Pediatrics- Dermatology Exam 100% Correct!!
Neonatal skin - ANSWERdeffers from adlt skin- less hairy, fewer sweat and sebaceous gland secretions, is thinner and has weaker intracellular attachments
Milia - ANSWERsuperficial epidermal inclusion cysts containig keratinized material firm papule 1-2 mm in diameter, pearly opalescent white, scattered over the face, forehead cheeks, nose and gums
epstein pearls - ANSWERmilia over the midline of palate
sebaceous hyperplasia - ANSWER1-2 mm papules usu located ovcer the nose, upper lip, cheeks, and forehead -minute profuse yellow white papules
-may be a sebacous gland response to maternal androgen
Sebaceous nevus of jadasson - ANSWERhairless, well circumsicribed lesion, located on the scalp, skin colored or yellow orange
-it may occur occasionally on the trunk
-risk of malignancy is small for bcc
-excision advised before adolescence if large
Erythema toxicum - ANSWERbenign, self limiting, asymptomiatic disorder of unknown etiology. Occur in 50% of term infants, less common in premies. Firm yellow white papules 1-2 mm on an erythematous base. Begins @ 24-48 hours f age
(may be as late as 10 days)
-flea bite appearance -smear of papules reveals eosinophils
MIliaria cystallina - ANSWERclear very superficial 1-2 mm vesicles NOT PAPULES resulting from obstruction of sweat glands with sweat retention in the epidermis
-lesions rupture spont leaving a tiny white scale (sweat, salt)
MIliaria Rubra (Prickly Heat) - ANSWER2-4 mm erythematous papules or papulovesciles. Caused by deep obstruction of sweat ducts and leakage of sweat into dermis with subsequent inflammation
Neonatal acne - ANSWER20% of normal neonates develop within 1st month, very common
-closed comedomes predominate on cheeks and forehead -occassionally open comedomes and pustules
-etiology unknown- has been attributed to placental transfer of maternal androgens, hyperactive neonatal adrenal glands and end organ hypersensitivity to androgens
-resolves spont by three months of age
infantile acne - ANSWERpresents at 3-16 mo of age, more common in females -lesons are more numerous, severe, and persistant than neonatal form -open and cloesd comedomes predominate with papules and pustules
-nodules are also seen with pitting and scarring-->send to derm -course can be brief or persis for months with spont remission by three years
-a histroy of severe acne in one or both parents may be present
-may require treatment with benzoyl peroxide and erythromycin
Alarm bells if infantile acne lasts more than - ANSWER6 months, hes growing faster than nrmal, he has a body odor, is developing pubic hair or breast tissue too early, male testes enlarging. These kids worry abt having androgen excess. This is not just
mild angorgeneric response if this kid is growing at a higher rate. This kid needs to be worked up could be something wrong with adrenals.
Mongolian spots - ANSWERflat, slate-grey to blue-black poorly circumscribed -most commonly over the lumbosacral area and buttocks
-incidence 90% in blacks and asians -accumulation of melanocytes deep within dermis
-usu fade by age 7 unless lesions are wide spread
Melanocytic nevi - ANSWERbenign clusters of melanocytic nevus cells
-most common tumors of childhood-familial tendency -most people acquire these lesions throughout childhood peaking in adolescence or late childhood
-have smooth border with sharp demarcation from surrounding skin
-minor risk of conversion to malignant melanoma- more lesions > risk
Giant hairy nevus - ANSWERpresent at birth and can occupy a large area, rare,
-uneven pigmentation, elevated, and may be covered with hair
-THIS IS NOT GOOD, has to be removed but it is extensive. Need to inflate the skin with a balloon, stretch skin and then excise lesion and replace with the new skin. -increased risk of conversion to MALIGNANT MELANOMA
Epidermal Nevus - ANSWERmay be visible at birth or appear within 1st months of life
-affect both sexes equally -elevated, linear widespread lesion
-rarely may be assoc. with skeletal, vascular, and cns lesions
Cafe au lait macules - ANSWERflat nonpalpable, coffee colored lesions. six or more >1 cm= neurofibromatosis
ash leaf macule - ANSWERflat hypopigmented lesion most often on the trunk
seen in pt with tuberous sclerosis
Nevus flammeus - ANSWER-salmon patch
-seen in half of all newborns
-most commonly at nape of neck, over upper eyelids, forehead
-represent distended capillaries and fade by 1-2 years
Capillary hemangiomas - ANSWERstrawberry hemangiomas
Neonatal skin - ANSWERdeffers from adlt skin- less hairy, fewer sweat and sebaceous gland secretions, is thinner and has weaker intracellular attachments
Milia - ANSWERsuperficial epidermal inclusion cysts containig keratinized material firm papule 1-2 mm in diameter, pearly opalescent white, scattered over the face, forehead cheeks, nose and gums
epstein pearls - ANSWERmilia over the midline of palate
sebaceous hyperplasia - ANSWER1-2 mm papules usu located ovcer the nose, upper lip, cheeks, and forehead -minute profuse yellow white papules
-may be a sebacous gland response to maternal androgen
Sebaceous nevus of jadasson - ANSWERhairless, well circumsicribed lesion, located on the scalp, skin colored or yellow orange
-it may occur occasionally on the trunk
-risk of malignancy is small for bcc
-excision advised before adolescence if large
Erythema toxicum - ANSWERbenign, self limiting, asymptomiatic disorder of unknown etiology. Occur in 50% of term infants, less common in premies. Firm yellow white papules 1-2 mm on an erythematous base. Begins @ 24-48 hours f age
(may be as late as 10 days)
-flea bite appearance -smear of papules reveals eosinophils
MIliaria cystallina - ANSWERclear very superficial 1-2 mm vesicles NOT PAPULES resulting from obstruction of sweat glands with sweat retention in the epidermis
-lesions rupture spont leaving a tiny white scale (sweat, salt)
MIliaria Rubra (Prickly Heat) - ANSWER2-4 mm erythematous papules or papulovesciles. Caused by deep obstruction of sweat ducts and leakage of sweat into dermis with subsequent inflammation
Neonatal acne - ANSWER20% of normal neonates develop within 1st month, very common
-closed comedomes predominate on cheeks and forehead -occassionally open comedomes and pustules
-etiology unknown- has been attributed to placental transfer of maternal androgens, hyperactive neonatal adrenal glands and end organ hypersensitivity to androgens
-resolves spont by three months of age
infantile acne - ANSWERpresents at 3-16 mo of age, more common in females -lesons are more numerous, severe, and persistant than neonatal form -open and cloesd comedomes predominate with papules and pustules
-nodules are also seen with pitting and scarring-->send to derm -course can be brief or persis for months with spont remission by three years
-a histroy of severe acne in one or both parents may be present
-may require treatment with benzoyl peroxide and erythromycin
Alarm bells if infantile acne lasts more than - ANSWER6 months, hes growing faster than nrmal, he has a body odor, is developing pubic hair or breast tissue too early, male testes enlarging. These kids worry abt having androgen excess. This is not just
mild angorgeneric response if this kid is growing at a higher rate. This kid needs to be worked up could be something wrong with adrenals.
Mongolian spots - ANSWERflat, slate-grey to blue-black poorly circumscribed -most commonly over the lumbosacral area and buttocks
-incidence 90% in blacks and asians -accumulation of melanocytes deep within dermis
-usu fade by age 7 unless lesions are wide spread
Melanocytic nevi - ANSWERbenign clusters of melanocytic nevus cells
-most common tumors of childhood-familial tendency -most people acquire these lesions throughout childhood peaking in adolescence or late childhood
-have smooth border with sharp demarcation from surrounding skin
-minor risk of conversion to malignant melanoma- more lesions > risk
Giant hairy nevus - ANSWERpresent at birth and can occupy a large area, rare,
-uneven pigmentation, elevated, and may be covered with hair
-THIS IS NOT GOOD, has to be removed but it is extensive. Need to inflate the skin with a balloon, stretch skin and then excise lesion and replace with the new skin. -increased risk of conversion to MALIGNANT MELANOMA
Epidermal Nevus - ANSWERmay be visible at birth or appear within 1st months of life
-affect both sexes equally -elevated, linear widespread lesion
-rarely may be assoc. with skeletal, vascular, and cns lesions
Cafe au lait macules - ANSWERflat nonpalpable, coffee colored lesions. six or more >1 cm= neurofibromatosis
ash leaf macule - ANSWERflat hypopigmented lesion most often on the trunk
seen in pt with tuberous sclerosis
Nevus flammeus - ANSWER-salmon patch
-seen in half of all newborns
-most commonly at nape of neck, over upper eyelids, forehead
-represent distended capillaries and fade by 1-2 years
Capillary hemangiomas - ANSWERstrawberry hemangiomas
