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Dermatological disorders in children

Dermatological disorders in children. Debbie King NP June 2007. Roseola. High Human herpes virus 6 fever Followed by rash Age 6mo-4yr Lasts 6 days Supportive care. Roseola. Fifths Disease. Fifths Disease. Parvovirus B19 Ages 5yr-14yr Slapped cheeks

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Dermatological disorders in children

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  1. Dermatological disorders in children • Debbie King NP • June 2007

  2. Roseola • High Human herpes virus 6 • fever • Followed by rash • Age 6mo-4yr • Lasts 6 days • Supportive care

  3. Roseola

  4. Fifths Disease

  5. Fifths Disease • Parvovirus B19 • Ages 5yr-14yr • Slapped cheeks • Fever, malaise, itching, joint pain • Fishnet like body rash • Risks • No tx • Rash comes and goes

  6. Scarlatina

  7. Scarlatina • Strep rash • Sandpaper feel • Pastia’s lines • Also known as scarlet fever

  8. Impetigo

  9. Impetigo • Common • Contagious • Staph or strep • Golden crusty scabs • Tx- review bactroban or keflex

  10. Rhus dermatitis

  11. Rhus dermatitis • Findings vary • Pruritis • Edematous • Linear • Vesicles • Tx with topical steriods or PO- PRN

  12. Contact Dermatitis

  13. Contact Dermatitis • ID of cause is essential • Tx 2 weeks with topical steroid

  14. Eczema

  15. Eczema • Eczematous inflammation • Erythema • Edema • Vesiculation • Pruritis • Supportive care • Steroids • Elidel – 2years or older BLACK BOX

  16. Urticaria

  17. Urticaria • Transient • Edematous • Red plaques- acute or chronic • No tests • Supportive care • Benadryl • Zyrtec etc. • Po steriods PRN

  18. Erythema Multiforme

  19. Erythema Multiforme • Lesions look like targets • Bullae develop in severe forms • Caused by medication or infections • Watch close • May tx with po steroids • Severe cases hospitalized

  20. Mastocytoma

  21. Mastocytoma • Solitary plaque • Red brown • Slightly raised • Stroking lesions induces intense erythema and a wheal (darier sign) • Usually clears by puberty • FYI: mastocytosis is a systemic disease

  22. Cafe au lait spots

  23. Cafe au lait spots • Light colored to brown • Macules • Birth- months • Size and number increase with age • 6 or more over 5 mm is associated with neurofibromatosis

  24. Neurofibromatosis

  25. Neurofibromatosis • Cafe au lait > 6 • Axillary or inguinal freckling • Nodules • Refer to opthomology • Hearing evaluation • Wilms tumor • Renal arthery stenosis • Refer to neurofibromatosis clinic

  26. Stevens Johnsons

  27. Stevens Johnsons • Sudden onset • Caused by herpes simplex, mycoplasma, and drugs (50% drugs) • Lesions variable • Dusky purple target lesions • Flu-like symptoms • Supportive treatment usually in the hospital

  28. Halo Nevus

  29. Halo Nevus • White depigmented halos surround nevi • Nevi may disappear • Oval or round • Around any type of nevi • occurs primarily during adolescence

  30. Sebaceous Nevus

  31. Sebaceous Nevus • Distinctive congenital lesion • Usually present at birth • Usually a single lesion • Linear to oval/ Plaque 1-3 cm • 3 stages- corresponds with maturation • Excision just before puberty is recommended • FYI-A triad of sebaceous nevus, epilepsy and metal retardation is rare.

  32. Miliaria

  33. Miliaria • Small • Superficial • Keratin cyst with no visible opening • No treatment

  34. Tinea Capitis

  35. Tinea Capitis • Diffuse or patchy fine white adherent scales • Hair loss • Resembles dandruff • Koh test • Tx- long term with Po med -1st line is still griseofulvin for 12 weeks -use along with a sulfide shampoo -new treatments now being studied

  36. Kerion

  37. Kerion • One or more inflamed boggy tender areas of alopecia with pustules • May have fever and adenopathy • Caused by tinea capitis • Tx based on clinical appearance • Steroids rarely helpful

  38. Tinea Corporis

  39. Tinea Corporis • Flat scaly spot with central clearing • Raised boarder • Usually mild with children • Tx- topically spectazole

  40. Tinea Versicolor

  41. Tinea Versicolor • Common • Usually asymptomatic • Small circular white macules on upper trunk • Tx- selsun blue

  42. Tinea Pedis

  43. Tinea Pedis • May present with classic ring worm pattern • Mostly found between toes • Sole can be covered with silvery scales • Tx- with children • Topical • OTC

  44. Blepharitis

  45. Blepharitis • Scale of the lids at lash line • Treat with baby shampoo

  46. Hemangioma

  47. Hemangioma • Red to purple dermal nodular lesion • Appear as a pale patch in 1st month of life • Enlarge for first year • Soft or moderately firm • Does not blanch • Disappears by age 5 • Location is important

  48. Mongolian Spots

  49. Mongolian Spots • Are dermal melanecytosis • Poorly defined • Blue-black-to gray • Usually sacral • May fade • Are confused with abuse

  50. Scabies

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