Erythematous rash in newborn that SPARES folds...
Erythematous rash in newborn INVOLVING folds...
Treatment of mild acne
Topical retinoid +/- anti-inflammatory (benzoyl peroxide)
TWO risk of giant congenital nevus (> 20cm predicted adult size)
1. Leptomeningeal melanocytosis (CNS involvement) 2. 1-2% risk of developing melanoma (with almost 100% mortality)
First line treatment of scabies
5% permethrin - leave on overnight, treat close contacts, repeat in 1 week
First line treatment of head lice
1% permethrin x 15 mins, repeat one week later
MRSA skin abscess management, < 1 month
- admit - drainage - vancomycin IV
MRSA skin abscess, infant 1-3mos, no surrounding erythema/cellulitis
Septra (if concern for cellulitis, add keflex)
MRSA skin abscess > 3 mos
I&D, send for culture
Name of the skin lesion associated with SJS & TEN
< 10% skin involvement
Toxic epidermal necrolysis
> 30% skin involvement
- nevus flammeus (port-wine stain) in V1 - glaucoma - leptomeningeal angioma
Infants with subcutaneous fat necrosis are at risk of
If resistant lice (failure of treatment), what can you treat with?
If a teen with acne failed topical anti-inflammatory/antibiotics + retinoids; what else can you do?
Doxycycline Anti-androgens (in female patients) Add topical retinoids/benzoyl peroxide
Treatment for tinea capitus
Treatment of comedonal acne
Treatment of inflammatory acne - mild
retinoids + anti-inflammatory (benzoyl peroxide + antibiotic)
Name the lesion, when they occur, natural history
May occur during puberty or pregnancy
The central pigmented nevus may disappear and the depigmented area usually repigments
Name the lesion
(pink/red, smooth, dome-shaped, firm, hairless papule)
usually < 1cm
local recurrence happens after excision 5% of the time
if suspect melanoma, excise entire lesion
Syndromes associated with the development of melanoma (3)
Familial mole-melanoma syndrome
Dysplastic nevus syndrome
BK mole syndrome
Definition of atypical nevus
When do they appear?
Acquired, 5-15mm, round to oval, irregular margins/colour
Usually develop in puberty
Management: skin exam Q6-12 mos, photos, sun protection, monitoring for melanoma
What meds should you think of if someone has photosensitivity?
What is Nikolsky sign?
Applying slight pressure with the thumb, the skin will wrinkle and the epidermis will separate from the dermis
How does isotrentoin (Accutane) work for acne?
Isotretinoin reduces size and secretion of sebaceous glands, normalizes follicular keratinization, prevents new microcomedone formation, decreases the population of P. acnes, and exerts an anti-inflammatory effect.
How long should someone avoid becoming pregnant after stopping Accutane?
at least 6 weeks
How can you prevent the teratogenic effect of Accutane?
Counsel patients to use 2 forms of birth control, do monthly pregnancy tests
What is this? Why does it occur?
Traction alopecia, common in black school-aged children, due to trauma from tight-braids, headbands (increased risk if chemically-relaxed hair)
Clinical features of Trichotillomania
Pulling, twisting, breaking of hair producing irregular areas of hair loss. Remaining hairs are various lengths and are blunt tipped (from breaking). Scalp appears normal.
Closely related to OCD.