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
2
Q
circumscribed, solid superficial elevations < 1 cm
A
papule
3
Q
papule > 1cm
A
plaques
4
Q
distinguish between a vesicle and a bulla
A
- vesicle < 1 cm
- bulla > 1 cm
5
Q
rounded or irregular shaped excavations into the dermis or deeper
A
ulcer
6
Q
thickened skin with accentuated skin markins
A
lichenification
7
Q
shallow, hemorrhagic linear excavations
A
excoriations
8
Q
what are congenital melanocytic nevi?
A
proliferations of benign melanocytes
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
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
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
12
Q
what is nevus sebaceous
A
hyperplasia of epidermis, sebaceous glands, hair follicles, apocrine glands
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
14
Q
what is concerning about nevus sebaceous
A
BCC or other malignancy may arise from lesion
15
Q
treatment of nevus sebaceous
A
- intermittent interval f/u is recommended
- refer to derm if concerning changes are observed
16
Q
what is aplasia cutis congenita
A
absence of skin present at birth that can be localized or widespread
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
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
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
20
Q
Neurofibromatosis type 1 is what type of disease
A
autosomal dominant
21
Q
name some signs and symptoms of Neurofibromatosis
A
- cafe-au-lait macules
- axillary or inguinal freckling
- neurofibromas
- lisch nodules (well-defined, dome-shaped elevations projecting from the surface of the iris )
- optic gliomas
- skeletal abnormalities
22
Q
Name the two major types of vascular anomalies in pediatrics
A
- vascular tumor: neoplasms proliferate and require tx to stop growth
- vascular malformation: abnormal blood vessels without rapid proliferation
- static or slow growing
23
Q
what is a port-wine stain
A
cutaneous capillary malformation; vascular malformation
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
25
management of port-wine stain
* no treatment needed
* pulse dye laser
* if widespread or associated with overgrowth of the extremities, refer to a vascular specialist
26
What are infantile hemangiomas
common benign vascular tumor
27
what are the risk factors for infantile hemangiomas
* low birth rate
* female
* twin gestation
* fair skin
28
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
infantile hemangiomas
29
what is a common complication of infantile hemangiomas
ulceration
30
clinical presentation
* faint, transient capillary malformation
* flat, pink/red patch
* typically midline of forehead, scalp, upper eyelid, posterior neck and back
nevus simplex (salmon patch)
31
what is the most common pediatric vascular lesion
\*present in 30-40% of newborns
nevus simplex (salmon patch)
32
when do nevus simplex (salmon patch) typically fade
1-2 years
33
what is a pyogenic granuloma
* common _acquired_ lobular vascular tumor
* occurs at any age
* develops rapidly (days to months)
34
pyogenic granuloma affects what areas of skin
affects skin particularly prone to trauma
* hands
* fingers
* face
* mucous membrane
35
how do you diagnose pyogenic granuloma
* biopsy needed to confirm diagnosis
36
treatment of pyogenic granuloma
* curettage or shave removal
* pulsed-dye laser
\*\*risk of recurrence is high
37
treatment for port-wine stains in a V1 distribution
urgent ophthalmologic evaluation
\* need to rule out Sturge Weber syndrome
38
pathogenesis of diaper dermatitis
* 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
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?
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
what signs/symptoms allows you to diagnose an Active lice infection
* visualize live lice (wet combing)
* nits may persist for months and does not indicate active infection
41
treatment of lice
* topical insecticides
* pyrethroids
* malathion
* benzyl alcohol
* spinosad
* conditioner should _not_ be used prior to application
* prophylactic treatment for others in same household
42
what is neonatal acne
\*not true acne
* inflammatory reaction possibly to malazzesia colonization
43
when does neonatal acne typically resolve
* resolves by 6-12 months of age
44
clinical presentation
* present in first 2-3 weeks of life
* inflammatory papules and pustules
* forehead, nose, cheeks
* no true comedones
neonatal acne
45
treatment of neonatal acne
* mild: cleansing with soap and water
* if persistant, may use ketoconazole or hydrocortisone
46
what is infantile acne
* presents at 3-4 months of age
* hyperplasia of sebaceous glands
* androgenic stimulation
* M \> F
* see inflammed pustules, comedones, pustules
47
when does infantile acne commonly resolve
2-3 years of age
48
management of infantile acne
* treatment often required to prevent scarring
* benzoyl peroxide
* topical abx
* topical retinoids
* oral treatment only needed in severe cases
49
pathogenesis of acne vulgaris
* 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
when trying a new acne treatment regimen, how long do you need try it for?
minimum of 8 weeks
51
role of topical retinoids in the treatment of acne vulgaris
* prevent formation and reduce number of comedones
* anti-inflammatory properities
52
What are these medications:
* Adapalene (Differin)
* Tazarotene (Tazorac)
* Tretinoin (Retin-A)
topical retinoids
53
what are the two most commonly used _topical_ abx to treat acne vulgaris
* clindamycin
* erythromycin
54
topical abx are commonly used in combo with what medications in the treatment of acne vulgaris
* benzoyl peroxide to prevent resistance
* topical retinoids
55
function of dapsone in the treatment of acne vulgaris
* abx
* MOA: inhibiting inflammation
56
what are the most commonly used oral abx to treat acne vulgaris
1. doxycycline
2. minocycline
3. erythromycin
4. tetracycline
57
indications of oral abx to treat acne vulgaris
moderate to severe acne
58
what oral contraceptive pills are commonly used a 2nd line therapy for acne vulgaris
* ortho Tri-Cyclen
* Yaz
* Estrostep
59
indication to use oral isotretinoin to treat acne vulgaris
severe recalcitrant acne or less severe treatment resistance
60
what required monitoring is associated with oral isotretinoin
* CBC, lipids, liver enzymes
* side effects
* depression
* HA, dry skin, GI upset
* iPLEDGE program to prevent pregnancy
