules, or plaques at birth
  • hair may or may not be present
  • appearance may change with time
  • lesions grow in proportion to individual size
A

congenital melanocytic nevi

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10
Q

clinical presentation

  • patch of bluish-grey pigmentation with irregular border and normal skin texture
  • most commonly affects buttocks and lower back
  • increased incidence in darker skin types
    • asian >> black> hispanic
  • usually present at birth or becomes evident on the first weeks of life
A

mongolian spot

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11
Q

management of mongolian spot

A
  • consider further work up in cases where extensive involvement with failure to thrive
  • affected areas tend to fase by age 2 and often disappear by age 10
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12
Q

what is nevus sebaceous

A

hyperplasia of epidermis, sebaceous glands, hair follicles, apocrine glands

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13
Q

clinical presentation

  • occurs primarily on the scalp or face
  • waxy solitary, smooth, yellow-orange hairless patch, often oval or linear in shape
  • usually becomes more pronounced in adolescence
    • may become bumpy, warty, or scaly
A

nevus sebaceous

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14
Q

what is concerning about nevus sebaceous

A

BCC or other malignancy may arise from lesion

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15
Q

treatment of nevus sebaceous

A
  1. intermittent interval f/u is recommended
  2. refer to derm if concerning changes are observed
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16
Q

what is aplasia cutis congenita

A

absence of skin present at birth that can be localized or widespread

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17
Q

clinical presentation

  • most commonly found midline posterior scalp
    • tuft of hair may surround defect which may indicate neural tube defect
  • may be associated fluid-filled bulla
  • lesions are well demarcated
A

aplasia cutis congenita

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18
Q

treatment of aplasia cutis congenita

A
  • gentle cleansing and ointment
  • referal to neurosx for surgical repair indicated for large or multiple scalp defects
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19
Q

clinical presentation

  • discrete uniformly pigmented macules or patches
  • most commonly found in african american population
  • present at birth or appear in early childhood
  • may be associated with neurofibromatosis type 1
A

cafe-au-lait macules

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20
Q

Neurofibromatosis type 1 is what type of disease

A

autosomal dominant

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21
Q

name some signs and symptoms of Neurofibromatosis

A
  1. cafe-au-lait macules
  2. axillary or inguinal freckling
  3. neurofibromas
  4. lisch nodules (well-defined, dome-shaped elevations projecting from the surface of the iris )
  5. optic gliomas
  6. skeletal abnormalities
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22
Q

Name the two major types of vascular anomalies in pediatrics

A
  1. vascular tumor: neoplasms proliferate and require tx to stop growth
  2. vascular malformation: abnormal blood vessels without rapid proliferation
    1. static or slow growing
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23
Q

what is a port-wine stain

A

cutaneous capillary malformation; vascular malformation

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24
Q

clinical presentation

  • presents at birth and does not regress
  • pink or dark red patches (may gradually darken or thicken)
  • may be associated with
    • soft tissue or bony overgrowth
    • sturge weber syndrome in the V1 distribution
A

port-wine stain

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25
Q

management of port-wine stain

A
  • no treatment needed
  • pulse dye laser
  • if widespread or associated with overgrowth of the extremities, refer to a vascular specialist
26
Q

What are infantile hemangiomas

A

common benign vascular tumor

27
Q

what are the risk factors for infantile hemangiomas

A
  • low birth rate
  • female
  • twin gestation
  • fair skin
28
Q

clinical presentation

  • may present superficial, deep, or mixed
    • superficial: bright red and minimally elevated
    • deep: larger with bluish color
  • rapid growth during 5-7 weeks of age
A

infantile hemangiomas

29
Q

what is a common complication of infantile hemangiomas

A

ulceration

30
Q

clinical presentation

  • faint, transient capillary malformation
    • flat, pink/red patch
    • typically midline of forehead, scalp, upper eyelid, posterior neck and back
A

nevus simplex (salmon patch)

31
Q

what is the most common pediatric vascular lesion

*present in 30-40% of newborns

A

nevus simplex (salmon patch)

32
Q

when do nevus simplex (salmon patch) typically fade

A

1-2 years

33
Q

what is a pyogenic granuloma

A
  • common acquired lobular vascular tumor
  • occurs at any age
  • develops rapidly (days to months)
34
Q

pyogenic granuloma affects what areas of skin

A

affects skin particularly prone to trauma

  • hands
  • fingers
  • face
  • mucous membrane
35
Q

how do you diagnose pyogenic granuloma

A
  • biopsy needed to confirm diagnosis
36
Q

treatment of pyogenic granuloma

A
  • curettage or shave removal
  • pulsed-dye laser

**risk of recurrence is high

37
Q

treatment for port-wine stains in a V1 distribution

A

urgent ophthalmologic evaluation

* need to rule out Sturge Weber syndrome

38
Q

pathogenesis of diaper dermatitis

A
  • excessive moisture, friction, increased pH causing localized skin to break down
    • may be caused by seborrheic derm; atopic derm
    • macerated sin increased susceptible for infection from urine and feces
39
Q

if diaper dermatitis are persistant and have moved from areas of contact with diaper to inbetween skin folds or developed pustules, what do you expect happened?

A

secondary infection

  1. candidal superinfection
    1. beefy red plaques (involves skin folds)
  2. impetigo: secondary infection Staph aureus
    1. fragile pustules and honey crusted erosions
40
Q

what signs/symptoms allows you to diagnose an Active lice infection

A
  • visualize live lice (wet combing)
  • nits may persist for months and does not indicate active infection
41
Q

treatment of lice

A
  • topical insecticides
    • pyrethroids
    • malathion
    • benzyl alcohol
    • spinosad
  • conditioner should not be used prior to application
  • prophylactic treatment for others in same household
42
Q

what is neonatal acne

A

*not true acne

  • inflammatory reaction possibly to malazzesia colonization
43
Q

when does neonatal acne typically resolve

A
  • resolves by 6-12 months of age
44
Q

clinical presentation

  • present in first 2-3 weeks of life
  • inflammatory papules and pustules
    • forehead, nose, cheeks
    • no true comedones
A

neonatal acne

45
Q

treatment of neonatal acne

A
  • mild: cleansing with soap and water
  • if persistant, may use ketoconazole or hydrocortisone
46
Q

what is infantile acne

A
  • presents at 3-4 months of age
  • hyperplasia of sebaceous glands
    • androgenic stimulation
    • M > F
  • see inflammed pustules, comedones, pustules
47
Q

when does infantile acne commonly resolve

A

2-3 years of age

48
Q

management of infantile acne

A
  • treatment often required to prevent scarring
  • benzoyl peroxide
  • topical abx
  • topical retinoids
  • oral treatment only needed in severe cases
49
Q

pathogenesis of acne vulgaris

A
  • chronic inflammatory disease of the pilosebaceous unit, self limited
  • factors
    • increased sebum production by sebaceous glands
    • hyperkeratinization of the follicle
    • colonization of follicle
    • inflammatory reaction
50
Q

when trying a new acne treatment regimen, how long do you need try it for?

A

minimum of 8 weeks

51
Q

role of topical retinoids in the treatment of acne vulgaris

A
  • prevent formation and reduce number of comedones
  • anti-inflammatory properities
52
Q

What are these medications:

  • Adapalene (Differin)
  • Tazarotene (Tazorac)
  • Tretinoin (Retin-A)
A

topical retinoids

53
Q

what are the two most commonly used topical abx to treat acne vulgaris

A
  • clindamycin
  • erythromycin
54
Q

topical abx are commonly used in combo with what medications in the treatment of acne vulgaris

A
  • benzoyl peroxide to prevent resistance
  • topical retinoids
55
Q

function of dapsone in the treatment of acne vulgaris

A
  • abx
  • MOA: inhibiting inflammation
56
Q

what are the most commonly used oral abx to treat acne vulgaris

A
  1. doxycycline
  2. minocycline
  3. erythromycin
  4. tetracycline
57
Q

indications of oral abx to treat acne vulgaris

A

moderate to severe acne

58
Q

what oral contraceptive pills are commonly used a 2nd line therapy for acne vulgaris

A
  • ortho Tri-Cyclen
  • Yaz
  • Estrostep
59
Q

indication to use oral isotretinoin to treat acne vulgaris

A

severe recalcitrant acne or less severe treatment resistance

60
Q

what required monitoring is associated with oral isotretinoin

A
  • CBC, lipids, liver enzymes
  • side effects
    • depression
    • HA, dry skin, GI upset
  • iPLEDGE program to prevent pregnancy

PEDS exam 2 (3 decks)

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