3/03 Pediatric Dermatology Flashcards Preview

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Flashcards in 3/03 Pediatric Dermatology Deck (25)
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1
Q

What does this baby have?

What do the babies develop?

How would you treat it?

A

Collodion Membrane aka Lamellar Ichthyosis

  • “Saran-wrap” covering at birth due to extensive scaling of the skin
  • infants develop respiratory distress, cracks, fissures, and temp instability

Treatment: supportive

2
Q

What does this baby have?

What do the babies develop?

How would you treat it?

A

Collodion Membrane aka Lamellar Ichthyosis

  • “Saran-wrap” covering at birth due to extensive scaling of the skin
  • infants develop respiratory distress, cracks, fissures, and temp instability

Treatment: supportive

3
Q

What does this baby have?

What do these babies develop?

How would you treat it?

A

Collodion Membrane aka Lamellar Ichthyosis

  • “Saran-wrap” covering at birth due to extensive scaling of the skin
  • infants develop respiratory distress, cracks, fissures, and temp instability

Treatment: supportive

4
Q

What does this baby have?

What is it caused by?

What are other problems that can develop as a result of this?

How do you treat it?

A

Diaper Dermatitis

  • red, itchy rash in diaper area caused by urine and feces (increases moisture comprises the stratum corneum, making it susceptible to friction)
  • creases are spared
  • 2˚ infections with candida albicans, staph aureus, and strep pyogenes are common
  • *Treatment**
  • reduce skin wetness
  • treat 2˚ infection
5
Q

What does this baby have?

What is it caused by?

What are other problems that can develop as a result of this?

How do you treat it?

A

Infantile Seborrheic Dermatitis

  • rash/pink to red-inflamed skin with yellow, waxy scales that appear on the scalp, face and body folds (seborrheic areas)
  • no established cause, but may be due to Malassezia (a lipid-dependent yeast, U2D); HIV is considered in severe cases
  • Begins early in life; improves around 1 yo

Treatment

  • gentle removal of scale
  • low potency hydrocortisone, pimicrolimus, tacrolimus
6
Q

What does this baby have?

A

Atopic Dermatitis

7
Q

What does this baby have?

A

Psoriasis

8
Q

What does this baby have?

What is it caused by?

What are some clinical features of this?

What would labs show?

How would you treat this?

A

Netherton Syndrome

  • AR SPINK5 mutations that results in chronic inflammation of the skin, resulting in a disrupted skin barrier
  • atopic diathesis and hair abnormalities: eczema, erythroderma, ichthyosis, short hair, and short stature
  • Elevated IgE
  • often seen in premature infants and failure to thrive (FTT) patients

Treatment
- systemic tacrolimus and pimicrolimus

9
Q

What does this baby have?

What is it caused by?

What symptoms do these babies present with?

How do you treat it?

A

Acrodermatitis Enteropathica

  • red scaly serpiginous patches in the skin folds and acral areas, but also happen around the eyes, mouth, and anus
  • due to zinc deficiency (can be inherited, AR, or acquired)
  • Tetrad of Sx: diarrhea, peri-orificial and acral vesiculobullous dermatitis, alopecia, and apathy
  • Irritability and failure to thrive

Treatment:
- oral zinc

10
Q

What does this baby have?

What is it caused by?

What does the histology show?

How do you treat it?

A

Erythema Toxicum Neonatorum

  • Benign, transient papules and pustular eruptions; “flea bitten” appearance, lesions appear in crops.
  • rarely affects palms & soles
  • etiology unknown, but it is common in healthy term infants; lasts for first 2-3 weeks of life
  • Smear of pustule shows abundant eosinophils

Treatment:
Reassure parents

11
Q

What does this baby have?

How do you treat it?

A

Scabies

  • intensely pruritic papules, small erosions, and crusted papules; characteristic finding: linear burrows typically on the hands and finger web spaces

Treatment
- Permethrin or Lindane

12
Q

What does this baby have?

What is it caused by?

What other d/o have this?

How do you treat it?

A

Cutis Marmorata

  • Transient mottling that occurs due to an exaggerated vasomotor response
  • infants are usually healthy
  • d/o with persistent mottling: Down syndrome, trisomy 18, hypothyroidism, neonatal lupus, septic shock

Treatment
- resolves with warmth

13
Q

What does this baby have?

What is it caused by?

What are some clinical features of this?

What would labs show?

How would you treat this?

A

Neonatal Lupus

  • pink annular patches with fine scales and central clearing
  • usually on the face and scalp; “raccoon-eyes” is characteristic
  • immunologic dz acquired through transplacental maternal antibodies
  • triad of: cutaneous lesions, irreversible heart block, and thrombocytopenia
  • anti-Ro antibodies
  • no treatment for the cutaneous lesions (resolves spontaneously), but pacemaker is necessary for the heart block
14
Q

What does this baby have?

What is it caused by?

Where does it normally affect?

What do these patients norally present with?

What would a biopsy show?

How do you treat it?

A

Henoch-Schonlein Purpura (HSP)

  • Small vessel vasculitis due to IgA immune complexes deposition in post-capillary venules often follows an acute respiratory illness (peak incidence is during the winter)
  • purpuric papules commonly affects buttock and lower extremities (gravity dependent areas), but can affect other organs also. Edema around the hands and feet can be prominent.
  • Tetrad of: palpable purpura, joint pain, abdominal pain, and glomerulonephritis
  • bx: leukocytoclastic vasculitis and IgA complex deposition

Treatment: Systemic corticosteroids for GI and renal complications

15
Q

What does this baby have?

What is it caused by?

What are other organs can be involved?

How do you treat it?

What drugs must you avoid?

A

Urticaria Pigmentosa

  • cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
  • Can involve liver, spleen, GI tract, bones
  • Common between 3-9 mo of age, but most resolve by puberty
  • Must distinguish from cancer

Treatment

  • Anti-histamines
  • must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
16
Q

What does this baby have?

What is it caused by?

What areas are these things commonly found in?

How do you treat it?

A

Pyogenic Granuloma (misnomer, since it is neither infectious or granulomatous!!)

  • exophytic dome-shaped papules made of proliferating capillaries with dense fibers septa
  • common on head, neck, and fingers
  • Rapid growth, fall off, re-grow
  • May be due to trauma and hormones (since this can occur at sites of injury and during pregnancy)

Treatment: electrodessication and curettage (ED&C)

17
Q

What does this baby have?

What is it caused by?

What is the typical presentation?

What are other problems/sequelae that can develop as a result of this?

A

Neurofibromatosis Type I (NF1)

  • AD, NF1 gene (TSG) mutation
  • presentation: café-au-lait macules, axillary freckling, neurofibromas, iris hamartomas
  • sequelae: Optic glioma, long bone dysplasia, scoliosis, learning disabilities, hypertension, macrocephaly
18
Q

What does this baby have?

What is it caused by?

What do these patients normally present with?

What are other organs may be involved?

(fyi - these aren’t the greatest pictures.. but were the only ones provided)

A

Tuberous Sclerosis Complex

  • AD; TSC1 (harmatin) and TSC2 (tuberin) mutations

physical findings

  • multiple hamartomas in CNS and skin
  • hypopigmented macules (ash leaf spots)
  • angiofibromas on face, CT nevi (reddish spots and lumps on face)
  • sub/periungual fibromas (weird outgrowths on near the nail plate)
  • Involves CNS, eyes, kidneys, heart and lungs.
19
Q

What does this baby have?

Where is it normally located?

What other syndrome it may be associated with?

A

Accessory Tragus

  • Flesh colored papules with or without cartilage; contains epidermal adnexal structure
  • usually located preauricular, but it can be on neck or cheek
  • can be unilateral or bilateral
  • Isolated lesion, but can be associated with Goldenhar Syndrome, so check hearing
20
Q

What do these babies have?

A

cyst

21
Q

What does this baby have?

What is it caused by?

How is it treated?

A

Gianotti- Crosti Syndrome

  • Papular acrodermatitis - symmetric papular eruptions on the face, buttocks and extremities
  • suspect viral etiology (commonly EBV, HepB)
  • Usually asymptomatic/mildly itchy
  • occurs between 1-6 years
  • Self limited 8-12 weeks
22
Q

What does this baby have?

What is it caused by?

How is it treated?

A

Gianotti- Crosti Syndrome

  • Papular acrodermatitis - symmetric papular eruptions on the face, buttocks and extremities
  • suspect viral etiology (commonly EBV, HepB)
  • Usually asymptomatic/mildly itchy
  • occurs between 1-6 years
  • Self limited 8-12 weeks
23
Q

What does this baby have?

What is it caused by?

What are other organs can be involved?

How do you treat it?

What drugs must you avoid?

A

Urticaria Pigmentosa

  • cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
  • Can involve liver, spleen, GI tract, bones
  • Common between 3-9 mo of age, but most resolve by puberty
  • Must distinguish from cancer

Treatment

  • Anti-histamines
  • must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
24
Q

What does this baby have?

What is it caused by?

What are other organs can be involved?

How do you treat it?

What drugs must you avoid?

A

Urticaria Pigmentosa

  • cutaneous mast cell disease that results in pruritic brown spots that blisters with rubbing or scrathing
  • Can involve liver, spleen, GI tract, bones
  • Common between 3-9 mo of age, but most resolve by puberty
  • Must distinguish from cancer

Treatment

  • Anti-histamines
  • must avoid non-immunologic mast cell degranulators (ie opiates, NSAIDs)
25
Q

What is Collodion Membrane?

What are some features of this disease?

How is it treated?

A

Collodion Membrane

  • “Saran-wrap” covering at birth
  • infants develop respiratory distress, cracks, fissures, and temp instability

Treatment: supportive