Pediatrics and Surgery
Other
Photosensitivity reactions
100
Light brown, oval macule
>1.5 cm, persistent through life and may increase with age
Related to neurofibromatosis
Look like birthmarks
cafe au lait
100
Clinical manifestations: intense itching, circumscribed, raised, erythematous, wheals, central pallor, migrates, serpiginous, transient (often gone in 24 hours), may have angioedema
Acute: <6 weeks
Chronic >6 weeks
Urticaria
100
Clinical manifestations: intense itching, erythematous papules that coalesce into plaques, trunks/forearms
polymorphous light eruption
200
Most common benign tumor of infancy (type of birthmark)
Proliferation of cells that develop into blood vessel endothelium
Bright red nodular plaques on head, neck , and trunk
hemangioma
200
Clinical manifestations: intense itch, eczematous lesions, lichenified, leathery, may be persistent
Immune mediated
300
Children or institutionalized
Most common worm in US
Transferred by humans
Asymptomatic, perianal pruritus
Scotch tape test
Treat with Mebendazole or Albendazole, do second treatment after 10 to 14 days
Can cause vulvovaginitis or salpingitis
Pinworms
300
Clinical manifestations: velvety, hyperpigmented plaques on skin, intertriginous sites, usually symmetric, dirty appearance, thickening, may have skin tags (acrochordons)
acanthosis nigraicans
400
Blue black macule over lumbosacral area
Lesions may fade over time
Confused with bruising
congenital dermal melanocytosis
400
Clinical manifestations: exaggerated sunburn, blisters, desquamation/peeling, edema, vesicles, bulla
Phototoxicity due to exogenous or endogenous agents
500
Common, increased risk with EBV, HHV, CMV, HIV
Common offenders: antibiotics, anticonvulsants, NSAIDs
HSR, exanthematous (75%), fixed drug eruption, warfarin necrosis, sweet syndrome, DRESS, acute generalized exanthematous pustulosis, severe mucocutaneous reactions
Lab testing: CBC, CMP, ANA
Treatment: identify drug and remove, topical corticosteroids, oral antihistamines, epinephrine, supportive
drug eruptions