Pediatric Dermatology Flashcards
What are salmon patches?
Light red macules found on the nape of the neck, eyelids, philtrum, and glabella
What is the prognosis for salmon patches?
fade with time in most cases, but if found on the nape of the neck, may persist
What is cutis aplasia? How does it appear?
- a congenital focal absence of epidermis with or without evidence of other layers of the skin
- Appears as a sharply marginated area, that is usually seen in the midline of the scalp
True or false: cutis aplasia is not usually an isolated defect–part of a syndrome
False–usually isolated defect
What is the treatment for cutis aplasia?
Excision, but larger ones may need hair transplant
What is the prognosis for dermal melanocytosis?
Fades within a few years
Which ethnicities are more commonly affected with dermal melanocytosis?
Blacks
Asians
Hispanics
What are the associations with ear anomalies?
- Hearing loss
- vertebral /cardiac / renal abnormalities
- Branchial fistulas
True or false: most of the time, ear anomalies are isolated defects
True
What is the treatment for a preauricular skin tag?
Ligate with suture if no pain. O/w ligate later by derm
What is erythema toxicum neonatorum? Prognosis?
- Blotchy, erythematous macules in 2-3 cm in diameter, with central vesicle or pustule
- Benign, usually resolving by 2 weeks
What will a gram stain show of scraping of erythema toxicum neonatorum?
Eosinophils
What areas of the body are and are not affected with erythema toxicum neonatorum?
Arms and legs affected, but spares the palms and soles
What are transient neonatal pustular melanosis? Prognosis?
Vesicles or pustules with a collarette of surrounding scales or pigmented macules
Which is present at birth erythema toxicum neonatorum, or transient neonatal pustular melanosis?
transient neonatal pustular melanosis
What ethnicity has a higher incidence of transient neonatal pustular melanosis?
Blacks
What will a smear of transient neonatal pustular melanosis show?
PMNs
What is the difference in distribution between transient neonatal pustular melanosis and erythema toxicum?
transient neonatal pustular melanosis affects the palms and soles while erythema toxicum does not
What are milia?
Benign white papules found on the nose or forehead of babies
What are sucking blisters?
Blisters on the arm of a neonate that is from sucking on the arm in utero
What is acne neonatorum? Prognosis?
- Multiple discrete papules that occurs around 6 weeks of age, and disappear before 8 months
- No correlation between this and teenager acne
What is another name for acne neonatorum?
Neonatal cephalic pustulosis
What are the three different morphologies of acne vulgaris?
- Comedonal
- Inflammatory
- Mixed
What is the comeonal form of acne vulgaris?
with closed (white) and open (blackhead) comedones
What is the inflammatory form of acne vulgaris?
With erythematous papules, nodules, or cyst like nodular lesions d/t colonization with p acnes
What is the bacteria that causes acne?
Propionibacterium acnes
What are the factors that lead to neonatal acne?
- Increased sebum production
- Abnormal keratinization
Why treat acne?
Scarring
Psych
What are the goals of treating acne? (3)
- Reduce sebum production
- Suppress P acnes
- Reducing inflammation
What is the hygiene changes that is used to treat acne?
wash several times a day, but not so often as to cause dry skin (which will worsen the condition)
What is the role of makeup with acne?
Has not been shown to change acne
What is the pharmacotherapy for acne?
- Benzoyl peroxide
- Topical retinoid
- Topical Abx
What is the MOA of retinoids?
Activate RXR, causing comedolytic response
What is the MOA of benzoyl peroxide?
Penetrates stratum corneum and ROS
Why are topical abx not recommended as monotherapy for acne?
Slow onset of action, and predictable emergence of resistance
How effective are topical abx in treating acne
Very
When are oral abx indicated for acne? What are the abx of choice?
Moderate to severe acne
-2nd gen tetracyclines
What are the side effects from tetracycline?
Tooth discoloration
Photosensitivity
What is the treatment for mild acne? What is there is an inadequate response to this?
Benzoyl peroxide or topical retinoids
OR
Triple therapy
-Change formulations
What is the treatment for moderate acne? What is there is an inadequate response to this?
Topical x2 OR all three
Oral isotretinoin or abx
What is the defect in Sturge-Weber syndrome? Mnemonic?
-Somatic activation of the GNAQ gene
Sporadic with port wine Stain Tram track appearance Unilateral Retardation Glaucoma/ GNAQ gene Epilepsy
What is the HAMARTOMASS mnemonic for tuberous sclerosis?
- Hamartomas
- Angiofibromas
- Mitral regurg
- Ash-Leaf spots
- Rhabdomyomas / renal cysts
- Tuberous sclerosis
- autosomal dOminant
- MR
- Angiomyolipomas
- Szs
- Shagreen patches
What are the skin findings of port wine stains?
Deep red macules on the face or extremities
Where is the port wine stain located with Sturge weber syndrome?
CN V1
What are cafe au lait spots?
Macules or patches with distinct borders that are benign, but if more than 5, consider NF1
What are the components of tje CAFE SPOT mnemonic for NF1?
Cafe au lait spots
Axillary/inguinal freckling
Fibromas
Eye (lisch nodules)
SPhenoid dysplasia
Optic Tumor
How many cafe au lait spots, and how big, is diagnostic for NF1?
6+ that are greater than 5 mm in children of 15 mm in adults
What are the characteristics of the Ash leaf spots with tuberous sclerosis?
2+ macule that ranges from 0.1 to 12 cm in size
Cardiac rhabdomyoma is almost pathognomonic for what disease?
Tuberous sclerosis
What are shagreen patches, and what disease are they found in?
Bumpy skin found in tuberous sclerosis
What is the inheritance pattern of tuberous sclerosis?
AD
What type of sunscreen should be used for kids under 6 months?
none–keep baby out of sunlight and use caps
What type of sunscreen should be used for kids over 6 months?
SPF 15 or better
Reapply q2 hours
What time of day is the highest chance of sunburn?
1000-1600
