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neonate skin

WVSOM -- Neonatal Dermatology

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