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neonate skin
WVSOM -- Neonatal Dermatology
| Question | Answer |
|---|---|
| How is newborn skin different from adult? | thinner, weaker intercellular attachments, fewer sweat adn sebaceous glands, few melanocytes, less terminal hair, greater skin surface to body ratio |
| what is the consequences of newborn skin differences? | inc. permeablity to topical agents; greater tendancy to blister; inc photosensitivity; dec response to tehrmal stress |
| What is skin like in preterm infants? | even thinner skin; few attachemnts; no eccrine glands; persistent lanugo |
| what is lanugo | ting and short body hair (peach fuzz); thins at 30 weeks |
| what is cause of most office visits for newborn dry skin? | desquamation |
| What happens to new born skin at 24-36 hour? | desquamation |
| how long does it take for desquamation to occur? | 21 days |
| what is desquamation? | shedding of outer layer of skin |
| what is acrocyanosis? | cyanosis aond hands and feet; must be differentiated form central cyanosis; caused by increased tone of peripheral areterioles in response to chilling |
| what is cutis marmorata | Netlike, reddish-blue mottling of the skin; normal response to chilling; can be a sign of sepsis; goes away with rewarming |
| what is ichtyosis | aka collodion baby; parchemnt-like collodion membrane that distorts the face adn extremities |
| what happens to the membrane in icthyosis? | membrane usually resolves into scales over time |
| what are sucking blisters? | superficial bullae present on upper limbs at birth; result of vigorus sucking in-utero |
| What is miliaria | sweat gland obsturction form over bundling |
| what is miliaria crystallina? | clear vesicles over head, neck and upper trucnk |
| waht is miliaria rubra | prickly heat; sites of occlusion or flexural areas |
| what is milia | tiny whitish-yellow papules containing keratin on NOSE, forehead adn chin |
| what is neonatal acne | resembles teenage acne with comedones, paules and pustules |
| what is erythemia toxicum neonatorum | intense erythema with central 2mm papule or pustule (fleabite); not on palms; smear of pustures reveals numerous eosinophils; fades in 5-7 days |
| what is transient neonatal pustular melanosis | pigmented macules with a scale (1-2mm); numerous neutrophils; reluves in 3 weeks |
| what is seborrheic dermatitis? | red, scaling eruption mainly on hair-bearing and intertriginous areas; cradle cap |
| what are mongolian spots? | flat, gray to bluish-black macules commonly over lumbosacral area; usually fade by age7; no risk of malignancy; may be confused with child abuse |
| what are congenital nevi | flat, tan macules or papules and well circumscribed |
| What needs to be followed throught out life with congential nevi | size, shape, outline, color, burning, itching, tenderness; may progress to melanoma |
| what size are small/medium congential nevi? | up to 20 cm |
| what are giant congential nevi? | > 20cm; unevenly pigmented with colors from borwn to black; removed as early as possible; requries close obersrvation with palpation of entire lesion even after exision because it may arise deep without visible skin change |
| What are hemangiomas? | most common benign tummor that is filled with blood when in a dependent position; composed of proliferating vascular end |
| what is a superficial hemangiomas? | strawberry capillary hemangioma; head and neck; infolution by age 6 |
| what are deep hemangiomas | deep seated capillary showing as bluish-red mass |
| what are complications of hemantiomas? (facial) | beard distribution (airway compromise); near the eye |
| Waht are lumbosacral complciations of hemangiomas | tethered cord; spinal dysraphism; imperforate anus; renal anomalies; sacral anomalies |
| what is PHACE syndrome | Posterior fossa/brain malmoration; Head/cervicofactial hemangioma; arterial anomalies; cardiac defects or coarctaion of aorta; eye anomolies |
| what is Kasabach-Merritt Syndrome? | rapidly enlarging hemangioma causing; Thrombocytopenia; microangiopathic hemolytic anemia; coagulopathy from RBC adn platelet trapping; activation of teh clotting system within the hemangioma |
| what is treatment of hemangiomas | OBSERVATION AS MOST HAVE SPONTANEOUS INVOLUTION; if complications: steroids; interferon; steroid injections; laser therapy; surgical resection |
| what is salmon patch? | vascular ectasia; symmetric with lesions on both sides of midline |
| what is port wine stain | present on head and neck; permanent; mature dilated dermal capillaries and represent a permanent defect |
| Sturge-Weber Syndrome | port-wine stain over teh ophthalmic branch of trigeminal nerve; intracranial calcifications; seizures; hemiparesis; glaucoma; mental retardation |
| Kklippel-trenaunay weber syndrome | port wine stain on extremity associated with local overgrowth of stoft tissue and bone; lower limb; leg-length discrepancies |
| What is TORCH | Toxoplasmosis, Other(syphallis), rubella, cytomegalovirus, herpes |
| What is toxoplasmosis | silent infection in pregnant women; hydrocephalus, chorioretinitis, intracerebreal calcifications |
| what do infants with toxoplasmosis have a risk for? | neurodevelopmental sequelae (seizures, developmental delays, paralysis, difficulty swallowing) |
| How is congenital syphilis mostly seen? | majority asymptomatic at birth but manifest symptoms if left untreated |
| what is seen in early syphilis | large round maculoapular lesions anywhere but also palms and soles; perioral fissures and scarring; lymphadenopathy; rhinitis; osteochondritis |
| what is seen in late syphilis | hutchinson teeth and mulberry molars;8th never deafness; sabre shin; saddle nose deformity |
| what are hutchinson teeth? | upper central incisors are small, barrel shaped and notched in teh center |
| What are mulberry molars | multiple peripheral cusps and a central cusp |
| what is seen in congenital rubella? | cataracts, deafness, heart malfomrations, blueberry muffin rash |
| what is blueberry muffin rash? | dermal erythropoiesis |
| what is seen in infants with CMV? | majority asymptomatic; may develop sensoineural hearing loss; periventricular calcificaitons, blueberry muffin rash, microcephally, thrombocytopenia, choriorentitis |
| what is seen with neonatal herpes | mother may never have had lesions; vesicle with erythematous halo |
| what is seen in disseminated neonatal herpes | respiratory distress, hepatitis, DIC, FOCAL SEIZURES |
| what is seen with encehpalitic herpeis? | focal seizures; bloody lumbar puncture |
| when are cutaneious manifestaions of herpes seen? | 3rd week of life |
Created by:
tjamrose
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