Derm 2

llbgurl's version from 2015-10-04 21:11

Section 1

Question Answer
solitary papule, irregular, rough surface; anywhere on body; can be in genitals in childrenverruca vulgarus
common wartverruca vulgarus
around cuticles of finger and toes; spread by traumaperiungual wart
spiny projections from the skin surface with a stalk; lips nose or eyelidsfiliform wart
flat-topped, smooth surface; usually many; skin colored or tan; common in sites of traumaflat wart
rough papules that disrupt the dermal ridges; painful; grouped together mosaicplantar warts
weight-bearing wartsplantar warts
discrete or confluent papules with rough surface that can be on the genitals or or oral mucosavenereal wart
vinereal wartcondylemata acuminate
caused by a variety of HPVverruca vulgarus
most spontaneously resolve, on treatment is unlikely to cure verruca vulgarus
crythotherapy, salicylic acid, laser, vesicants, surgerycytodestruction
interferon, cimetidine, immunologic
retinoic acid, podophyllumantiprliferative
descrete umbilicated papules that may eventually have extrusion of the contents molluscum contagiosum
dermatitis (dryness, erythema, scaling) are common around lesionsmolluscum contagiosum
lesions usually found around eyes, axilla, and extremitiesmolluscum contagiosum
poxvirusmolluscum contagiosum
will eventually resolve without treatmentmolluscum contagiosum
dermal curette remove entire papule; very painfulmolluscum contagiosum
canthardin applications, imiquimod cream, cimetidine oral, potassium chloride, podophyllummolluscum contagiosum
larger lesions can become red and purulent and may leave some scarringmolluscum contagiosum
Impetigo around lesions commonmolluscum contagiosum
over 100 lesions in an older child should raise concern for aidsmolluscum contagiosum

Section 2

Question Answer
open sores with honey-colored crustsImpetigo
starts as a vesicle with a fragile roof that breaks easilyImpetigo
common on exposed areas like face nose and extremitiesImpetigo
very high attack rack, more common in poor socioeconomic conditionsImpetigo
staphylococcus aureus, Group A strep, MRSAImpetigo
no cultures or diagnostics necessary unless concern for other skin conditionImpetigo
systemic antibotics for 10 days: Cephalexin, Dicloxacillin, Cloxacillin, Erythromycin Impetigo
topical mupirocin is showing increase resistance, removal of crusts is not helpful with scrubbing with H20 and soap, home from school until on abx X24 hoursImpetigo
post strep glomerulonephritisImpetigo
starts with a sore with a blister; blister is fragile an easily shed leaving an out rim of desquamationBullous Impetigo
Staph, group A strep, MRSABullous Impetigo
treated like impetigo oral abx for 10 days Cephalexin, Dicloxacillin, Cloxacillin, Erythromycin Bullous Impetigo
firm, dry, dark rust with surrounding erythema and induraction, pressure on the crusts causes purulent material to oozeEcthyma
staphylococcus aureus, group a strepEcthyma
treated like impetigo oral abx x10 daysEcthyma
occurs in skins folds (neck, axilla, groin) confluent red area with oozing of light yellow drainage, child does not appear illBacterial intertigo
staphylococcus aureus, group A beta hemolytic strepBacterial intertigo
may look like staph scalded skin syndrome but child is not ill like with this syndromeBacterial intertigo
no oozecandidia intertigo
ill defined erythematous plaques that are warm and tender to palpation cellulitis
may have evidence of previous injury, abrasion or penetrating traumacellulitis
perirectal erythema and painful defication; may involve perivaginal redness and may present with constipationperianal cellulitis
H. Flu = Blue Hueperiorbital cellulitis
streptococcus, H. flu, Staph aeurs, MRSAcellulitis
streptococcusperianal cellulitis
culture center or advancing edge of lesion rarely gives positive resultscellulitis
IM/Oral Penicillin cellulitis
acutely ill: hospitalize and IV abxcellulitis
recurrent infections, necrotizing fascitis, toxic shock syndromecellulitis
begins as cellulitis with severe pain, edema, fever and bullae on an erythematous surfacenecrotizing fascitis streptococcal gangrene
quickly progresses to ulcer, eschar, and gangrene within a few daysnecrotizing fascitis streptococcal gangrene
type 1: polymicrobial infection in a child WITH underlying diseasenecrotizing fascitis streptococcal gangrene
type 2: flesh eating strep, usually a healthy child or those with chicken poxnecrotizing fascitis streptococcal gangrene
hospital, debridement, fluid, PCN IV abx, IVIG, mortality is highnecrotizing fascitis streptococcal gangrene
toxin mediated rash, most common in preschool and school aged child scarlet fever
exathem appears at 24-48 hours after infection: facial flushing; circumoral pallorscarlet fever
white strawberry tongue --> turns to red strawberry tonguescarlet fever
fine maculopapular rash on erythematous skin, spreads from neck down and more prominent in warm areas like the groinscarlet fever
palms and soles are spared of rashscarlet fever
petechiae in a linear pattern in flex creases are calledpastia lines/sign
pastia linesscarlet fever
streptococcusscarlet fever
penicillin tx of choice, erythromycin for allergic patients 10 days of treatment still recomended, bland ointment for discomfortscarlet fever
rash similar to mono, kawasaki disease, TSS and rubellascarlet fever
can have peeling of distal toes and fingersscarlet fever

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