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What are the symptoms of atopic dermatitis?
- 1. Pruritis
- 2. typical morphology/distribution
- 3. chronic relapsing dermatitis
- 4. personal/family hx of atopy
What does "atopy" consist of?
- 1. asthma
- 2. hay fever
- 3. atopic dermatitis
What is the distribution sites of 3 different phases?
- 1. infancy--> all over
- 2. kids-->neck,elbow, kneeds, feet, palms
- 3. Adults--> palms/feet
What is keratosis pilaris?
Type of atopic dermatitis--> seen on outer arms, chest
What disease is a topic of Atopy with chronic eczema of anterior sole of foot?
Juvenile Plantar dermatosis
What are some exacerbating factors in atopics?
- 1. xerosis, overbathing, soap overuse
- 2. contact irritants, allergens
- 3. infection
- 4. food/dust mite allergies (usually not a factor)
What does staph pyodermas look like?
-pustules superimposed on atopic dermatitis
What patient education should be given for atopic dermatitis?
- 1. avoid precipitating factors
- 2. Moisturize
- 3. topical corticosteriods
- 4. new topical immunosuppressants
- 5. oral anti-staph antibiotics
If an infection is suspected in a patient with a history of atopic dermatitis, what bacteria should you empirically treat for?
staph until culture comes back
When should derm be referred?
- -Diagnostic dilemmas (weird patterns)
- -refractory to txt
What is pityraisis alba?
Asymptomatic hypopigmented patches on children's cheeks
What is the txt for pityriasis alba?
- -no txt therapy
- -possible trial of 1% HC cream
What are symptoms of seborrheic dermatitis?
- -greasy scaling
- -minimal itching
- -scalp & face
What is txt for "cradle cap" seborrheic dermatitis?
-gently debried with washcloth & baby shampoo
What are symptoms of Erythema infectiosum (Human parvovirus B19)
-"slapped cheeks", reticulated erythema
What is the treatment for erythema infectiosum (Parvovirus)?
-Observation--> no longer contagious after rash appears
What are symptoms of roseola infantum (human herpes virus 6)?
- -High fever but child doesn't look ill
- -Then rash breaks out (pink macules, fades away in a couple days)
Which derm disease is associated with a "harold's patch"?
Pityriasis rosea (human herpes virus 7)
What is txt for pityriasis rosea?
Observation: antipruritis prn, erythromycin?, oral corticosteroids
What are the 5 of 6 criteria for diagnosing Kawasaki Disease?
- 1. FUO >5 days
- 2. conjunctival injection
- 3. changes in lips or oral mucosa
- 4. cervical lymph
- 5. polymorpheus examthem
- 6. changes of peripheral extremities
What is the txt for Kawasaki's disease?
Diagnosis: Lesions (papules) for 1 month, "spreading", asymptomatic
Diagnosis: Pustules filled with eosinophils found on newborn
Eyrthema toxicum (resolves in a few days)
Diagnosis: Newborn with scattered pustules and small tan spots. Central pigmentatio within resolving pustules
Transient Neonatal Pustular Melanosis
Diagnosis: White bumps on newborn
Diagnosis: yellow/pink bumpy area on scalp since birth
- Nevus sebaceus
- -Should be surgically removed b/c frequent malignant changes
What is aplasia cutis congentia?
-scab looking on head near suture line--> get skull imaging
What are symptoms of Henoch-Schonlein Purpura?
- -palpable purpura
- -red spots on legs, abdominal pain, joint aches x days
- -vascultitis with GI/urinary tract symp
- -common on buttocks/extremeties
- -check for systemic involvement
Diagnosis: fever and itchy spots x 2days, delicate vesicle on erythematous base
chicken pox (varicella)
Diagnosis: cough, fever, conjunctivitis, coryza (cold symptoms), Koplik's spots, diffuse maculopapular rash
- -supportive txt, Vitamin A (prevents severity)
Diagnosis: linear petichiae called Pastia's lines, looks like "goosebumps on a sunburn"
Scarlet Fever: Group A strep exfoliative toxin
What is the treatment for scarlet fever?
Diagnosis: Kid brought in with fever, and football shaped pustules on his hands. What do you suspect?
Hand-foot-mouth disease (coxsackie)
Diagnosis: Kid presents with petechiae & fever. Appears toxic looking
-polymorphic lesions (hives) < 24hs, no cause usually found
What is the txt for urticaria?
- -systemic antihistamines--> further eval for cause
- **if lesion present--> not urticaria
Diagnosis: Kid presents with itchy rash at the boot line on his leg. What do you suspect?
What is a signifcant cause of acne vulgaris?
- -overactive sebum excretion
- -affects hair follicles with sebacceous gland