PEDS CH.45 INTEGUMENTARY | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
Pediatric Skin considerations Answer: Infant's epidermis is thinner than adults
-Blood vessels closer to skin making them more readily to lose heat
-Substances are more easily absorbed through their skin
-Bacteria has easier access to infants and younger children
Epidermis and dermis are loosely bound to each other
-It takes less friction to separate the layers and cause skin breakdown
Contains more water
-More easily dehydrated
Less pigmentation in ALL races
-Increased risk of sun damage and UV exposure
Describe children with darker skin Answer: More pronounced cutaneous reactions than
lighter skinned children
Hyper and hypo pigmentation is more pronounced in any dermatologic condition
Hypertrophic scars and keloids are more common
Describe Sebaceous Glands Answer: Sebaceous glands function immaturely at birth
Temperature regulation is less effective in infants and younger children due to diminished
funcsion of the eccrine glands.
-They become fully functional in pre-adolescence.
Secreted sebum serves to lubricate the skin and hair
-This process is increased during adolescence - ACNE
-Apogrine glands also develop during adolescence - BODY ODOR
Laboratory studies Answer: -CBC (infection and inflammation)
-ESR (infection and inflammation)
KOH Prep
-Potassium hydroxide - used to identify fungal infection
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
, -Skin is scraped and drop of KOH 20% is added to specimen
-Wound culture of skin drainage
Serum IgE
-Tests for atopic dermatitis (allergic reaction)
Patch or Skin testing
-Tests for atopic or contact dermatitis (allergic reaction)
Bacterial Infections most commonly caused by Answer: Strep infections (group A Beta
hemolytic streptococcus)
Staph Infections (staphylococcus aureus)
Bacterial Infections: Describe Impetigo Answer: Caused by staphylococcus aureus (S.
aureus)
2 types
Bullous- Develops from sporadic occurrence pattern and develops on intact skin after
staph aureus toxin produced
Non-bullous-Usually involved after some skin trauma and develops as a secondary skin
infection or another skin disorder such as atopic dermatitis
Impetigo skin findings (2) Answer: Papules that progress to vesicles then painless pustules
Honey colored crust develops after rupture
Impetigo Treatment (4) Answer: Good hygiene
Remove honey crusted lesions and apply mupirocin
If lesions are numerous, may need first generation cephalosporin (Keflex)
Cool compresses
Describe Scalded skin syndrome (4) Answer: Caused by staphylococcus aureus (S.
aureus)
S. aureus produces toxin which then causes mass exfoliation
Abrupt onset with diffuse erythema (redness) and tenderness
Most common in infants and very rare beyond 5 years of age
Describe Scalded skin syndrome skin findings (3) Answer: Flat bullae that rupture within
hours of appearance
APPHIA – Crafted with Care and Precision for Academic Excellence. 2
STARTS HERE! LEARN, PRACTICE & EXCEL!
Pediatric Skin considerations Answer: Infant's epidermis is thinner than adults
-Blood vessels closer to skin making them more readily to lose heat
-Substances are more easily absorbed through their skin
-Bacteria has easier access to infants and younger children
Epidermis and dermis are loosely bound to each other
-It takes less friction to separate the layers and cause skin breakdown
Contains more water
-More easily dehydrated
Less pigmentation in ALL races
-Increased risk of sun damage and UV exposure
Describe children with darker skin Answer: More pronounced cutaneous reactions than
lighter skinned children
Hyper and hypo pigmentation is more pronounced in any dermatologic condition
Hypertrophic scars and keloids are more common
Describe Sebaceous Glands Answer: Sebaceous glands function immaturely at birth
Temperature regulation is less effective in infants and younger children due to diminished
funcsion of the eccrine glands.
-They become fully functional in pre-adolescence.
Secreted sebum serves to lubricate the skin and hair
-This process is increased during adolescence - ACNE
-Apogrine glands also develop during adolescence - BODY ODOR
Laboratory studies Answer: -CBC (infection and inflammation)
-ESR (infection and inflammation)
KOH Prep
-Potassium hydroxide - used to identify fungal infection
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
, -Skin is scraped and drop of KOH 20% is added to specimen
-Wound culture of skin drainage
Serum IgE
-Tests for atopic dermatitis (allergic reaction)
Patch or Skin testing
-Tests for atopic or contact dermatitis (allergic reaction)
Bacterial Infections most commonly caused by Answer: Strep infections (group A Beta
hemolytic streptococcus)
Staph Infections (staphylococcus aureus)
Bacterial Infections: Describe Impetigo Answer: Caused by staphylococcus aureus (S.
aureus)
2 types
Bullous- Develops from sporadic occurrence pattern and develops on intact skin after
staph aureus toxin produced
Non-bullous-Usually involved after some skin trauma and develops as a secondary skin
infection or another skin disorder such as atopic dermatitis
Impetigo skin findings (2) Answer: Papules that progress to vesicles then painless pustules
Honey colored crust develops after rupture
Impetigo Treatment (4) Answer: Good hygiene
Remove honey crusted lesions and apply mupirocin
If lesions are numerous, may need first generation cephalosporin (Keflex)
Cool compresses
Describe Scalded skin syndrome (4) Answer: Caused by staphylococcus aureus (S.
aureus)
S. aureus produces toxin which then causes mass exfoliation
Abrupt onset with diffuse erythema (redness) and tenderness
Most common in infants and very rare beyond 5 years of age
Describe Scalded skin syndrome skin findings (3) Answer: Flat bullae that rupture within
hours of appearance
APPHIA – Crafted with Care and Precision for Academic Excellence. 2
