Peds Derm

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Author:
mycards2014
ID:
148473
Filename:
Peds Derm
Updated:
2012-04-19 00:40:26
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Peds Derm
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Description:
Derm on kids
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  1. What is this:
    Erythematous macules surrounding small pustules (containing eosinophils). “Flea bites.”
    Erythema Toxicum Neonatorum
  2. Erythema Toxicum Neonatorum
    Who?
    Where?
    Other signs?
    Tx?
    • New borns (1-4 after birth)
    • Anywhere
    • No systemic signs
    • This is self-limiting, just reassure parents.
  3. Erythema Toxicum Neonatorum
  4. What is this:
    Pustular lesions; rupture easily
    After rupture evolve into hyperpigmented macules
    Transient Neonatal Pustular Melanosis
  5. Transient Neonatal Pustular Melanosis
  6. Transient Neonatal Pustular Melanosis
    Who?
    Where?
    Other signs?
    Tx?
    • Newborns (usually in the first 24hrs), AA > whts
    • Anywhere
    • None
    • Reassurance
  7. Cutis Marmorata
  8. What is:
    Blanching mottled or lacy erythema
    Cutis Marmorata
  9. Cutis Marmorata
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Babies
    • Everywhere
    • Due to decreased core temp
    • None
    • Reassurance
  10. Milia -
  11. What is this:
    Nonconfluent pearly papules with minimal surrounding erythema
    Milia
  12. Milia
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Up to 50% of newborns
    • Usually face, eyes, nose (occasionally trunk)
    • Superficial keratin cyst - over growth
    • None
    • Reassurance
  13. Milia --> Epstein Pearl
  14. What is this:
    Pruritic erythematous macules and vesicles on warm skin
    Miliaria rubra
  15. Miliaria Rubra
  16. Miliaria crystallina - Small non-inflammatory vesicles
  17. Miliaria
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Babes
    • Typically in intertriginous or occluded areas
    • Sweat retention when eccrine glands partially close
    • Warm skin
    • Reassurance
  18. Acne Infantum
  19. What is:
    Pearly papules with surrounding erythema
    Acne Infantum
  20. Acne Infantum
    Who?
    Where?
    Other signs?
    Tx?
    • Newborns and infants (peaks at 2 mo)
    • Forehead, cheeks and nose
    • None
    • Reassurance
  21. Mongolian Spot
  22. What is this:
    Large benign bluish-gray/black pigmented nevus
    Mongolian Spot
  23. Mongolian Spot
    Who?
    Where?
    Other signs?
    Tx?
    • Babes
    • Lower back, butt, thighs
    • None
    • Reassurance, usually fades!
    • ** make sure to document b/c can look like child abuse
    • Capillary Malformation
    • AKA nevus flammeus, port wine stain, stork bite/angel’s kiss, macular stain
  24. Capillary Malformation
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Babes, children (present at birth, persists through life)
    • Face, head (anywhere)
    • Collection of mature capillaries
    • Assocation with Sturge-Weber syndrome (port wine stain)
    • Observation
  25. Hemangiomas
  26. What is:
    Reddish-purple raised nodule on skin
    Hemangioma
  27. Hemangioma
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Babes, not present at birth. Expand 1-2 yo and then involute
    • Can be anywhere (including internal; suspect this if there are hemangiomas in beard-growth distribution or there are more than two lesions on the body)
    • Proliferation of immature capillaries
    • None (unless there are internal hemangiomas causing trouble)
    • Observation (steroids if airway is in danger, surgery)
  28. Where is the distribution of atopic dermatitis in babes?
  29. What is the distribution of atopic dermatitis in children?
  30. Candida Dermatitis - beefy erythema with satellite lesions
  31. Diaper dermatits - folds are spared
  32. Treatment for diaper dermatitis
    Barrier cream (zinc oxide) and frequent diaper changes
  33. Treatment for candida dermatitis
    Nystatin cream, barrier cream, and frequent diaper changes
  34. Ichthyosis
  35. Ichthyosis
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Onset in early childhood (normal at birth)
    • Anywhere
    • Congenital disorders of keratinization leading to dry scaly skin --> Ichthyosis vulgaris is most common
  36. Seborrheic Dermatitis
  37. What is this:
    Cradle Cap dermatitis
    Seborrheic Dermatitis
  38. Seborrheic dermatitis
    Who?
    Where?
    Other signs?
    Tx?
    • Babes (resolves by 1yo)
    • Dense concentrations of sebaceous glands (scalp, eyebrows, body folds
    • Can be fine flaky to thick greasy yellow scales with or without an underlying erythematous patch or plaque base
    • Medicated shampoos (zinc, selenium, ketoconazole), topical
    • corticosteroids, manual removal of scales
  39. Perianal Strep Dermatitis (notice sharp margins)
  40. What is this?
    Bright red, sharply demarcated perianal patches.
    Perianal dermatitis
  41. Perianal dermatitis
    Who?
    Where?
    Other signs?
    Tx?
    • Children 6 mo to 8 yrs.
    • Perianal (duh)
    • Painful defecation, yellow crust
    • Oral (penicillin or amoxicillin) and topical antibiotic (mupirocin) for 10 days.
  42. Staph Scalded Skin Syndrome
  43. Staph scalded skin syndrome
    Who?
    Where?
    Why?
    Other signs?
    Tx?
    • Usually in children <5 years age
    • Perioral and periorbital crusting or generalized erythema with Staph scarlatina
    • Epidermolytic toxin produced by Staph aureus
    • Nikolsky sign - Fragile bullae with superficial desquamation upon traction
    • IV antibiotics (vancomycin AND clindamycin)
  44. What is this?

    Flesh colored to pink dome-shaped umbilicated papules
    Molluscum Contagiosum
  45. What is this:
    Vesicles and pustules with “honey-colored crusting”
    Impetigo
  46. What is this:

    Erythematous, pruritic, and scaly lesions usually with an annular shape that grows outward leaving a central clearing
    Tinea corporis
  47. What is this?
    Fixed, typically non-pruritic annular red macules, papules, and plaques
    Erythema multiforme
  48. How is Erythema multiforme and Steven Johnsons syndrome different?
    • SJS involves two or more mucus membranes
    • Erythema m. is cause by infection (HSV, EBV, mycoplasma)
    • SJS is caused by drug
  49. Leishmaniasis
  50. How is Leishmaniasis spread?
    What happens?
    Tx?
    • Sandfly bites
    • Ulcer formation at the site of the bite which may take up to a year to heal, scarring
    • Antimony containing compounds (meglumine, sodium stibogluconate)

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