CM- Derm -13- Pediatric Derm
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| has a childhood phase 4-10yrs of age of dry papular intensely pruritic papules and plaques affecting flexural surfaces | atopic dermatitis
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| Apart from pruritis and dryness of flexural surfaces what else do you see | cracking dryness scaling of hands and feet
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| when does atopic dermatitis generally improve | improves during the warm moist months
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| how many pediatric patients get over their contact dermatitis or improve and what percent develops a chronic dermatitis | 75% improve 25% develop chronic condition
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| what do you generally see with adults with atopic dermatitis on flexural surfaces | lichenification and hyperpigmentation
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| what are some of the associated findings with pediatric atopic dermatitis | xerosis-dry skin
ichthysosis vulgaris
keratosis pilaris
hyperlinearity of palms
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| What family history is present with most pediatric atop dermatitis patients | fam hx of allergic rhinitis, asthma, food allergies, and migraines
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| What external factors may make atopic dermatitis worse in a pediatric | wool, soaps, dry skin, food, infectious agents
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| what would be the treatment for ped atopic derm | mild soap, hydration/moisturizer, hydrocortisone, antipruritics, avoidance of ext factors
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| marked by honey colored crust is often complication of atopic dermatitis can be caused by staph aureus or group A strep or both | Impetigo
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| Where is impetigo most commonly found | face, extremities, hands and neck
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| How does impetigo spread | impetigo is often pruritic so patient scratches and moves bacteria to new areas autoinnoculation
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| When does impetigo peak | peaks in warm months with increased exposure to insect bites and injury
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| caused by group a strep begins as a papule that develops into a small vesicle surrounded by erythema | Non bullous impetigo
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| type of impetigo generally caused by staph | bullous impetigo
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| small thinned walled pustules or large bullae rupture to leave shallow erythematous base sourrounded by superficial peeling may coalesce or form satelite lesions | Bullous impetigo
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| occurs mostly in kids >36months can be caused by insect bites or local trauma, or infection that spreads such as conjunctivitis, hordeolum, lacrimal system infections or impetigo | Periorbital cellulitis
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| What is a major problem with periorbital cellulitis | it can cause blindness
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| what secondary infection can hematogenous spread of bacteremia from a nasopharyngela pathogen cause | periorbital cellulitis
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| what secondary infection can sinusitus causing venous and lymphatic congestion cause | periorbital cellulitis
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| what are the s/sx associated with periorbital cellulitis | erythema, swelling, tenderness of the eyelids, without evidence of orbital congestion, fever, vesicles if w/ hsv and violaceous if concurrent h flu infection
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| what is the treatment for patient with periorbital cellulitis | admit pt for IV abs and watch for septicemia
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| a bacterial infection of the lymph vessels with inflammation of a channel of lymph vessels | acute lymphangitis
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| what are the s/sx of acute lymphangitis and what additional s/sx may a child present with | causes painful, red streaks, may get enlarged lymph nodes often called blood poisoning by lay person
Child may present with- fever and tachycardia
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| what usually causes acute lymphangitis | strep
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| how do you dx acute lymphangitis | CBC with blood culture
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| What is the Tx for acute lymphangitis | oral abs or systemic abs
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| what is an exanthem | rash or red spot
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| What are the 7 examples of viral exanthems | 1-chickenpox
2-rubeola
3-rubella
4-pityriasis rosea
5-fifths disease/ erythema infectiousum
6-hand, foot and mouth disease
7-roseola (sixths disease)
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| Also known as english measles and morbilli caused by paramyxovirus morbillivirus | rubeola
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| how is rubeola transmitted | transmitted via airborne droplets
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| what are the s/sx of rubeola | fever, dry cough, runny nose, inflammed eyes, sensitivity to light, tiny red spots with bluish white centers found inside the mouth on inner lining of cheek
a skin rash made up of large flat blotches that often flow into one another
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| What are koplik's spots and when do the occur | they are tiny red spots with a bluish white center found on inner lining of cheek inside the mouth. Appears before skin rash in rubeola
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| what would be the concern with a women who contracts rubeola while pregnant | it is associated with spontaneous abortions and premature delivery
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| Also known as the german measles or 3 day measles caused by togavirus | rubella
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| How is rubella transmitted | airdroplets
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| what are the s/sx of rubella | generally very mild and often hard to notice
mild fever
headache
stuffy or runny nose
inflamed red eyes
enlarged tender lymph nodes
a fine pink rash that begins on face and quickly spread to the trunk and then the arms and legs before disappearing
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| How long does rubella generally last | 2 to 3 days
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| since rubella seems to be so mild what is the major problem with it | if a pregnant women is infected with rubella it is teratogenic and can cause congenital rubella syndrome
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| What are the characteristics of congenital rubella syndrome | glaucoma, cataracts, hearing deficits, microphthalmia, psychomotor, retardation, congenital heart defects, oranomegaly, and a rash. Earlier fetus is infected the worse the defects and has a high mortality rate
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| Most commonly in adolescents and young adults may have flu like symptoms before rash which is "herald patch" a large isolated oval lesion that is usually pink and scaly | pityriasis rosea
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| What do you generally get 5-10 after the pink scaly rash in pityriasis | get a small lesions on the trunk shaped like a christmas tree (oval erythematous papules with an inner collarette of scales)
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| found in school aged kids also called slapped cheek, erythema on face with lacy, reticulated blanching erythema on trunk and extremities with fever and arthralgias usually fades in 2-3weeks | Fifths disease/ erythema infectiousum, parvo B-19
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| Benign self limited viral disease highly contagious caused by coxsackievirus a16 spread by direct contact you get thin walled gray vesicles especially on tongue, palate, buccal mucosa, fingers, toes, palms and soles | hand-foot-mouth disease
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| HOw long does it take for hand-foot-mouth disease to resolve | 10-14 days
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| caused by HHV-6 primarily occurs in kids 6months to 2yrs incubates for 5-15 days followed by an abrupt onset of a high fever cervical lymphadonapthy and mild URI symptoms | Roseola infantum (sixths disease)
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| What are the secondary more visible symptoms that follow the high fever in roseola infantum | you get a rapid onset of a nonpruritic rose pink blanching rash consisting of discrete macule and papules first on trunk then spreads to neck and extremities
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| Common fungal infection of children w/ pruritic annular lesions with central clearing and active vesicular border | Tinea Corporis
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| How do kids generally get tinea corporis | generally get it from pets or direct human contact
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| how do you dx tinea corporis | KOH prep looking for hyphae
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| What is the Tx for tinea corporis | Rx of topical antifungal or griseofulvin for widespread lesions
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| Most common cause of hairloss in kids you can have two types dry type and black dot type | tinea capitis
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| what is the dry type of tinea capitis like | lesion may be dry and scaly simulating dandruff of the scalp, psoriasis and lichen planus
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| What is the black dot type of tinea capitis like | usually the lesion is dry where the hair is cut short from the stumps and bases of infected hairs are prominent. You get some erythema and pruritis
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| What is tinea capitis infection gone bad called | kerion- with a boggy inflammation of the scalp
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| what is the treatment for tinea capitis/kerion | oral griseofulvin or lamasil as topical antifungals are not effective
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| the scalp has a special mouse smell with a characteristic solid crust formed over the infected area which may spread to cover the whole scalp. Condition is chronic and may end with scarring alopecia | Favus
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| Most commonly in adolescents and young adults may have flu like symptoms before rash which is "herald patch" a large isolated oval lesion that is usually pink and scaly | pityriasis rosea
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| What do you generally get 5-10 after the pink scaly rash in pityriasis | get a small lesions on the trunk shaped like a christmas tree (oval erythematous papules with an inner collarette of scales)
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| found in school aged kids also called slapped cheek, erythema on face with lacy, reticulated blanching erythema on trunk and extremities with fever and arthralgias usually fades in 2-3weeks | Fifths disease/ erythema infectiousum, parvo B-19
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| Benign self limited viral disease highly contagious caused by coxsackievirus a16 spread by direct contact you get thin walled gray vesicles especially on tongue, palate, buccal mucosa, fingers, toes, palms and soles | hand-foot-mouth disease
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| HOw long does it take for hand-foot-mouth disease to resolve | 10-14 days
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| caused by HHV-6 primarily occurs in kids 6months to 2yrs incubates for 5-15 days followed by an abrupt onset of a high fever cervical lymphadonapthy and mild URI symptoms | Roseola infantum (sixths disease)
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| What are the secondary more visible symptoms that follow the high fever in roseola infantum | you get a rapid onset of a nonpruritic rose pink blanching rash consisting of discrete macule and papules first on trunk then spreads to neck and extremities
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| Common fungal infection of children w/ pruritic annular lesions with central clearing and active vesicular border | Tinea Corporis
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| How do kids generally get tinea corporis | generally get it from pets or direct human contact
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| how do you dx tinea corporis | KOH prep looking for hyphae
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| What is the Tx for tinea corporis | Rx of topical antifungal or griseofulvin for widespread lesions
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| Most common cause of hairloss in kids you can have two types dry type and black dot type | tinea capitis
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| what is the dry type of tinea capitis like | lesion may be dry and scaly simulating dandruff of the scalp, psoriasis and lichen planus
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| What is the black dot type of tinea capitis like | usually the lesion is dry where the hair is cut short from the stumps and bases of infected hairs are prominent. You get some erythema and pruritis
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| What is tinea capitis infection gone bad called | kerion- with a boggy inflammation of the scalp
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| what is the treatment for tinea capitis/kerion | oral griseofulvin or lamasil as topical antifungals are not effective
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| the scalp has a special mouse smell with a characteristic solid crust formed over the infected area which may spread to cover the whole scalp. Condition is chronic and may end with scarring alopecia | Favus
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