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Pediatrics > Pediatrics-dermatology > Flashcards

Pediatrics-dermatology Flashcards

1
Q

What are some examples of a papulosquamous dermatitis?

A

Seborrheic dermititis, pityriasis rosea, psoriasis

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2
Q

What are some ex.s of a dermatologic condition covered?

A

acne, inherited disorders, excematous disorders

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3
Q

What is the most common pediatric derm condition?

A

Eczema>skin infestations/infections>benign rashes

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4
Q

What are secondary lesions?

A

Often complication of overdried skin or scratching. Can include infections.

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5
Q

What is Sclerosis(secondary lesion)

A

thickened skin with loss of elasticity and skin appendages

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6
Q

what are scales?

A

flakes of compact karatin, loose or adherent

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7
Q

what are crusts?

A

Dried serum, blood, pus or other exudative material

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8
Q

What primary derm lesions are

A

macule, papule, vesicle, some pustule, wheal and telangiectasias

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9
Q

What primary derm lesions are >.5cm?

A

patch, nodules, plaques, bulla, and some pustules, wheals, telangiectasias

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10
Q

What are some descriptors for dermatologic lesions?

A

color, blanching(vascular will blanch, perception(pain/itch), configuration(linear, annular, discrete), distribution(acral,truncal,localized), duration

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11
Q

Test for fungi and dermatophytes?

A

KOH (hyphae), budding yeast

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12
Q

Test for hsv?

A

Tzanck test-cytologic exam(giant multinucleic cells)

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13
Q

Test for Tinea versicolor?

A

Wood light

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14
Q

Which acne medication is teratogenic?

A

Accutane(retinoid PO)- requires abstinence contract- for severe acne

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15
Q

What is acne?

A

Sebum disorder, most common derm problem in teens, tx. teens, not important in infants

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16
Q

What hormone stimulates acne?

A

Androgens

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17
Q

What bacteria forms pustules in acne?

A

Propionibacterium acnes (staphlyococci)

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18
Q

What yeast obstructs follicles?

A

Malassezie furfur

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19
Q

What are open versus closed comedones?

A

Open: black heads-plug in stratum corneum Closed: white heads-obstructed sabaceous follicle

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20
Q

Which comedone causes inflammatory lesion?

A

Closed

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21
Q

What is the most severe form of acne?

A

Nodularcystic acne

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22
Q

What is the mainstay of acne treatment?

A

Keratolytic agents (benzoyl peroxide, salicylic acid, azelaic acid) if refractory switch to topical retinoids- tretinoin, adapalene, tazarotene then third choice is benzoyl and retinoid

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23
Q

What can you use oral antibiotics for acne?

A

In pustular and nodulocystic types- only to calm down inflammation- not long term use(tetracycline/Erythromycin)

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24
Q

What is the treatment of choice for severe nodulocystic acne/

A

PO retinoid- Isotretinoin (1mg/kg/day for 20 week period)

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25
Q

What are some inherited skin disorders?

A

Ichthyosis and epidermolysis bullosa

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26
Q

What is ichthyosis?

A

Autosomal dominant, dry, hard, fish scales or stratum corneum

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27
Q

What is the most common type of ichthyosis and treatment?

A

Ichthyosis vulgaris and ammonium lactate(12%)

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28
Q

What is a severe form of ichthyosis?

A

Collodion baby or “harlequin baby”- Sasauge casing skin- can be born with malformations, respiratory failure,

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29
Q

what is epidermolysis bullosa?

A

Auto dominant-skin fragility with blistering. Tx as burn.

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30
Q

What is a common feature of inherited dermatologic disorder?

A

Most have a disorder with collagen or other dermal proteins/components

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31
Q

What treatment do you provide for epidermolysis bullosa?

A

Topical ointments, non-stick dressing, padding, intermittent antibiotics for infections

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32
Q

What are the EB types?

A

EBS,JEB,DEB- they are based on the site of blister formation with the layer of the skin

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33
Q

What is the classic versino of eczematous lesions?

A

Atopic dermatitis- the itch that rashes

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34
Q

Atopic dermatitis is located where?

A

in moisture retained places and places where friction is -flexor surfaces

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35
Q

How do you treat eczema?

A

emollients(eucerin, vaseline, cetaphil,aquaphor) and Topical steroids

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36
Q

Dyshidrotic eczema is treated with?

A

High potencey topical steroids and antiperspirants(aluminum based deoderant) and wet dressings -double cotton cloves at night

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37
Q

intertrigo

A

wet, moist weeping rash…tx. based on presentation.bacterial(purulent d/c with crusting), fungal(red sattelate lesions/bumpy/raised)

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38
Q

Keratosis Pilaris

A

back of arms/places with friction-can use keratoytics-rehydrate

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39
Q

Contact dermatitis

A

Diaper rash, chemical irritations, metals, poison ivy, tx: corticosteroids

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40
Q

Perioral dermatitis

A

Lip licker dermatitis, tx: Mainstay(topical antibiotics- metronidazole/clindomycin) vaseline at bedtime, steroid creams(rare),

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41
Q

Sebhorreic dermatitis?

A

Greasy, yellow colored, scaling lesions, “cradle cap” tx: selenium, head and shoulders, infant brushes to rub off tissue

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42
Q

What are some pigmented lesions associated with disease?

A

Cafe au lait spots(neurofibramatosis), ash leaf spots(tuberous sclerosis), port wine stains(nevus flammeus/vascular malformations)

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43
Q

What are some pigmented birthmarks?

A

Mongolian spots, melanocytic nevi, salmon patches, hemangiomas

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44
Q

What is a hallmark of congenital melanocytic nevi?

A

The down grow in size, most shrink actually

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45
Q

Vascular birthmarks?

A

Nevus simplex(stork bites), port wine stain

46
Q

What are port wine stains associated with?

A

Sturge Wiber syndrome- trigeminal nerve- MR, seizures glaucoma

47
Q

What are cafe au lait spots associated with?

A

neurofibramatosis

48
Q

What are ash leaf spots associated with?

A

Tuberous sclerosis

49
Q

Psoriasis

A

Papulosquamous disorder- silver scale on purple base- if break off they bleed- extensor surfaces

50
Q

guttate psoriasis?

A

Post strep infection often- truncal distribution- papular- doesn’t have large plaques

51
Q

How do you treat psoriasis?

A

Topical steroids, coal tar, sunlight, methotrexate(if diffuse)

52
Q

How do you differentiate psoriasis from fungus?

A

Non itchy, nonpainful

53
Q

Pityriasis rosea

A

herald patch appears 2 weeks prior to rash(looks tinea corporis), christmas tree distribution, itchy, tx: antihistamine, sunlight exposure,

54
Q

Impetigo is caused by?

A

Staph aureus (GAS is possible)

55
Q

Tx for impetigo?

A

PO- Cephalexin, or clindamycin, mupirocin(localized)

56
Q

What causes erysipelas

A

strep pyogenes(GAS), warm migrating macular rash, often on faces of children

57
Q

How do you tx erysipelas?

A

PEN G

58
Q

Cellulitis

A

Indurated erythema with fluctuant mass, often strep, staph if abscess

59
Q

How do you treat cellulitis?

A

anti-staph(1st line cephalosporin) abx and abscess drainage

60
Q

Folliculitis?

A

Can be staph/strep of pseudomonas for hot tub- shaving/friction/ not always treat

61
Q

Staph scalded skin syndrome

A

Staph aureus, tender, warm, febrile, positive

62
Q

how do you tell the difference between staph scalded skin syndrome and steven jonhsons syndrom?

A

SSS wil not affect the mucous membranes(mouth/eyes/

63
Q

How do you differentiate tinea infections from others?

A

Mounded scaling annualar distribution with central clearing,

64
Q

Do you treat ring worm or tinea corporis with nystatin?

A

No! Nystatin is good for thrush though

65
Q

Treatment for ringworm?

A

Tocical imidazoles(lotimazole, miconazole, econazole) if refractory use oral anti-fungal

66
Q

What might mimic ringworm?

A

Nummular eczema and granuloma annulare

67
Q

Erythema migrans?

A

associated with Lyme disease

68
Q

erythema multiforma

A

targatoid -no scaling

69
Q

tinea capitis

A

black dot tinea– will cause alopecia, ring shapped, itchy,

70
Q

Kerion

A

complicated tinea capitis- is when fungus has trave tx. topical, griseofulvin or other oral medications(get LFT)

71
Q

Tinea pedis in children is

A

uncommon- suspect eczema

72
Q

tinea versicolor tx:

A

selenium sulfide and topical anti-fungals

73
Q

vitaligo versus tinea versicolor

A

more progressive, more hypopigmented, not just chest and back

74
Q

Candida is?

A

Thrush or diaper rash (satellite lesions)

75
Q

Treatment for candida?

A

topical nystatin

76
Q

What causes warts?

A

HPV

77
Q

treatment for warts?

A

freezing, keratolytics, podophillin, retin-A

78
Q

Molluscum contagiosum is caused by what?

A

Pox viruses (skin-skin)- fluid inside

79
Q

What is the common discription of molluscum contagiosum?

A

Umbilicated pearly papules with waxy surface (itchy)

80
Q

What is the treatment or MC?

A

curettage, liquid nitrogen, podophyllin- very contagious

81
Q

How do you treat scabies?

A

permethrin 5%, lindane(not in infants)

82
Q

Where do you often see scabies?

A

finger webbing, flexor aspects or wrists, anterior axillary folds, wast, navel

83
Q

How do you treat lice?

A

permethrin, pyrethrum, always retreat d/t eggs, shave head

84
Q

What are some allergic/inflammatory reactions?

A

erythema nodosum, erythema multiforme, stevens johnson syndrome, toxic epidermal necrolysis

85
Q

how do you differentiate dandruff from lice?

A

Lice will appear uniformly on 1-3in from scalp, smooth oval shapped and shiny versus dandruff is closer to the scalp and look more shaggy, jacked, flaky, less on hair shaft

86
Q

Erythema nodulosum

A

painful raised hot lesions- strep toxin reaction or if recurring think IBD, drug reaction, RA, lupus

87
Q

What is the most common cause of erythema nodulosum?

A

Strep

88
Q

erythema multiforme causes?

A

drug erruption often pcn or NSAIDS, can be d/t hsv,

89
Q

Stevens johnson syndrome presentation

A

often post URTI, red blistered, eroded, bloody, conjunctivitis, scarred, mouth ulcers, High fever, LAD,

90
Q

Drugs that cause SJS?

A

ABX:pcn, sulf, tetracyclines, NSAIDS, AED: carbamazepine, phenytoin

91
Q

TEN

A

blistering and peeling of top layer of skin often d/t drug reaction, covers >30% body surface area

92
Q

how do you treat impetigo?

A

mupiriocin

93
Q

How do you treat chicken pox?

A

Oatmeal baths, calomine

94
Q

How do you treat molluscum contagiosum?

A

wait it out or podofolin

95
Q

Kowasacki disease

A

+5 days high fever, cracked red lips, cervical LAD, conjunctivitis, (mucocutaneouslymphoid syndrome)- admit, CRP and ESR will be elevated tx: IVIG and aspirin, get Echo (coronary aneurysms)

96
Q

What is the main complication associated with kawasaki disease?

A

vasculitis- coronary artery aneurysms

97
Q

When does kawasaki disease occure?

A

6mo-4 years, peak incidence at one year

98
Q

What are the symptoms of Kawasaki diseease?

A

pink eye, oral mucosal change, enlarged lymph nodes, patchy rash, peeling skin

99
Q

treatment for kawasaki?

A

admit, get ECHO, high dose aspirin, give IVIG, followed by cardiologist for 6 months

100
Q

Herpangina

A

Coxasackie virus—Oral lesiona without the exanthem (hand-foot-mouth)

101
Q

Viral exanthems?

A

varicella, measles, german measles, roseola, fifth disease(erythema infectiosum)

102
Q

Gianotti- crosti syndrome

A

Post viral rash- acral papular rash- itchy

103
Q

erythema toxicum

A

benign inflammation, resolves, macule with central papule, benign

104
Q

skin mottling

A

temporature changes, wide spread can be bad

105
Q

Milia

A

sebum plugs, infants, 3-4 weeks resolve

106
Q

Subcutaneous fat necrosis

A

newborns, firm and rubbery feeling(lipoma esk)

107
Q

sucking blister

A

blistering or redness

108
Q

herpatic whitlow

A

HSV-painful

109
Q

Pityriasis alba

A

whitening of skin-post inflammatory

110
Q

Neonatal acne

A

excess androgens from mom- resolves on own-don’t treat

Pediatrics (8 decks)

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