Peds Derm

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Peds Derm
2013-03-06 17:27:22

Pediatric Dermatology
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  1. What are the symptoms of atopic dermatitis?
    • 1. Pruritis
    • 2. typical morphology/distribution
    • 3. chronic relapsing dermatitis
    • 4. personal/family hx of atopy
  2. What does "atopy" consist of?
    • 1. asthma
    • 2. hay fever
    • 3. atopic dermatitis
  3. What is the distribution sites of 3 different phases?
    • 1. infancy--> all over
    • 2. kids-->neck,elbow, kneeds, feet, palms
    • 3. Adults--> palms/feet
  4. What is keratosis pilaris?
    Type of atopic dermatitis--> seen on outer arms, chest
  5. What disease is a topic of Atopy with chronic eczema of anterior sole of foot?
    Juvenile Plantar dermatosis
  6. 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)
  7. What does staph pyodermas look like?
    -pustules superimposed on atopic dermatitis
  8. 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
  9. 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
  10. When should derm be referred?
    • -Diagnostic dilemmas (weird patterns)
    • -refractory to txt
  11. What is pityraisis alba?
    Asymptomatic hypopigmented patches on children's cheeks
  12. What is the txt for pityriasis alba?
    • -no txt therapy
    • -reassurance
    • -possible trial of 1% HC cream
  13. What are symptoms of seborrheic dermatitis?
    • -erythema
    • -greasy scaling
    • -minimal itching
    • -scalp & face
  14. What is txt for "cradle cap" seborrheic dermatitis?
    -gently debried with washcloth & baby shampoo
  15. What are symptoms of Erythema infectiosum (Human parvovirus B19)
    -"slapped cheeks", reticulated erythema
  16. What is the treatment for erythema infectiosum (Parvovirus)?
    -Observation--> no longer contagious after rash appears
  17. 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)
    • -Observation
  18. Which derm disease is associated with a "harold's patch"?
    Pityriasis rosea (human herpes virus 7)
  19. What is txt for pityriasis rosea?
    Observation: antipruritis prn, erythromycin?, oral corticosteroids
  20. 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
  21. What is the txt for Kawasaki's disease?
    • 1. Aspirin
    • 2. IVIG
  22. Diagnosis: Lesions (papules) for 1 month, "spreading", asymptomatic
    Molloscum contagiosum
  23. Diagnosis: Pustules filled with eosinophils found on newborn
    Eyrthema toxicum (resolves in a few days)
  24. Diagnosis: Newborn with scattered pustules and small tan spots. Central pigmentatio within resolving pustules
    Transient Neonatal Pustular Melanosis
  25. Diagnosis: White bumps on newborn
  26. Diagnosis: yellow/pink bumpy area on scalp since birth
    • Nevus sebaceus
    • -Should be surgically removed b/c frequent malignant changes
  27. What is aplasia cutis congentia?
    -scab looking on head near suture line--> get skull imaging
  28. 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
  29. Diagnosis: fever and itchy spots x 2days, delicate vesicle on erythematous base
    chicken pox (varicella)
  30. Diagnosis: cough, fever, conjunctivitis, coryza (cold symptoms), Koplik's spots, diffuse maculopapular rash
    • Measles
    • -supportive txt, Vitamin A (prevents severity)
  31. Diagnosis: linear petichiae called Pastia's lines, looks like "goosebumps on a sunburn"
    Scarlet Fever: Group A strep exfoliative toxin
  32. What is the treatment for scarlet fever?
    oral antibiotics
  33. Diagnosis: Kid brought in with fever, and football shaped pustules on his hands. What do you suspect?
    Hand-foot-mouth disease (coxsackie)
  34. Diagnosis: Kid presents with petechiae & fever. Appears toxic looking
  35. Describe urticaria.
    -polymorphic lesions (hives) < 24hs, no cause usually found
  36. What is the txt for urticaria?
    • -systemic antihistamines--> further eval for cause
    • **if lesion present--> not urticaria
  37. Diagnosis: Kid presents with itchy rash at the boot line on his leg. What do you suspect?
    chigger bites
  38. What is a signifcant cause of acne vulgaris?
    • -overactive sebum excretion
    • -affects hair follicles with sebacceous gland