Pediatric Skin Disorders

What is the largest organ in the body?

Skin

Why do infants have a greater risk of having topic meds absorbed systemically?

They have thin skin and a large body surface are

pH alkaline in the 1st week of life which puts infants at a greater risk of:

infections

Active sebaceous glands due to maternal hormones put infants at a risk for developing:

Milia

Neonatal acne is due to:

An inflammatory reaction to yeast on the skin. Forms pustules that last 1-3 month

IgA is dimished until...

2-5 years which makes them more prone to infections when they are less athan 2 years. IgA also helps to establish normal gut flora

Eccrine gland matures by...

2-3 years old. This allows for perspiration and more effective thermoregulation

Aprocrine gland is function at...

8-10 years old. Sweat glands are concentration in axillae, scalp, face, abdomen, and genital area. They further mature during puberty

Darker pigmented skin has more...

melanin

Lighter pigmented skin is more prone to...

UV damage

Pallor and cyanosis is more easily detected in...

mucus membranes and nail beds

Darker pigmented skin is more prone to...

keloid formation

Impetigo

Honey crusted lesions that are causes by streptococcus or staphylcoccus from nose picking or scratching

What is the treatment for impetigo?

Topical mupirocin within 24 hours, trim nails, good hygiene, out of school for 24-48 hours, scab and heal

Seborrheic dermatitis

Cradle cap, thick whitish yellow scaly oily patches on the scalp, forehead, and eyebrows that is commonly present in the first 3 months of life. This is due to a dysfunction of sebaceous glands and hormones

What is the treatment for seborrheic dermatitis?

Removing the crusts, mineral oil to scalp, cleanse daily with mild shampoo

Diaper dermatitis

Inflammatory reaction from prolonged exposure to urine and feces. Increases pH and activates fecal enzymes. Sin maceration in area that diaper covers

Treatment for diaper dermatitis

Barriers, open to air, frequent diaper changes. May progress to fungal diaper dermatitis

Diaper candiasis

Erythematous base with bumpy rash, red papules with peeling skin in the folds with satellite lesions outward

Treatment for diaper candiasis

Nystatin cream/ointment. If there is thrush, add oral nystatin

Atopic dermatitis (eczema)

Type 1 IgE mediated, on face elbows and back of knees, before 2 years of age, response to food/environmental allergies and sweating. Intense itching. Rash developed with subsequent pruiritus, interferes with sleep. Eczema and rhinitis are risk factors for asthma

Treatment for atopic dermatitis (eczema)

Hydrations, moisturizers, topical steroids such as hydrocortisone and triamcinolone, antihistamines, avoid triggers, trim nails, antibiotic for secondary bacterial infections, and immune modulators

Causes of contact dermatitis

Detergents, jewelry, perfumes rubber, latex, and poison ivy. Most common is from nickel

Treatment for contact dermatitis

Avoidance of triggers, topical steroidal cream

Staphylococcal scalded skin

Caused by toxin secreting staph, MSSA, MRSA. Under the age of 5, most common in infancy, low grade fever, fussiness for 24-48 hours, followed by peeling and blistering of the skin, very painful, may progress to blod stream infection if not identified quickly, hospitalization is necessary

Treatment for staphylococcal scalded skin

It is dependent on the organism. IV clindamycin, Clindamycin and cefazolin or nafcillin or clindamycin and vancomycin, acetaminophen

Periorbital cellulitis causes

From strep/staph infection, fungal. From insect bites, scratch or an abrasion, extension of impetigo, extension of poison ivy, extension of sinus infection

Treatment for periorbital cellulitis

Hospitalization. ENT/opthalmology consults, CT or head and sinuses, IV antibiotics and anaerobic coverage such as vancomycin, ceftriaxone, and metronidazole, NSAIDS or acetaminophen