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EOR 3 - Peds > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

Cradle cap

A

dz: Seborrheic dermatitis
path: malassezia furfur

CP: itchy, flaky/scaly, greasy, yellowish

tx: mineral oil to scalp (infants)
selenium sulfide shampoo (teens)

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2
Q

What is the treatment for seborrheic dermatitis?

A

infants: mineral oil
teens: selenium sulfide shampoo

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3
Q

Diaper dermatitis

A

contact dermatitis

CP: SPARES inguinal folds (DDx: Candida - affects inguinal folds)

Tx: avoid irritant, keep skin surface dry, use emollients

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4
Q

What is the DDx for diaper dermatitis?

A

Candida

CP: satellite lesions, “beefy red” rash, affects inguinal folds

Tx: TOP antifungal (fluconazole, nystatin)

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5
Q

Perioral dermatitis

A

eti: can be triggered by steroid creams/ointments, cosmetics

CP: small red bumps around mouth +/- nose, cheeks, eyes

tx: TOP Abx, +/- top steroids

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6
Q

What is the treatment for perioral dermatitis?

A

avoid triggers/cosmetics

topical abx +/- top steroids

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7
Q

What is the most common type fo cutaneous drug reactions?

A

exanthematous eruptions (delayed)

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8
Q

What does the rash look like for drug eruptions?

A

starts on trunk, spreads to face/extremities

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9
Q

What is the treatment for drug eruptions?

A

stop drug

rash will clear 2-3 days after drug is stopped

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10
Q

5Ps

A

lichen planus

purple, pruritic, polygonal, planar, papules/plaques

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11
Q

What is the treatment for lichen planus?

A

top steroids (mod - strong)

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12
Q

White, lacy, reticular lesions

A 
oral lesions (Wickham striae) 
lichen planus of the mouth
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13
Q

Herald patch

A

seen with pityriasis rosea

typically on trunk w/ scaling

follows langer’s lines (Christmas tree)

lasts between 4-10 weeks

rare in children <3-4 yo

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14
Q

SATAN

A

high risk drugs seen with SJS/TENS

sulfa drugs
allopurinol
tetracyclines
AEDs (carbamazepines, lamotrigine, pheytoin) 
NSAIDs
Nevirapine
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15
Q

SJS/TEN

A

mucocutaneous reaction
type 4 HSR

<10% BSA = SJS
>30% BSA = TENs

CP:
onset within 8 weeks - rapid progression
prodrome (fever, malaise, flu-like sxs)
Begins on face/trunk, spreads outward
Nikolsky sign - sloughing - detachment of epidermis
Mucosal membrane involvement in >90% of cases

sub-epidermal cleavage –skin biopsy

tx: supportive treatment

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16
Q

Which type of HSR is SJS/TENs?

A

4

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17
Q

CP of SJS/TENS?

A

onset within 8 weeks - rapid progression
prodrome (Fever, malaise, flu-like sxs)
begins on face/trunk – spreads outward
Nilkolsky sign - sloughing - detachment of epidermis
Mucosal membrane involvement in >90% of cases

Sub-epidermal cleavage - skin biopsy

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18
Q

SSSS

A

path: exotoxin in staph aureus causes breakdown in desmosomes and detachement within epdiermal layer

CP: exofloiative rash, flaccid bullae, skin desquamation

Recent URI
starts on face (perioral), neck, spreads to axillae and groan

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19
Q

Erythema mutliforme

A

eti: thought to be hypersensitivity to virus (HSV, mycoplasma)

half of all cases occur <20yo

CP: target lesion (3 zones = dark center, pale inner ring, red outer ring)
exanthem - starts on distal extremities and spreads proximally

EM minor: confined to extremities and face (no mucous membrane involvement)

EM major: affects extensive surface area, bullous lesions

self limited: resolves in 2 weeks

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20
Q

What is the most common etiology of erythema multiforme?

A

HSV

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21
Q

Erythema multiforme rash and distribution

A

Target or Iris lesions - round shape with 3 concentric zones
dark center, pale inner ring, red peripheral outer zone

distal extremities and spreads proximally

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22
Q

What is drug induced hypersensitivity syndrome?

A

skin eruption with systemic sxs + internal organ involvement

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23
Q

What is serum sickness?

A

immune complex (type 3) occurs after animal proteins or serum or drugs

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24
Q

How does serum sickness present?

A

rash, joint pain, fever

erythema occurs on sides of fingers, toes, hands

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25
Black dot alopecia
tinea capitis | infection of scalp and hair shafts
26
What is the treatment for tinea capitis?
griseofluvin | selenium sulfide shampoo
27
T. Rubrum
tinea corporis
28
What is the tx for tinea corprois?
local miconazole or clotrimazole
29
Tinea cruris
jock itch spares the scrotum tx: local miconazole or clotrimazole
30
Tinea unguium
onchyomycosis | peeling of distal nail plate
31
What is the tx for onchyomycosis?
oral ketoconazole or griseofluvin
32
Spaghetti and meatballs
tinea versicolor on KOH prep
33
M. furfur
tinea versicolor
34
How can you tell the difference b/w diaper dermatitis and candida infection?
skin fold are only involved in candida infections should suspect is > 3 days beefy red erythema with satelite lesions
35
What is the treatment for diaper dermaititis?
open air exposure topical zinc oxide 1% hydrocortsione (use < 2 weeks)
36
How do you tx perioral dermatitis?
topical metronidazole or erythromycin | spares vermillion border
37
Atopic triad
Eczema + allergic rhinitis + asthma T cell mediated immune reaction
38
Where is atopic dermatitis in infancy?
on the face as opposed to adolesence where its on flexor surfaces
39
Milia
keratin filled papules found on the face - without erythema | often confused with sebaceous hyperplasia
40
Sebaceous gland hyperplasia
maternal androgen - similar to neonatal acne regression occurs when hormone levels decline "hormones leaving the body"
41
Neonatal acne
sebaceous gland blockage | peaks around 2 weeks of age and resolves with a decline in maternal hormones in 3-4 months
42
M. furfur
tinea versicolor AND seborrheic dermatitis CRADLE CAP - yellow/pink greasy appearing scales on scalp and erythematous scaling on neck and face
43
What is the treatment for cradles cap?
ketoconazole 2% cream/shampoo 2x/wk
44
When does SJS or TEN present?
within 8 weeks of exposure to drug
45
What is the difference between SJS and TEN?
SJS <10% of BSA | TEN >30% of BSA
46
What is the treatment for acne in adolescence?
Mild: Topical ABX and benzoyl peroxide Moderate: benzoyl peroxide + tretinoin + topic ABX Severe: Oral ABX or accutane (isotretinoin)
47
What is the most common cause of hair loss in men?
androgenic alopecia anagen phase = 2-6 years (80-90% of hairs on scalp_
48
What is the treatment for androgenic alopecia?
Minoxidil (Rogaine) | Finasteride (lowers scalp DHT - inhibits 5alpha reductase)
49
Exclamation point hairs
alopecia areata T cell mediated inflammation disrupts hair cycle non-scarring hair loss onset < 30yo
50
What is the treatment for alopecia areata?
intralesional triamcinolone
51
Telogen effluvium
diffuse hair loss possibly secondary to zinc deficiency or drug use? positive hair pull sign - follicles are easily extracted
52
What is impetigo?
superficial bacterial infection of the epidermis MC s. aureus and Group A strep
53
Who gets impetigo?
< 6yo MC
54
How does impetigo present?
honey colored crusts MC on face and extremities
55
Bullous impetigo vs ecthyma?
bullous impetigo: toxins from S. Aureus - MC on trunk and in folds, less common on face Ecthyma: deeper into dermis - MC on distal extremities
56
What is the treatment for impetigo?
Mupirocin (bactroban) - covers MRSA - topical systemic: cephalexin (keflex)
57
What is the first line treatment for verrucae?
common warts salicylic acid
58
Target or IRIS lesions
erythema multiforme MC etiology: HSV
59
Who gets erythema multiforme?
M > F | 20-40yo
60
How does erythema multiforme present?
typically an acute, self limited reaction (1-3 weeks) prodrome: fever, malaise, myalgia, sore throat, cough Rash: evolve over days - sharply demarcated target and IRIS lesions - 3 concentric zones distal extremities --> usually spread proximally to palms, soles, elbows, and knees may demonstrate koebner phenomenon
61
What is the difference b/w erythema multiforme minor and major?
Minor: little or no mucosal involvement Major: ALWAYS has mucosal involvement - bullous lesions +/- Nikolsky sign
62
What is the treatment for erythema multiforme?
usually resolves spontaneously within 3-5 weeks oral antihistamines and topical steroids for sx relief oral prednisone for severe cases
63
What causes lichen planus?
mucocutaneous dermatosis associated with Hep C
64
How does lichen planus present?
papulosquamous exanthem 6Ps: purple, polygonal, prurutic, planar, papules, plaques Wickham striae - orally +/- koebner's phenomenon
65
Who gets lichen planus?
1% of the population 30-60yo majority spontaneously remit in 1-2 years
66
Oral lichen planus is associated with what?
SCC
67
What is the treatment for lichen planus?
Topical corticosteroids - clobetasol, betamethasone, deproprionate intralesional injections of triamcinolone for resistance lesions
68
What is pityriasis rosea?
etiology is unknown possibly viral age of onset: adolescents through adults spring or fall MC
69
How does pityriasis rosea present?
Prodrome phase: malaise, HA, mild constitutional sxs Herald patch: Trunk is MC location Exanthem - christmas tree distribution
70
Pediculosis
lice ``` pediculosis capitis (head lice) pediculosis pubic (pubic lice) pediculosis corpora (body lice) -- can transmit trench fever and typhus ```
71
What is the treatment for head lice?
1% permethrin (NIX) and repeat in 1 week
72
What is the treatment for pubic lice?
1% lindane shampoo for 5 minutes ALL sexual partners should be treated FULL sexual workup must be done
73
Sarcoptes saciei
mite causes scabies
74
What do you tell a family that is being treated for scabies in regards to expected recovery?
itching may persist for 7-14 days after successful treatment
75
What is the treatment for scabies?
12 hour application of permethrin 5% location
76
How can you dx scabies?
apply topical tetraycline and examine skin with wood's lamp
77
What is molluscum contagiosum?
a poxvirus (wart like - umbilicated)
78
Who gets molluscum contagiosum?
rare under 1 yo | MC < 5yo or young adults
79
How does molluscum contagiosum present?
umbilicated papules 2-5mm skin colored self limited - takes about 2 months for a single lesion to heal
80
Urticaria is what type of reaction?
IgE mediated
81
A pt with urticaria also has arthritis and a fever, what should you be concerned for?
serum sickness
82
What is the difference between 1st, 2nd, and 3rd degree burns?
1st: epidermis 2nd: dermis 3rd: hypodermis (subcutanous tissue)
83
Rule of 9s
``` BSA burns adults: head 9% trunk: 36% arms: 18% legs: 36% perinum: 1% ```
84
Parkland formula
LR (fluid of choice) 4ml x BSA burn x weight (kg) = total fluid amount replace 1/2 in first 8 hours replace 2nd 1/2 in next 16 hours
85
Mongolian Spots
dermal melanosis benign persistence of dermal melanocytes in neonates blue color is caused by melanocytes More common in non-caucasian races MC locations: sacrum and shoulders gradually fades during first 2 months of life
86
What is the course of mongolian spots?
gradually fades during first 2 months of life

EOR 3 - Peds (9 decks)

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