Derm part 1 Flashcards
PE of diaper dermatitis
An erythematous scaly diaper area often with papulovesicular or bullous lesions, fissures, and erosions
Causes of diaper dermatitis
Overhydration of the skin Maceration Prolonged contact with urine and feces Retained diaper soaps Topical preparations More than 3 diarrheal stools/day Adverse effects of oral abx Early sign of biotin deficiency
Tx of diaper dermatitis
Zinc oxide ointment Acetyl tocopherol Pure white petrolatum ointment Aquaphor 1-2-3 paste
Sx of perioral dermatitis
Sensation of stinging and burning
H/o long-term use of topical steroids
PE of perioral dermatitis
Skin lesions occur as grouped reddish papules, papulovesicles, and papulopustules on an erythematous base with a possible confluent aspect
Primarily a perioral distribution
Causes of perioral dermatitis
Topical steroid preparations Cosmetics UV light, heat and wind Microbiologic factors Hormonal factors
Tx of perioral dermatitis
Therapy similar to that for rosacea
Topical praziquantel
S/sx of lichen planus
Insidious lesions that usually develop on flexural surfaces of the limbs
After a week later, generalized eruption.
Pruritis
Papules are violaceous, shiny, and polygonal
Wickham striae
Labs for lichen planus
Direct immunofluorescence study in lichen planus
Tx for lichen planus
Mild cases: fluorinated topical steroids
Light therapy
Retinoid-like agents
S/sx of pityriasis rosea
Herald patch of 2-5 cm that is pink and oval with a central clearing
1-2 wks later, 0.5-2 cm macules with fine, branlike scale arranged parallel to skin tension lines
Where is the herald patch found in pityriasis rosea?
Breast
Lower torso
Proximal thigh
Tx of pityriasis rosea
Manage any pruritis with oral antihistamines, phototherapy and low-potency topical corticosteroids
PE of erythema multiforme
Abrupt onset of round, deep red, well-demarcated macules and papules with a dusky gray or bullous center
Involves <10% of the body
Target lesion of erythema multiforme
Three concentric rings:
- Outermost is red
- Intermediate is white
- Center is dusky red or purple
Most common cause of erythema multiforme in children
Herpes simplex virus
Tx of erythema multiforme
Symptomatic
Oral antihistamines to suppress pruritus, stinging, and burning
What usually precedes SJS or TEN?
Prodrome of fever, malaise, and upper respiratory sx 1-14 days before the onset of cutaneous lesions
Presentation of SJS/TEN
Red macules that appear suddenly and tend to coalesce into large patches with a predominant distribution over the face and trunk
Lesions evolve rapidly into bullae and areas of necrosis
Difference between SJS, SJS/TEN, and TEN
SJS is <10% of body surface area
SJS/TEN is 10-30% of body surface area
TEN is >30% of body surface area
What areas are involved in SJS/TEN?
Any mucosal surface may be involved
What are the most common causes of SJS/TEN in children?
Drugs -NSAIDs -Sulfonamides -Anticonvulsants -Antibiotics Mycoplasma pneumoniae infections
Tx of SJS/TEN
Discontinuation of offending agent Supportive care Meticulous wound care Parenteral or nasogastric feeding Careful fluid management and monitoring of electrolytes
Contributing factors of acne
Gender Age Genetic factors Environment Stress
