Pediatric Derm Flashcards
2 week old baby with funny bumps all over her nose
- noticed at birth
- on nose
- always there
- increasing in number
Milia
Bohn Nodules (Milia)
Epstein Pearls (Milia)
6 week old baby with tiny blisters on body
- started a week ago
- head, neck, trunk
- always there but wax and wane
- vesicles appear, rupture, desquamate
- worse when hot, better when cool
Miliaria
miliaria crystalline
-superficial eccrine closure
-usually no erythema
-hours to days
miliaria rubra (heat rash)
-deeper sweat gland obstruction
-erythematous papules
2 week old baby with rash on face after coming home from hospital
- 2 weeks ago
- face
- constant
- gotten worse
Acne noeonatorum (baby acne)
- tx: reassurance
Baby acne
- 20% newborns
- open comedones/closed comedones
- stimulation of sebaceous glands by androgens
- no tx indicated or benzoyl peroxide lotion 2.5%
2 week old infant blisters on skin leaving dark spots
-coming home from hospital
-chin, neck, forehead, chest, arms
-go away in 2 days but leaves macules
Transient neonatal pustular melanosis
DDx: congenital herpes simplex (will have erythematous base)
Tx: reassurance
Neonatal Herpes Simplex Virus
- vertical transmission of HSV
- needs to be identified and treated
4 month old with something on her face that is growing
- noticed at birth but smaller
- R side scalp
- 3 mos of growth
- deep red/purple, raised, large mass
Hemangioma of Infancy
Tx: reassure or refer, can spontaneously resolve but consider laser, cryo, steroids
-mutation of genes regulating endothelial cell proliferation
- superficial: bright red strawberry
-deep: blue or skin colored
-mixed: deep and superficial parts
Hemangioma of Infancy
PHACE syndrome
-Posterior fossa brain malformations
-large segmental infantile Hemangioma
-Arterial anomalies
-Cardiac anomalies
-Eye and Endocrine anomalies
-possible clefts
1 week old baby with really large red spot on R side of face
- red skin, diffuse, no lumps or bruising
port wine stain/nevus flammeus
-Tx: reassurance vs referral
-blanchable pink/red patch
-unilateral, somewhat dermatomal
-will grow with child/thicker/darker
-cosmetic treatment
Sturge-Weber syndrome
-port wine stain surrounding eye
-risk of glaucoma, seizures, intellectual disability
-refer to specialists
1 week old baby with large red spot on neck
- nape of neck
- pink red
Nevus Simplex/Stork Bite/Angel Kiss/Salmon patch
-capillary malformation
-blanchable
-fades in 1-2 years
-look for sinus or pit, patch of hair for underlying spinal abnormalities if located at lumbosacral area
1 week old baby with large blue spot on back at birth
- above buttocks, back
-bluish gray, looks like bruising
congenital dermal melanocytosis/slate gray nevus (used to be called Mongolian spot)
Tx: reassure and document
- delayed disappearance of dermal melanocytes
- completely benign, usually fade in 1-2 years and gone by age 6-10
2 year old girl large spots getting darker
- early infancy
- trunk
- always there
- getting darker
cafe au lait spots
Tx: reassurance (refer or laser)
- early infancy and enlarge until about age 2
- vary in color
- caused by an increase in melanin/giant melanosomes
- smooth or irregular borders
- size and number varies
-may be a marker of other genetic conditions/abnormalities and is observed in 95% of pts with neurofibromatosis type 1 (NF1) with 6 or more lesions
2 month old with scales on head
- scalp
- 1 month
- gradually getting worse
Seborrheic dermatitis/cradle cap
Tx: gentle washing with emollients, antifungals or dandruff shampoo if suspecting fungus
- can be secondary to malassezia, biotin insufficiency, overactive sebaceous glands, immune disorders
5 year old girl with rash on face
- 1 day
- both cheeks
- sudden and unchanging
- URI syx a few weeks ago that resolved
- nothing alleviating
Erythema infectiosum (5th Disease)
Tx: reassurance, tx for underlying symptoms
- parvovirus B19
- prodromal symptoms a week after exposure lasting a few days
Erythema Infectiosum (Fifth disease)
