Peds Final: Dermatological Conditions

Front 1

diaper dermatitis: incidence

Back 1

- bottle-fed infants > breast-fed
- peak 9-12 mos.

Front 2

diaper dermatitis: pathophysiology

Back 2

- not an infection
- d/t prolonged and repetitive contact w/an irritant: urine, feces, soaps, ointments, etc.
- prolonged contact produces: higher friction

Front 3

what is the best way to take care of diaper dermatitis

Back 3

take the diaper off and air it out

Front 4

diaper dermatitis: irritants

Back 4

- previously thought to be ammonia
- urine: increase pH from urea breakdown and promotes activity of fecal enzymes
- feces: enzymes increase skin permeability

Front 5

diaper dermatitis: CM

Back 5

- on convex surfaces and on folds

Front 6

diaper dermatitis: CM (candida albicans)

Back 6

- bright red, lesions with raised borders
- painful
- r/t immune status and antibiotic therapy

Front 7

diaperdermatitis: management

Back 7

- change diapers frequently
- soap and H2O + hydrocortisone for rashes
- ointments: petroleum based, zinc oxide based, low potency hydrocortisone
- reapply after each change

Front 8

seborrheic dermatitis

Back 8

- mostly on scalp (cradle cap)
- cause unknown
- can involve eyelids, external ear canal, nasolabial folds, and inguinal region
- soak head with baby shampoo

Front 9

seborrheic dermatitis: CM

Back 9

thick, adherent, yellowish, scaly, oily patches, may or may not be pruritic

Front 10

seborrheic dermatitis: management

Back 10

- prevention with hygiene (shampoo)
- apply shampoo, leave until crusts softens, rinse, remove crust w/comb

Front 11

atopic dermatitis (eczema)

Back 11

- pruritic eczema
- begins during infancy
- hereditary

Front 12

AD (eczema): genetics

Back 12

- family Hx of exzema, food allergies, asthma, or allergic rhinitis
- elevated IgE levels and possible T-cell dysfunction

Front 13

AD (eczema): climates

Back 13

better in humid climates, worse in fall and winter

Front 14

AD (eczema): management

Back 14

- **hydrate the skin
- relieve pruritis with non medicated moisturizer, benedryl for itching
- reduce flare-ups or inflammation
- prevent and control secondary infection

Front 15

AD: hydrating skin

Back 15

- avoid bubble baths
- tepid baths w/mild soap, no soap or an emlusifying oil, followed by an immediate application of an emollient

Front 16

AD: pruritus relief

Back 16

- colloid baths
- cool, wet compress
- topical steroids for flare-ups
- systemic antibiotics for infections
- oral antihistamines: allegra, claritin

Front 17

AD: nursing considerations

Back 17

control pruritus
- short fingernails
- gloves, onesies
- no rough fabrics
- mild detergent
- no latex products
- family support

Front 18

fungal infections

Back 18

candida albicans
- **inside the creases of the skin
- **bright red, lesions, raised borders
- yeast like
- maternal vaginal infection, contact, contaminated hands, bottles and nipples

Front 19

candida: management

Back 19

antifungals: nystatin (for oral thrush), miconazole, clotimezole, ketoconazole

Front 20

fungal infections: tinea capitis (ringworm)

Back 20

- lesions in the scalp, hairline, or neck
- scaly, circumscribed patches
- scaly areas of alopecia
- pruritic
- person to person, animal to person (cats)
- Tx: oral and topical antifungals

Front 21

fungal infections: tinea pedis (athletes foot)

Back 21

- btw. toes and plantar surface
- maceration and fissuring btw toes
- patches w/pinhead-sized vesicles on plantar surface
- pruritic
- adolescents and adults
- oral antifungal and local applications of tolnaftate

Front 22

fungal infections: tinea corporis

Back 22

- round or oval
- erythematous, scaly patch
- spreads peripherally and clears centrally
- Dx through direct microscopic examination of scales
- animal origin
- Tx: oral and topical antifungals

Front 23

scabies

Back 23

- caused by mite
causes pruritis that leads to excoriation
- maculopapular lesions: dark webbed spots

Front 24

scabies: presentation

Back 24

- infants: papules, burrows, or vesicles
- <2: feet and ankles
- >2: hands and wrists
Tx: scabicide on entire body

Front 25

lice

Back 25

- parasite
- itching d/t crawling insect and insect saliva on skin
- nits attached to hair staff
Tx: permethrin (NIX). (RID) contraindicated for allergies to ragweed or turpentine

Front 26

lice: family education

Back 26

- no sharing of hair accessories
- machine was everything in HOT water
- vaccum
- seal non washable items for 10 days
- soak hair supplies in killing solution for 1 hour or boiling water for 10 mins.

Front 27

impetigo neonatorum: ballous impetigo

Back 27

- bullous vesicular lesions on the buttocks, perineum, face, trunk, and extremities
- crusty & red
Tx: oral antibiotics, topical bactroban

Front 28

impetigo contagiosa

Back 28

- **honey colored crust
- sharp margins, irregular outlines
Tx: soak crust off & apply ointment underneath

Front 29

viral exanthums: roseola

Back 29

- d/t herpesvirus
- 6-24 months
- transmitted by respiratory secretions

Front 30

viral exanthums (roseola): CM

Back 30

- high fever 3-8 days
- pale rash that starts on teh trunk and spreads to face, neck and extremeties
- rash lasts 1-2 days
- benign and self limiting

Front 31

chickenpox (varicella)

Back 31

-spread by respiratory secretions and lesions
- **contagious 1 day before rash appears and until all blisters have formed scabs
- 5 day hospital stay
- lesions must crust before children go back to school

Front 32

anaphylaxis

Back 32

coughing/difficulty breathing - sign
selling lips -> throat swelling -> difficulty breathing

Front 33

anaphylaxis: Tx

Back 33

epin SQ or IM 0.01 ml/kg, benadryl IV or PO, methylprednisolon 1-2 mg/kg

Front 34

open wounds

Back 34

- clean with water, flush w/sterile water

Front 35

primary, secondary or tertiary intention

Back 35

primary - immediately sew up
secondary - leave open and heal on it's own
tertiary - leave open, heal partially, then close