Normal Pediatric Skin and Soft Tissue Conditions

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Normal Pediatric Skin and Soft Tissue Conditions Sirous Partovi, M.D.

Erythema Toxicum Neonatorum Impressive title - innocuous skin condition Erythematous macule with a focal small papule, seen anyplace - aside from the palms and soles. The injuries are pressed with eosinophils, and there might go with eosinophilia in the blood tally. The cause is obscure, and no treatment is required as the rash vanishes following 1-2 weeks.

Miliaria Prickly warmth, sweat rash Many red macules with focal papules, vesicles or pustules are available. These might be on the storage compartment, diaper range, head or neck.

Subcutaneous Fat Necrosis Self constrained, generous condition Sharply differentiated ruddy to violaceous plaques or knobs Etiology dubious Onset initial few days-weeks of life Cheeks, back, rump, arms, and thighs

Infantile Atopic Dermatitis Cause is obscure Red, irritated papules and plaques that overflow and hull Sites of Predilection Face in the youthful Extensor surfaces of the arms and legs 8-10 mo. Antecubital and popliteal fossa , neck, confront in more established

Differential Diagnosis-Atopic Dermatitis Seborrheic dermatitis Contact dermatitis Nummular dermatitis Psoriasis Scabies

Eczema-Treatment Avoidance or end of inclining elements Hydration and oil of dry skin Anti-pruritic operators Topical steroids

Seborrheic Dermatitis Common, by and large self-constraining Its cause stays sick comprehended There is a hereditary inclination Most regular between the ages of 1 to 6 mo. Oily, salmon-hued scaling emission Hair-bearing and intertriginous regions The rash causes no distress or tingling

Seborrheic Dermatitis-Treatment Anti-seborrheic cleanser Topical steroids

Pityriasis Rosea Mild incendiary exanthem of obscure cause, possibly popular Benign, self restricted issue Occasionally there are prodromal side effects including discomfort, cerebral pain, sore throat, weakness, and arthralgia. Proclaim fix pink in shading and textured imitating tinea corporis

Diaper Rash

Candidal Dermatitis Starts off in the profound flexures which demonstrate far reaching erythema on the rear end muscular red shading There are likewise raised edge, sharp marginization and white scale at the outskirt of injuries, with pinpoint pustulo-vesicular satellite sores

Seborrheic Dermatitis Salmon-hued oily sores with yellowish scale and inclination for intertriginous territories Involvement of the scalp, face, neck, and post auricular and flexural zones

Irritant Dermatitis Rash limited to the arched surfaces of the buttocks,perineal zone, bring down stomach area, and proximal thighs, saving the intertriginous wrinkles Excessive warmth, dampness, and sweat maintenance Harsh cleansers, cleansers, and topical drugs

Viral Exanthems

Smallpox-Variola Fatality 40 % First attacks upper respiratory tract From lymph hubs it spreads by means of hematogenous spread Chills, fever, cerebral pain, daze, SZ Face to upper arms and trunk, lastly to lower legs

Chickenpox-Varicella Herpes infection varicellae Incubation period 10-21 days Fever, discomfort, hack, fractiousness, pruritus Papules  vesicles  crusting Spreads centripetally

Varicella Complications: Bacterial superinfection CNS inclusion Pneumonia Hepatitis, joint inflammation Reye's disorder VZIG

Varicella – Treatment Oral acyclovir-signs Healthy nonpregnant adolescents and grown-ups Children > 1 yr with interminable cutaneous or aspiratory conditions Patients on perpetual salicylate treatment Patients accepting short or irregular courses of aerosolized corticosteroids Dose: 80 mg/kg/day in four separated measurements for 5 days

Varicella – Post presentation VZIG (1 vial/5 kg IM) : Pts on high dosage steroids Immunocompromised without a past filled with CP Pregnant ladies Newborns uncovered 5 days before birth and 2 days after conveyance Neonates destined to nonimmune moms Hospitalized untimely babies < 28 weeks' growth

Measles Rubeola-paramyxovirus Occurs in scourges Incubation 8-12 days Fever, torpidity, Cough, coryza, conjunctivitis with clear release and photophobia Koplik spots Rash starts on the face and spreads to trunk and furthest points

Measles – Post Exposure Immunoglobulin treatment signs All helpless contacts Infants 5 mo. To 1 year of age Immunocompromised Pregnant ladies <5 mo. In the event that mother without insusceptibility Live measles infection antibody contraindication Immunocompromised-barring HIV Pregnancy Allergy to eggs, or neomycin

Rubella German Measles Epidemic nature Winter-spring Prodrome Face  neck  trunk Lymphadenopathy Serologic testing

Hand-Foot-Mouth Disease Enteroviruses coxsackieviruses An and B echoviruses Vesicular sores, might be petechial Associated with aseptic meningitis, myocarditis

Erythema Infectiosum Fifth ailment Mildly infectious, parvovirus B-19 Pre-school and youthful school-age kids Prodrome: mellow disquietude Rash: "slapped cheek", circumoral paleness, fringe gentle macular conveyance Complication

Exanthem Subitum Roseola Infantum Children 6-19 months Abrupt onset of high fever Febrile seizures Rash creates after fever disseminates Mainly on trunk

Infectious Mononucleosis Acute, self constrained ailment Epstein-Barr infection Oral transmission – brooding 30-50 days Fever, weariness, pharyngitis, LA, splenomegaly, atypical lymphocytosis Exanthem is found in 10-15% Erythematous, maculopapular, morbilliform, scarlatiniform, urticarial, hemorrhagic, or even nodular

Bacterial Exanthems

Impetigo Superficial contamination of the dermis Two sorts: Impetigo contagiosa Bullous impetigo Etiology Group A ß hemolytic streptococcus Coagulase positive S. aureus Treatment : Keflex, erythromycin, Bactroban

Scarlet Fever Toxin delivering strain of gathering A  - hemolytic streptococcus Strep pharyngitis with systemic protestations Rash from neck to trunk to furthest points Sandpaper feel, erythema, warmth White and red strawberry tongue Petechiae in straight shape Complications Treatment

Staphylococcal Scalded-Skin Syndrome Generally in under 5 years old Induced by exotoxin created by staphylococci Fever, papular erythematous rash beginning around mouth-not including oral mucosa Positive Nikolsky's sign Diagnosis: Tzanck test, bacterial culture Treatment Complications

Meningococcemia Usually sudden onset of fever, chills, myalgia, and arthralgia Rash is macular, nonpruritic, erythematous injuries Petechial rash creates in 75% of cases Neisseria meningitides Fever, rash, hypotension, stun, DIC Treatment: PCN G

Differential Diagnosis Gonococcemia HSP Typhoid fever Rickettsial ailment Erythema multiforme Purpura fulminans

Rocky Mountain Spotted Fever Most regular rickettsial contamination in US Abrupt fever, cerebral pain, and myalgia Rash from limits towards trunk Macules  petechiae Treatment Tetracycline Doxycycline Chloramphenicol

Cellulitis Most normal life forms: S. aureus S. pyogenes H. flu sort B (HIB) Most regular destinations? CBC, x-beam?

Cellulitis-Treatment IV anti-infection agents in: Immunocompromised Ill seeming Suspected bacteremia <6 mo. Of age WBC> 15K High fever Rapidly advancing

Periorbital-Orbital Cellulitis S. aureus, S. pneumoniae , and HIB CBC, blood culture, CT LP? IV anti-toxins Admit

Fungal Infections

Henoch-Schnlein Purpura No reasonable etiologic specialist, regularly post viral 2-10 years old Palpable purpura over the rear end and LE Transient transitory joint pain Renal and GI association

Kawasaki Syndrome Unknown etiology Peak frequency 18-24 months Clinical discoveries: Fever for no less than five days Conjunctivitis Polymorphous rash Oral cavity changes Cervical adenopathy