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Peds - Derm Flashcards

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1
Q

first degree burn

A

dry, red, no blisters

epidermis only

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2
Q

second degree burn

A

moist, blisters

extends beyond epidermis

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3
Q

third degree burn

A

dry, leathery, pearly, waxy

extends from epidermis to dermis to underlying tissues (fat, muscle, bone)

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4
Q

Of particular concern with significant burns?

A

HYPO thermia especially in young children

First 6 hours are critical, hospitalize immediately

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5
Q

Identifying factors in dermatology

A

MORPHOLOGY - character of lesion itself
CONFIGURATION - how the lesions present in relation to each other
DISTRIBUTION - where on the body the lesions appear

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6
Q

(morphology)

MACULE

A

small, flat discoloration

freckle, petechiae, flat nevi

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7
Q

(morphology)

PATCH

A

large, flat discoloration
may have surface changes

big macule

mongolian spots, cafe au lait spot

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8
Q

(morphology)

PAPULE

A

small, elevated skin lesion
< 1 cm

ant bite, psoriasis

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9
Q

(morphology)

NODULE

A

elevated, firm lesion

> 1 cm

(big papule)

fibroma

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10
Q

(morphology)

TUMOR

A

“mass”

firm, elevated lump

(big nodule)

can be benign or malignant

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11
Q

(morphology)

WHEAL

A

slightly raised and extending a bit below the epidermis

often allergic in origin

aka hive or PPD

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12
Q

(morphology)

PLAQUE

A

scaly, elevated lesion

classic for psoriasis

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13
Q

(morphology)

VESICLE

A

small lesion filled with serous fluid

< 1 cm

varicella, herpes simplex, herpes zoster

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14
Q

(morphology)

BULLA

A

large lesion filled with serous fluid (big vesicle)

> 1 cm

blister

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15
Q

(morphology)

PUSTULE

A

small lesion filled with pus

< 1 cm

acne, impetigo

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16
Q

(morphology)

ABCESS

A

large lesion filled with pus

> 1 cm

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17
Q

(morphology)

CYST

A

large, raised lesion filled with serous fluid, blood and pus

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18
Q

primary lesion

A

first appearing

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19
Q

secondary lesion

A

follow primary

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20
Q

(configuration)

SOLITARY or DISCRETE

A

individual lesions that remain separate

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21
Q

(configuration)

GROUPED

A

in a cluster

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22
Q

(configuration)

CONFLUENT

A

lesions that run together

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23
Q

(configuration)

LINEAR

A

scratch, streak, line, or stripe

poison ivy

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24
Q

(configuration)

ANNULAR

A

circular

ring worm

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25
(configuration) POLYCYCLIC
annular lesions that merge
26
Distribution examples
Where on the body the lesions appear ``` face trunk extremities groin dermatomal feet axilla ```
27
Rash which typically is found in buccal cavity, palms, and soles
Rash of syphilis ddx - pityriais rosea
28
Rash which follows dermatomes
Zoster
29
Rash which tends to be confluent
Tinea
30
Medications which exacerbate acne. (2)
steroids | anticonvulsants
31
NP management of acne | non-pharmacologic
avoid oil-based products | mild cleanser and moisturizer
32
NP management of MILD acne | pharmacologic (5)
``` topical treatment, generally in this order: benzoyl peroxide retinoic acid tretinoin salicylic acid topical ABT - erythromycin, clindamycin ```
33
NP management of MODERATE acne | pharmacologic
add systemic ABT to topical treatment: Doxycycline Erythromycin Minocycline
34
NP management of SEVERE acne
refer to dermatology :-)
35
Which acne medication should be used at night because it is inactivated by UV light and oxidized by benzoyl peroxide?
tretinoin (Retin-A)
36
Why are erythromycin and clindamycin lotions or pads often effective in treating acne?
because the causative agent is often staph
37
jock itch
tinea cruris
38
scalp ringworm
tinea capitus
39
body ringworm
tinea corporis
40
athlete's foot
tinea pedis
41
hypo- or hyperpigmented macules on the limbs
tinea versicolor
42
fungal infection of the nail
tinea unguium | onychomycosis
43
Which of the tineas tend to be pruritic?
tinea cruris | tinea pedis
44
Appearance of fungal infection on microscopic slide treated with KOH?
hyphae = "spaghetti and meatballs"
45
fungal infection of the hand(s)
tinea manuum
46
tinea capitus rx
griseofulvin x 6 weeks
47
tinea corporis rx
topical -azole ketoconazole micoconazole
48
tinea cruris rx
topical -azole terbinafine cream griseofulvin if severe
49
tinea pedis rx | tinea manuum
macerated stage - aluminum subacetate solution dry, scaly stage - topical antifungals oral therapy if severe
50
tinea versicolor rx
selenium sulfide shampoo x 7 days | itraconazole (Sporanox) PO
51
Chicken pox - aka caused by
varicella zoster - caused by the herpes virus
52
How is varicella spread?
direct contact with lesions or airborne | 48 hours prior until after lesions are crusted
53
Varicella management
prevention - vaccine for pruritis - topicals, antihistamine for fever - acetominophen acyclovir - if given in first 24 hours can reduce duration, severity; particularly important to immunocompromised
54
If unimmunized are exposed, what is management?
isolate from day 7 - 21
55
What are the likely causes of death from varicella?
pneumonia | hepatitis
56
What is a drug interaction concern with anti-fungals?
They are CYP 450 blockers
57
Management of molluscum (5 + 1 + 1)
``` trentinoin (Retin-A) Salicylic acid Liquid nitrogen Trichloracetic acid Silver nitrate ``` mechanical removal (NOT in 1* care) OR wait for spontaneous resolution
58
Atopic dermatitis - diagnostics
Radio-allergosorbent test (RAST) or skin test --> dust mite allergy Serum IgE Eosinophilia
59
Atopic dermatitis - management
Extensive moisturizing Topical steroids: hydrocortisone, desonide, triamcinolone Systemic steroids: in extreme cases only
60
Acute or chronic Results from direct skin contact with irritant nickel is most common cause
Allergic contact dermatitis
61
Allergic dermatitis - management
Remove offending agent Topical steroids - high potency if needed Oral steroid taper
62
Irritant (Diaper) dermatitis - defined
Most common diaper rash
63
Irritant (Diaper) dermatitis - peak age
9 - 12 months
64
What happens if steroids are applied to fungal infection?
Condition worsens
65
Irritant (Diaper) dermatitis - management (1 + 5) | consider possible causes...
keep clean and dry mild = barrier emollients - butt paste erythema, papules = hydrocortisone severe erythema, vesicles = burrow's solution secondary bacterial = mupirocin, bactroban secondary fungal = nizoral, ketoconazole
66
A common, benign, hyperproliferative inflammatory skin disorder
Psoriasis

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