This document defines common dermatology terms like macule, papule, plaque, wheal, and provides descriptions of primary skin lesions including erythema toxicum neonatorum, miliaria, subcutaneous fat necrosis, infantile atopic dermatitis, seborrheic dermatitis, candidal dermatitis, irritant dermatitis and describes various infectious exanthems like measles, rubella, hand-foot-mouth disease, erythema infectiosum, exanthem subitum, infectious mononucleosis, impetigo, scarlet fever, meningococcemia, Rocky Mountain spotted fever, Henoch-Schnlein purpura and Kawasaki

3. Common dermatology terms
Macule: circumscribed change in skin color without elevation or
depression.
Papule: solid elevated lesion usually <0.5 cm in diameter.
Plaque: raised lesion >0.5cm in diameter
Wheal (hive): rounded or flat-topped elevated lesion formed by local
dermal edema.
Purpura: non-blanching erythema or violaceous color due to
extravasation of blood.
Nodule: palpable solid lesion of varying size
Vesicle: circumscribed elevated lesion which contains free fluid and is
<0.5 cm in diameter
Bulla (blister): same as vesicle but with diameter >0.5 cm.
Cyst: sac containing liquid or semisolid material usually in the dermis.
Pustule: circumscribed elevated lesion which contains pus
Abscess: collection of pus in the dermis or subcutis.

4. Primary skin lesions

6. Erythema Toxicum Neonatorum
Huge title - harmless skin condition
Erythematous macule with a central tiny papule,
seen anywhere - except the palms and soles.
The lesions are packed with eosinophils, and
there may be accompanying eosinophilia in the
blood count.
The cause is unknown, and no treatment is
required as the rash disappears after 1-2 weeks.
.

7. Erythema Toxicum Neonatorum

8. Prickly heat, sweat rash.
Many red macules with central papules, vesicl
es or pustules are present.
These may be on the trunk, diaper area, head
or neck.
Miliaria

9. Miliaria

10. Self limited, benign condition.
Sharply demarcated reddish to violaceous plaques
or nodules.
Etiology uncertain.
Onset first few days- weeks of life.
Cheeks, back, buttocks, arms, and thighs.
Subcutaneous Fat Necrosis

11. Subcutaneous Fat Necrosis

12. Cause is unknown
Red, itchy papules and plaques that ooze and
crust
Sites of Predilection
Face in the young
Extensor surfaces of the arms and legs 8-10 mo.
Antecubital and popliteal fossa, neck, face in older
Infantile Atopic Dermatitis

13. Infantile Atopic Dermatitis

14. Infantile Atopic Dermatitis

15. Avoidance or elimination of predisposing
factors.
Hydration and lubrication of dry skin.
Anti-pruritic agents.
Topical steroids.
Eczema- Treatment

16. Common, generally self-limiting.
Its cause remains ill-understood.
There is a genetic predisposition.
Most frequent between the ages of 1:6 mo.
Greasy, salmon-colored scaling eruption.
Hair-bearing and intertriginous areas.
The rash causes no discomfort or itching.
Seborrheic Dermatitis

17. Seborrheic Dermatitis

18. Seborrheic Dermatitis

19. Anti-seborrheic shampoo
Topical steroids
Seborrheic Dermatitis-
Treatment

21. Starts off in the deep flexures which show wide
spread erythema on the buttocks-beefy red color.
There are also raised edge, sharp marginization
and white scale at the border of lesions, with pin
point pustulo-vesicular satellite lesions
Candidal Dermatitis

23. Salmon-colored greasy lesions with yellowish
scale and predilection for intertriginous areas.
Involvement of the scalp, face, neck, and post
auricular and flexural areas
Seborrheic Dermatitis

25. Rash confined to the convex surfaces of the
buttocks, perineal area, lower abdomen, and
proximal thighs, sparing the intertriginous
creases.
Excessive heat, moisture, and sweat retention.
Harsh soaps, detergents, and topical
medications
Irritant Dermatitis

28.  Variola viruses ,Fatality 40 %.
First invades upper respiratory tract.
From lymph nodes it spreads via hematogenous
spread.
Chills, fever, headache, delirium, SZ.
 Face to upper arms and trunk, and finally to
lower legs
Smallpox- Variola

30. Herpes virus varicellae
Incubation period 10-21 days
Fever, malaise, cough, irritability, pruritus
Papules vesicles crusting
Spreads centripetally
Chickenpox-Varicella

32. Complications:
Bacterial superinfection
CNS involvement
Pneumonia
Hepatitis, arthritis
Reye’s syndrome
 VZIG
Varicella

33. Oral acyclovir- indications:
Children > 1 yr with chronic cutaneous or pulmonary conditions
Patients on chronic salicylate therapy
Patients receiving short or intermittent courses of aerosolized
corticosteroids
Dose: 80 mg/kg/day in four divided doses for 5 days
Varicella
Treatment

34. VZIG (1 vial/5 kg IM) :
Pts on high dose steroids
Immunocompromised
Pregnant women
Newborns exposed 5 days prior to birth and 2 days
after delivery
Neonates born to nonimmune mothers
Varicella
Post exposure

35. Rubeola- paramyxovirus.
Occurs in epidemics.
Incubation 8-12 days.
Fever, lethargy, Cough, coryza, conjunctivitis
with clear discharge and photophobia.
Koplik spots.
Rash begins on the face and spreads to
trunk and extremities.
Measles

37. Immunoglobulin therapy- indications
All susceptible contacts
Infants 5 mo. To 1 year of age
Immunocompromised
Pregnant women
Live measles virus vaccine- contraindication
Immunocompromised
Pregnancy
Allergy to eggs
Measles
Post exposure

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

39. Enteroviruses
coxsackieviruses A and B
echoviruses
Vesicular lesions, may be petechial.
Associated with aseptic meningitis, myocarditis
Hand-Foot-Mouth Disease

41. Fifth disease
Mildly contagious, parvovirus B-19
Pre-school and young school-age children
Prodrome: mild malaise
Rash: “slapped cheek”, circumoral pallor,
peripheral mild macular distribution
Erythema Infectiosum

43. Roseola Infantum(HHV-6B)
Children 6-19 months
Abrupt onset of high fever
Febrile seizures
Rash develops after fever dissipates
Mainly on trunk
Exanthem Subitum

45. Acute, self limited illness
Epstein-Barr virus
Oral transmission – incubation 30-50 days
Fever, fatigue, pharyngitis, LA, splenomegaly,
atypical lymphocytosis
Exanthem is seen in 10-15%
Erythematous, maculopapular, morbilliform,
scarlatiniform, urticarial, hemorrhagic, or even
nodular
Infectious Mononucleosis

48. Superficial infection of the dermis
Two types:
Impetigo contagiosa
Bullous impetigo
Etiology
Group A ß hemolytic streptococcus
Coagulase positive S. aureus
Treatment : B-lactam ABs, erythromycin
Impetigo

51. Toxin producing strain of group A  -hemolytic
streptococcus
Strep pharyngitis with systemic complaints
Rash from neck to trunk to extremities
Sandpaper feel, erythema, warmth
White and red strawberry tongue
Petechiae in linear form
Treatment :penicillin or amoxicillin
Scarlet Fever

53. Usually sudden onset of fever,chills, myalgia,and
arthralgia
Rash is macular, nonpruritic, erythematous
lesions
Petechial rash develops in 75% of cases
Neisseria meningitides
Fever, rash, hypotension, shock, DIC
Treatment: PCN G
Meningococcemia

55. Most common rickettsial infection in US
Abrupt fever, headache, and myalgia
Rash from extremities towards trunk
Macules  petechiae
Treatment
Tetracycline
Doxycycline
Chloramphenicol
Rocky Mountain Spotted Fever

57. No clear etiologic agent, often post viral
2-10 years of age
Palpable purpura over the buttocks and LE
Transient migratory arthritis
Renal and GI involvement
Henoch-Schnlein Purpura

59. Unknown etiology
Peak incidence 18-24 months
Clinical findings:
Fever for at least five days
Conjunctivitis
Polymorphous rash
Oral cavity changes
Cervical adenopathy
Kawasaki Syndrome