Lisa Derm 2 - Ucla

Front 1

stages and tx of Hemangiomas -

Back 1

- rapidly grow 6-9 mo age;
50% gone by 5 yo; 90% by 9
--oral steroids (2-4 mg/k/day) x 3- 6 wks for vital areas( eye, nose lips, ear, airway)
-INVF alpha for recalcitrant cases
-propanolol if CS fail;

Front 2

Periobital hemangiomas ~ complx

Back 2

~ amblyobia due to visual obstruction or astigmatism;

Front 3

Tufted angiomas, kaposiform hemangioendoetheliomas
-rapidly increase in size w/ platelet trapping, consumptive coagulapthy, micronagiopathic anemia
? tx and dx?

Back 3

Kassabach Merit
TX: supperitve, steroids, INF, vincritsine

Front 4

Beard hemangiomas ~ what?

Back 4

~ upper airway hemangiomas; symptomatic b/w 6-12 wks; **recurrent stridor

Front 5

PHACES syndrome: name?

Back 5

Posterior fossa brain malformations, Hemangiomas-large plaque like facial, areterial anomlies, cardiac defects, eye abnl, sternal clefting

Front 6

Lumbosacral hemangiomas ~ what?
Liver hemangiomas~?

Back 6

~ tethered cords, lipomeningoceles
Liver hemang-~ HM, CHF, anemia, occasional thrombocytopenia

Front 7

Hypothryoridsm ~? hemangioma

Back 7

~liver, large segmental hemangiomas

Front 8

Salmon patches (nevus simplex, vascular stain) - occur mostly where, ? fade; whats tx?

Back 8

70 % NB on eyelids, glabella, forehead, neck nape: face lesions fade by 6-12 mo; NO TX needed

Front 9

Present at birth, macular pink –red in color; U/L, segmental, darker w/ cobblestone surface w/ time
-Tx

Back 9

POrt wine stain;
tx: : vascular specific pulsed dye laser

Front 10

PWS of forehead, upper or lower eyelid ~

Back 10

~ ipsilateral glaucoma, ipsilateral leptomeningeal angioma; ~ sz, hemipareisis, MR
-sturge weber

Front 11

PWS ~ limb hypertrophy, lymphedema, venous malformations, GI/bladder angiomas;

Back 11

Klippel-Trenaunay; no tx

Front 12

Aq’d vascular lesion, most commonly on upper ext or face/ red-brown in color, firm nodule, bleeds easily;
dx and Tx?

Back 12

Pyogenic granuloma;
tx: : removal (curettage, lasery, cryotheraphy, surgical excision)

Front 13

Benign melanocytic lesion, firm, dome shaped nodule or papule, red-brown in color; blanches w/ pressure; face or upper ext;

Back 13

Spitz nevus

Front 14

Skin, CNS, orthopedic manifestation; neurofibromas –after puberty;
-how dx, genetics, chromosome; what

Back 14

NF1; AD, chrom 17; ~ pheo, RAS
-dx: need 2/7 for dx (café aulait: >6 after birth > 5 mm; or >15 mm post puberty; lisch nodules (iris hamartomas); neurofibromas, optic nerve glioma; inguinal axillary freckling, bony defects, FH of NF1)

Front 15

> 3 ash leaf spots (hypopigmented skin), periventricular/cortical tubers, sebaceous gland hyperplasia, shagreen patch (cobblesone skin-leathery, orange peel), sub/periungual fibroma, cardiac rhabodmyoma; retinal nodular hamartomas, renal angiomyolipoma; dx and how dx?

Back 15

tuberous sclerosis; Need >2 for dx:

Front 16

Not present at birth, appears day 1-4, cz?; red macules → yellow, white 1-3 mm papules or pustules w/ red base; spares palms soles, lasts 2-3 wks; Stain: eosinophils

Back 16

Erythema Toxicum

Front 17

Superficial vesicopustular lesions, PRESENT at BIRTH!!, vesicles rupture w/ first bath (w/in 1-2 days)→scale, no redness, hyperpigmented macules at site of vesicles, persist x months; Blacks > whites; cz ? stain: neutrophils w/o bacteria; vs staph infection – involves hair follicles, stain: PMN + gm + cocci

Back 17

-Transient neonatal pustular Melanosis

Front 18

Dev d/o of capillaries, veins, localized; ~ gluacomoa, cleft lip, MR, syndactyly, hypothroidism, dystrophic teeth

Back 18

Cutis marmorata Telangiectatica Congenita

Front 19

Normal reticulated bluish mottling of ext in response to cold

Back 19

Cutis marmorata

Front 20

Sharply demarcted indurated plaques w/ patchy overlying redness over bony prominences, end of first month of life; due to pressure trauma, asphyxia or hypothermia; resolves spontaneously ~ hypercalcemia

Back 20

Subcutaneous fat necrosis

Front 21

Not present at birth; seen 2-4 wks age x 1-3 mo; papules, pustules not comedones; no tx; can use benzoyl peroxide or erythromycin topically

Back 21

Neonatal acne

Front 22

Occurs 3 mo – 4-5 years; often severe, treated like acne in adolescent; ~ more severe acne as an adolescent; consider abnl androgen source if > 1 yr

Back 22

Infantile acne

Front 23

Mimics neonatal acne; probable inflammatory response to Malasezzia; tx: anti-yeast meds

Back 23

Neonatal cephalic pusutulosis

Front 24

-2-4 wks life, clears spontaneously by 6-12 mo; recurs as teen ;cz:? greasy, yellow-white scale w/ red macules or papules; scalp, forehead, ears, eyebrows, nasolabial folds, chest, axilla, diaper area; not prurutic

Back 24

Seborrheic dermatitis
cz?: Pityrosporum ovale

Front 25

if ~ profuse ear d/c or hi UOP ~ seb derm, whats dx?

Back 25

histiocytosis X!!

Front 26

whats seb derm tx?

Back 26

Tx: mild – none; mineral oil before shampooing, scrubbing w/ brush, mild keratotolytic (zinc, sulfur, salicylic acid); Low potency topical CS cream or ointment ; zinc or selenium shampoos, ketoconazole cream or shampoo – agents that kill P. ovale

Front 27

Ring-shaped, red, scaly lesions on face or scalp, red macules, papules, telangicatisias, atrophy;
~ hepatitis, hemolysis, thrombocytopenia or aplastic anemia; No history or prior dx in mom in ½ cases;
-cz and dx? how dx ; tx?

Back 27

neonatal lupus
-cz: due to maternal AB crossing placenta
=Dx: anti Ro- (SSA) and anti-La (SSB);
tx: Tx of skin lesions: none, low strength CS, sunblock, resolves by 6-12 mo

Front 28

-clustered or grouped vesicles on red base on but/scalp, not present at birth; wright stain: shows ? ;
-dx and tx?

Back 28

neonatal herpes;
-wright stain: multinucleated giant cells, eosinophilic intranuclear inclusions
-TX: IV acyclovir; vs Inconteninetia pigmenti – also has vesicles but in linear patern w/o base

Front 29

what allergy ~ Atopic derm?

Back 29

Most common: egg, cows milk, soy, wheat, peanuts, fish;

Front 30

what ages/stages of location deos atopic derm occur?

Back 30

Infants: cheeks, scalp, auricular area; trunk ext –severe;
-spares axillae, diaper area, papules, vesicles;
-Child: flexural eareas, wrists, andkles
* Adolescents: hands, feet, eyelids w/ some flexural areas;
-AA: follicular pattern

Front 31

tx of atopic derm?

Back 31

Avoid drying: emollients, mild soap; short lukewarm baths w/ emollient application w/in minutes
-control itching: topical CS once x day > bathing or under emollient to increase penetration!! X 7-14 days
-inflammation: CS, topical immunomodulators (tacrolimus) –inhibits calcinuerin w/o systemic SE
-tx infection: acyclovir, topical antifungals, antbx; weepy lesions~ bacterial infx; staph aureus colonization
-AVOID steroid-antifungal combos;