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Flashcards in Peds - Derm II Deck (43):
1

A common, benign, hyperproliferative inflammatory skin disorder

Psoriasis

2

Psoriasis - what's going on?
(4)

o Epidermal turnover time is reduced from 14 days to 2 days
o Keratinazation doesn't occur
o Immature NUCLEATED cells are seen on the horny layer
o May be immunologically mediated

3

Psoriasis - typical lesion

Lesions are red, sharply defined plaques with silvery scales

4

Psoriasis - hallmark *sign*

Auspitz's sign - droplets of blood when scale is lifted

5

Psoriasis - management

o Topicals for the scalp = tar, salicylic acid
o Topical steroids for the skin = betamethasone, - triamcinolone
o If severe - UVB light, coal tar exposure

6

Pityriasis rosea - cause and timing

o thought to be viral
o more common in spring and fall
o often patients report a recent URI

7

Pityriasis rosea -
duration

3-8 weeks, self-limiting

8

Pityriasis rosea -
differential, especially if no itching or if palmar/plantar are involved

syphillis

9

Management of pityriasis rosea pruritis (3)

o oral antihistamines (atarax/hydroxizine, claritin)
o topical antipruritic
o topical steroids (triamcinolone)

10

Examples of topical antipruritics (4)

Sarna lotion
Prax lotion
Itch-x gel
Cetaphil with menthol

11

What oral antibiotic can be used to dry up the lesions of pityriasis rosea?

Erythromycin x 14 days

12

Impetigo - typically caused by which gram positive organisms?

strep
staph

13

Impetigo - pharmacotherapy for MILD cases

Bactroban
Bacitracin

14

Impetigo - PO pharmacotherapy for more SEVERE cases

strep --> erythromycin or PCN
staph --> erythromycin or cephalexin

15

Impetigo - pharmacotherapy for cellulitis
(3)

IV ABT
o nafcillin
o vancomycin
o doxycycline

16

Scabies - incubation

4 - 6 weeks

17

Scabies management (2)

Permethrin (Nix) - repeat in 1 week
or
Ivermectin - do not use in pregnant, lactating - kills eggs so can cross blood-brain barrier

18

A spirochetal disease; the most common vector-borne disease in US

Lyme disease

19

Lyme disease organism

Borrelia burgdorferi

20

Lyme disease - stage 1
(2)

Erythema migrans
Flu-like s/sx

21

Lyme disease - stage 2
(3)

Headache
Stiff joints
Bell's palsy

22

Lyme disease - stage 3
(3)

Joint pain
Subacute encephalopathy
Acrodermatitis chronicum atrophicans

23

Acrodermatitis chronicum atrophicans

Associated with Lyme disease

Blue-red discoloration of distal extremity with edema

24

Lyme disease -
Which antibody detection test is initially done?

ELISA

25

Lyme disease -
What test is confirmatory?

Western blot assay

26

Lyme disease -
Is ESR likely to be elevated?

Yes

27

Lyme disease -
Diagnostic criteria

Exposure to tick habitat in past 30 days AND
o erythema migrans OR
o late manifestation AND
o lab confirmation

28

Lyme disease -
Management if SKIN symptoms only -->

Doxy if over 7 years of age
amoxicillin or cefuroxime if not

29

Lyme disease -
Management of stage 2 or 3

Refer to infectious disease specialist

30

Possible acute complications of Rubeola (4)

ear infection
pneumonia
encephalitis
acute thrombocytopenic purpura

31

Possible chronic complication of Rubeola (1)

Chronic brain disease - subacute sclerosing panencephalitis

32

Acute, contagious viral disease known for its teratogenicity

Rubella / 3-day measles / German measles

33

Characteristic rash of Rubella

Fine, erythematous papular rash which starts on FACE
Spreads to extremities and trunk

34

Location of Rubellar lymphadenopathy

post auricular
sub occipital

35

Fever, runny nose, cough, red eyes, spreading skin rash, Koplik's spots, highly contagious

Rubeola / ordinary measles

36

Erythematous maculopapular rash which starts on face and spreads, gone in 72 hours

Rubella / 3-day measles / German measles

37

URI symptoms, rash on trunk then extremities, high fever with ABRUPT END when RASH develops; seen in 6 month - 2 year olds

Sixth disease / Roseola infantum

38

A contagious exanthematous disease caused by human parvovirus B19.

Erythema Infectiosum

39

Fifth disease - diagnostics

Can test for B19 IgG, IgM

40

How can pregnant women exposed to Fifth disease be treated to protect the fetus?

Immunoglobulin

41

What can intrauterine infection with fifth disease cause?

fatal anemia

42

Sixth disease / Roseola infantum - pathogen

Human herpesvirus 6 (HHV-6)

43

A highly contagious, viral illness resulting in uleration and inflammation of the soft palate (herpangina) and papulovesicular exanthem on hands and feet.

Coxsackie virus / Hand-Foot-and-Mouth