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Medicine - Pediatrics
Lec 1 - Dermatology
49
Medical
Graduate
02/21/2010

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Cards

Term
Numbered Exanthems: (6)
Definition

1: Measles (rubeola) 2: Scarlet fever 3: Rubella 4: Dukes Disease 5: Erythema Infectiosum 6: Roseola Infantum

Term
- Viral disease (Paramyxovirus) - Highly contagious via resp droplets - Communicable before prodrome - 4d after eruption onset - Incubation 7-14 days
Definition

Measles (Rubeola)

Term

Prodrome: conjunctivitis, coryza, cough, fever

Eruptive: 4th-5th day of sx, lasts 5-10d. Koplik spots. head-to-toe progression

Complications: pneumonia, SSPE

Definition

Measles (Rubeola)

Term
- Group A beta hemolytic strep - Incubation 2-4 days Prodrome: fever, pharyngitis, h/a, chills. Tongue yellow/white coat w/protruding papillae, 4-5d later "strawberry tongue". Tonsillopharyngeal erythema, exudate. Palate petichial macules Eruptive: sandpapery rash, Pastia's lines, desquamation
Definition

Scarlet fever

Term
Complications: Post strep glomerulonephritis, Rheumatic fever Dx: Clinical presentation, *GS* THROAT CULTURE
Definition

Scarlet fever

Term

- Togavirus

Prodromal phase: mild h/a, malaise, fever, lymphadenopathy (retroauricular, post cervical, occipital) 4-7d before exanthem

Eruptive: face to trunk to extremities. Pink to rosy red macules/papules

Definition

Rubella (German Measles)

Term

Causative agent: Parvovirus B19. Mildly contagious via resp 2wks - 3d before eruptive. Seasonal - winter, spring.

- May cause aplastic anemia d/t affinity for RBC

Definition

Erythema Infectiosum (FIFTH Disease)

Term
Prodrome: few days h/a, fever, chills, resp symptoms. Most asymptomatic. Eruptive: 3 PHASES - slapped cheek, reticular erythema, recurrent phase Tx: tx jt pain or itching
Definition

Erythema Infectiosum

Term

Cause: HHV-6 and -7. Herpesviridae. Age: 6mos - 4yo (transplacental Ab protect until 6mos)

Presents w/very high fever, breaks day 4 then exanthem. +/- suboccipital lymphadenopathy, leukopenia

*may trigger a febrile seizure*

Definition

Roseola Infantum

Term
Coxsackie Virus A16: Enterovirus - summer and fall - kids 1-4yo - spread oral/nasal secretions, stool - incubation 4-6d
Definition

Hand, Foot, Mouth Dz

Term
Prodrome: low fever, malaise, sore throat 1-2d, 20% lymphadenopathy
Exanthem: Palate, tongue, buccal mucosa vesicular then ulcerated. painful. Hands, feet cloudy vesicles w/red halo. heal 7-10d w/o scar
Definition
Hand, Foot, Mouth Dz
Term
- Herpesviridae family
- Highly contagious, airborne, vesicular fluid. 2d before rash - all lesions crusted
Definition
Varicella
Term
Prodrome: usu. absent. brief h/a, fever, malaise, chills, arthralgia, myalgia
Eruptive: 24-48hrs after prodrome. "Dewdrop on a rose petal". starts central, spreads outward
Complications: skin infxn (staph, strep), neuro, pnemonia
Definition
Varicella
Term
- Benign epidermal neoplasms
- Common HPV 1,2,4,7
- Flat HPV 3,10
- Plantar HPV 1,2,4
Definition
Varrucae
Term
Office and Home tx for Verruca Vulgaris
Definition
Office tx: paring, cryotherapy. canthardin
Home: 1st paring, salicylic acid. 2nd imiquimod under occlusion
Term
Tx for Verruca Plana
Definition
Retinoid, Light cryotherapy, Imiquimod, Cantharidin
Term
- Poxvirus
Exanthem: 2-5mm papules, flesh colored, dome shaped w/central umbilication
Definition
Molluscum Contagiosum
Term
Office and Home tx for Molluscum Contagiosum
Definition
Office 1st Cantharone, 2nd cryotherapy.
Home 1st Retinoid, 2nd imiquimod
Term
where is atopic dermatitis on kids? adults?
Definition
Kids - face, trunk, extensor surfaces.
Adults - flexor surfaces
Term
- Staph aureus or GABS
- honey colored crust
- common w/other exanthems
Tx: topical bactroban, cx
Definition
Impetigo
Term
What are the 4 processes that form acne?
Definition
Hyperkeratinization, Androgen stimulation, Bacterial infxn, Inflammation
Term
What is the cause and tx of comedonal/pomade acne?
Definition
Cause: oil-containing products on face
Tx: d/c use, topical retinoids (Tretinoin) 12wks
Term
Papules, pustules, cysts, and nodules WITH comedones
Definition
Inflammatory acne (Rosacea DOES NOT have comedones)
Term
Tx for mild inflam acne
Definition
anti-inflam qam.
comedolytic qhs.
Term
Tx for mod inflam acne
Definition
Medicated wash qam.
Topical abx qam.
Soap free cleanser qhs.
Retinoid qhs.
Consider adding PO abx
Term
Tx for severe inflam acne
Definition
Same topical tx as mod.
Add PO abx if not tried yet.
Consider oral contraceptives, Isotretinoin 6mos (blood work before, at 1 mon, any dose increase, after)
Term
Tx for cystic acne
Definition
deep, likely to scar.
Topical regimen.
PO abx.
Oral contraceptive.
Isotretinoin
Term
- red, brown nodules. usu. infants
Complications: bacterial infxn, pain, itching for mos, post-______ dermatitis
Definition
Scabies
Term
What is the Dx and Tx for scabies?
Definition
Dx: *GS* KOH prep of scraping.
Tx: 5% prometherin neck down on kids and adults. to hairline on infants. Apply now and in 10-14d
Term
- black dot alopecia
- pustules and scale
- adenopathy
Definition
Tinea capitis
Term
Tx for Tinea capitis?
Definition
Griseofulvin everyday for 2mos, re-cx. Selenium sulfide shampoo
Term
- smooth, even border
- autoimmune
- pitted nails
- tx w/high potent topical steroid
Definition
Alopecia areata
Term
- irregular borders
- hairs diff lengths
Definition
Trichotillomani
Term
- linear, yellowish
- thicker at birth, puberty
- small risk malignant
- becomes verrucous in response to hormones
Definition
Nevus sebaceous
Term
Tx for Nevus sebaceous?
Definition
excise prior to puberty
Term
- patchy or diffuse scaling
- fine or greasy scale
Definition
Seborrheic dermatitis
Term
Tx for Seborrheic dermatitis?
Definition
medicated shampoos, possibly topical steroid
Term
Tx for KP?
Definition
Lactic acid, glycolic acid, urea, retinoids
Term
- pink papulopustules
- infancy to adulthood
- ? juvenile rosacea
- Tx w/topical or PO abx
Definition
Perioral dermatitis
Term
- monomorphic, papular eruption around the mouth, nose and eyes
- Tx: wean off topical steroid, Topical abx
Definition
Periorificial granulomatous dermatitis
Term
- minimally scaly patches
- face, upper body
- kids, young adults
- assoc w/atopy
Tx: sunscreen, emollients, mild top steroid
Definition
Pityriasis alba
Term
- light macules after preceding dermatitis
- resolves w/o scarring in mos-yrs
Tx: sunscreen
Definition
Postinflammatory hypopigmentation
Term
- usu. hypopigmented, occas. hyper
- Pityrosporum ovale and orbiculare
- lipophilic yeast
Tx: selenium sulfide, Topical antifungals
Definition
Tinea (Pityriasis) Versicolor
Term
- autoimmune
- depigmented
- not atrophic
- depig. areas flouresc under Wood's lamp
- repigments in follicular pattern
Tx: top steroids, light box
Definition
Vitiligo
Term
- macular erythema, papules
- spares the folds
Tx: air exposure, gentle cleansing, Zinc oxide diaper paste
Definition
Irritant contact dermatitis
Term
- satellite papules or pustules
- fine scale
- involves the folds
Tx: Nystatin, Ketoconazole, *Oxistat (Oxiconazole) bid
Definition
Candidiasis
Term
- pink, well demarcated patches w/satellites
- less scale than expected d/t urea in urine
Tx: frequent diaper changes, low potency top steroid
Definition
Inverse psoriasis
Term
- well demarcated erythema
- satellite small papules/pustules
- pain and itching
Tx: top mupirocin, gentle cleansing
Definition
Perianal strep
Term
What complications can occur from varicella?
Definition
  • Eczema herpeticum
  • Kaposi varicelliform eruption
  • Ramsey Hunt syndrome
  • Postherpetic neuralgia
  • Aspirin tx assoc w/Reyes
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