Peds Clipp - Derm

Front 1

Name for lesion:

flat, circumscribe, <5mm

Back 1

Macule

Front 2

Macule: what size?

Back 2

<5mm
FLAT

Front 3

Derm name for:

Freckle

Back 3

Macule

Front 4

Name for lesion:

Flat, >1cm

Back 4

Patch

Front 5

Patch: what size?

Back 5

>1cm

Front 6

Name for lesion:

Elevated, <5mm

Back 6

Papule

Front 7

Papule: size?

Back 7

<5mm

Front 8

Name for lesion:

Elevated, >1cm

Back 8

Plaque

(may represent confluence of papules)

Front 9

Name for lesion:

Elevated, fluid-containing lesion, >1cm

Back 9

Bulla

(<1cm = vesicle)

Front 10

Vesicle: what size?

Back 10

<1cm

(fluid-containing)

Front 11

Name for lesion:

Circumscribed collection of leukocytes

Back 11

Pustule (NOT vesicle)

Front 12

Difference b/w:

Papule vs. vesicle vs. pustule

Back 12

Papule: <5mm, raised, no fluid
Vesicle: <1cm, clear fluid
Pustule: any size, pus

Front 13

Name for lesion:

Elevated, INVOLVES DERMIS (may extend into subQ)

Back 13

Nodule

Front 14

Nodule: defining feature?

Back 14

Involves dermis

(majority of lesion is below skin)

Front 15

Name for lesion:

Elevated; superficial transient edema

Back 15

Wheal

Front 16

Difference b/w:

Telangectasia vs. petechiae vs. purpura

Back 16

Telang: DILATED superficial venule/art/cap

Petech: CAP hemorhage (no blanch)

Purp: bleed under skin

Front 17

Do petechiae blanch? purpura?

Back 17

Neither blanch

Front 18

Name for lesion:

Fine or coarse keratin flakes; loose or adherent

Back 18

Scale

Front 19

Name for lesion:

Dried serum/blood/pus overlying lesion

Back 19

Crust

Front 20

Name for lesion:

Depressed lesion w/lost epidermis; NOT extend into dermis (no scar)

Back 20

Erosion

Front 21

Erosion: involves what layers?

Back 21

Epidermis only

(NO dermis)

Front 22

Name for lesion:

Depressed lesion extending into dermis/subQ --> leads to scar

Back 22

Ulcer

Front 23

Acute urticaria:

Underling mxn

Back 23

TYPE 1 hypersens

Front 24

Acute urticaria:

what % pop at some point in life

Back 24

15%

Front 25

Acute urticaria:

-itchy?
-symm lesions?
-do lesions coalesce?
-lesions same age?
-how long do lesions last?

Back 25

intense itch
ASYMM; DIFF AGES
lesions can coalesce
last 12-24 h

Front 26

What dz:

5yo with pruritic rash on arms, legs, trunk; erythematous and EDEMATOUS; multiple plaques with clearings; lesions last 12-24h

Back 26

Acute urticaria

Front 27

Acute urticaria:

what causes itch?

Back 27

Mast cells --> histamine

Front 28

Acute urticaria: DEFINING FEATURE (to separate from exanthem)?

Back 28

ITCHY (releived w/antihistamine)

Front 29

Acute urticaria: which is greater allergen -- dog saliva or dander?

Back 29

SALIVA

Front 30

Acute urticaria:

Assoc w/asthma-ecz?

Back 30

YES

Front 31

What dz:

Insect bites --> pruritic lesions 3-10mm, RECURRENT/CHRONIC (1-2w)

Back 31

Papular urticaria

Front 32

Papular urticaria:

Underlying trigger?

Back 32

INSECT BITES

Front 33

Papular urticaria:

Smaller or larger lesions than acute urticaria?

Back 33

SMALLER (3-10mm)

Front 34

Papular urticaria:

Lesions last how long?

Back 34

Insect bite --> lesions for 1-2 weeks!

Front 35

What pathogen:

SCARLET FEVER

Back 35

Strep

Front 36

What dz:

erythematous, fine, SANDPAPER RASH in skin creases

Back 36

Strep --> scarlet fever

Front 37

What dz:

Dusky red macules (symmetrical) --> sharply demarcated wheals --> target lesions

Back 37

Erythema multiforme

Front 38

Erythema multiforme:

-symm?
-progression of lesions

Back 38

Symm

red macules --> demarcated wheals --> targets

Front 39

Erythema multiforme: underlying mxn?

Back 39

ACUTE HYPERSENS

-most commonly 2/2 HSV (may see after meds)

Front 40

Erythema multiforme: how long do individual lesions last?

Back 40

1-3w

Front 41

What dz:

Herpes infection --> target lesions lasting 1-2 weeks

Back 41

Erythema multiforme

Front 42

Drug eruptions: all due to type 1 hypersens?

Back 42

No - can be non-immunologic trigger of mast release (e.g. opiate, NSAID)

Front 43

Erythema infectiosum: where does reticular rash appear? (body parts)

Back 43

Trunk, extrems

(NOT face - slapped)

Front 44

Erythema infectiosum: what pathogen?

Back 44

Parvo B19

Front 45

Name for:

Lyme dz papule --> large erythematous, annular patch

Back 45

Erythema migrans

Front 46

Erythema migrans: due what dz?

Back 46

LYME

(initial large erythem patch)

Front 47

Difference b/w:
Erythema migrans vs. Erythema multiform

Back 47

Migrans: Lyme bite --> erythem patch

Erythema multiform: HSV infxn --> acute HYPERSENS --> maculs -> wheals --> targets

Front 48

What dz:

3-5d fever --> pink maculopapular rash on trunk --> face and extrems

Back 48

Roseola (HHV-6)

Front 49

Roseola: due what pathogen?

Back 49

HHV-6

Front 50

Roseola: fever?

Back 50

Yes - fever 3-5d --> pink maculopapular rash on trunk & extrems

Front 51

Name for:

Cradle cap

Back 51

Seborrh dermatitis

Front 52

What dz:

Erythematous plaques with GREASY YELLOW SCALE

Back 52

Seborrh dermatitis (e.g. cradle cap)

Front 53

Can Cradle Cap spread?

Back 53

Yes - may see ears/neck --> DIAPER AREA

Front 54

Causes what dz:

Malassezia

Back 54

Seborrh dermatitis (older pts)

Front 55

Eczema/atopic derm: common what AREA of scalp?

Back 55

POSTERIOR

Front 56

Eczema: flexor or extensor?

Back 56

EXTENSOR

Front 57

Diaper candidiasis: peaks what age?

Back 57

7-10mo

Front 58

Psoriasis: waxy or non-waxy scale?

Back 58

NON-WAXY

Front 59

Childhood psoriasis: what % pts have FHx?

Back 59

40% have FHx psoriasis

Front 60

White or black head:

Open comedone

Back 60

BLACK

Front 61

Folliculitis & Furuncolosis: due what pathogen?

Back 61

STAPH

Front 62

Name for:

PAPULES in beard area

Back 62

Pseudofolliculitis

Front 63

Pseudofolliculitis:

-where located?
-papules or pustules?

Back 63

BEARD (adj hair follicles)

PAPULES (NOT pustules)

Front 64

Acne: due blockage of what type of gland?

Back 64

Pilosebacious

Blockage --> sebum --> superinfect w/proponiobacterium

Front 65

Erythema nodosum: underlying mxn?

Back 65

HYPERSENS rxn

2/2 infxn, drug, IBD

Front 66

Erythema nodosum:

-tender?
-pustular?

Back 66

TENDER
NODULAR - not pustular

Front 67

Leads to what dz:

-block pilosebacious gland
-block apocrine follicular unit

Back 67

Piloseb --> acne

Apocrine --> hidranetitis suppurative

Front 68

Hidradenitis suppurative:

Due blockage what unit?

Back 68

APOCRIN

Front 69

Hidradenitis suppurativa:

Superinfected with what pathogens (2)

Back 69

Staph aureus
Strep pyogenes

Front 70

Hidradenitis suppurativa: what is distribution in:

-M
-F

Back 70

M: perineal & perianal

F: groin, axilla, inframamm

Front 71

Rosacea: see in children?

Back 71

early form in adols

Front 72

Rosacea: see what TYPES of lesions (mac/pap/pust, etc)

Back 72

Papules & micropustules

NOT comedones

Front 73

What dz:

Redness on malar & nasal surface --> worse with EtOH/spicy/temp/stress

Back 73

Rosacea

Front 74

Rosacea: how tx?

Back 74

topical METRONIDAZOLE

Front 75

Perioral dermatitis: variant of what skin dz?

Back 75

ROSACEA

(RANDOM!!!!!)

Front 76

What dz:

Erythema, scaling & papules/pustules around mouth, nose, eyes of adolescent (*no comedones)

Back 76

Perioral dermatitis (a variant of rosacea)

Front 77

Perioral dermatitis: see comedones?

Back 77

NO! (imporant)

See erythema, scaling, papules, pustules

Front 78

Perioral dermatitis: how tx?

Back 78

Topical metronidazole

Front 79

Chronic contact dermatitis: what type of hypersens rxn? onset how long after contact?

Back 79

TYPE IV

Onset 24-72h s/p contact

Front 80

Chronic contact dermatitis:

Resolves after how long avoidance

Back 80

days-weeks

Front 81

Chronic contact dermatitis:

Commonly due to what med?

Back 81

TRIPLE ANTIBIOTIC THERAPY --- BACITRACIN

Front 82

Bacitracin: can CAUSE what skin dz?

Back 82

Chronic contact dermatitis

Front 83

Poison ivy/oak/sumac:

-cause what skin dz (name)
-what type of hypersens

Back 83

Chronic contact dermatitis

TYPE IV

Front 84

Nickel:

-cause what skin dz (name)
-what type of hypersens

Back 84

Chronic contact dermatitis

TYPE IV

(SAME AS POISON IVY, etc)

Front 85

How are skin lesions different?:

Acute vs chronic contact dermatitis

Back 85

Acute: vesicles, edema, erythema, extremely pruritic

Chronic: no vesicles

Front 86

Impetigo: what 2 pathogens

Back 86

Staph aureus
Strep pyogens (GAS)

Front 87

Impetigo: how tx? how tx if MRSA w/abscess?

Back 87

TOPICAL MUPIROCIN

if comp --> systemic abx

Front 88

Tinea corporus:

-what CLASS of pathogen?
-expect what exosure?

Back 88

Fungus

Animal exposure

Front 89

What dz:

Annular, well-circumscribed scaly plaque w/raised border --> center becomes brown OR hypopigments --> enlarges/coalesces --> mildly pruritic

Back 89

Tinea corporus (ringworm)

Front 90

Tinea corporus:

-well circumscribed?
-pruritic?

Back 90

WELL CIRCUM!

Mildly pruritic OR asympt

Front 91

Tinea corporus:

how dx?

Back 91

CLINICAL

can confirm w/KOH scraping --> branches & rod-shaped septated hyphae

Front 92

What dz:

coin-shaped lesions on legs & buttocks

Back 92

Nummular eczema

Front 93

Nummular eczema:

-where distrib?
-scale?

Back 93

Buttocks & legs

Scale (sim tinea)

Front 94

Pityriasis alba:

-hypo or hyperpigmentation?
-associated w/what exposure?

Back 94

Hypopigment on face/neck/upper trunk

SUN exposure

Front 95

What dz:

Hypopigmented lesions 0.5-5cm with well-defined border on face, neck, upper trunk s/p sun exposure

Back 95

Pityriasis alba

Front 96

What dz:

Large scaly plaque with raised border --> scaly papules & plaques on lines of cleavage

Back 96

Pityriasis rosea

Front 97

#1 etio diaper rash

Back 97

Irritant dermatitis

Front 98

What dz:

Diaper rash on CONVEX surfaces of skin; spares intertriginous creases

Back 98

Irritant dermatitis

Front 99

Irritant dermatitis: how tx (what med)?

Back 99

Zinc oxide (cream, ointmnet)

Front 100

Irritant dermatitis --> diaper rash:

Inv intertriginous crease?

Back 100

No

Front 101

What dz:

Diaper rash w/papules --> plaques & satellites

Back 101

Diaper candidiasis

Front 102

Diaper candidiasis: how tx?

Back 102

Nystatin

Imidazole, miconazole, ketoconazole effective but not approved by FDA

Front 103

What dz:

Diaper rash + streaks of blood on stool

Back 103

GAS (strep pyogenes)

Front 104

Can diaper rash 2/2 strep pyogenes lead to systemic infxn?

Back 104

YES

Front 105

Diaper rash 2/2 GAS (pyogenes):

how tx?

Back 105

Oral abx

Front 106

Diaper rash: can be caused by what vitamin deficiency?

Back 106

Zinc

(e.g. acrodermatitis enteropathica, CF)

Front 107

What dz:

Diaper rash --> crusty, weepy, may bleed

Back 107

Langerhans cell histocytosis

Front 108

Langerhans cell histocytosis: how dx?

Back 108

skin bx

Front 109

Acute urticaria: how tx? (2)

Back 109

OTC loratidine/ceterizine --> oral prednisone

*NOT topical steroid (wide distrib)

Front 110

Seborrheic dermatitis: how tx:

-infant
-older child

Back 110

Infant: baby oil & brush --> medicated shampoo --> topical hydrocortisone

Older: ketoconazole cream

Front 111

Comedonal acne:

-OTC drug?
-Drug of choice?
-Add which abx?

Back 111

OTC: benzoyl peroxide (BPO)

#1: Retinoids (Tretinoin, adapalene)

TOPICAL abx: clinda, erythro

Front 112

Comedonal acne:

-OTC drug?
-Drug of choice?
-Add which abx?

Back 112

OTC: benzoyl peroxide (BPO)

#1: Retinoids (Tretinoin, adapalene)

TOPICAL abx: clinda, erythro

Front 113

Inflammatory acne: add which drug?

Back 113

ORAL tetracycline, OCPs

Front 114

Inflammatory acne: add which drug?

Back 114

ORAL tetracycline, OCPs

Front 115

Retinoids: apply what time of day?

Back 115

NIGHT

photosens --> sunburn

Front 116

Acne:

Apply retinoid & BPO at same time?

Back 116

NO - BPO inactivates retinoid

Retinoid at night (photosens)
BPO in AM

Front 117

Retinoid: apply to moist or dry skin?

Back 117

BONE DRY

(moisture makes more irritating)

Front 118

Doxycycline: not used under what age?

Back 118

no use <9yo (dental stain)

Front 119

What acne medicine:

S/E pseudotumor cerebri

Back 119

Doxy

Front 120

Chronic contact dermatitis:

-use steroid? dosing?

Back 120

Medium topical steroid bid x 2w

Front 121

Pediculosis capitis:

How tx if you find nits but no adult lice on pt?

Back 121

NO TX

Only tx if find adult

Front 122

Pediculosis capitis:

Is vinegar or suffocating-ointment effective?

Back 122

No

Front 123

Permethrin:

Tx what dz?

Back 123

Pediculosis capitis (lice)

Front 124

Permethrin shampoo: kill lice ova?

Back 124

NO - only kill adults (increasing resistance)

use 2-3x per WEEK

Front 125

Malathion: tx what dz?

Back 125

Pediculosis capitis (lice)

Front 126

Pediculosis capitis:

Most effective drug?

Back 126

Malathion 0.5% topical

(Lindance less effective 2/2 resistance)

Front 127

Tx what dz:

Permethrin 5% cream at night --> wash off in AM

Back 127

Scabies

(permethrin shampoo also used for lice)

Front 128

Scabies: perform O/N permethrin washes how often?

Back 128

initial --> once again in a week

Front 129

Scabies: what is most persistent sx? how tx?

Back 129

Itching may persist wks

Topical steroid, OTC diphenhydraminne

Front 130

Scabies: how tx if no response to permethrin (or allergy)?

Back 130

IVERMECTIN

(only FDA approved for >15kg)

Front 131

Warts:

What fraction spont resolve in 2 yrs?

Back 131

2/3

Front 132

Warts:

OTC salicyclic acid useful?

Back 132

YES

Front 133

Warts: which more effective:

salicyclic acid OR liq N2

Back 133

SALICYCLIC ACID

Front 134

Warts:

Cantharidine effective?

Back 134

UNCLEAR

Front 135

Warts:

Candidal Ag therapy effective?

Back 135

LIMITED EVIDENCE

(immunotherapy)