Pediatric primary care final exam
1. Candida diper dematitis: }Common skin irritation of the genital perianal area
}Describes an inflammatory skin eruption limited to the diaper area
}Usually caused by prolonged contact with urine/ feces
}Occurs in 95% of infants
}Peaks at 9-12 months
}Treatment-
PROTECTION and frequent changes
This pictures looks like jacket dermatitis, it looks likes punched out dermatitis
All diper rashes do not have to be red
It does not always have to be with prolonged contact, the kids butt can be sensitive It is
just causing more irritation
More protection is the cream, tell the parents, get the hairdryer and put on cool setting and blow dry butt Soak in the
baking soda
2.Diper dermatitis: }Represents 10-20 % of all skin disorders seen in primary care
}Risk of developing a diaper dermatitis throughout childhood is one in four
}In infants this can be as high as 7-35 % }Peak
age of incidence is 9-12 months of age }Types:
}Irritant dermatitis- asymptomatic erythema to painful scaling papules and superficial erosions
3.candida diper dermatitis: ******}Candidal dermatitis- results from irritant dermatitis being untreated for more than three
days it can become secondarily infected with candida
Has beefy red appearance, satellite papules are classicæ
}Candidal infections commonly affect the skin fold areas
}History can be consistent with
diarrhea, recent antibiotic use and
oral thrush
4.erythema infectiosum (Fifth disease): disease caused by the parovirus B19 the disease is highest in childhood from age 5
to 15 years old.
clinical findings in the prodromal phase are mild fever, myalgia, malasie, headache, and URI symptoms
, Pediatric primary care final exam
Rash appears 7 to 10 days after the prodromal stage and occurs in three stages, it first appears on the face as an intense red
eruption (slapped cheek) with circumoral pallor that last 1-4 days.
Next there is a lacy maculopapular eruption that appears on the trunk and moves peripherally to the arms, thighs, and
buttock. Palms and soles are generally not involved. This phase can last a month. Finally the rash subsides.
TX: viral so conservative. Can do transfusion for those with hemolytic anemia or immunocompromised. IVIG can
also help
**children in rash phase may attend school
5.Tinea infections: }Distinguished by the causative species of fungi and location they manifest }Tinea capitus- scalp
}Tinea corporis- body ringworm
}Tinea cruris- jock itch
}Tinea manuum & tinea pedis- athlete's foot
}Tinea versicolor (hypo/ hyperpigmentation macules on the limbs }tinea
unguium- fungal invasion of the nails
Disincted by location manifest
These locations
**know the name and what area of the body they are saying the tinnea is on ***know this
slide!!!!!!
Tinea versicolor- with a black lamp- it will glow for the tinea infection
They are usually hypo or hyperpigmentated, they are macular, they can be on trunk areas on the limbs as well
The sun makes it worse, or the sweat makes it worse
6. scabies: }Caused by the itch mite sarcoptes scabiei which burrow under the skin and cause intense itching
}Highly contagious spread through close contact or shared clothing or linen
}Female mite lays 3 eggs per day which take 2 weeks to hatch
}Classic s/s of scabies is burrow marks in between webbing of fingers and toes
May also have tracking
Treatment - permethrin, 1 week later retreat
Scabies, this is another mite
If suspicious for scabies, look in webbing of kids hands and toes
, Pediatric primary care final exam
Burrowing and biting with scabes
Permetharin and one time
And treat one time in the family
7.Pityriasis rosea: }A mild acute inflammatory disorder
}Unknown cause but thought to be viral
}Self limiting lasting 3-8 weeks
}Herald spot- 1-10 cm solitary ovoid slightly erythematous lesion that enlarges quickly with central clearing Often
mistaken for what?æ
}Common on the trunk and proximal extremities
}Lesions follow a Christmas tree pattern
8.contact dermaitis: }An acute or chronic dermatitis as a result of direct contact with chemicals or allergens
}Appears as tiny vesicles that may weep and encrust }Scaling
and erythema common in chronic cases }Treatment:
Identify and eliminate the causeæ
moisturizeræ
Topical corticosteroidsæ
This can be related to allergy or
If it is on the hands, ask if what are they playing with, any new soaps
If it is really bad can see scaling and redness
Treat it like any other skiin inflammation with moisturizer
If it is something not better can follow up
But hydrocortisone should work
}"Lucky luke or cowboy holster" dermatitis - contact dermatitis in the diaper region characterized by its pattern of
involvement which resembles a cowboy's gun belt with triangular erythema located beneath the side bands 9. Pediculosis:
}Pediculosis- (lice) affects the head, body or pubic area
}Pediculosis capitis- head
}Pediculosis corporis- body
}Pediculosis pubis- pubic area
, Pediatric primary care final exam
In pubic area- the big thing with lice
Super hard to get rid of
The eggs can be differentiated
These stick to the hair shaft
The treatment is easy but must repeat it
Can do the over the counter- nix or permethrin- do 1 treatment and then do another treatment in a week
Santiziing daily, taking stuff pillow and blankets, putting them in air lock bags, vaccuming care seats It is a lot of
work for parents to do
***know this slide
10. Koilonychia: is a condition where the nails become abnormally shaped, appearing thin, curved inward, and indented
like a spoon
can be seen commonly in iron deficient anemia
11. iron deficiency anemia: Common childhood anemia caused by inadequate availability of iron to sustain bone marrow
erythropoiesis or hemoglobin synthesis
Usually seen between 9 - 24 months of age
Caused by decreased iron intake, increased needs, or slow GI blood loss
In infancy - is caused by an inadequate iron intake
Common in preterm infants
Low iron formula or exclusively breast fed for more than 6 months
Micro hemorrhage from the gut from early intake of whole milk (prior to 9 months)
Excessive whole milk intake
Iron present in breast milk is more bioavailable than the iron in cow's milk
Ascorbic acid increases absorption
Tea decreases absorption
Pretty common in kids, usually because of decrease iron intake or they have increased needs
Infants, usually from inadeuqet iron intake
Exclusively breast fed infants for more than 6 months can cause this to
There is a microhemorrage from a gut
1. Candida diper dematitis: }Common skin irritation of the genital perianal area
}Describes an inflammatory skin eruption limited to the diaper area
}Usually caused by prolonged contact with urine/ feces
}Occurs in 95% of infants
}Peaks at 9-12 months
}Treatment-
PROTECTION and frequent changes
This pictures looks like jacket dermatitis, it looks likes punched out dermatitis
All diper rashes do not have to be red
It does not always have to be with prolonged contact, the kids butt can be sensitive It is
just causing more irritation
More protection is the cream, tell the parents, get the hairdryer and put on cool setting and blow dry butt Soak in the
baking soda
2.Diper dermatitis: }Represents 10-20 % of all skin disorders seen in primary care
}Risk of developing a diaper dermatitis throughout childhood is one in four
}In infants this can be as high as 7-35 % }Peak
age of incidence is 9-12 months of age }Types:
}Irritant dermatitis- asymptomatic erythema to painful scaling papules and superficial erosions
3.candida diper dermatitis: ******}Candidal dermatitis- results from irritant dermatitis being untreated for more than three
days it can become secondarily infected with candida
Has beefy red appearance, satellite papules are classicæ
}Candidal infections commonly affect the skin fold areas
}History can be consistent with
diarrhea, recent antibiotic use and
oral thrush
4.erythema infectiosum (Fifth disease): disease caused by the parovirus B19 the disease is highest in childhood from age 5
to 15 years old.
clinical findings in the prodromal phase are mild fever, myalgia, malasie, headache, and URI symptoms
, Pediatric primary care final exam
Rash appears 7 to 10 days after the prodromal stage and occurs in three stages, it first appears on the face as an intense red
eruption (slapped cheek) with circumoral pallor that last 1-4 days.
Next there is a lacy maculopapular eruption that appears on the trunk and moves peripherally to the arms, thighs, and
buttock. Palms and soles are generally not involved. This phase can last a month. Finally the rash subsides.
TX: viral so conservative. Can do transfusion for those with hemolytic anemia or immunocompromised. IVIG can
also help
**children in rash phase may attend school
5.Tinea infections: }Distinguished by the causative species of fungi and location they manifest }Tinea capitus- scalp
}Tinea corporis- body ringworm
}Tinea cruris- jock itch
}Tinea manuum & tinea pedis- athlete's foot
}Tinea versicolor (hypo/ hyperpigmentation macules on the limbs }tinea
unguium- fungal invasion of the nails
Disincted by location manifest
These locations
**know the name and what area of the body they are saying the tinnea is on ***know this
slide!!!!!!
Tinea versicolor- with a black lamp- it will glow for the tinea infection
They are usually hypo or hyperpigmentated, they are macular, they can be on trunk areas on the limbs as well
The sun makes it worse, or the sweat makes it worse
6. scabies: }Caused by the itch mite sarcoptes scabiei which burrow under the skin and cause intense itching
}Highly contagious spread through close contact or shared clothing or linen
}Female mite lays 3 eggs per day which take 2 weeks to hatch
}Classic s/s of scabies is burrow marks in between webbing of fingers and toes
May also have tracking
Treatment - permethrin, 1 week later retreat
Scabies, this is another mite
If suspicious for scabies, look in webbing of kids hands and toes
, Pediatric primary care final exam
Burrowing and biting with scabes
Permetharin and one time
And treat one time in the family
7.Pityriasis rosea: }A mild acute inflammatory disorder
}Unknown cause but thought to be viral
}Self limiting lasting 3-8 weeks
}Herald spot- 1-10 cm solitary ovoid slightly erythematous lesion that enlarges quickly with central clearing Often
mistaken for what?æ
}Common on the trunk and proximal extremities
}Lesions follow a Christmas tree pattern
8.contact dermaitis: }An acute or chronic dermatitis as a result of direct contact with chemicals or allergens
}Appears as tiny vesicles that may weep and encrust }Scaling
and erythema common in chronic cases }Treatment:
Identify and eliminate the causeæ
moisturizeræ
Topical corticosteroidsæ
This can be related to allergy or
If it is on the hands, ask if what are they playing with, any new soaps
If it is really bad can see scaling and redness
Treat it like any other skiin inflammation with moisturizer
If it is something not better can follow up
But hydrocortisone should work
}"Lucky luke or cowboy holster" dermatitis - contact dermatitis in the diaper region characterized by its pattern of
involvement which resembles a cowboy's gun belt with triangular erythema located beneath the side bands 9. Pediculosis:
}Pediculosis- (lice) affects the head, body or pubic area
}Pediculosis capitis- head
}Pediculosis corporis- body
}Pediculosis pubis- pubic area
, Pediatric primary care final exam
In pubic area- the big thing with lice
Super hard to get rid of
The eggs can be differentiated
These stick to the hair shaft
The treatment is easy but must repeat it
Can do the over the counter- nix or permethrin- do 1 treatment and then do another treatment in a week
Santiziing daily, taking stuff pillow and blankets, putting them in air lock bags, vaccuming care seats It is a lot of
work for parents to do
***know this slide
10. Koilonychia: is a condition where the nails become abnormally shaped, appearing thin, curved inward, and indented
like a spoon
can be seen commonly in iron deficient anemia
11. iron deficiency anemia: Common childhood anemia caused by inadequate availability of iron to sustain bone marrow
erythropoiesis or hemoglobin synthesis
Usually seen between 9 - 24 months of age
Caused by decreased iron intake, increased needs, or slow GI blood loss
In infancy - is caused by an inadequate iron intake
Common in preterm infants
Low iron formula or exclusively breast fed for more than 6 months
Micro hemorrhage from the gut from early intake of whole milk (prior to 9 months)
Excessive whole milk intake
Iron present in breast milk is more bioavailable than the iron in cow's milk
Ascorbic acid increases absorption
Tea decreases absorption
Pretty common in kids, usually because of decrease iron intake or they have increased needs
Infants, usually from inadeuqet iron intake
Exclusively breast fed infants for more than 6 months can cause this to
There is a microhemorrage from a gut
