Week 2 - Pediatric Dermatology

What is acne vulgaris?

Most common cutaneous disorder affecting adolescents and young adults; most common skin disorder in the US

What are the 2 comedones of acne vulgaris?

- Open (blackheads): partially blocked pore due to oxidation of melanin

- Closed (whiteheads): completed blocked pore that is fleshed-colored or white bumps.

What is the treatment for acne?

Topical retinoids

What are drug eruptions?

cutaneous reactions to medications usually beginning w/i 1-2 weeks of offending drug

What is erythema multiforme?

A skin condition most commonly caused by HSV infection (mycoplasma pneumonia in kids) that presents with concentric circles (aka target lesion)

What's the difference between EM major and minor?

EM major - presents with severe mucosal involvement

EM minor- presents with minimal mucosal involvement

What are other causes of erythema multiforme, aside from infections?

- NSAIDs

-Sulfa drugs

- Anti epileptics

What is Stevens-Johnson syndrome?

A severe mucocutaneous condition that presents with painful progressive rash and Nikolysky sign, with mucous membrane involvement in most cases (>90%)

What is the leading cause of SJS?

Medications

What is the management for SJS?

Withdraw offending drug

What is alopecia?

hair loss

What are the three types of alopecia?

- Alopecia areata

- Trichotillomainia

- Tinea capitis

What is alopecia areata?

Loss of hair (not a rash; skin is smooth)

How is alopecia areata treated?

Corticosteroids

What is trichotillomania?

hair pulling disorder presenting with broken hair, missing eyelashes & eyebrows

What is the presentation of tinea capitis?

Fungal appearing rash

What is paronychia?

infection of the nail bed commonly caused by Staph Auerus

How is paronychia treated?

I&D

What is the clinical presentation of Measles (aka Rubeola)?

- Koplic spots - 1-2 days before rash appears

- Associated with 4 c's (cough, coryza, conjunctivitis, cephalocaudal rash)

Who is more susceptible to Measles?

Unvaccinated

What is German measles (Rubella)?

A condition presenting with mild and self-limiting symptoms and is teratogenic in unvaccinated pregnant females

What is congenital rubella?

Non-vaccinated wome becomes infected with Rubella while pregnant

She presents with very mild symptoms but it causes congenital anomalies (cardiac defects, development delays, etc.)

What is roseola infantum?

- AKA Sixth Disease

- A condition where child usually appears well looking and non-toxic

- May present with high fever and a rash on the trunk usually appears 1-2 days after fever breaks

What is erythema Infectiosum?

Fifth disease "slapped cheeks" due to Parvovirus B19, presenting with mild URI prodrome where fever is NOT prominent

What are complications of erythema infectiosum?

In-utero infection: Hydrops fetalis

What is impetigo?

superficial skin infection presenting with honey-colored crusted lesions, usually presenting in pts with hx of skin trauma

How does intertrigo present?

- Red intertriginous area w/o satellite lesions

How does bullous impetigo present?

- Ruptured bullae or peeling ring-like lesions

What is a common clinical feature of non-inflammatory & inflammatory tinea capitis?

Cervical adenopathy

Are topical treatments effective in tinea capitis?

No; they do not penetrate hair follicles

terbinafine, griselfulvin

How does canididal diaper dermatitis present?

Erythematous maculopapular rash w/ satellite lesions

How does tineal diaper dermatitis present?

Raised, red scaly borders

What is scabies?

A condition presenting with scabbed or scaling papules/vesicles in the webbed spaces, that are itchy (other worse at night)

What is the clinical presentation of molluscum contagiosum?

Smoothly pearly papules w/ an umbilicated center

What causes varicella?

varicella zoster virus

How is varicella transmitted?

Respiratory droplets and direct contact

What is the clinical presentation of varicella?

- Prodrome of mild fever, malaise

- Rash

- Pruritus

How is varicella diagnosed?

- Clinical

- Can confirm with PCR, direct fluroscent AB or Tzank smear

What is the treatment for varicella?

- Supportive care

- Antivirals

What are the teratogenic effects of varicella?

- Congenital defects

- Fetal demise is possible if contracted during pregnancy

What is the treatment for diaper dermatitis?

- Frequent diaper changes

- Vaseline, A&D ointment

- Hydrocortisone

What are clinical features of diaper dermatitis?

Irritant contact dermatitis that occurs in the diaper area but spares the skin folds

What is the most common chronic skin disease of childhood?

Eczema/atopic dermatitis

What is atopic dermatitis?

Chronic, relapsing form of dermatitis / eczema

What is eczema herpeticum?

HSV superinfection on top of severe eczema

What are complications of atopic dermatitis?

Infections (bacterial, candidal, viral)

What is the treatment for atopic dermatitis?

- Cutaneous hydration

- Topical corticosteroids

- Antihistamine for itch

What is seborrheic dermatitis?

Common form of eczema that is present in children <6 mo. And adolescents that does not typically present with itching + presents with greasy yellow plaques

What is the treatment for seborrheic dermatitis?

- Use mineral oil and comb

- Shampoo

What is pityriasis rosea?

- Begins with Herald Patch

- Scaling rash to trunk in a classic "Christmas tree" pattern

What is dermal melanocytosis?

Skin condition that presents with blue-gray patches that must be documented at birth to avoid confusion with bruising

What is mottling?

lacy pattern of dilated blood vessels under the skin due to immature vascular response to cold or stress