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Pediatrics Clerkship > Pediatric rashes > Flashcards

Pediatric rashes Flashcards

1
Q

Milia

A
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2
Q

Molluscum contagiosum

A
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3
Q

Cradle cap?

A

Seborrheic dermatitis affecting primarily the scalp.

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4
Q

Hemangioma

A

Natural hx: May present as patch of telangiectasias at birth. Proliferation: age 0-1, bright red raised nodule. Involution: Age 1-9. Deeper red/violet, regression in size.

Management: Observation. Topical beta blocker (eg propranolol) for ulcerated or cosmetically sensitive areas (eg face)

Complications: ulceration/scarring; vision impairment if near eye; Life-threatening if near airway.

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5
Q

Stork bites

A

aka angel kisses

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6
Q

fifth disease

A

Erythema infectiosum:

“Slapped cheek first”

Then lacy/reticular rash on trunk, extremities. Exacerbated by heat

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7
Q

Mongolian spot

A

dermal melanocytosis

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8
Q

seborrheic dermatitis

A

Yellow/scaling (cradle cap if seen just in scalp)

Red/greasy plaques on rest of body = nonitchy.

Can affect genital area.

Self limiting

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9
Q

Types of diaper rash

A

Variant 1:

spares creases. Tx = zinc oxide

Variant 2 - candidal type

Beefy red, papular, + satellite lesion. Involves creases.

Tx = antifungal

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10
Q

infantile eczema/atopic dermatitis

A

Risk factors: low humidity; relatives w/ eczema, allergies, asthma

Clinical features: In babies - itchy red scaly crusted lesions on extensor surfaces, trunk, cheek, scalp. Spares diaper area

In older kids - lichenified plaques in flexor surfaces - eg antecubital

Universally pruritic, but babies cannot scratch so become agitated.

Tx = aggressive moisturization +/- steroid ointment

Complications: Eczema herpeticum; cellulitis/abscess; discomfort interfering w/ daily activities/sleep

Pathogenesis: epidermal dysfunction due to improper synthesis of stratum corneum components

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11
Q

intertrigo

A

Moisture trapped in skin folds causes irritation (eg neck, axilla –> intertriginous areas)

Causes irritation

Can be worsened by infection w/ bacteria, yeast.

Tx: keep area dry - vigilant towel trying after bathing baby. May need to give antifungal meds.

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12
Q

congenital nevomelanocytic nevi

A

pigmented plaques, often w/hair.

have an increased rate of transformation to melanoma (risk increases with size)

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13
Q

cafe au lait spots

A

If >6 spots >5 cm in diameter, r/o NFM, Mccune Albright

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14
Q

coxsackie

A

Painful vesicles in posterior pharynx.

May cause dehydration b/c kid won’t drink due to pain.

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15
Q

impetigo

A

honey crusted lesion.

Stap, Strep

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16
Q

Henoch Schonlein purpura

A

Non-blanching.

IgA vasculitis

Abdominal pain - may have arthralgia, renal involvement. Can cause intussusception.

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17
Q

Eczema herpeticum

A

Potential complication of severe atopic dermatitis. Superinfection w/ herpes simplex virus can cause vesicular eruption on preexisting inflamed skin. Pts often have fever and pain.

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18
Q

Erythroderma (exfoliative dermatitis)

A

Erythema and scaling in >90% of body. Bright red patches coalesce and gradually peel.

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19
Q

Staphylococcal scalded skin syndrome

A

Pathogenesis: S. aureus exfoliative toxin

Clinical features: fever, irritability. Generalized erythema, blisters. Epidermal shedding (Nikolsky sign). Mucosal surfaces typically spared. May have nasopharyngeal colonization or a primary skin lesion.

Mgmt: antistaphylococcal antibiotic (nafcillin, vanc); wound care

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20
Q

Bullous impetigo

A

Localized form of Staph scalded skin syndrome also caused by exfoliative toxin-producing S aureus.

Pts appear well, with blisters confined to primary area of infection.

When ruptured, blisters have honey-colored crust.

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21
Q

Erysipelas

A

Bacterial infection (GAS) of dermis presents w/ well-demarcated, warm tender area of erythema. Overlying bullae can develop in severe cases, and pts often have constitutional symptoms (fever, chills).

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22
Q

Erythema multiforme

A

Self-limited reaction to certain infections (Eg herpes simplex) that manifests as targetoid lesions. Lesions may have central bullae, but Nikolsky sign is negative.

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23
Q

Scarlet fever

A

Erythrogenic toxin-producing strains of GAS, presents w/ fine, pink, sandpaper-like rash following episode of pharyngitis in kids. Prominent in flexural areas and often desquamates but does not cause blistering or a positive Nikolsky.

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24
Q

Toxic epidermal necrolysis

A

Extensive (>30% body surface area) skin blistering and erosion typically triggered by medication. Positive Nikolsky.

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25
Q

AV malformation

A

Composed of veins, arteries, capillaries. Appear as purple-red patches with visible veins. Often warm with palpable thril or audible bruit.

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26
Q

Nevus flammeus

A

Port wine stain.

Capillary malformation appearing as a blanchable, erythematous patch. Present from birth and does not regress.

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27
Q

Nevus simplex

A

(Eg macular stain, salmon patch, stork bite, angel kiss). Blanching, pink patch that most commonly occurs on eyelid, glabella, nape of neck. Typically present at birth and fades spontaneously by age 1-2, although neck lesions may persist w/ no sequelae.

28
Q

Pyogenic granuloma

A

Small, bright red, dome-shaped papule that commonly bleeds. Lesion grows initially and does not involute.

29
Q
A
30
Q

Tinea capitis

A

Epidemiology: Most commmon in African American children; transmission via direct contact or from fomite (eg shared combs)

Clinical features: scaly erythematous patch with hair loss on scalp

+/- black dots in affected area

+/- tender lymphadenopathy

Management: oral griseofulvin or terbinafine

31
Q

Autoimmune causes of hair loss:

A

Alopecia areata: causes smooth circular areas of hair loss without scaling

Discoid lupus erythematosus: presents w/ well-demarcated inflammatory plaques, hypo- or hyperpigmented lesions, scarring, and photosensitivity.

32
Q

Lab findings with gastroschisis?

A

Gastroschisis is an isolated defect.

Elevated AFP - passes through the exposed bowel wall into the amniotic fluid

33
Q

Erythema marginatum

A
34
Q

Erythema infectiosum

A

Parvovirus B19 (slapped cheek, then reticular rash)

35
Q
A
36
Q
A
37
Q
A
38
Q

Nonbullous impetigo

A

S. aureus, S pyogenes

Erythematous papules that evolve rapidly into painful pustules. Pustules leave honey colored crusted exudates. Nonpruritic. Increased risk in patients with underlying skin probs (eczema, abrasian, insect bite)

Tx = topical ointment (eg mupirocin)

39
Q
A
40
Q
A
41
Q

Erythema chronicum migrans

A

Pathognomonic for Lyme disease

Nonpruritic, annular rash a/w tick bite.

42
Q

Nummular dermatitis

A

Scaly, pruritic.

treatment of choice = topical corticosteroids

43
Q

Homocystinuria

A

AD disorder from deficiency of cystathionine synthase, an enzyme involved in metabolism of methionine.

Like Marfan: Pts have pectus deformity, tall stature, arachnodactyly.

Unique: fair complexion, thromboembolic events, and ID.

Downward lens dislocatino (c/w Marfan that is upward).

44
Q

Ehlers Danlos

A

collagen disorder characterized by scoliosis, joint laxity, aortic dilation.

45
Q

Congenital contractural arachnodactyly

A

AD condition resulting from mutations in fibrillin-2 gene. Tall stature, arachnodactyly, multiple contractures in lg joints.

No ocular or CV sx.

46
Q

Most common and second most common primary bone malignancy of childhood?

A
  1. Osteosarcoma
  2. Ewing sarcoma
47
Q

Vitamin B6 deficiency

A

pyridoxine deficiency can result in neurologic impairment (confusion, irritability, seizure) and skin and mucus membrane breakdown (Stomatitis, cheilosis)

48
Q

Vitamin B12 (cobalimin) deficiency

A

macrocytic anemia and hypersegmented neutrophils

49
Q

Vitamin E deficiency

A

hemolytic anemia and neurologic abnormalities such as ataxia

50
Q

Vitamin K deficiency

A

Coagulopathy and leads to easy bruising or bleeding from mucosa and in deep tissues

51
Q

Treatment of ADHD (medications)

A

stimulants (dextroamphetamine, methylphenidate)

atomoxetine (SNRI)

alpha-2-adrenergic agonists (clonidine, guanfacine) or certain antidepressants (bupropion, TCAs) = nonstimulant options for children who respond poorly to trial of stimulants or atomoxetine

52
Q
A
53
Q

You diagnose androgen insensitivty syndrome. What do you do next?

A

Elective gonadectomy. (Patients with cryptorchid testes are at risk of testicular cancer (eg dysgerminoma, gonadoblastoma) due in part to elevated intraabdominal temp that causes abnormal spermatogenesis and aberrant germ cell differentiation)

54
Q

Inafnt small for gestational age - complications

A

Hypoxia, perinatal asphyxia, meconium aspiration, hypothermia, hypoglycemia, hypocalcemia, polycythemia.

Polycythemia results from increased EPO secretion in response to fetal hypoxia.

55
Q

Antidote - TCA/ aspirin OD

A

sodium bicarb

56
Q

Antidote - torsades de points

A

Mangesium sulfate

57
Q

Antidote - lithium toxicity

A

Hemodialysis

58
Q

Antidote - moderate to severe lead poisoning

A

Calcium EDTA

59
Q

Antidote - cardiac abnormalities in hyperkalemia

A

Calcium gluconate

60
Q
A
61
Q

Antidote - mild or moderate lead poisoning

A

Oral succimer

62
Q

Antidote - acetaminophen toxicity

A

N-Acetylcysteine

63
Q

Tinea corporis

A
64
Q

Nummulur eczema

A
65
Q
A

Pediatrics Clerkship (2 decks)

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