rash decisions
DESCRIPTION
Rash Decisions. Ethan Pettit, D.O. FAAP. Erythema Toxicum. Up to 60% of Term infants Healthy infants Vesicles/ pustues with ring of red around E=E Erythema toxicum = Eosinophils Typically gone by 7 days. Pustular Melanosis. Neonatal HSV?. Infant Nevus. Dilated fetal capillaries - PowerPoint PPT PresentationTRANSCRIPT
RASH DECISIONSETHAN PETTIT, D.O. FAAP
ERYTHEMA TOXICUMUp to 60% of Term infantsHealthy infantsVesicles/pustues with ring of red aroundE=E
• Erythema toxicum=EosinophilsTypically gone by 7 days
PUSTULAR MELANOSIS
NEONATAL HSV?
INFANT NEVUSDilated fetal capillaries
• 40% of newbornsFlat, dull, pinkFront and back
• 95% of front will fade• 50% of back will fade
PORT WINE STAIN
NEVUS FLAMMEUSCaution to Face distributionLaser treatment
HEMANGIOMAS
HEMANGIOMASBenign Proliferation of endothelial cells. 1-3% at birth10% Caucasians by 1 yearMore females than malesMore common in preterm or SGA
HEMANGIOMASProliferation
• Up to yearStabalization
Involution• Typically after 2
HEMANGIOMAS TREATMENTLocation
• Cosmetic vs DangerousLargeUlcerated
ECZEMAATOPIC DERMATITIS
TINEA VS ECZEMA
ECZEMA TREATMENTMoisture, Moisture, Moisture
• Eucerin, Aquaphor, Cedophil, Aveeno, Vanicream• RIGHT out of the bath
Wet to dry wraps
ECZEMA TREATMENTSteroids
• Creams:• Hydrocortisone 1%, 2.5%• Triamcinolone• Desonide
• Sometimes oral steroids
ECZEMA TREATMENTSecondary infections
Cut nails short
Bleach water baths (1/2 cup per tub)
ECZEMA HERPETICUM
ECZEMA HERPETICUM TREATMENTTreat the HSV, Watch for bacterial infection as well
SEBORRHEACradle capScalyGreasyUsually not itchy
SEBORRHEA TREATMENTDandruff shampooAntifungal creamLow potency steroid cream
KERATOSIS PILARIS
HIVES
HIVES TREATMENTSteroids can help in extreme casesAntihistamines
• Benadryl• Zyrtec• Hydroxizine
CHRONIC HIVESMay or may not have an identifiable triggerAllergy testingMost resolve within a few years
PITYRIASIS ALBA
PITYRIASIS ALBAOften starts with erythematous lesionsLeaves behind hypopigmented lesions
Limited treatment options• If topical steroids used with initial lesions, may prevent
hypopigmented• UV sun protection
PITYRIASIS ROSEABenignSelf limited
• Sometimes 6-8 weeksHerald PatchChristmas Tree pattern
INFECTION RASHES
IMPETIGO
IMPETIGOStaph and StrepTypically honey crustedOften the face
IMPETIGO TREATMENTTopical
• Mupirocen• Don’t forget the nose
Topical not enough• Cephalexin
Sometimes MRSA
HERPES SIMPLEX
SCARLET FEVER
VIRAL EXANTHEM
SSSS
STAPH SCALDED SKIN SYNDROMEToxin mediatedTender skinShearing skinLack of mucosal involvement
compared to SJS or TEN (deeper)
MENINGOCOCCEMIA
HENOCH SCHONLEIN PURPURA
Tinea CorporisVs
Granuloma Annulare
KOH
TINEA VERSICOLOR
TINEA VERSICOLORKOH (spaghetti and meatballs)
TreatmentSelenium SulfideTopical antifungal
ACNEGentle CleanserBenzoyl Peroxide
EpiduoTopical Retinoids
Retin Amay take 6-8 weeks
BUG BITES
SCABIES
SCABIES TREATMENT5% PermethrinBedding cleaned in AMTreat all family members (even if not symptomatic)
BED BUGS
FLEAS
STINGS
LOCAL REACTION
WARTS
WART TREATMENTCryotherapy
care to nail bedsSalicylic AcidTapeAbrasion
CALLUS
MOLLUSCUM
NEUROCUTANEOUS
NEUROFIBROMATOSIS TYPE 1Café au lait macules
6 or moreNeurofibromas
often not until after pubertyLisch nodules
CAFÉ AU LAIT
NEUROFIBROMAS
LISCH NODULES
TUBEROUS SCLEROSIS
TS ANGIOFIBROMAS
ACKNOWLEDGMENTSKelly McClean MD, Michigan Board ReviewRobert Colman MD, Whitney Molis MD, Pediatric and Adult allergy P.C. http://www.onlinedermclinic.comhttp://hardinmd.lib.uiowa.edu/pictures22/dermnet/http://www.skinsight.com/imageshttp://dermatlas.comhttp://dermnet.comhttp://dermatologyoutlines.comhttp://www.allergyasthmamichigan.comhttp://0.tqn.com/w/experts/DermatologyGoogle images