Peds - Derm II Flashcards
A common, benign, hyperproliferative inflammatory skin disorder
Psoriasis
Psoriasis - what’s going on?
4
o Epidermal turnover time is reduced from 14 days to 2 days
o Keratinazation doesn’t occur
o Immature NUCLEATED cells are seen on the horny layer
o May be immunologically mediated
Psoriasis - typical lesion
Lesions are red, sharply defined plaques with silvery scales
Psoriasis - hallmark sign
Auspitz’s sign - droplets of blood when scale is lifted
Psoriasis - management
o Topicals for the scalp = tar, salicylic acid
o Topical steroids for the skin = betamethasone, - triamcinolone
o If severe - UVB light, coal tar exposure
Pityriasis rosea - cause and timing
o thought to be viral
o more common in spring and fall
o often patients report a recent URI
Pityriasis rosea -
duration
3-8 weeks, self-limiting
Pityriasis rosea -
differential, especially if no itching or if palmar/plantar are involved
syphillis
Management of pityriasis rosea pruritis (3)
o oral antihistamines (atarax/hydroxizine, claritin)
o topical antipruritic
o topical steroids (triamcinolone)
Examples of topical antipruritics (4)
Sarna lotion
Prax lotion
Itch-x gel
Cetaphil with menthol
What oral antibiotic can be used to dry up the lesions of pityriasis rosea?
Erythromycin x 14 days
Impetigo - typically caused by which gram positive organisms?
strep
staph
Impetigo - pharmacotherapy for MILD cases
Bactroban
Bacitracin
Impetigo - PO pharmacotherapy for more SEVERE cases
strep –> erythromycin or PCN
staph –> erythromycin or cephalexin
Impetigo - pharmacotherapy for cellulitis
3
IV ABT
o nafcillin
o vancomycin
o doxycycline
Scabies - incubation
4 - 6 weeks
Scabies management (2)
Permethrin (Nix) - repeat in 1 week
or
Ivermectin - do not use in pregnant, lactating - kills eggs so can cross blood-brain barrier
A spirochetal disease; the most common vector-borne disease in US
Lyme disease
Lyme disease organism
Borrelia burgdorferi
Lyme disease - stage 1
2
Erythema migrans
Flu-like s/sx
Lyme disease - stage 2
3
Headache
Stiff joints
Bell’s palsy
Lyme disease - stage 3
3
Joint pain
Subacute encephalopathy
Acrodermatitis chronicum atrophicans
Acrodermatitis chronicum atrophicans
Associated with Lyme disease
Blue-red discoloration of distal extremity with edema
Lyme disease -
Which antibody detection test is initially done?
ELISA
Lyme disease -
What test is confirmatory?
Western blot assay
Lyme disease -
Is ESR likely to be elevated?
Yes
Lyme disease -
Diagnostic criteria
Exposure to tick habitat in past 30 days AND
o erythema migrans OR
o late manifestation AND
o lab confirmation
Lyme disease -
Management if SKIN symptoms only –>
Doxy if over 7 years of age
amoxicillin or cefuroxime if not
Lyme disease -
Management of stage 2 or 3
Refer to infectious disease specialist
Possible acute complications of Rubeola (4)
ear infection
pneumonia
encephalitis
acute thrombocytopenic purpura
Possible chronic complication of Rubeola (1)
Chronic brain disease - subacute sclerosing panencephalitis
Acute, contagious viral disease known for its teratogenicity
Rubella / 3-day measles / German measles
Characteristic rash of Rubella
Fine, erythematous papular rash which starts on FACE
Spreads to extremities and trunk
Location of Rubellar lymphadenopathy
post auricular
sub occipital
Fever, runny nose, cough, red eyes, spreading skin rash, Koplik’s spots, highly contagious
Rubeola / ordinary measles
Erythematous maculopapular rash which starts on face and spreads, gone in 72 hours
Rubella / 3-day measles / German measles
URI symptoms, rash on trunk then extremities, high fever with ABRUPT END when RASH develops; seen in 6 month - 2 year olds
Sixth disease / Roseola infantum
A contagious exanthematous disease caused by human parvovirus B19.
Erythema Infectiosum
Fifth disease - diagnostics
Can test for B19 IgG, IgM
How can pregnant women exposed to Fifth disease be treated to protect the fetus?
Immunoglobulin
What can intrauterine infection with fifth disease cause?
fatal anemia
Sixth disease / Roseola infantum - pathogen
Human herpesvirus 6 (HHV-6)
A highly contagious, viral illness resulting in uleration and inflammation of the soft palate (herpangina) and papulovesicular exanthem on hands and feet.
Coxsackie virus / Hand-Foot-and-Mouth
