Things that make you go Hmmmmm ……. Or It is what it is!. Objectives. Identify benign skin lesions with confidence Identify resources for dermatology education AND one new thing about management of Hemangiomas. Lichen Striatus. Primary phase.
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Things that make you go Hmmmmm……
It is what it is!
Fading and Flattening
-Common 9months to 6 years but can occur earlier or later
-Last 1-3 years
-Relapses of short duration have been noted after complete clearing
Large dermal nevi commonly shoulder but not exclusively
First described by Dr. Duncan in Houston in 1987
At fist glance these patients may appear to have confluent and reticulated papillomatosis (CARP) or acanthosisnigricans
In contrast to derma neglecta soap and water will not wash this off, isopropyl alcohol is necessary
When this condition is suspected, firm, persistent pressure should be applied while rubbing the skin with alcohol.
The cause of terra firma-formedermatosis is unknown.
This a variant of dry skin
It is usually asymptomatic
Appears worse in summer, better during school year
Treatment is sunscreen and moisturizer
If you mom think it is fungal…..
Do a culture
Become more extensive in drier climate.
Individual lesions represent plugs of stratum corneum in individual follicular openings
ie: Skin Trash
Moisturizer with urea of lactic, salycylic acid
May help but is not curative.
Hypopigmented thickened papules often on elbows , knees
Can be eczematous and very itchy
Knuckle pads were medically first described by Garrod in 1893 and are also named Garrod's pads
There is no known established, generally successful therapy.
Injection of corticosteroids (triamcinolone) can soften and sometimes even shrink the pads. Radiation therapy has also been reported to be successful in some cases but not consistently.
Knuckle pads can be surgically removed in the case of pain associated with them. .
Aplasia Cutis Congenita
Developmental defect rather than birthmark
Occurs in about 1 in 5000 births
Ulcerated defects may heal with scar.
Although usually benign, the hair collar sign may be associated with other physical anomalies and malformation syndromes.
No specific laboratory tests are required, although a hair collar sign signals the possibility of a CNS malformation and thus may warrant an MRI scan to rule out an underlying pathology
Appears at birth as slightly raised yellow orange nevus
At puberty become raised and warty
Basal cell carcinoma and other benign tumors occur in 15-50% of the tumors
Excision recommended prior to puberty.
Essential that children with any type of Mastocytosis not be given the following medications:
Opiates (codeine, demerol, morphine)
In the case of surgery very important that perioperative medications carefully
Some things can be fixed and some cannot…..
However we do know that education and information
is just as valuable as cures can be.
The goal is always………….