peds- derm pearls Flashcards
(33 cards)
how can you differentiate rosacea from acne vulgaris
rosacea does not have comedomes
this skin condition is characterized by areas of open comedones (blackheads) w/ incomplete blockage, closed comedones (whiteheads) w/ complete blockage, papules, pustules, nodules, and cysts, that may result in scarring
acne vulgaris
treatment of acne vulgaris involves
Most acne- topical retinoids.
Cystic acne- tetracyclines, then oral retinoids - isotretinoin (causes dry lips, liver damage, increased triglycerides/cholesterol, pregnancy category X). Must obtain 2 pregnancy tests prior to starting it and monthly while on it.
what is androgenic alopecia?
gradual conversion of terminal hairs –> indeterminate –> vellus hair
Which autoimmune disorder is most commonly associated with patchy hair loss on the scalp?
Alopecia Areata
Which type of alopecia is characterized by sudden, diffuse hair loss and is often triggered by stress or illness?
Telogen Effluvium
Androgenetic alopecia is typically a clinical diagnosis, but what labs would you order to work-up a cause?
hormones - testosterone, DHEA, prolactin
treatable - thyroid (TSH), anemia (CBC), autoimmune (ANA)
what is the treatment for androgenic alopecia?
Topical: Minoxidil/Rogaine 2%, %5; *hair loss first before regrowth
Finasteride 1 mg ⇒ inhibits T and DHT
Spironolactone ⇒ blocks DHT
what is the common location of atopic dermatitis? what type of sensitivity rxn is it?
flexor surfaces ⇒ antecubital and popliteal folds
IgE, type 1 hypersensitivity
Infant- face and scalp
Adolescent- flexural surfaces
describe the presentation of atopic dermatitis
Pruritic, eczematous lesions, xerosis (dry skin), and lichenification (thickening of the skin and an increase in skin markings).
*Atopic association ⇒ asthma, etc.
what is the treatment for atopic dermatitis?
Review medications: OTX, RX, homeopathic, hot water, humidifier
Antihistamine (Hydroxyzine or Benadryl)
Topical or oral steroids
PUVA Phototherapy
what is the treatment of contact dermatitis?
Avoid aggravating agents
Antihistamine (Hydroxyzine or Benadryl)
Zinc oxide (diaper rash)
Topical (triamcinolone cream 0.1%) or oral steroids, Burow’s solution (aluminum acetate)
PUVA Phototherapy
what are common secondary infections of diaper dermatitis?
Satellite lesions ⇒ candidiasis
Impetigo (s. aureus)
Herpes simplex virus (child sexual abuse)
what is spared in perioral dermatitis?
the lop margin (vermillion border)
what is the treatment for perioral dermatitis? what should be avoided?
Topical metronidazole, avoid steroids
Mild: topical ALONE 1st line
Topical Pimecrolimus 0.1%
Erythromycin solution q12h
Metronidazole 0.75% gel q12h
Clindamycin lotion q12 hours
Oral ABX: Doxycycline if necessary - no gels, solutions, or lotions on eye
Moderate: topical + oral ABX
what is the most common cause of erythema multiforme?
herpes simplex
other causes: mycoplasma pneumonia, URI, drugs are less comon
how does erythema multiform present? how is it different than urticaria, SJS/TEN?
Presents as raised (papular), target lesions with multiple rings and dusky center (as opposed to annular lesions in urticaria)
Negative Nikolsky sign (as opposed to SJS/TEN)
Erythema infectiosum (fifth disease)
Parvovirus B19 - “slapped cheek” rash on face - lacy reticular rash on extremities, spares palms, and soles
Resolves in 2-3 weeks
Treatment is supportive, anti-inflammatories
what may parvovirus cause in patients with sickle cell and G6PD?
aplastic crisis (normocytic-normochromic anemia)
Hand-foot-and-mouth disease
Children < 10 years old caused by coxsackievirus type A virus producing sores in the mouth and a rash on the hands, feet, mouth, and buttocks
The virus usually clears up on its own within 10 days
Treatment is supportive, anti-inflammatories
Measles (Rubeola)
The 4 C’s - cough, coryza, conjunctivitis, and cephalocaudal spread (head down)
Morbilliform - maculopapular, brick red rash on face beginning at hairline then progressing to palms and soles last - rash lasts 7 days
Koplik spots (small red spots in buccal mucosa with blue-white pale center) precedes rash by 24-48 hours.
Treatment is supportive - anti-inflammatories, isolate for 1 week after onset of rash. MMR vaccine (12-15mo, 4-6yr)
Rubella (German measles)
**“3-day rash” ** pink light-red spotted maculopapular rash first appears on the face, spreads caudally to the trunk and extremities, and becomes generalized within 24 hours (lasts 3 days)
Cephalocaudal spread of maculopapular rash, lymphadenopathy (posterior cervical, posterior auricular)
Although the distribution of the rubella rash is similar to that of rubeola, the spread is much more rapid, and the rash does not darken or coalesce
*Nagayama spots *
Teratogenic in 1’st trimester - congenital syndrome - deafness, cataracts, TTP, mental retardation
Treatment consists of supportive care. MMR vaccine (12-15mo, 4-6yr)
which xanthem is teterogenic in the first trimester?
Rubella - congenital syndrome - deafness, cataracts, TTP, mental retardation
Roseola (sixth disease)
**Herpesvirus 6 or 7,
**
only childhood exanthem that starts on the trunk and spreads to the face
High fever 3-5 days then rose pink maculopapular blanchable rash on trunk/back and face;
Treatment is supportive and in most cases, roseola is a benign and self-limited disease
Fever can be controlled with antipyretics (eg, acetaminophen) if it is associated with discomfort
The rash resolves without treatment
