Chapter 42: Alterations of the Integument in Children

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Questions and Answers

What is the primary cause of acne vulgaris?

Hormonal changes

Bacterial infection of the skin

Occlusion of sweat glands

Obstruction of pilosebaceous follicles (correct)

What characterizes atopic dermatitis in infants and young children?

Acne-like lesions on the back and chest

Tendency for hormonal development

Red, scaly lesions on the face and extremities (correct)

Fungal infections of the scalp

Which skin infection is characterized by a honey-coloured crust?

Molluscum contagiosum

Tinea capitis

Diaper dermatitis

Impetigo (correct)

What type of dermatitis is associated with prolonged exposure to irritants like urine and feces?

Diaper dermatitis Signup and view all the answers

Which condition is directly caused by the exfoliative toxin of Staphylococcus bacteria?

Staphylococcal scalded-skin syndrome Signup and view all the answers

What is a characteristic feature of molluscum contagiosum?

Pale papular lesions filled with viral debris Signup and view all the answers

What symptoms are associated with rubeola?

Fever, sore throat, and conjunctivitis with a rash Signup and view all the answers

What is the primary cause of chickenpox?

Varicella-zoster virus Signup and view all the answers

What is the typical duration of the rash associated with roseola?

24 hours Signup and view all the answers

Which type of irritation can lead to secondary infection with Candida albicans?

Diaper dermatitis Signup and view all the answers

How long are individuals with chickenpox contagious?

1 day before rash until 5 to 6 days after Signup and view all the answers

What primarily causes the inflammatory lesions in hydradinitis suppurativa?

Occlusion of pilosebaceous follicles Signup and view all the answers

Which type of hemangioma typically resolves spontaneously by 5 years of age?

Strawberry hemangioma Signup and view all the answers

What causes scabies?

An itch mite Signup and view all the answers

Which statement about lice infestation is true?

Lice cause pruritic dermatitis by secreting toxic saliva. Signup and view all the answers

What distinguishes a cavernous hemangioma from a strawberry hemangioma?

Cavernous hemangiomas are present at birth and have larger vessels. Signup and view all the answers

What are flea bites characterized by?

Clusters with a central puncture site Signup and view all the answers

Which of the following is a type of cutaneous vascular malformation present at birth?

A port-wine stain Signup and view all the answers

What condition is characterized by the accumulation of macules, papules, and pustules in neonates?

Erythema toxicum neonatorum Signup and view all the answers

Study Notes

Acne vulgaris is the most prevalent skin disorder, characterized by obstruction of pilosebaceous follicles and proliferation of Propionibacterium acnes, primarily affecting the face, neck, and upper trunk. It presents as non-inflammatory and inflammatory lesions.
Hidradenitis suppurativa is a chronic condition marked by the occlusion of pilosebaceous follicles, commonly in skin folds, leading to inflammatory nodules, sinus tracts, fistulae, and scarring.

Dermatitis

Atopic dermatitis alters the skin barrier, manifesting as red, scaly lesions on the face, cheeks, and flexor surfaces in infants and young children. It is linked to inflammatory cytokines, elevated IgE levels, and a family history of asthma and hay fever.
Diaper dermatitis is irritant contact dermatitis from prolonged exposure to urine and feces, often complicated by secondary infection with Candida albicans.

Skin Infections

Impetigo, a contagious bacterial infection, can present as two forms: bullous (large, fluid-filled blisters) and vesicular (small blisters), known for weeping lesions with honey-colored crusts.
Staphylococcal scalded-skin syndrome (SSSS) is caused by exfoliative toxins from staphylococci, leading to painful blistering over extensive skin areas and necessitating systemic antibiotic treatment.
Tinea capitis and tinea corporis are fungal infections affecting the scalp and body, respectively, caused by dermatophytes.
Thrush is an oral fungal infection due to Candida albicans.
Molluscum contagiosum, a poxvirus infection, results in pale papular lesions filled with viral and cellular debris.
Rubella is a communicable viral disease presenting with fever, sore throat, enlarged lymph nodes, and a maculopapular rash lasting 1 to 4 days.
Rubeola, also known as measles, is characterized by high fever, conjunctivitis, and a red rash that spreads from the head to the trunk, with complications possible.
Roseola is a benign infantile disease that begins with a sudden fever lasting 3 to 5 days, followed by a short-lived rash.
Smallpox (variola) was a deadly and contagious viral disease, eradicated through vaccination.
Chickenpox (varicella) is a highly contagious disease caused by the varicella-zoster virus, presenting vesicular lesions and contagiousness extending from 1 day before to 5–6 days after the rash appears.
Herpes zoster (shingles) results from reactivation of the chickenpox virus, causing vesicles along the sensory nerve distribution.

Insect Bites and Parasites

Scabies is caused by the itch mite, leading to pruritic papules and vesicles through skin burrowing; it spreads through direct contact.
Pediculosis, or lice infestation, results from bloodsucking parasites damaging the skin and is characterized by pruritic dermatitis; lice are spread by direct contact and identifiable by nits on hair.
Fleabites cause pruritic wheals and occur in clusters, often associated with tight clothing.
Bedbugs are blood-sucking parasites living in furniture or bedding, producing pruritic wheals and nodules.

Cutaneous Hemangiomas and Vascular Malformations

Cutaneous hemangiomas are benign tumors formed from rapid vascular endothelial cell growth, creating extra blood vessels.
Vascular malformations are rare congenital anomalies of blood vessels present at birth.
Strawberry hemangiomas are vascular lesions found at birth, grow alongside the child, and typically resolve by age 5.
Cavernous hemangiomas are larger, bluish-red lesions present at birth that usually involute by age 9, sometimes requiring surgical intervention if near critical areas like the eyes or genitalia.
Port-wine stains are congenital capillary malformations that persist throughout life.
Salmon patches are pink, macular lesions that usually resolve by 1 year of age.

Other Skin Disorders

Miliaria consists of small pruritic papules or vesicles due to sweat duct obstruction in infants.
Erythema toxicum neonatorum is a benign condition involving macules, papules, and pustules that resolves spontaneously within weeks after birth.

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Description

Test your knowledge on common skin conditions like acne vulgaris, hidradenitis suppurativa, and various types of dermatitis. This quiz covers the causes, symptoms, and management of these prevalent skin disorders. Perfect for students in dermatology or medical fields.