Peds DERM Flashcards
Rashes classification
Fungal
Bacterial
Viral
Atopic/Allergic/Contact
Infestation/Bites
Cradle Cap (Seborrheic Dermatitis)
Seborrheic dermatitis is a common, inflammatory disease of the newborn with a characteristic pattern for different age groups
Usually occurs because the parent is reluctant to scrub over the anterior fontanel
May occur on the face
Exanthem
a skin eruption occurring as a symptom of a general disease
Enanthem
eruptive lesions on the mucous membranes
Tinea capitis
Tinea capitis is a fungal infection of the scalp that most often presents with pruritic, scaling areas of hair loss.
TrichophytonandMicrosporumspecies of dermatophyte fungi are the major causes of tinea capitis.
The infection is often contracted from another human or an animal through direct contact.
Treatment:
Oral antifungal treatment:
Griseofulvin
Griseofulvin dose
Microsize: Oral: 20 to 25 mg/kg/day in single or 2 divided doses; maximum daily dose: 1,000 mg/day
Ultramicrosize: Oral: 10 to 15 mg/kg/day once daily; maximum daily dose: 750 mg/day
**Microsize oral suspension, tablets: Administer with a fatty meal (eg, whole milk, ice cream, peanut butter) to increase absorption; shake suspension well before use.
Fungal rashes
The history is longer, it progresses for long periods of time.
Sometimes it improves but it is persistent
Spreads slower, progresses at a longer rate
Diaper dermatitis (diaper rash)
Most common skin eruption in infants and toddles
Fungal diaper rash
well-demarcated border, smooth, shiny, “fire engine red”, papular rash
Occasional satellite lesions
Candida albicans
Impetigo
CLASSIC LESION IS HONEY COLORED CRUSTED LESION
Bacterial skin infection caused by invasion of the epidermis by pathogenic Staphylococcus aureaus or Streptococcus pyogenes, or a combination of the two.
Determine if febrile
Examine all skin looking for erosions covered by honey-colored crusts
Check for regional lymphadenopathy
HIGHLY CONTAGIOUS–change sheets
Impetigo treatment
For multiple lesions, systemic antibiotics may be needed.
Bactrim
Keflex
If only a few lesions are present, consider use of topical Bactroban TID for 7-10 days, re-evaluate if no response in 3-5 days
Gentle washing with an antibacterial soap to remove crust must be done if Bactroban is used
Condition is highly contagious.
follow up in one week to determine response to treatment
Molluscum Contagiousum
viral rash, benign with no systemic manifestations
Characterized by waxy, discrete, flesh-colored umbilicated or dome-shaped papules
A part of the Pox family of viruses
Hang out for months up to a year
Viral exanthems
viral rashes
Roseola
Varicella
HFM
Roseola-Exanthem Subitum
Acute viral infection occurring primarily in children under 3
Incubation 5-15 days
Adute onset of prodromal fever lasting 3-7 days, mild adenopathy
Abrupt resolution of fever and eruption of rash occur.
Rash begins on trunk and spreads to face and extremities.
Discrete pinkish maculopapular rash that last 1-2 days
Treatment: symptomatic for fever
The rash of roseola appears as the fever abates. It starts on the neck and trunk and spreads to the extremities. As depicted above, it is erythematous, blanching, and macular or maculopapular
Coxsackie viruses A and B
causes roseola rash
varicella zoster
Herpes virus –contagious via airborne droplets or by direct cutaneous contact with fluid filled vesicles
The average incubation period for varicella infection is 14 to 16 days, although this interval can range from 10 to 21 days. The period of infectivity is generally considered to last from 48 hours prior to the onset of rash until skin lesions have fully crusted
chicken pox
Vesicular lesions on an erythematous base are characteristic of chickenpox. The lesions occur in crops and are present in a variety of stages from maculopapular to vesicular or even pustular. Central necrosis and early crusting is also visible.
Parvovirus b19–
“slap cheek”
most classically causes erythema infectiosum (EI), a mild febrile illness with rash. It often occurs in outbreaks among school-aged children, although it can occur in adults as well. EI is also referred to as “fifth disease” since it represents one of six common childhood exanthems, each named in order of the dates they were first described.
make sure not to come around pregnant people
Atopic dermatitis
ECZEMA
Extremely puritic skin disorder involving cutaneous hypersensitivity
Hereditary component
Patients with acute, severe dermatitis should be referred to a specialist
Education of parent on the chronicity of the condition
management goal is to reduce dry skin
Keep skin well hydrated with daily baths in only warm water, soak for 10 minutes, use mild soap such as Dove, and avoid over scrubbing
Pat skin dry after a bath and apply moisturizer immediately to damp skin
Wear 100% cotton clothes
atopic dermatitis treatment
recommended moisturizers
Eucerin
Aquaphor
Aveeno
Pharm tx
Topical Steroids
Apply thin layer 2 times a day for 7-14 days
Infants and children: Hydrocortisone ointment 2.5% (use 1% on face and intertriginous areas)
Adolecents: Triamcinalone acetonide ointment 0.1%
Milder cases can use steroid cream instead of ointment
Urticaria/ Hives
Viral and bacterial infections– Acute urticaria may develop during or following a viral or bacterial infection, particularly in children. Infections are associated with over 80 percent of cases of acute urticaria in some pediatric series. Immune activation, involving immune complex formationand/orcomplement activation, is a proposed mechanism, although the exact pathogenesis is unclear.
Scabies
Scabies is a cutaneous infestation caused by the miteSarcoptes scabiei. Classic scabies is typically characterized by an intensely pruritic eruption with small, often excoriated, erythematous papules in sites such as the fingers, wrists, axillae, areolae, waist, genitalia, and buttocks
peticulosis
Pediculosis capitis is a common condition caused by infestation of the hair and scalp byPediculus humanus capitis(the head louse), one of three distinct varieties of lice specifically parasitic for humans
Pruritus occurs as an allergic reaction to lice saliva injected during feeding. In a patient without prior infestation, the onset of itching may be delayed until sensitization occurs after four to six weeks
Treatment of pediculosis capitis is recommended. Topical pediculicides are the most common initial treatments. Manual removal of lice (wet combing) is sometimes used as an alternative to topical pediculicide therapy. Oral therapy is occasionally required for refractory infestations
scabies treatment
Topicalpermethrinis highly effective for scabies, with cure rates in randomized trials approximating or exceeding 90 percent. Oralivermectinis an alternative first-line treatment that has the advantages of ease of administration and lower cost. Special considerations are warranted for young children and pregnant women.
