large vessels under skin. less frequently resolve spontaneously.
10 to 15% will have secondary neoplastic changes
a type of hamartoma. has many fibrous elements. does not go away as hemangiomas do
advanced case
advanced case, probably from lying on ground
advanced case, probably from sitting on ground
advanced case, secondarily infected
aka ankyloglossus
aka annulus migrans
aka bird headed dwarf, rare condition
aka blood blister. traumatic, a pinch
aka goltz disease
aka harlequin fetus aka lamellar ichthyosis.
aka harlequin fetus aka lamellar ichthyosis. collodian was used to help bandages stick and caused a similar skin reaction. may resolve completely or develop into a chronic ichthyosis
aka herpes zoster, does not cross midline, reactived varicella infection
aka prow brow;. prominent nasion due to craniosynostosis
aka prune belly syndrome. absent of deficient abdominal musculature
aka ring worm
aka sand sores, in florida: florida sores, in nc: dew sores
aka sand sores, in florida: florida sores, in nc: dew sores; aka pyoderma
aka stork bite, can become lichenified and secondarily infected
aka: donohue syndrome - prenatal adipose deficiency, full lips, islet cell hyperplasia
aka: erythema infectiosum, caused by parvovirus b19
aka: goltz syndrome
all lesions are papular or plaques (no vesicles). self limited
allergic reaction
allergic reaction to medication
alopecia due to fungal infection
also in kinship 6.74-6.76
ash leaf spot (like a reverse nevus). when present, appear in early childhood. present prior to appearance of tubers
associated with down's syndrome
associated with neurofibromatosis
associated with obesity, diabetes, polycystic ovaries
associated with possible seizures and mental retardation
associated with smallpox vaccination (vaccinia), about two weeks after vacination
autosomal dominant, plaques of hyperkeratosis, occur early in infancy
benign condition
benign condition of infant
both parents of african american descent
bullae beginning to form on arm. more advanced and desquamated bullae on trunk
cafe au lait, pt has neurofibromatosis
can be infections (gonorrhea) or chemical (agno3)
can cause a dermatitis
can involve iris and retina
caused by enterovirus, usually cocksaxievirus a16 or enterovirus 71. macules, papules and papulopustules all occur concurrently
caused by repeatedly pushing the tip of the nose up with hand (allergic salute)
central necrosis just beginning, surrounding erythema
central necrosis, surrounding erythema
characteristic bullous lesions
characteristic crater like lesions, always in diaper area
characteristic eyebrows, upturned nose, mid face hypoplasia, minor skeletal anomalies, short stature, mental retardation, low set ears, peaked shoulders
characteristic pustular lesion, not infectious. no treatment needed. resolution after months
characteristic wide, straight ear canal
child beaten with an electrical extension cord. still has plug on one end
christmas tree like distribution, cured by tincture of time
classic satellite lesions
classic target lesions; bullae on erythematous base, various sizes
classical papulovesicle appearance, very itchy. this is not a typical adult presentation
classical scaly appearance. edema is also part of this condition
clinically euthyoroid
close up, look like large positive ppd test
close up.
close up. in resolving phase. no scarring will be associated with this if left alone
close up. lose, redundant skin. evaluation needed to determine if spinal cord involvement present.
close up. usually confused with massive staph skin infection.
color of coffee with cream - cafe au lait spots
complication of ear piercing
complication of plastibell circumcision
complication of sweat chloride test
congenital
congenital, area looks and feels like scar tissue
consider possibility may have spinal cord involvement. follow clinically.
correctable with plastic surgery, non syndromic
craniosynostosis
dark field positive - lesions with many spirochetes
defects of eyes, nose, lip, forebrain (of holoprosencephaly type).
demonstrating the appearance of this condition in an older child
demonstrating the appearance of this condition in an older child and extropion
dependent part of body is red, transient and reversible phenomena
described as mottled appearing, lace like, moth eaten
diff dx includes: meningococemia, other infection, henoch-schšnlein purpura
different stages - new (upper right), crater, beginning to crater, papule (left of crater), papulovesicle on far left
diffuse nature greatly decreases possibility of under the skin pathology
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drug reaction (sulfa?)
earlier lesion
early stage, one of many presentations
early track formation in center of picture,
burrows on right. can become secondarily infected.
early. the papules will coalesce into a raised ring pattern (annulare). involves the dermis. frequently misdiagnosed, benign, self limited. usually at hands, feet, ankles (distal extremities)
effect on growth
eyes are prominent - eyes are normal size, face bones are small
fairly fresh, with vesicle
finding can be part of a syndrome
florida state board of health 1908-1909
four days old
frequently associated with allergic states
frequently resolve spontaneously
frequently resolve spontaneously although blue color is poor prognosis for spontaneous resolution
frequently resolve spontaneously, this one has been traumatized and is resolving by fibrosis
frequently resolve spontaneously, thus surgery probably not indicated for this hemangioma.
frequently resolve spontaneously. intervention needed if vision impaired
frequently resolve spontaneously. may need surgical intervention due to location (hard to feed)
frequently resolve spontaneously. mixed cavernous and capillary
frequently resolve spontaneously. resolution nearly complete
frequently resolve spontaneously. resolution of lesion is beginning in central portion.
frequently resolve spontaneously. this one has been traumatized and excoriated. resolution of lesion is beginning in central portion.
frequently resolve spontaneously. young lesion
fresh/newer granuloma
from ankle bracelet
from earring
from exposure of wet mouth against plastic bottle. probably due to propping bottle.
from head rolling. linear pattern is the diagnostic clue. typical in young infants (they spend a lot of time laying down)
from spilling of mixed drink
from sunlight exposure
from wearing nickel based necklace
frontal view
gastric peristalis waves noted across abdomen
granuloma after treatment with topical agno3
granuloma to be treated with topical agno3
graphic illustration of absent red reflex
has potential for malignant transformation
healing
heliotrope (purple/pink) color over knuckles
hereditary, autosomal dominant. onset typically at school age or later
hip dysplasia should be evaluated as possible cause
histiocytosis
hx very helpful; cough and high fever. rash occurs several days into illness
id reaction is to candida diaper dermatitis
in active stage, cause of necrosis unknown in this case
in contrast to slide 2.10
incidental umbilical hernia
inflammation of neck likely due to contact with shirt collar
involvement of gums
involves the dermis. frequently misdiagnosed, benign, self limited. usually at hands, feet, ankles (distal extremities)
iris often with sparse/absent pigmentation
just beginning
kerion present
kerion present. traction on hair roots increases susceptibility to this infection
knee lichenification often caused by crawling on synthetic material (like a rug)
lateral view
lateral view demonstrating alopecia, dilates scalp veins, retrognathia.
lateral view, hair loss is a characteristic. rare dysmorphic syndrome. characterized by appearing prematurely age. early death is rare (contrast with progeria)
lateral view. rare dysmorphic syndrome. characterized by appearing prematurely age. early death is rare (contrast with progeria)
lichenified, split. from crawling on carpet usually
makes the tabloid!
malignant transformation likely, especially thickened element (sessile nodules)
mast cell condition. when lesions rubbed, it urticates
may or may not be associated with deafness
medically inconsequential. commonly called flat warts
millimeter marks on rt of picture
more advanced, bullae have ruptured
more commonly seen in fifth finger
more mature granuloma
mother of pt in picture 6.74
multiple anomalies, usually retarded
nail pitting
necrotic rectum and anus
needs prompt recognition and referral to ophthalmologist
needs surgical correction
needs surgical correction due to risk for airway obstruction.
no angle of femoral neck. found in hutchinson-gilford-progeria syndrome
no ill effects, resolve spontaneously (but may take years). treatment is available
no treatment needed
non pruritic (looks like it should be!)
normal blue sclera seen in young infants, not robin egg blue seen with osteogenesis imprefecta
not as common as mid frontal vascular nevus (nevus flamus)
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not present at birth. more obvious in dark skin individuals
note alopecia
note area is lichenified
note cataracts. rare dysmorphic syndrome. characterized by appearing prematurely age. early death is rare (contrast with progeria)
note indention, cause of necrosis unknown in this case
note localized foot gigantism caused by hemangioma. frequently resolve spontaneously although blue color is poor prognosis for spontaneous resolution
note nails and hyperkeratotic plaque on foot
note perioral cyanosis
note small jaw and mandible, note periorbital duskiness
note snuffles a classic finding in newborns; when present, evaluate for syphilis.
note super infection of ear skin - probably due to candida (low grade infection, well demarcated)
now healed, residual scar
occurs in older persons. due to trauma of sun, wind, sand exposure
often tx'ed errantly as staph infection
one of many presentations
papulovesicles are characteristic of poison ivy dermatitis
parotiditis
part of the picture of tinea capitus
patient has enlarged liver and spleen. primary liver disease not characteristically associated with spleenomegaly.
patient received breast reduction surgery
potential for malignant transformation
potentially toxic
prompt referral needed to achieve optimal outcome
pt is in her mid teens, has associated seizures
pt's face contacted shoulder of individual that was vaccinated; got vaccinia (aka smallpox vaccination)
rare dysmorphic syndrome. characterized by appearing prematurely age. early death is rare (contrast with progeria)
rarely seen, unknown significance. sometimes associated with stridor.
redundant skin due to stretching caused by hernia
responds to tincture of time
sad face
secondary alopecia
seen in infants who kick their feet a lot. caused by friction against e.g. sheets. not really ingrown. true ingrown toenails rarely seen in infants
self limited (months) condition
self limited, responds to tincture of time
should be excised
since in newborn, may fall out
single vesicle
sometimes have patches of scleroderma like skin (different histology). in this individual it is in a undershirt pattern
sometimes part of waardenberg syndrome (deafness, iris heterochromia...)
splash of plant material (ex: oils from citrus fruit peel) on skin, then reaction when exposed to sunlight
spontaneously resolve (not a tooth erupting)
stages seen in this slide: papules and papulovesicles
sublingual cystic structure of salivary gland. typically drain spontaneously but needs surgical excision
surgical correction required to restore function
surgical excision warranted
suspect when a single toe is swollen and red. look for hair, it is not easily seen/found
taken at progeria camp
teeth are normal size, jaw and mandible are small, causing crowding. more prone to caries
ten days old
this is a side effect to cyclosporin use
this is atypical mycobacterium. (not obvious from picture...)
this patient has coffin-iris syndrome (see 3.53 and 3.54)
this patient has holt-oram syndrome
this pt with neurological damage, living in a unsanitary home. milk was spilt on pt and roaches ate milk and some of his skin
this was tapped for diagnostic and therapeutic purposes; occurred in the pre cat scan era
tongue may interfere with respiration
transverse crease in achilles tendon area is due to inability to dorsiflex feet. has congenitally short achilles tendon
treat infection with anti-staph oral agent
treatment: attempt to keep area dry and cool. often has candida present (tx for this)
two days old
typical appearance on a mucosal surface
typical circular or oval plaque. more common in people with atopic dermatitis
typical facial appearance
typically does not involve ductal tissue
uncommon
uncommonly marked case
underlying scalp is scarred appearing. possibly due to amniotic bands
untreated
usually caused by staph
usually confused with massive staph skin infection.
vascular nevus, can involve eye, inside of mouth, nose and meninges
vision loss. missing red reflex. transmission occurs when contaminated dirt is eaten (larvae must be ingested).
vitiligo is only rarely congenital
wide spread seborrheic dermatitis, diarrhea, failure to thrive.
wide variety causes, sometimes fungal, viral bacterial infection, autoimmune, can be associated with malignancy (if so, resolves when malignancy treated)
yellow discoloration of lesions reflects liver involvement/jaundice |
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