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What is this:
Erythematous macules surrounding small pustules (containing eosinophils). “Flea bites.”
Erythema Toxicum Neonatorum
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Erythema Toxicum Neonatorum
Who?
Where?
Other signs?
Tx?
- New borns (1-4 after birth)
- Anywhere
- No systemic signs
- This is self-limiting, just reassure parents.
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Erythema Toxicum Neonatorum
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What is this:
Pustular lesions; rupture easily
After rupture evolve into hyperpigmented macules
Transient Neonatal Pustular Melanosis
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Transient Neonatal Pustular Melanosis
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Transient Neonatal Pustular Melanosis
Who?
Where?
Other signs?
Tx?
- Newborns (usually in the first 24hrs), AA > whts
- Anywhere
- None
- Reassurance
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What is:
Blanching mottled or lacy erythema
Cutis Marmorata
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Cutis Marmorata
Who?
Where?
Why?
Other signs?
Tx?
- Babies
- Everywhere
- Due to decreased core temp
- None
- Reassurance
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What is this:
Nonconfluent pearly papules with minimal surrounding erythema
Milia
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Milia
Who?
Where?
Why?
Other signs?
Tx?
- Up to 50% of newborns
- Usually face, eyes, nose (occasionally trunk)
- Superficial keratin cyst - over growth
- None
- Reassurance
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What is this:
Pruritic erythematous macules and vesicles on warm skin
Miliaria rubra
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Miliaria crystallina - Small non-inflammatory vesicles
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Miliaria
Who?
Where?
Why?
Other signs?
Tx?
- Babes
- Typically in intertriginous or occluded areas
- Sweat retention when eccrine glands partially close
- Warm skin
- Reassurance
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What is:
Pearly papules with surrounding erythema
Acne Infantum
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Acne Infantum
Who?
Where?
Other signs?
Tx?
- Newborns and infants (peaks at 2 mo)
- Forehead, cheeks and nose
- None
- Reassurance
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What is this:
Large benign bluish-gray/black pigmented nevus
Mongolian Spot
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Mongolian Spot
Who?
Where?
Other signs?
Tx?
- Babes
- Lower back, butt, thighs
- None
- Reassurance, usually fades!
- ** make sure to document b/c can look like child abuse
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- Capillary Malformation
- AKA nevus flammeus, port wine stain, stork bite/angel’s kiss, macular stain
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Capillary Malformation
Who?
Where?
Why?
Other signs?
Tx?
- Babes, children (present at birth, persists through life)
- Face, head (anywhere)
- Collection of mature capillaries
- Assocation with Sturge-Weber syndrome (port wine stain)
- Observation
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What is:
Reddish-purple raised nodule on skin
Hemangioma
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Hemangioma
Who?
Where?
Why?
Other signs?
Tx?
- Babes, not present at birth. Expand 1-2 yo and then involute
- Can be anywhere (including internal; suspect this if there are hemangiomas in beard-growth distribution or there are more than two lesions on the body)
- Proliferation of immature capillaries
- None (unless there are internal hemangiomas causing trouble)
- Observation (steroids if airway is in danger, surgery)
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Where is the distribution of atopic dermatitis in babes?
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What is the distribution of atopic dermatitis in children?
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Candida Dermatitis - beefy erythema with satellite lesions
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Diaper dermatits - folds are spared
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Treatment for diaper dermatitis
Barrier cream (zinc oxide) and frequent diaper changes
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Treatment for candida dermatitis
Nystatin cream, barrier cream, and frequent diaper changes
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Ichthyosis
Who?
Where?
Why?
Other signs?
Tx?
- Onset in early childhood (normal at birth)
- Anywhere
- Congenital disorders of keratinization leading to dry scaly skin --> Ichthyosis vulgaris is most common
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What is this:
Cradle Cap dermatitis
Seborrheic Dermatitis
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Seborrheic dermatitis
Who?
Where?
Other signs?
Tx?
- Babes (resolves by 1yo)
- Dense concentrations of sebaceous glands (scalp, eyebrows, body folds
- Can be fine flaky to thick greasy yellow scales with or without an underlying erythematous patch or plaque base
- Medicated shampoos (zinc, selenium, ketoconazole), topical
- corticosteroids, manual removal of scales
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Perianal Strep Dermatitis (notice sharp margins)
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What is this?
Bright red, sharply demarcated perianal patches.
Perianal dermatitis
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Perianal dermatitis
Who?
Where?
Other signs?
Tx?
- Children 6 mo to 8 yrs.
- Perianal (duh)
- Painful defecation, yellow crust
- Oral (penicillin or amoxicillin) and topical antibiotic (mupirocin) for 10 days.
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Staph Scalded Skin Syndrome
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Staph scalded skin syndrome
Who?
Where?
Why?
Other signs?
Tx?
- Usually in children <5 years age
- Perioral and periorbital crusting or generalized erythema with Staph scarlatina
- Epidermolytic toxin produced by Staph aureus
- Nikolsky sign - Fragile bullae with superficial desquamation upon traction
- IV antibiotics (vancomycin AND clindamycin)
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What is this?
Flesh colored to pink dome-shaped umbilicated papules
Molluscum Contagiosum
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What is this:
Vesicles and pustules with “honey-colored crusting”
Impetigo
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What is this:
Erythematous, pruritic, and scaly lesions usually with an annular shape that grows outward leaving a central clearing
Tinea corporis
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What is this?
Fixed, typically non-pruritic annular red macules, papules, and plaques
Erythema multiforme
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How is Erythema multiforme and Steven Johnsons syndrome different?
- SJS involves two or more mucus membranes
- Erythema m. is cause by infection (HSV, EBV, mycoplasma)
- SJS is caused by drug
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How is Leishmaniasis spread?
What happens?
Tx?
- Sandfly bites
- Ulcer formation at the site of the bite which may take up to a year to heal, scarring
- Antimony containing compounds (meglumine, sodium stibogluconate)
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