askaderm.net

2. Neonatal
dermatology
Infectious
Papulo-squamous
dermatosis
Pigmented
dermatosis

3. Neonatal dermatology

4.  At birth
5% of newborn with darkly
pigmented skin
Pustules and
hyperpigmented macules
with collarette of scales
Infants are otherwise well
No treatment is necessary

5. Onset 24-48 h after birth
50% of full term infants
Blotchy eryhtematous
macules, papules, and
pustules.
Resolves spontinously
over a few days without
therapy

6. Neonatal acne
1st 2-3 weeks of life
Non comedonal pustular
eruption
Most commenly seen on
the cheeks
Malassezia spp.
Spontaneous involution
over weeks to months

7.  1 week after birth
Lasts for several months
Resolved by 1 years of age
Ill defined erythematous
patches with waxy scales over
scalp mainly ( cradle cap)
Bathing and application of
emollients

11.  Miliaria crystallina and
miliaria rubra
Obstruction of eccrine gland
due to increase temperature
Spontaneous resolution with
cooling
Limiting excessive swaddling

12. Candidal
dermatitis
Psoriasis
Seborrhic
dermatitis
Contact
dermatitis
Scabies
Perianal
strep.
Acroderm
-atitis
enterpathi
-ca
Atopic
dermatitis

13. Candidal
dermatitis
 intense erythema with
desquamation/ superficial
erosions
Satellite pustules
Favors folds, genitalia
KOH
h/o recent Abx use ,
thrush

14. Contact
dermatitis
Irritant ˃ allergic
Glazed erythema +/- scales
Punched out erosions
Favors convex surface
Spares folds
Prolong contact with urine/
faces
Over time psuedoverrucous
papules can develoop

15. Seborrhic
dermatitis
 well demarcated salmon
colored to red moist or scaly
patches and plaques
 favors folds
Involv. Other flexural sites, scalp

16. Psoriasis
 well demarcated erythematous plaques
Shiny in folds, scaly on convex surfaces
Psoriasiform lesions elsewhere
+/- family history

17. Atopic
dermatitis
 excoriations, lichnification
Favors skin at diaper margins and convex surfaces
Often relative sparing of the diaper area
Marked pruritus
Eczematous lesions in usual site of AD

18. Perianal
strep.
 sharply demarcated, bright red erythema
No satellite lesions
Perianal area, skin folds
Pain, itch, foul odor
+/- pharyngitis or family members

19. Bullous
impetigo
 flaccid bullae, vesiculopustules,
superficial shiny red erosions with a
collarette of scales
Gram stain +

20. Acroderm
-atitis
enterpathi
-ca
 erythematous crusted patches/
plaques with flaccid bullae
Perianal, periorificial and distal
extremities
↓ zinc , ↓ALP

21.  Acute phase:
Mild corticosteroid preparations are helpful
Topical imidazole creams are added for 2ry candidal infection
Chronic phase:
Avoidance of the causative factors
Freequent changing disposable diapers
Emollients

24. Infectious

25. Viral
Bacterial
Fungal
Parasite

27. Erythema Infectiosum
Slapped cheek
Parvovirus B19
Most common in children 4-10 years of age
Mild prodormal symptoms 7-10 days before
exanthem appears
Bright red macular erythema over cheeks
followed by lacy eruption on the extremities ( 4
days)
Last for 1 to 3 weeks

28. Papular Pupuric Gloves and
Socks Syndrome
Children and young adults
Edema, erythema of palms
and soles in association with
petechiae and purpura
Burning and pruritus

30. Hand Foot Mouth disease
Coxsackievirus A6, A16 and enterovirus
Children < 10 years +/- adults
Present with fever and malaise
Grayish vesicular eruption on the palms and soles
Erosive stomatitis
Onychomadesis following HFMD
Self limited
Good prognosis with supportive care

32. Herpangina
 3-10 years old
Entervirus, coxsackievirus
Febrile illness
Exanthem often absent
Painful grayish vesicles on
tonsil,s palate and buccal
mucosa
Self limited

33. Gianotti Crosti Syndrome
 papular acrodermatitis of childhood
6 months – 14 years of age ( 2 yr)
HBV, EBV
Mild constitutional symptoms
Abruptly, symmetric monomprphic
papular eruption on the extremities,
face and buttock
Spares trunk
Not itchy
Self limited ( 3-4 weeks)

34. Measles
 Robeola / 1st disease
Measles virus
Incidence greatly dcreased
with vaccination
Prodrome of fever, cough,
coryza, conjunctivitis and
koplik spots
Erythematous macules and
papules
Cephalocaudad direction

35. Rubella
German measles/ 3rd disease
Togavirus
Unvaccinated children
 mild prodrome: fever, headache
and URTI
Erythematous macules and papules
Cephalocaudad direction
Forchheimer’s spots
Lymphoadenopathy
Fade 2-3 days withh supportive ttt.

36. Roseola infantum
Exanthem subitum/ 6th disease
6 months- 3 years
HHV 6
Sudden onset of high fever
Rash begins as fever subsides
Rose red macules and paules
Trunk mainly
Febrile seizures
 self limited

37. Unilateral laterothoracic
exanthem
Viral ?!
6months – 10 years
URTI or GI Prodrome
Unilateral
Most commonly in axilla
Can be generalized
Morbiliform or eczematous
 3-6 weeks and then resoles spontaneously

38. Infectious mononucleosis
EBV
adolescent and young adult
Triad of pharyngitis, fever and
lymphoadenopathy 80%
Morbiliform, urticarial, petechial,
or erythema multiforme like lesions
ttt with ampicillin- hypersensitivity
2-3 weeks with supportive ttt

39. Varicella
Chickenpox
VZV
Children and adults
Contagious
Mild fever, malaise and myalgia
Eruption of pruritic erythematous
macules and papules starting on the
scalp and face and the downward
spearding
Vesicles
All stage lesions
+ oral mucosa

40. Heal within 7-10 days
Self limited in healthy children
Antipyretics
Antihistamines
Tepid bath
Calamine lotion
If statred within 24- 72 hrs acyclovir has been
shown to decrease the duration and severity of
varicella

41. Kawasaki disease
5 years of age
Cause ?? infectious
Criteria 5 out of 6:
Polymorphous exanthem
Fever ˃ 5days 39°C
Conjunctivitis (B/L)
Palmoplanter erthyma, edema
or desquamation
Swollen lips or red toungue
Cervical lymphoadenopathy

42. Cardiac involvement
CNS
GI
Musculoskeletal
Genitourinary
Labs
Aim of ttt to decrease inflammation
IVIg 2 g/kg over 10-12 hrs
Aspirin 80-100 mg/kg od for 4 weeks

43. Henoch schonlein purpura
4-7 years
Cause?? Viral vs. strep
Preceded by URTI
Purpuric macules and papules
favoring lower extremities and
buttocks
Arthralgia, Abdominal pain, nephritis
IgA vasculitis
Self limited weeks-months

44. Acute Hemorrhagic edema of
infancy
Finkelstein’s disease
Infectious?? Viral or bacterial
4-24 months of age
Child is well appearing
Annular, circular or targetoid purpuric
plaques on face and extremities
Tender, non pitting edema of acral sites
Spontaneous resolution within 1-3
weeks
Leukocytoclastic vasculitis

45. Scarlet fever
1-10 years old
Group A b hemolytic strep.
Preceded by sudden onset of sore
throat, headache and high fever.
Sandpaper like
Hand and foot desquamiation
Pastia’s line
Red strawberry tongue
Ttt: penicilllin 10-14 days

46. Warts
HPV
Destructive methods

47. Molluscum contagiosum
Poxvirus
Umblicated pink firm papules
Destructive methods
Trial of topical retin a products
Self limited

48. Imeptigo
Children
Contagious
Staph. Aureus / strep.
Macules – vesicle or pustule
Superficial erosion with
honey colored crust
Face
Self limited resolves within 2
weeks
Fucidin or bactroban cream

49. Tinea vesicolor
Malassezia furfur
Hyper- hypo macules and
patches with fine scales
Summer
Ttt: topical imidazole

50. Tinea corporis Tinea capitis

51. Head lice
Pediculus humanus capitis
Feeds every 4-6 hr
Scalp prutitus
Commonly found behind the
ear and at nape of neck

53. Scabies
Sarcoptes scabiei var hominis
Intense pruritus
Worse at night
Symmetrical papules,
vesicles and nodules
Scabicide
Pruritus can persist 2-4
weeks after ttt

54. Papulo-squamous
Papulo-squamous dermatosis

55. Complex genetic disease with
environmental influences
10-30% of the children
More in high income
 Ass. With asthma and allergic
rhinoconjuctivitis
Acute vs chronic

56. Early onset
• First 2 years of life
• Most common type
• 60% go into remission by 12 years of age
Late onset
• Start after puberty
• Women
Senile onset
• After 60 years of age
• Recent category

57. Acute inflammation
Cheeks, scalp and extenor aspects of
the extremites
infants
Chronic inflammation
Lichenification
Flexural sites
Children and adult

66. Ill defined
hypopigmented macules
and patches
Dark skin color
Mainly in face

67.  Due to impaired skin barrier
S. aureus/ Strep. pyogenes

68.  Herpes simplex virus
Initially eruption of vesicles
Punched out eerosions with
hemorrhagic crust
Head, neck and trunk
Fever+
Superinfection with staph. Aureus

72. HHV 7?
Initial herald patch ( 1-2 week)
Salmon colored oval patches and
plaques with inner scale
Christmas tree pattern (posterior
trunk)
Inverse , vesicles, purpuic and
pustules are rare variants
Self limited

73. 25% before age of 15
Genetic factor
Trigger factors
Koebner phenomenom
Infection
Endocrine factors
Psychogenic stress
Drugs
Alcohol consuption
Smoking
Obesity

74. Non pustular pso.
Chronic plaque pso.
Erythrodermic pso.
Guttate pso.
Pustular pso.
Generalized ( Von Zumbusch)
Annular
Exanthematic ( AGEP)
Localized
Pustulosis of palms and soles
Acrodermatitis continua of hallopeau

75. Special locations
Scalp pso.
Flexural pso.
Nail pso.
Pso. Arthritis

77. Pigmented dermatosis

78.  amelanotic macules and patches
Asymptomatic
Classification:
Localized
Focal
Segmental
mucosal
Generalized
Vulgaris
Acrofacial
Universal

79.  investigation
FBS/ RBS
TSH
CBC
Vit D