Peds Rot Derm
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| Tx for molluscum contagiosum | topical imiquimod, topical cantharidin, oral cimetidine, cryotherapy with liquid nitrogen, and curettage.
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| Cause of molluscum contagiosum | caused by a poxvirus that induces the epidermis to proliferate, forming a pale papule. Umbilicated, white or whitish yellow papules in groups on the genitalia or trunk
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| Skin colored papules with irregular surfaces | warts (verrucous surfaces). Intraepidermal tumors caused by infection with HPV. There are over 100 types of this DNA virus which induces the epidermal cells to proliferate, thus resulting in a warty growth
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| No therapy for warts is ideal and 30% of warts will clear in ___ months irrespective of the therapy chosen | 30%
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| Gold standard tx for warts | liquid nitrogen; lesion should stay white for 20 seconds. Pt should be seen at tx intervals of 2-3 wks. Flat warts may respond to: .05% tretinoin cream, or topical imiquimod (aldara) cream. Electrosurgery should be avoided b/c it causes scarring.
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| Tx for venereal warts | Imiquimod, 25% podophyllum resin (podophyllin) painted on the lesions to be left on for 4 hours and then washed off
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| Tx for pediculoses capitus | 5% permethrin
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| Tx for scabies | first, dx with immersion oil. Examine the parents for unscratched burrows. Permethrin 5% is now the tx of choice applied overnight and then washed off
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| Grouped erythematous papules surrounded by a flare | urticaria. Tx: topical corticosteroids and oral antihistamines.
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| Abrupt fever of 103-106 lasting for 1-5 days. On the third or fourth day, a maculopapular rash appears on the trunk and spreads peripherally | Roseola infantum (in infants and young children); caused by human herpes virus 6 (HHV-6).
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| Erythema Infectioisum (fifth dz) is caused by the DNA-containing parvovirus B19. Parvovirus B19 infection during pregnancy is associated with | fetal hydrops and death of the fetus
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| Fever, anorexia, oral pain, followed by crops of ulcers on the tongue and oral mucosa and a vesicular rash on the hands, feet, and occasionally the buttocks | hand-foot-and-mouth dz; common acute dz of young children during the spring and summer caused by coxsackie A viruses.
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| Tzanck test is used to look for | multinucleated giant cells in varicella
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| Causes of Impetigo | S. aureus in bullous impetigo; S. aureus and Group A strep in non-bullous impetigo.
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| Tx of Impetigo | Limited nonbullous Impetigo can be treated topically with mupirocin. Bullous and non-bullous impetigo can be treated with a first gen cephalosporin like cephalexin. If MRSA suspected, then clindamycin or septra
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| Causes of Cellulitis | In children, it is most commonly caused by Group A b-hemolytic strep or S. aureus.
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| Tx of cellulitis | mild: oral abx such as cephalexin or amoxicillin-clavulanic acid
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| The most common pathogen in hematogenously spread cellulitis | Streptococcus pneumoniae
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| A child with a peripheral cellulitis with lympthadenopathy or lymphangitic streaking and the child with orbital cellulitis should have | a blood culture sent to determine whether bacteremia is present.
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| The three fungal organisms that cause superficial tinea infections | Trichophyton, Microsporum, and Epidermophyton.
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| Systemic antifungals are required in the treatment of? | Tinea capitus (oral grisefulvin 4-6 wks) and infection of the nails.
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| Tx of Tinea corporis, Tinea cruris and Tinea pedis | Topical antifungals for at least 4 weeks. Ex: clotrimazole
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| Tinea (pityriasis) versicolor is caused by | Malassezia furfur. Tx: selenium sulfide shampoo and antifungal agent
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| Diaper rash with firey red papular lesions in the skin folds and with satellite lesions | candida. 80% of diaper rashes lasting more than 4 days are colonized with candida. Barrier creams and nystatin are the first-line treatments
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| First line tx of acne | benzoyl peroxide: works by decreasing the colonization of P. acnes and decreasing the development of microcomedones by lessening the concentration of surface free fatty acids
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| Psoriasis | cannot be cured, characterized by remissions and exacerbations. Occurs at skin points of repeated trauma/extensor surfaces; the rash is non-pruritic.
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| Describing Psoriasis | nonpruritic rash of erythematous papules that coalesce to form plaques with sharply demarcated borders and a silvery or yellow-white scale. The scales tend to build up into layers, and their removal may cause bleeding (Auspitz sign). Usually symmetric.
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| Psoriatic rash that involves the mucous membranes | Reiter's syndrome
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| Allergic triad | allergic rhinitis, asthma and atopic dermatitis (eczema)
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| Tx of atopic dermatitis | moisturizers followed by the use of topical corticosteroids for areas of inflammation. Pimecrolimus cream for >24 months, in addition to Topical tacrolimus (both immunomodulators)
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| Pts with hereditary angioedema have an inherited | C1 esterase inhibitor deficiency
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| Gold standarad for food allergies | Double-blind placebo challnege-food challenge
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| The most common form of irritant contact dermatitis seen in peds office | diaper rash.
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| Congenital malformation that appears on the scalp, rarely on the face. Hairless spot, thin, elevated plaque with a characteristic organie color and a pebbly, or warty surface | Nevus sebaceous. About 10% of patients can expect to develop BCC in the lesion. Excision is recommended around puberty for cosmetic reasons and to prevent BCC
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| Skin colored, brown or grayish brown lesions present at birth. Composed of closely set verrucous papules, well circumscribed | Epidermal nevus. A brownish irregular plaque with a verrucous surface
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| Smooth skin colored papules (1-10mm in diameter) that are grouped on the trunk. Connective tissue birthmark | Shagreen patch. Also associated in some cases with tuberous sclerosis
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