Rashes of neonatal + childhood (tx in infectious dz for infections)

Question 1

Mongolian spot

Answer 1

More common in dark sinned races

Flat blue or gray lesions with well defined margins (do not fade into skin)

Usually disappear in first few years of life

Most often in presacral area

2/2 melanin-containing melanocytes in dermal layer

VS child abuse - bruises FADE INTO skin and have diff colors

Question 2

Erythema toxicum

Answer 2

Small papules or pustules on erythematous base

Usually disappear after 1st day of life –> several weeks

Pustules full of eosinophils

Baby looks good! Not ill

Vs Staph scalded skin syndrome - full of neutrophils and skin cx = staph aureus and baby looks ILL

Other DDx = pyoderma (any skin dz that has pus like impetigo), candida

Question 3

Milia

Answer 3

keratin-filled cyst that can appear just under the epidermis

Small inclusion cysts
Pearly white

In mouth –> Epstein’s pearls

Question 4

Cutis marmorata

Answer 4

Skin = lacy pattern like cobblestones

Vasomotor response to cold stress

Persistent in:

• Trisomy 21
• Trisomy 18
• cutis marmorata telangiectasia congenita

Question 5

Neonatal acne

Answer 5

Open adn closed comedones

Possibly 2/2 circulating androgenic hormones

Rarely need tx

Question 6

Nevus simplex (Salmon patch)

Answer 6

Flat vascular lesion disappearing with time
- EXCEPTION: nuchal area may persist

Usually over eyelids, glabella, nuchal area

Can become darker when cry

Vs port wine stains = permanent and unilateral

Question 7

Capillary (strawberry) hemangioma

Answer 7

Macular lesions –> can quickly grow

Occur anywhere

Bright red

Grows rapidly and then spontaneously regress

Tx not necessary b/c regress spontaneously

Question 8

Nevus sebaceus (of Jadassohn)

Answer 8

Yellow-orange hairless plaques resembling flat warts on scalp

Seen in infancy

Potential to become malignant –> remove by adolescence

Question 9

Cafe au lait spots

Answer 9

Tan or light brown flat lesions

Sharply demarcated

Occur anywhere, any shape

Question 10

Pinpoint rash

Begins at head and moves down the body

Postauricular lymphadenopathy

Rose spots on palate

Answer 10

Rubella

Question 11

Rash preceded by cough, coryza, conjunctivitis, and blue-white spots on buccal mucosa

Mobilliform rash starts from head and moves down

Answer 11

Measles (Rubeola)

Fever stays

Will always have a prodrome

Question 12

Vesicular rash beginning on trunk

Spreads to face and extremities with lesions of diff age

Answer 12

Varicella

Question 13

Macular rash appearing after many days of high fever

Usually in infants

Can have tense fontanelle if not closed

Answer 13

Roseola (HHV 6 = Exanthem subitum)

Question 14

Slapped cheek rash on face

URI sx

Answer 14

Erythema infectiosum (Parvovirus B19)

Tx = supportive

Go back to school ok because once you have the rash, no longer contagious

Worry about arthritis in adults

Question 15

Erythematous sandpaper like rash

Strawberry tongue

Pastia lines

Miliary sudamina

Fever

Sore throat

Answer 15

Scarlet fever

Scarlet fever is usually 2/2 URI

But can be 2/2 wound infections, burns, strep skin infections

Question 16

Vesicular rash on palms and soles

Ulcers in oral mucosa

Answer 16

Hand food mouth disease

Coxsackie!

Question 17

Nevus flammeus

Answer 17

Port wine stain

assoc w/ Sturge Weber disease

Question 18

erythema chronicum migrans

Answer 18

lyme disease

Question 19

Pale, rose-red maculopapular rash

Starts peripherally and spreads to entire body including pals and soles

Answer 19

Rocky mountain spotted fever

Question 20

Is neonatal varicella bad?

Answer 20

If mom is immune, is usually mild since baby has moms antibodies

Only time varicella severe is if mom gets infection first time 5 days before birth