peds21 Flashcards
cause of psoriases
usually aut dom; causes immune disreg which causes epidermal proliferation
silvery scaled lesions
psoriasis
koebner phenomenon
new lesions develop at sites of skin trauma; seen in psoriasis
nai involvement in psoriasis
common
treatment of psoriasis
moderae or high steroids, UV light, vit D, salicylic aicd for scalp involvemnt, retinoids, and anthralin (downregulates epidermal growth factor)
miliaria rubra (heat rash)
cuased by disrupted sweat ducts near the upper dermis (by occlusion or friction)that results in sweat being released and sweat induces inflamm response
what does heat rash look like?
small erythematois pruritic papules or vesicles in areas of occlusion or areas that have been rubbed
treatment of heat rash
avoid occlusive clothing, avoid sweating; no meds necessary
serum sickness
hypersens disorder that initially appears as hives but then becomes systemic; meds like cephalosporin are common causes
erythema multiforme
hypersens reaction to many poss stimuli (drugs, viruses, bacteria, etc.)
three kinds of erythema multiforme
erythema multiforme minor, erythema multiforme major, stevens-johnson syndrome
classic skin lesion in all forms of erythema multiforme
target lesion with a fixed dull red oval macules with a dusky center that may contain a papule or vesicle
toxic epidermal necrolysis
severe reaction to drugs that results in widespread epidermal necrosis; clinical features may include sloughing of the epidermis, no target lesions are seen
niolsky sign
skin peels away with lateral pressure; often present in toxic epidermal necolysis
mortality in toxic epidermal necrolysis
10-30% because can get sepsis, dehydration, and electrolyte abnormalities
tinea capitus
fungal infection of the hair, acquired by human to human contact 95% of the time
clinical features of tinea capitus
patchy hair loss, in which hair breaks at the root (black dot ringworm) or broken hairs are thickened and white M canis infection); infected area may have scales and pustules
kerion
large red boggy nodule; may be present in tinea capitus and is a hypersens reaction to the fungus (dermatophyte)
occipital and posterior cervical lymphadenopathy
very suggestive of tinea capitus
diagnosis of tinea capitus
microscopic eval of hairs with 10% koh to identify fungal hyphae; hairs fluoresce under woods light if m canis is the infecting organism (5% of time)
treatment of tinea capitus
systemic oral antifungals (e.g. griseofulvin) for 6-8 weeks. Topical antifungals are ineffective; very contagious!
tinea corporis
fungal infection of the body
tinea pedis
fungal infection of the foot
tinea cruris
fungal infection of the groin
pathogens that cause fungal infection of the skin
m. canis, t. tonsurans, and other trichophyton species
tinea corporis aka
ringworm
clinical feautres of tinea corporis
oval or circular scaly erythematous patches with partial central clearing
clinical features of tinea pedis (athlete’s foot)
present in postpubertal adolescents with sclaing and erythema between the toes or on the plantar aspect of the foot
clinical features of tinea cruris
scales and erythema int eh groin and inguinal creases
tinea unguium (onycomycosis)
fungal infection of the nails characterized by thickening and yellow discoloration of one or more nails (usually toenails)
treatment of tinea unguium
topical treatments don’t work that well; systemic treatments sometimes work
tinea versicolor
caused by yeast that invades stratum corneum; scaly oval macules on the trunk, prox arms, and face; macules may be hypo or hyperpigmented and change with sun; infection can be asympt
diagnosis of tinea versicolor
koh exam (spaghetti and meatballs appearance) or under woods light
management of tinea versicolor
overnght app of selenium sulfide for 3-4 weeks; ketoconazole shampoo or cream, or systemic antifungal
viral exanthem
skin rash associated with viral infection
enanthem
rash involves the oral mucosa as well
morbilliform
measles like
scarlatiniform
scarlet fever like: papular, vesicular, and petechial
measles and rubella
cause rash
erythema infectiosum
fifth disease, parvovirus B19
fifth disease most common in who
school kids
how is parvovirus transmitted
resp secretions
parovirus can cause what
aplastic crisis (esp in patients with hemoglobinopathies), prolonged anemia in immunosupp patients, and fetal hydrops or miscarriage
clinical features of fifth disease
begins URI, then bright red macular rash on the cheeks; then lacy reticular rash on the trunk and extremities; arthalgias may be present but are more
best screening exam for red reflex
bruckner test (direct opthalmoscope at patient’s eyes from 2 feet away)
hirschberg test
assess eye alignment by evaluating for the symm of light reflecting off both corneas
what is visual acuity at birth?
20/200
abnormal visual development results from what two possibilities?
improper eye alignment (such as strabismus) or some condition that blocks retinal stimulation (like congenital cataract)
when is visual development most crucial?
3-4 months
