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40 Notes
2012-04-06 12:46:04

Alterations of the Integument in Children
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  1. Dermatitis
    • Atopic dermatitis commonly occurs as red, scaly lesions on the face, cheeks, and flexor surfaces of the extremities in infants and young children and is associated with elevated IgE levels and a family history of asthma and hay fever.
    • Diaper dermatitis is a type of irritant contact dermatitis that develops from prolonged exposure to urine and feces and often becomes secondarily infected with Candida albicans.
  2. Acne Vulgaris
    Acne vulgaris is a common disorder related to obstruction of pilosebaceous follicles and proliferation of Propionibacterium acnes, primarily of the face, neck, and upper trunk. It is characterized by both non-inflammatory and inflammatory lesions.
  3. Infections of the Skin
    • Impetigo is a contagious bacterial disease occurring in two forms: bullous and vesicular. The toxins from the bacteria produce a weeping lesion with a honey-colored crust.
    • Staphylococcal scalded-skin syndrome (SSSS) is a staphylococcal skin infection that occurs more commonly in young children with low titers of antistaphylococcal antibody. Painful blisters and bullae form over large areas of the skin, requiring systemic antibiotics for treatment.
    • Tinea capitis and tinea corporis are fungal infections of the scalp and body caused by Dermatophytes.
    • Thrush is a fungal infection of the mouth caused by Candida albicans.
    • Molluscum contagiosum is a poxvirus of the skin that produces pale popular lesions filled with viral and cellular debris.
    • Rubella (3-day measles) is a communicable viral disease characterized by fever, sore throat, enlarged cervical and postauricular nodes, and a generalized maculopapular rash that lasts 1 to 4 days.
    • Rubeola is a viral contagious disease with symptoms of high fever, enlarged lymph nodes, conjunctivitis, and a red rash that begins on the head, spreads to the trunk and extremities, and lasts 3 to 5 days. Both bacterial and viral complications may accompany rubeola.
    • Roseola is a benign disease of infants with a sudden onset of fever that lasts 3 to 5 days, followed by a rash that lasts 24 hours.
    • Chickenpox (varicella) is a highly contagious disease caused by the varicella-zoster virus. Vesicular lesions occur on the skin and mucous membranes. Individuals are contagious from 1 day before the development of the rash until about 5 to 6 days after the rash develops.
    • Herpes zoster (shingles) is a viral eruption of vesicles on the skin along the distribution of a sensory nerve caused by chickenpox virus that persists in sensory nerve ganglia.
    • Smallpox (variola) was a highly contagious, deadly viral disease that has been eradicated worldwide by vaccination but may be a bioterrorist threat.
  4. Insect Bites and Parasites
    • Scabies is an itching lesion caused by the itch mite, which burrows into the skin forming papules and vesicles. The mite is very contagious and is transmitted by direct contact.
    • Pediculosis (lice infestation) is caused by blood-sucking parasites that secrete a toxic saliva and damage the skin to produce a pruritic dermatitis. Lice are spread by direct contact and are recognized by the ova or nits that attach to the shafts of body hairs.
    • Fleabites produce a pruritic wheal with a central puncture site and occur as clusters in areas of tight-fitting clothing.
    • Lyme disease is caused by the spirochete Borrelia burgdorferi transmitted by rick bites with cutaneous and systemic inflammatory symptoms.
    • Bedbugs are blood-sucking parasites that live in cracks of floors, furniture, or bedding and feed at night. They produce pruritic wheals and nodules.
  5. Vascular Disorders
    • Hemangiomas are benign tumors that form from the rapid growth of vascular endothelial cells and result in formation of extra blood vessels.
    • A strawberry hemangioma is a vascular lesion present at birth that proliferates in size and then grows at the same rate as the child. Most lesions resolve spontaneously by 5 years of age.
    • A cavernous hemangioma is present at birth, with larger vessels than a strawberry hemangioma, and is bluish red. Cavernous hemangiomas usually involute by 9 years of age and may require surgical removal is located near the eyes, nares, or genitals.
    • Salmon patches are macular pink lesions with dilated capillaries that usually resolve by 1 year of age.
    • Port-wine stains are congenital malformations of dermal capillaries that do not fade with age.
  6. Other Skin Disorders
    • Miliaria is small pruritic papules or vesicles that result from closure of the sweat duct opening in infants.
    • Erythema toxicum neonatorum is a benign accumulation of macules, papules, and pustules that spontaneously resolves within a few weeks after birth.