Pediatric Dermatology Guide for Nurse Practitioners

Explore visual diagnosis challenges from the Pennsylvania Coalition of Nurse Practitioners' annual conference in 2010, covering topics such as neonatal acne, seborrheic dermatitis, and eczema/atopic dermatitis in infants. Enhance your knowledge on common skin conditions affecting newborns and learn about their presentation, management, and prognosis.

• Pediatric Dermatology
• Nurse Practitioners
• Infant Skin Conditions
• Visual Diagnosis
• Pennsylvania Conference

akh_gia Follow

Uploaded on Sep 07, 2024 | 0 Views

Download Presentation

Please find below an Image/Link to download the presentation.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.

Presentation Transcript

1. JEOPARDY Visual Diagnosis Pennsylvania Coalition of Nurse Practitioners 8thAnnual Conference November 12-13, 2010

2. Baby Bummers Describe This Rash Rings and Things The Dark Side Fingers and Toes Potpourri 100 100 100 100 100 100 200 200 200 200 200 200 300 300 300 300 300 300 400 400 400 400 400 400 500 500 500 500 500 500

3. Baby Bummers 100 Answer Answer

4. Baby Bummers 100 Answer Question Question

5. Babby Bummers 100 Neonatal Acne Erythematous papules or pustules Resembles acne vulgaris as seen in adolescents May be present at birth or develop in early infancy Usually on cheeks, occasionally affects chin and forehead Etiology not clearly defined may be due to hormonal stimulation of sebaceous glands that have not yet involuted No treatment necessary in most cases

6. Baby Bummers 200 Answer Answer

7. Baby Bummers 200 Answer Seborrheic Dermatitis In newborns and infants often begins in 1st 12 weeks of life May start with scaly dermatitis of scalp (cradle cap) May spread over face including the forehead, ears, eyebrows, nose and back of head Erythematous, greasy, salmon colored, and sharply marginated oval scaly lesions may involve other parts of the body Prognosis is good some clear in 3 to 4 weeks, even without treatment and most clear spontaneously by 8 to 12 months of age Rx: apply baby or mineral oil to scalp, leave on overnight, remove scales with soft baby brush or tooth brush in am and wash off Question Question

8. Baby Bummers 300 Answer Answer

9. Baby Bummers 300 Answer Eczema/Atopic Dermatitis Question Question

10. Baby Bummers 400 Answer Answer

11. Baby Bummers 400 Answer Intertrigo Erythematous rash in neck folds (or other intertriginous areas) characterized by superficial inflammation Can become secondarily infected by yeast or bacteria Treat like diaper rash Question Question

12. Baby Bummers 500 Answer Answer

13. Baby Bummers 500 Answer Erythema Toxicum Neonatorum Benign, self-limited condition, etiology unknown Blotchy, evanescent erythematous macules, sometimes with associated small papules, vesicles and pustules on erythematous base Lesions disappear and reappear at different locations Peak onset at 48 hours after birth, generally resolves by 5-14 days of life Question Question

14. Describe This Rash 100 Answer Answer

15. Describe This Rash 100 Answer Vesicular exanthem, teardrop vesicles on an erythematous base = Varicella All stages and sizes of lesions may be found at the same time and in the same vicinity Eruption usually begins abruptly on the trunk, face and scalp, with successive crops of pruritic lesions minimal involvement of distal aspect of extremities Question Question

16. Describe This Rash 200 Answer Answer

17. Describe This Rash 200 Answer Erythematous maculopapular rash Roseola Infantum (exanthem subitum = sixth disease) Eruption characterized by discrete rose pink macules or maculopapules 2-3 mm in diameter that fade on pressure and rarely coalesce. Usually appears on trunk and may spread to neck, upper and lower extremities Question Question

18. Describe This Rash 300 Answer Answer

19. Describe This Rash 300 Answer Erythematous raised oval/round papules and macules, (wheals) some with central clearing, some with coalescence= Urticaria (hives) Typical lesions have a white palpable center of edema with a variable halo of erythema. Vary from pinpoint sized papules to large lesions several cms in diameter Central clearing, peripheral extension and coalescence of individual lesions result in oval, annular or bizarre serpiginous configurations Question Question

20. DescribeThis Rash 400 Answer Answer

21. Describe This Rash 400 Answer Small smooth topped papules around corona of penis= Pearly Penile Papules Lesions are located on the corona of the penis and occur in 15% of adolescent males; Lesions are 1-3 mm in diameter; occurring in 1-5 rows Question Question

22. Describe This Rash 500 Answer Answer

23. Describe This Rash 500 Answer Greyish or yellowish white small specks on shafts of hair and erythematous papules with scabs = Lice Pediculosis capitis (head lice) and pediculosis pubis (pubic lice) Can have impetigo of scalp, postoccipital lymphadenopathy, dermatitis of neck, shoulders and posterior auricular areas. Nits are small, oval whitish and measure about 0.5 mm in length Can have erythematous papules with scabs or superinfection in GU area Question Question

24. Rings and Things 100 Answer Answer

25. Rings and Things 100 Answer Pityriasis Rosea Acute self limited disorder-not contagious Typically affects teens Usually lasts 4-14 weeks Herald patch followed by Christmas tree distribution Symptomatic treatment for itch Question Question

26. Rings and Things 200 Answer Answer

27. Rings and Things 200 Answer Granuloma Annulare Papules or nodules in a ring typically on the dorsum of hands and feet 1- 5cm Can occur at any age Disappear spontaneously months to 2 years Steroids topically not recommended because of dermal atrophy Question Question

28. Rings and Things 300 Answer Answer

29. Rings and Things 300 Answer Tinea Corporis Annular sharply demarkated scaly patches with clear center, often pruritic Usually 1-2 lesions All ages Treat with topical antifungal clotrimazole for 2-3 weeks Organism microsporum or trichophyton Question Question

30. Rings and Things 400 Answer Answer

31. Rings and Things 400 Answer Tinea Versicolor Multiple scaling oval patchy lesions hyper- or hypopigmented Typically occurs in adolescents Generally asymptomatic Treat with selenium sulfide shampoo Persistent lesions treat with oral ketoconazole Question Question

32. Rings and Things 500 Answer Answer

33. Rings and Things 500 Answer Erythema Multiforme Symmetric eruption on extensor surfaces of arms and legs, backs of hands and feet Target lesions macular, urticarial, and vesiculobullous (sharply marginated) Often preceded by herpes simplex (history of cold sores) More severe form: Stevens Johnsons involves mucous membranes Treatment: supportive care antihistamines Question Question

34. The Dark Side 100 Answer Answer

35. The Dark Side 100 Answer Acanthosis Nigricans Light brown to black verrucous hypertrophic lesions, classically on the neck, axillae and groin Familial tendency, obese individuals May be related to risk diabetes, insulin resistance states Lac-hydrin and Retin A, periodic abrasion with Buff Puff Weight loss also can help Question Question

36. The Dark Side 200 Answer Answer

37. The Dark Side 200 Answer Mongolian Spot Deep brown to slate gray or blue-black large macular lesions Typically over lumbosacral areas, buttocks and lower limbs Seen in over 90% of African American infants, 81% of Asians, 70% of Hispanics, 9.6% of Whites Usually fade by age 2 occasionally persist into adulthood but usually disappear by age 7-13 years Question Question

38. The Dark Side 300 Answer Answer

39. The Dark Side 300 Answer Congenital Pigmented Nevus Most are small (less than 1.5cm diameter) or medium (15 to 20cm) sized Flat pale hyperpigmented macules or papules, well circumscribed lesions Risk of developing malignant melanoma over lifetime (2.5-5%) in medium size nevus (uncertain) REFER: very large, irregular pigment, red or blue (different colors), irregular shape, irregular surface characteristics Question Question

40. The Dark Side 400 Answer Answer

41. The Dark Side 400 Answer Caf au Lait Spot Large round or oval, flat lesions of light brown pigmentation found in 10- 20% of normal individuals May be a sign of neurofibromatosis: 6 or more spots greater than 1.5cm in diameter Look for axillary freckling early sign of NF- freckling called Crowe s sign Question Question

42. The Dark Side 500 Answer Answer

43. The Dark Side 500 Answer Linear Epidermal Nevus Linear arrangement of hypertrophic warty papules Usually present at birth can appear during early childhood, pruritic Chronic course resistant to therapy, may need excision if irritating Question Question

44. Fingers and Toes 100 Answer Answer

45. Fingers and Toes 100 Answer Onychomycosis Primarily caused by Trichophyton rubrans and T mentagrophytes Topical therapy often ineffective, especially as monotherapy; may help prevent recurrence Oral therapy with terbinafine (Lamisil), itraconazole (Sporanox); Terbinafine has pediatric dosing; treat for months, until disease-free nail is seen All oral therapy requires periodic (q4-6 week) monitoring of CBC and LFTs Consider referral if diagnosis unclear or for possible surgery Question Question

46. Fingers and Toes 200 Answer Answer

47. Fingers and Toes 200 Answer Plantar Wart Black dots often visible Caused by HPV Seen in 7-10% of the population, highest incidence ages 10-19 years of age Warts can be spread from one person to another and auto-inoculation also can occur Duration ranges from a few months to 5 years or more. 25% disappear spontaneously in 3-6 months Treatment: OTC salicylic acid, duct tape?, freezing Question Question

48. Fingers and Toes 300 Answer Answer

49. Fingers and Toes 300 Answer Herpetic Whitlow Caused by HSV-1 or HSV-2 Often associated with thumb-sucking, or occupational exposure Primary infection can be associated with systemic symptoms Topical acyclovir can help primary infection; oral acyclovir can decrease recurrence in patients with frequent recurrence Can do scraping for diagnosis, avoid deep incision; always consider whitlow before incising a paronychia Question Question

50. Fingers and Toes 400 Answer Answer

Load More ...