Dermatology Flashcards
(47 cards)
Erythema toxicum neonatorum
Transient, benign, polymorphous skin rash of infancy.
Erythematous macules followed by wheals, vesicles, and sometimes pustules.
Palms and soles spared
Incidence, risk factors and typical age for erythema toxicum neonatorum
Occurs in 50-60% of newborns
More common in full-term/post-term infants and those with >2500g birth weight
Usually appears 24-48 hours after birth and resolves in 5-7 days
Acne neonatorum: definition and management
A new vulgaris appearing in the first 2-6 weeks of life, presumably 2/2 maternal and neonatal androgens
Self-limiting, occurs in 20% of infants
“6-week rash”
Port wine stain
Possible complications and associated conditions
Lesions covering entire half of face or bilateral face may be associated with Sturge Weber syndrome (neuro-ocular manifestations)
Hypertrophy Of soft tissue and bone with extremity lesions
Lesions on back, particularly crossing midline, associated with spinal/vertebral malformations
Port wine stain management
Refer to dermatologist early. Pulsed dye laser treatment recommended early in infancy, definitely before 1 year
Growth pattern for capillary hemangioma
Rapid growth beginning at birth and peaking around 6 months.
Involution begins between 9-12 months
10% resolution per year (10% at 1 year, 50% at 5 years, etc)
Complications of hemangiomas
Depth rather than size determines risk
Very deep may cause cardiovascular compromise
Thrombocytopenia may occur from platelet sequestration
Visual disturbance with orbital/eyelid/periorbital
Occult hepatic hemangiomas possible
Head/face lessons carry risk if subglottic lesion with airway compromise (hoarseness and stridor rapidly worsening in first weeks of life)
Ulceration as involution occurs
Lesions concerning for neurofibromatosis or Albright syndrome
Cafe au lait spots that are > 1.5cm or 6 or more in number
Risk factors for malignant melanoma development
Sunburn and excessive exposure prior to 10yoa
Family history
Albinism management
Sun protection counseling
Derm referral for skin changes
Ophtho referral for vision assessment
Vitiligo
Definition
Acquired autoimmune destruction of melanocytes resulting in hypopigmented areas on skin, oral mucosa and genitalia
Segmental- unilateral, 2 dermatomes
Generalized- >2 dermatomes, often bilateral
Vitiligo management
Sun protection
Topical steroids
Topical tacrolimus (inhibits T-cels)
Derm referral for other therapies
Psoriasis definition
Acquired inflammatory disorder with chronic relapsing-remitting pattern of erythematous plaques With silver-grey-white scales
Psoriasis guttate
Small patches primarily on trunk, upper arms and thighs
Often follows strep infection
Psoriasis vulgaris
Large plaques primarily on elbows and knees
Often associated with constant rubbing and trauma, “Koebner’s response”
Psoriasis management
Controlled and limited sunlight exposure
Topical corticosteroids
At least BID moisturizer or mineral oil
Atopic derm
Etiology/incidence
Disorder of skin barrier function, chronic forms often associated with filaggrin mutation and deficiency. Some associated with high IgE levels and altered immune function
10-15% incidence
Up to 50% develop other atopic disease
Up to 25% have symptoms that persist into adulthood
Dermatitis management
Topical steroids, oral antihistamine for pruritis, topical antibiotic for secondary infection
Diaper/atopic: emollients
Seborrheic: antiseborrheic shampoos, mineral oil, topical steroids, or topical salicylic acid. Some infants benefit from topical ketoconozole (melasezzia species may play too in etiology)
Burn classification
Superficial: epidermis only; erythema, edema, and dry tenderness
Partial-thickness: involve epidermis and part of dermis; includes moist areas and blisters
Full-thickness: Epidermis, dermis, and dermal appendage involvement; white, brown, black, swollen, dry areas with loss of sensation
Define minor burn
Less than 10% BSA for superficial burns
Less than 2% BSA for partial- or full-thickness
Define major burn
More than 10% BSA for superficial burns
More than 2% BSA for partial- or full-thickness burns
Any burns of hands, feet, face, eyes, ears, and perineum, regardless of BSA involved
Burn diagnostics
Electrolyte studies, especially if burn is extensive
Culture of secondary infections
Burn management - when to admit
Inpatient admission for all major burns, suspected abuse, esophageal or airway burns, or concomitant injuries (i.e. fractures)
Outpatient burn management
Cool compresses
Pain control - acetaminophen or ibuprofen
Prophylactic antibiotics on open blistered areas (mupirocin or silver sulfadiazine [don’t use on face])
Push fluids for hydration
Topical emollients to repair and maintain barrier
