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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
What are some inherited skin disorders?
Ichthyosis and epidermolysis bullosa
26
What is ichthyosis?
Autosomal dominant, dry, hard, fish scales or stratum corneum
27
What is the most common type of ichthyosis and treatment?
Ichthyosis vulgaris and ammonium lactate(12%)
28
What is a severe form of ichthyosis?
Collodion baby or “harlequin baby”- Sasauge casing skin- can be born with malformations, respiratory failure,
29
what is epidermolysis bullosa?
Auto dominant-skin fragility with blistering. Tx as burn.
30
What is a common feature of inherited dermatologic disorder?
Most have a disorder with collagen or other dermal proteins/components
31
What treatment do you provide for epidermolysis bullosa?
Topical ointments, non-stick dressing, padding, intermittent antibiotics for infections
32
What are the EB types?
EBS,JEB,DEB- they are based on the site of blister formation with the layer of the skin
33
What is the classic versino of eczematous lesions?
Atopic dermatitis- the itch that rashes
34
Atopic dermatitis is located where?
in moisture retained places and places where friction is -flexor surfaces
35
How do you treat eczema?
emollients(eucerin, vaseline, cetaphil,aquaphor) and Topical steroids
36
Dyshidrotic eczema is treated with?
High potencey topical steroids and antiperspirants(aluminum based deoderant) and wet dressings -double cotton cloves at night
37
intertrigo
wet, moist weeping rash…tx. based on presentation.bacterial(purulent d/c with crusting), fungal(red sattelate lesions/bumpy/raised)
38
Keratosis Pilaris
back of arms/places with friction-can use keratoytics-rehydrate
39
Contact dermatitis
Diaper rash, chemical irritations, metals, poison ivy, tx: corticosteroids
40
Perioral dermatitis
Lip licker dermatitis, tx: Mainstay(topical antibiotics- metronidazole/clindomycin) vaseline at bedtime, steroid creams(rare),
41
Sebhorreic dermatitis?
Greasy, yellow colored, scaling lesions, “cradle cap” tx: selenium, head and shoulders, infant brushes to rub off tissue
42
What are some pigmented lesions associated with disease?
Cafe au lait spots(neurofibramatosis), ash leaf spots(tuberous sclerosis), port wine stains(nevus flammeus/vascular malformations)
43
What are some pigmented birthmarks?
Mongolian spots, melanocytic nevi, salmon patches, hemangiomas
44
What is a hallmark of congenital melanocytic nevi?
The down grow in size, most shrink actually
45
Vascular birthmarks?
Nevus simplex(stork bites), port wine stain
46
What are port wine stains associated with?
Sturge Wiber syndrome- trigeminal nerve- MR, seizures glaucoma
47
What are cafe au lait spots associated with?
neurofibramatosis
48
What are ash leaf spots associated with?
Tuberous sclerosis
49
Psoriasis
Papulosquamous disorder- silver scale on purple base- if break off they bleed- extensor surfaces
50
guttate psoriasis?
Post strep infection often- truncal distribution- papular- doesn’t have large plaques
51
How do you treat psoriasis?
Topical steroids, coal tar, sunlight, methotrexate(if diffuse)
52
How do you differentiate psoriasis from fungus?
Non itchy, nonpainful
53
Pityriasis rosea
herald patch appears 2 weeks prior to rash(looks tinea corporis), christmas tree distribution, itchy, tx: antihistamine, sunlight exposure,
54
Impetigo is caused by?
Staph aureus (GAS is possible)
55
Tx for impetigo?
PO- Cephalexin, or clindamycin, mupirocin(localized)
56
What causes erysipelas
strep pyogenes(GAS), warm migrating macular rash, often on faces of children
57
How do you tx erysipelas?
PEN G
58
Cellulitis
Indurated erythema with fluctuant mass, often strep, staph if abscess
59
How do you treat cellulitis?
anti-staph(1st line cephalosporin) abx and abscess drainage
60
Folliculitis?
Can be staph/strep of pseudomonas for hot tub- shaving/friction/ not always treat
61
Staph scalded skin syndrome
Staph aureus, tender, warm, febrile, positive
62
how do you tell the difference between staph scalded skin syndrome and steven jonhsons syndrom?
SSS wil not affect the mucous membranes(mouth/eyes/
63
How do you differentiate tinea infections from others?
Mounded scaling annualar distribution with central clearing,
64
Do you treat ring worm or tinea corporis with nystatin?
No! Nystatin is good for thrush though
65
Treatment for ringworm?
Tocical imidazoles(lotimazole, miconazole, econazole) if refractory use oral anti-fungal
66
What might mimic ringworm?
Nummular eczema and granuloma annulare
67
Erythema migrans?
associated with Lyme disease
68
erythema multiforma
targatoid -no scaling
69
tinea capitis
black dot tinea-- will cause alopecia, ring shapped, itchy,
70
Kerion
complicated tinea capitis- is when fungus has trave tx. topical, griseofulvin or other oral medications(get LFT)
71
Tinea pedis in children is
uncommon- suspect eczema
72
tinea versicolor tx:
selenium sulfide and topical anti-fungals
73
vitaligo versus tinea versicolor
more progressive, more hypopigmented, not just chest and back
74
Candida is?
Thrush or diaper rash (satellite lesions)
75
Treatment for candida?
topical nystatin
76
What causes warts?
HPV
77
treatment for warts?
freezing, keratolytics, podophillin, retin-A
78
Molluscum contagiosum is caused by what?
Pox viruses (skin-skin)- fluid inside
79
What is the common discription of molluscum contagiosum?
Umbilicated pearly papules with waxy surface (itchy)
80
What is the treatment or MC?
curettage, liquid nitrogen, podophyllin- very contagious
81
How do you treat scabies?
permethrin 5%, lindane(not in infants)
82
Where do you often see scabies?
finger webbing, flexor aspects or wrists, anterior axillary folds, wast, navel
83
How do you treat lice?
permethrin, pyrethrum, always retreat d/t eggs, shave head
84
What are some allergic/inflammatory reactions?
erythema nodosum, erythema multiforme, stevens johnson syndrome, toxic epidermal necrolysis
85
how do you differentiate dandruff from lice?
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
Erythema nodulosum
painful raised hot lesions- strep toxin reaction or if recurring think IBD, drug reaction, RA, lupus
87
What is the most common cause of erythema nodulosum?
Strep
88
erythema multiforme causes?
drug erruption often pcn or NSAIDS, can be d/t hsv,
89
Stevens johnson syndrome presentation
often post URTI, red blistered, eroded, bloody, conjunctivitis, scarred, mouth ulcers, High fever, LAD,
90
Drugs that cause SJS?
ABX:pcn, sulf, tetracyclines, NSAIDS, AED: carbamazepine, phenytoin
91
TEN
blistering and peeling of top layer of skin often d/t drug reaction, covers >30% body surface area
92
how do you treat impetigo?
mupiriocin
93
How do you treat chicken pox?
Oatmeal baths, calomine
94
How do you treat molluscum contagiosum?
wait it out or podofolin
95
Kowasacki disease
+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
What is the main complication associated with kawasaki disease?
vasculitis- coronary artery aneurysms
97
When does kawasaki disease occure?
6mo-4 years, peak incidence at one year
98
What are the symptoms of Kawasaki diseease?
pink eye, oral mucosal change, enlarged lymph nodes, patchy rash, peeling skin
99
treatment for kawasaki?
admit, get ECHO, high dose aspirin, give IVIG, followed by cardiologist for 6 months
100
Herpangina
Coxasackie virus—Oral lesiona without the exanthem (hand-foot-mouth)
101
Viral exanthems?
varicella, measles, german measles, roseola, fifth disease(erythema infectiosum)
102
Gianotti- crosti syndrome
Post viral rash- acral papular rash- itchy
103
erythema toxicum
benign inflammation, resolves, macule with central papule, benign
104
skin mottling
temporature changes, wide spread can be bad
105
Milia
sebum plugs, infants, 3-4 weeks resolve
106
Subcutaneous fat necrosis
newborns, firm and rubbery feeling(lipoma esk)
107
sucking blister
blistering or redness
108
herpatic whitlow
HSV-painful
109
Pityriasis alba
whitening of skin-post inflammatory
110
Neonatal acne
excess androgens from mom- resolves on own-don’t treat

Pediatrics (8 decks)

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