PAEA EOR PEDIATRIC
What is the common causative "bug" in diaper dermatitis? –
Candidiasis
What is the treatment for diaper dermatitis, commonly caused by candida? –
Topical Nystatin, Lotrimin, Diflucan (Fluconazole) PO for 2 weeks
Keep area clean, dry and open to air!
Perioral dermatitis is most common in what age group? –
Young women (age 16-45)
Patient presents with discrete erythematous micropapules and micropapulovesicles that
often become confluent on the face with "sparing of the vermilion border". What is the
likely diagnosis? –
Perioral dermatitis
The cause of perioral dermatitis is unknown but can be aggravated by chronic
________ use –
oral steroid
What is the treatment for perioral dermatitis, a common skin disorder in young women
that presents with micropapulovesicles that spare the vermillion border? –
Avoid topical steroids. Topical tx: Metronidazole .75% gel BID or Azelaic acid BID,
erythromycin 2% gel BID. Systemic tx: Minocycline/Doxycycline 100mg daily until
clear, then 50mg daily for another 2 months
What are some common allergy causing drugs in peds? –
Anticonvulsants, Insulin (esp animal sources of insulin), Iodinated (containing
iodine) xray contrast dyes (these can cause allergy-like reactions), Penicillin and
related antibiotics, Sulfa drugs
Jessie is a 4y2mo old female presenting to your clinic with a history of what appears to
be a 1st exposure drug reaction. You know that since it is the first time, she likely hasn't
had any problems and her immune system may have produce an antibody called ___
against the drug. –
IgE
1st exposures to allergies don't always cause drug eruptions because your body makes
an antibody (IgE). However, in the second exposure your body makes _____ which
causes the allergy symptoms. –
histamine
,What are the 6P's of Lichen Planus? –
Planar, purple, polygonal, pruritic, papules, plaques
Patients with lichen planus may present with lacy, reticular white lines covering the
lesions. These are called.. –
Wickham Striae
Patients with lichen planus may form in lines related to scratching. This is called the
_______ phenomenon. –
Koebner
After lesion resolution occurs in lichen planus, post inflammatory
________________________ may cocur. –
Hyperpigmentation
What is the normal distribution of lichen planus/ -
Cutaneous lesions form on FLEXOR surfaces of: wrists, forearms, legs.
Oral lichen planus, genitalia, scalp lichen planus, nail lichen planus
WHAT IS TREATMENT OF LICHEN PLANUS? –
USUALLY SELF LIMITING, BUT CAN BE TREATED WITH ANTIHISTAMINES LIKE
HYDROXYZINE, OR LOCAL STEROIDS LIKE BETHAMETHASONE ETC
LICHEN PLANUS LOOKS LIKE THIS.......... -
What is the normal age of onset of pityriasis rosea? –
10 - 43 years
Pityriasis roasea is most common in what seasons? –
Fall/spring
Though the etiology of pityriasis rosea is unknown, this virus is suspected. –
suspect herpes virus type 7 (HSV 7)
Presents with single Herald Patch- oval slightly scaly plaque 2 cm, salmon colored with
fine callorette of scale. 2 weeks later-fine scaling papules and plaques with collarette of
scale in a Christmas tree distribution of trunk. What is the likely diagnosis? –
Pityriasis Rosea
T or F. Pityriasis Rosea is usu. self-limited and resolves on its own in 6-12 weeks. –
True
What is the treatment for pityriasis rosea? –
antihistamines, topical steroids, UVB light. self limiting
THIS IS WHAT PITYRIASIS ROSEA LOOKS LIKE.............. -
,JJ is a 7yr3mo female who presents with a fever, chills and body aches. Integumentary
exam reveals a painful purplish red rash that spreads and blisters. What syndrome is
she suffering from? –
Steven Johnson Syndrome
This is a vesiculobullous disease of skin, mouth, eyes, genitalia. Ulcerative stomatitis
leads to hemorrhagic crusting. –
Steven Johnson Syndrome
Name 5 drugs that may cause SJS. –
sulfonamides, PCN, phenytoin, phenobarbital, Allopurinol
What is the treatment for SJS including supportive treatment? –
D/C offending drug immediately. Supportive tx: fluid and electrolyte balance,
fluids, high caloric supplementation, prevention of sepsis. Steroids- controversial
This is a progression of SJS to full thickness skin detachment. –
Toxic epidermal necrosis
Sheet like peeling of the epidermis with slight pressure is called a positive
____________ sign and is often seen in toxic epidermal necrosis –
Nikoloksy
What is the treatment for toxic epidermal necrosis? –
Aggressive fluid & electrolyte management, wound care, pain control
What is the principle risk factor for erythema multiforme? –
HSV
Patient presents with targetoid "iris" lesions that are dusky red and round,
maculopapules, typically on extremities, may have oral mucosal involvement.
What is the likely diagnosis? –
Erythema Multiforme
This skin disorder occurs in younger males, freq recurrences, less fever, milder
mucosal lesions, no association with collagen vascular dz, HIV, or cancer
(SJS, Erythema Multiforme, TEN)?? –
Erythema Multiforme
What is the treatment for erythema multiforme, a skin d/o that occurs in younger males
that presents with targetoid "iris" lesions that are dusky, red and round, maculopapules
that are typically on extremities and may have mucosal involvement? –
Prednisone
, THIS IS ERYTHEMA MULTIFORME................ -
WHAT IS AN EXANTHEM? –
*any eruptive skin rash that may be associated with fever or other systemic
symptoms.
*Causes include infectious pathogens, medication reactions and, occasionally, a
combination of both.
*In children, exanthems are most often related to infection and, of these, viral
infections are the most common.
THIS IS AN EXANTHEM....... –
EXAMPLE IS ROSEOLA
Open comedones are called _____ heads, while closed comedones are called
_____heads –
black, white
How do you manage acne vulgaris/ -
*Do not squeeze lesions: forces pus into dermis, causes inflammation and
scarring.
*Limit washing face to 2-3 times per day.
*Avoid abrasive soaps, gear soap to skin condition. Skin dry: Purpose soap. Skin
oily: Dial soap.
*Change cosmetics to water based products.
**Topical meds: Retin A 0.025% cream every other day, Benzoyl peroxide 2.5%
THIS IS ACNE VULGARIS......... -
What is the treatment for lice?
o Body lice (Pediculus humanus)
o Head lice (Pediculosis capitus)
o Pubic lice (Pthirus pubis) - *Nix cream rinse (1% permethrin)*
Kwell shampoo (1% lindane)
Resistance to both developing and Occlusion questionable
What is the "bug" we call scabies? –
o Sarcoptes scabiei
Where does scabies most commonly present? –
o Fingers, wrists, toes
What is the treatment for scabies? –
Elimite (5% permethrin)
Eurax (10% crotamiton)
Kwell (1% lindane- avoid in infants)
What is the common causative "bug" in diaper dermatitis? –
Candidiasis
What is the treatment for diaper dermatitis, commonly caused by candida? –
Topical Nystatin, Lotrimin, Diflucan (Fluconazole) PO for 2 weeks
Keep area clean, dry and open to air!
Perioral dermatitis is most common in what age group? –
Young women (age 16-45)
Patient presents with discrete erythematous micropapules and micropapulovesicles that
often become confluent on the face with "sparing of the vermilion border". What is the
likely diagnosis? –
Perioral dermatitis
The cause of perioral dermatitis is unknown but can be aggravated by chronic
________ use –
oral steroid
What is the treatment for perioral dermatitis, a common skin disorder in young women
that presents with micropapulovesicles that spare the vermillion border? –
Avoid topical steroids. Topical tx: Metronidazole .75% gel BID or Azelaic acid BID,
erythromycin 2% gel BID. Systemic tx: Minocycline/Doxycycline 100mg daily until
clear, then 50mg daily for another 2 months
What are some common allergy causing drugs in peds? –
Anticonvulsants, Insulin (esp animal sources of insulin), Iodinated (containing
iodine) xray contrast dyes (these can cause allergy-like reactions), Penicillin and
related antibiotics, Sulfa drugs
Jessie is a 4y2mo old female presenting to your clinic with a history of what appears to
be a 1st exposure drug reaction. You know that since it is the first time, she likely hasn't
had any problems and her immune system may have produce an antibody called ___
against the drug. –
IgE
1st exposures to allergies don't always cause drug eruptions because your body makes
an antibody (IgE). However, in the second exposure your body makes _____ which
causes the allergy symptoms. –
histamine
,What are the 6P's of Lichen Planus? –
Planar, purple, polygonal, pruritic, papules, plaques
Patients with lichen planus may present with lacy, reticular white lines covering the
lesions. These are called.. –
Wickham Striae
Patients with lichen planus may form in lines related to scratching. This is called the
_______ phenomenon. –
Koebner
After lesion resolution occurs in lichen planus, post inflammatory
________________________ may cocur. –
Hyperpigmentation
What is the normal distribution of lichen planus/ -
Cutaneous lesions form on FLEXOR surfaces of: wrists, forearms, legs.
Oral lichen planus, genitalia, scalp lichen planus, nail lichen planus
WHAT IS TREATMENT OF LICHEN PLANUS? –
USUALLY SELF LIMITING, BUT CAN BE TREATED WITH ANTIHISTAMINES LIKE
HYDROXYZINE, OR LOCAL STEROIDS LIKE BETHAMETHASONE ETC
LICHEN PLANUS LOOKS LIKE THIS.......... -
What is the normal age of onset of pityriasis rosea? –
10 - 43 years
Pityriasis roasea is most common in what seasons? –
Fall/spring
Though the etiology of pityriasis rosea is unknown, this virus is suspected. –
suspect herpes virus type 7 (HSV 7)
Presents with single Herald Patch- oval slightly scaly plaque 2 cm, salmon colored with
fine callorette of scale. 2 weeks later-fine scaling papules and plaques with collarette of
scale in a Christmas tree distribution of trunk. What is the likely diagnosis? –
Pityriasis Rosea
T or F. Pityriasis Rosea is usu. self-limited and resolves on its own in 6-12 weeks. –
True
What is the treatment for pityriasis rosea? –
antihistamines, topical steroids, UVB light. self limiting
THIS IS WHAT PITYRIASIS ROSEA LOOKS LIKE.............. -
,JJ is a 7yr3mo female who presents with a fever, chills and body aches. Integumentary
exam reveals a painful purplish red rash that spreads and blisters. What syndrome is
she suffering from? –
Steven Johnson Syndrome
This is a vesiculobullous disease of skin, mouth, eyes, genitalia. Ulcerative stomatitis
leads to hemorrhagic crusting. –
Steven Johnson Syndrome
Name 5 drugs that may cause SJS. –
sulfonamides, PCN, phenytoin, phenobarbital, Allopurinol
What is the treatment for SJS including supportive treatment? –
D/C offending drug immediately. Supportive tx: fluid and electrolyte balance,
fluids, high caloric supplementation, prevention of sepsis. Steroids- controversial
This is a progression of SJS to full thickness skin detachment. –
Toxic epidermal necrosis
Sheet like peeling of the epidermis with slight pressure is called a positive
____________ sign and is often seen in toxic epidermal necrosis –
Nikoloksy
What is the treatment for toxic epidermal necrosis? –
Aggressive fluid & electrolyte management, wound care, pain control
What is the principle risk factor for erythema multiforme? –
HSV
Patient presents with targetoid "iris" lesions that are dusky red and round,
maculopapules, typically on extremities, may have oral mucosal involvement.
What is the likely diagnosis? –
Erythema Multiforme
This skin disorder occurs in younger males, freq recurrences, less fever, milder
mucosal lesions, no association with collagen vascular dz, HIV, or cancer
(SJS, Erythema Multiforme, TEN)?? –
Erythema Multiforme
What is the treatment for erythema multiforme, a skin d/o that occurs in younger males
that presents with targetoid "iris" lesions that are dusky, red and round, maculopapules
that are typically on extremities and may have mucosal involvement? –
Prednisone
, THIS IS ERYTHEMA MULTIFORME................ -
WHAT IS AN EXANTHEM? –
*any eruptive skin rash that may be associated with fever or other systemic
symptoms.
*Causes include infectious pathogens, medication reactions and, occasionally, a
combination of both.
*In children, exanthems are most often related to infection and, of these, viral
infections are the most common.
THIS IS AN EXANTHEM....... –
EXAMPLE IS ROSEOLA
Open comedones are called _____ heads, while closed comedones are called
_____heads –
black, white
How do you manage acne vulgaris/ -
*Do not squeeze lesions: forces pus into dermis, causes inflammation and
scarring.
*Limit washing face to 2-3 times per day.
*Avoid abrasive soaps, gear soap to skin condition. Skin dry: Purpose soap. Skin
oily: Dial soap.
*Change cosmetics to water based products.
**Topical meds: Retin A 0.025% cream every other day, Benzoyl peroxide 2.5%
THIS IS ACNE VULGARIS......... -
What is the treatment for lice?
o Body lice (Pediculus humanus)
o Head lice (Pediculosis capitus)
o Pubic lice (Pthirus pubis) - *Nix cream rinse (1% permethrin)*
Kwell shampoo (1% lindane)
Resistance to both developing and Occlusion questionable
What is the "bug" we call scabies? –
o Sarcoptes scabiei
Where does scabies most commonly present? –
o Fingers, wrists, toes
What is the treatment for scabies? –
Elimite (5% permethrin)
Eurax (10% crotamiton)
Kwell (1% lindane- avoid in infants)
