CHẨN ĐOÁN , ĐIỀU TRỊ NHỮNG BỆNH LÝ DA LIỄU TRẺ EM, HÌNH ẢNH MINH HOẠ RÕ RÀNG DỄ HIỂU, DỄ TRA CỨU
Dermatology Cover Spread:Layout 2/24/10 9:56 AM Page A QUICK REFERENCE GUIDE American Academy of Pediatrics Section on Dermatology Editors: Daniel P Krowchuk, MD, FAAP, and Anthony J Mancini, MD, FAAP Now you can consult a single authoritative AAP resource for the guidance you need to evaluate, diagnose, treat, and manage more than 100 pediatric and adolescent skin conditions More than 250 full-color images aid in accurate recognition and differential diagnosis Bullous Diseases Genodermatoses Hair Disorders Skin Disorders in Neonates/Infants Drug Eruptions Cutaneous Manifestations of Rheumatologic Diseases Other Disorders Daniel P Krowchuk, MD, FAAP Anthony J Mancini, MD, FAAP Selected content highlights Dermatitis Acne Skin Infections Infestations Papulosquamous Diseases Vascular Reactions Vascular Lesions Disorders of Pigmentation Lumps and Bumps Pediatric Dermatology P Dermatology y Pediatric Dermatology Custom-built for efficient, confident problem-solving Essential information on each condition is presented in the precise sequence in which you need it in the clinical setting • • • • Etiology/Epidemiology Signs and Symptoms Look-alikes How to Make the Diagnosis • • • • Treatment Prognosis When to Worry or Refer Resources for Families For other pediatric resources, visit the American Academy of Pediatrics online Bookstore at www.aap.org/bookstore AAP Pediatric Dermatology A QUICK REFERENCE GUIDE Editors Daniel P Krowchuk, MD, FAAP Anthony J Mancini, MD, FAAP 00 Front Matter PED DERM 8/17/06 11:03 PM Page i Pediatric Dermatology A Quick Reference Guide Section on Dermatology American Academy of Pediatrics Editors Daniel P Krowchuk, MD, FAAP Anthony J Mancini, MD, FAAP 00 Front Matter PED DERM 8/17/06 11:03 PM Page ii American Academy of Pediatrics Department of Marketing and Publications Staff Maureen DeRosa, MPA Director, Department of Marketing and Publications Mark Grimes Director, Division of Product Development Jeff Mahony Manager, Product Development Mark Ruthman Electronic Product Development Editor Sandi King, MS Director, Division of Publishing and Production Services Kate Larson Manager, Editorial Services Theresa Wiener Manager, Editorial Production Linda Diamond Manager, Art Direction and Production Jill Ferguson Director, Division of Marketing and Sales Linda Smessaert Manager, Publication and Program Marketing Library of Congress Control Number: 2006928514 ISBN-10: 1-58110-220-8 ISBN-13: 978-1-58110-220-8 MA0354 The recommendations in this publication not indicate an exclusive course of treatment or serve as a standard of medical care Variations, taking into account individual circumstances, may be appropriate The mention of product names in this publication is for informational purposes only and does not imply endorsement by the American Academy of Pediatrics Copyright © 2007 American Academy of Pediatrics All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior permission from the publisher Printed in China 3-136/1006 10 00 Front Matter PED DERM 8/17/06 11:03 PM Page iii Reviewers/Contributors Editors Daniel P Krowchuk, MD, FAAP Chief, General Pediatrics and Adolescent Medicine Department of Pediatrics Wake Forest University School of Medicine Winston-Salem, NC Anthony J Mancini, MD, FAAP, FAAD Associate Professor of Pediatrics and Dermatology Northwestern University Feinberg School of Medicine Head, Division of Pediatric Dermatology Children’s Memorial Hospital Chicago, IL Associate Editors J Thomas Badgett, MD, PhD, FAAP Professor of Pediatrics University of Louisville School of Medicine Louisville, KY Amy J Nopper, MD, FAAP, FAAD Associate Professor of Pediatrics/Dermatology University of Missouri–Kansas City School of Medicine Section Chief, Dermatology Children’s Mercy Hospitals & Clinics Kansas City, MO Steven D Resnick, MD, FAAP, FAAD Chief, Division of Dermatology Bassett Healthcare Associate Clinical Professor of Dermatology College of Physicians and Surgeons, Columbia University Cooperstown, NY Michael L Smith, MD, FAAP, FAAD Associate Professor of Medicine and Pediatrics Division of Dermatology Vanderbilt University Medical Center Nashville, TN 00 Front Matter PED DERM iv 8/17/06 11:03 PM Page iv Reviewers/Contributors Patricia A Treadwell, MD, FAAP, FAAD Assistant Dean for Cultural Diversity Professor of Pediatrics Indiana University School of Medicine Riley Children’s Hospital Indianapolis, IN American Academy of Pediatrics Board of Directors Reviewer Kathryn Piziali Nichol, MD, FAAP American Academy of Pediatrics Errol R Alden, MD, FAAP Executive Director/CEO Roger F Suchyta, MD, FAAP Associate Executive Director Maureen DeRosa, MPA Director, Department of Marketing and Publications Mark Grimes Director, Division of Product Development Jeff Mahony Manager, Product Development Lynn Colegrove, MBA Manager, Section on Dermatology Mark Ruthman Electronic Product Development Editor Reviewers Committee on Drugs Committee on Environmental Health Committee on Genetics Council on School Health Section on Clinical Pharmacology & Therapeutics Section on Infectious Diseases Section on Plastic Surgery Section on Rheumatology Copy Editor Kate Larson Cover Design by DesignWorld Book Design by Linda J Diamond 00 Front Matter PED DERM 8/17/06 11:03 PM Page v Dedication Dedicated to our families—Heidi and Will; Nicola, Mallory, Christopher, and MacKenzie—whose understanding and support made this project possible 00 Front Matter PED DERM 8/17/06 11:03 PM Page vi 00 Front Matter PED DERM 8/29/06 8:16 AM Page vii Table of Contents vii Table of Contents Foreword xi Editors’ Note xii Approach to the Patient With a Rash Diagnostic Techniques Therapeutics 13 Dermatitis Atopic Dermatitis 21 Contact Dermatitis (Irritant and Allergic) 31 Acne Acne Vulgaris 41 Neonatal and Infantile Acne 53 Periorificial Dermatitis 57 Skin Infections Localized Viral Infections Herpes Simplex 63 10 Herpes Zoster 71 11 Molluscum Contagiosum 75 12 Warts 79 Systemic Viral Infections 13 Erythema Infectiosum/Human Parvovirus B19 Infection (Fifth Disease) 87 14 Gianotti-Crosti Syndrome 91 15 Hand-Foot-and-Mouth Disease (HFMD)/Herpangina 95 16 Measles 99 17 Papular-Purpuric Gloves and Socks Syndrome (PPGSS) 105 18 Roseola Infantum (Exanthem Subitum) 109 19 Rubella 111 20 Unilateral Laterothoracic Exanthem (ULE) 117 21 Varicella 119 Localized Bacterial Infections 22 Acute Paronychia 125 23 Blistering Dactylitis 129 24 Ecthyma 131 00 Front Matter PED DERM viii 8/17/06 11:03 PM Page viii Table of Contents 25 Folliculitis/Furunculosis/Carbunculosis 135 26 Impetigo 139 27 Perianal Streptococcal Dermatitis 143 Systemic Bacterial, Rickettsial, or Spirochetal Infections With Skin Manifestations 28 Lyme Disease 149 29 Meningococcemia 153 30 Rocky Mountain Spotted Fever (RMSF) 157 31 Scarlet Fever 161 32 Staphylococcal Scalded Skin Syndrome (SSSS) 165 33 Toxic Shock Syndrome (TSS) 169 Fungal and Yeast Infections 34 Candida 175 34A Angular Cheilitis/Perlèche 177 34B Candidal Diaper Dermatitis 179 34C Chronic Paronychia 181 34D Neonatal/Congenital Candidiasis 183 34E Thrush 187 35 Onychomycosis 189 36 Tinea Capitis 193 37 Tinea Corporis 199 38 Tinea Cruris 203 39 Tinea Pedis 207 40 Tinea Versicolor 211 Infestations 41 Cutaneous Larva Migrans 217 42 Head Lice 221 43 Insect Bites and Papular Urticaria 225 44 Scabies 233 Papulosquamous Diseases 45 Lichen Nitidus 241 46 Lichen Planus (LP) 243 47 Lichen Striatus 247 48 Pityriasis Rosea 249 49 Psoriasis 253 50 Seborrheic Dermatitis 257 00 Front Matter PED DERM 8/17/06 11:04 PM Page ix Table of Contents ix Vascular Reactions 51 Cutis Marmorata 263 52 Erythema Multiforme (EM)/Stevens-Johnson syndrome (SJS) 267 53 Toxic Epidermal Necrolysis (TEN) 271 54 Urticaria 275 Vascular Lesions 55 Cutis Marmorata Telangiectatica Congenita (CMTC) 281 56 Infantile Hemangioma 285 57 Kasabach-Merritt Phenomenon 295 58 Pyogenic Granuloma 299 59 Telangiectasias 303 60 Vascular Malformations 309 Disorders of Pigmentation Hypopigmentation 61 Albinism 319 62 Pityriasis Alba 323 63 Post-Inflammatory Hypopigmentation 325 64 Vitiligo 327 Hyperpigmentation 65 Acanthosis Nigricans 333 66 Acquired Melanocytic Nevi 337 67 Café au Lait Macules 341 68 Congenital Melanocytic Nevi (CMN) 345 69 Ephelides 349 70 Lentigines 351 71 Mongolian Spots 355 Lumps and Bumps 72 Cutaneous Mastocytosis 359 73 Granuloma Annulare 363 74 Juvenile Xanthogranuloma 367 Bullous Diseases 75 Childhood Dermatitis Herpetiformis 371 76 Epidermolysis Bullosa (EB) 375 77 Linear IgA Dermatosis 381 00 Index PED DERM 8/18/06 2:46 PM Page 541 Index papular-purpuric gloves and socks syndrome, 106 rubella, 114 Pre-hemangiomas, 285 Primidone, 459 Propionibacterium acnes, 41 Proteus syndrome, 314 Pruritus atopic dermatitis, 26, 27 cutaneous larva migrans, 217 head lice, 221, 223 infantile acropustulosis, 445, 446 lichen planus, 243, 244 lichen sclerosus et atrophicus, 505 scabies, 233, 236 tinea cruris, 203 unilateral laterothoracic exanthem, 117 varicella, 120 Pseudohyphae candidal diaper dermatitis, 180 chronic paronychia, 181 neonatal/congenital candidiasis, 183 potassium hydroxide preps, 8, 8f thrush, 188 Pseudomonas aeruginosa, 135 Pseudoephedrine, 465, 465f “Ps” of lichen planus, 243, 243f Psoralens plus ultraviolet A (PUVA) psoriasis, 256 vitiligo, 328 Psoriasis acute paronychia look-alike, 126 associated conditions, 256 atopic dermatitis look-alike, 25 candidal diaper dermatitis lookalike, 180 diagnosing, 255 diaper dermatitis, 434, 437f etiology/epidemiology, 253 541 head lice look-alike, 222 juvenile dermatomyositis lookalike, 478 lichen planus look-alike, 244 lichen sclerosus et atrophicus lookalike, 504 lichen striatus look-alike, 248 linear lesion arrangement, look-alikes, 255 neonatal lupus erythematosus, 486, 489 onychomycosis look-alike, 189 perianal streptococcal dermatitis look-alike, 144 prognosis and referrals, 256 resources for families, 256 scabies look-alike, 235 seborrheic dermatitis look-alike, 259 signs and symptoms, 253–255, 253f, 254f subacute cutaneous lupus erythematosus look-alike, 488 tinea corporis look-alike, 200 treatment, 255–256 Psychological disorders, 430 Psychomotor retardation, 112 Pulex irritans, 226 Pulmonary system toxic epidermal necrolysis, 272, 274 tuberous sclerosis complex, 408 Pulsed dye laser therapy infantile hemangioma, 291, 292 pyogenic granuloma, 300 telangiectasias, 306 vascular malformations, 313, 314 warts, 82 Purple urticaria, 469, 470f, 471 Purpura fulminans meningococcemia, 154 varicella, 120 Pustular psoriasis, 254 00 Index PED DERM 542 8/18/06 2:46 PM Page 542 Index Pustules primary lesion types, 3, 3f toxic shock syndrome, 170, 170f PUVA (psoralens and ultraviolet A) therapy psoriasis, 256 vitiligo, 328 Pyogenic granulomas diagnosing, 300 etiology/epidemiology, 299 infantile hemangioma look-alike, 290 look-alikes, 300 prognosis and referrals, 301 resources for families, 301 signs and symptoms, 299, 299f telangiectasia look-alike, 305 treatment, 300 vascular malformations, 314 Pyrethrins, 222 Pyrithione zinc shampoo, 259, 260 Q Q fever, 228 R “Raccoon eyes” appearance, 486 Racial background atopic dermatitis, 23 pityriasis rosea, 250, 250f transient neonatal pustular melanosis, 453 Radiation therapy, 296 Radio-contrast dye, 462 Range of motion, 391 Ranitidine, 277 Rapidly involuting congenital hemangiomas, 286 Rapid streptococcal test, 162 Raynaud phenomenon, 485, 490 Recessive dystrophic epidermolysis bullosa, 375, 377, 377f, 380 Red blood cell transfusions, 296 “Red strawberry tongue,” 162, 162f Relapsing fever, 228 Renal system systemic lupus erythematosus, 491 toxic epidermal necrolysis, 272, 274 tuberous sclerosis complex, 404, 407, 408 Respiratory syncytial virus, 91 Reticulated mottling cutis marmorata, 263, 263f cutis marmorata telangiectatica congenita, 263, 281 Reticulated port wine stain, 282 Retinoblastomas, 367 Retinoid pearls, 49 Retinoids, systemic ichthyosis, 391 lichen planus, 245 systemic lupus erythematosus, 492 Retinoids, topical acne vulgaris, 45f, 46f, 47f, 48, 49, 50 molluscum contagiosum, 77 neonatal acne, 56 psoriasis, 256 Rheumatic fever, 163 Rheumatoid nodules, 364 Rickettsialpox, 120 Rickettsia rickettsii, 157 Rifampin, 138 Rituximab, 480 Rocky Mountain spotted fever atypical measles look-alike, 101 diagnosing, 158 etiology/epidemiology, 157 look-alikes, 158–159 meningococcemia look-alike, 154 papular-purpuric gloves and socks syndrome, 106 prognosis and referrals, 160 resources for families, 160 00 Index PED DERM 8/18/06 2:46 PM Page 543 Index signs and symptoms, 157–158, 157f, 158f tick bites, signs and symptoms of, 228 treatment, 159–160 Rosacea, 44, 488 Roseola infantum (exanthem subitum) diagnosing, 110 etiology/epidemiology, 109 look-alikes, 110 measles look-alike, 101 prognosis and referrals, 110 resources for families, 110 signs and symptoms, 109, 109f treatment, 110 Rotavirus, 91 Rubella diagnosing, 114 etiology/epidemiology, 111 Gianotti-Crosti syndrome, 91 look-alikes, 113 measles look-alike, 101 prognosis and referrals, 114 resources for families, 115 signs and symptoms, 111–112, 111f, 112f treatment, 114 Rubeola See measles (rubeola) “Ruffled sock” appearance of hair cuticle, 419f S Salicylates aspirin, 500 urticarial drug reactions, 462 varicella, 121 Salicylic acid acne vulgaris, 48 seborrheic dermatitis, 260 warts, 17, 82, 82t 543 Salmon patches prognosis, 315 signs and symptoms, 309, 309f treatment, 313 Sandpaper rash, 161 Sarcoidosis granuloma annulare look-alike, 364 periorificial dermatitis look-alike, Sarcoptes scabiei, 233 Satellite lesions, 179, 179f Scabies associated conditions, 237 atopic dermatitis look-alike, 25 childhood dermatitis herpetiformis look-alike, 372 cutaneous larva migrans look-alike, 218 diagnosing, 235, 236f erythema toxicum look-alike, 442 etiology/epidemiology, 233 incontinentia pigmenti look-alike, 395 infantile acropustulosis look-alike, 445 look-alikes, 234–235 mineral oil preparations, 10, 11f neonatal/congenital candidiasis look-alike, 184 nodules, 233, 234f, 237 prognosis and referrals, 237 resources for families, 237 seborrheic dermatitis look-alike, 258 signs and symptoms, 233, 233f, 234f treatment, 236–237 Scaling of lesions, Scalp, and psoriasis, 254, 254f Scarlet fever associated conditions, 164 diagnosing, 162 00 Index PED DERM 544 8/18/06 2:46 PM Page 544 Index Scarlet fever (continued) erythema infectiosum look-alike, 89 etiology/epidemiology, 161 exanthematous drug reaction lookalike, 462 Kawasaki disease look-alike, 499 look-alikes, 163 prognosis and referrals, 164 resources for families, 164 signs and symptoms, 161–162, 161f, 162f staphylococcal, 163, 167, 170 staphylococcal scalded skin syndrome look-alike, 167 toxic shock syndrome look-alike, 170 treatment, 162 Schwannomas, 399 Scleroderma, 478 Sebaceous hyperplasia, 55 Seborrheic dermatitis adult, 258, 258f, 259, 260 allergic contact dermatitis lookalike, 37 atopic dermatitis look-alike, 25 candidal diaper dermatitis lookalike, 179 diagnosing, 259 diaper dermatitis, 433, 436f etiology/epidemiology, 257 head lice look-alike, 222 infantile, 257, 257f, 258–259 intertrigo look-alike, 447 irritant diaper dermatitis lookalike, 32 look-alikes, 258–259 neonatal and infantile acne lookalikes, 55 neonatal lupus erythematosus, 486 perianal streptococcal dermatitis look-alike, 144 prognosis and referrals, 260 psoriasis look-alike, 255 resources for families, 260 scabies look-alike, 235 signs and symptoms, 257–258, 257f, 258f tinea capitis look-alike, 194 treatment, 259–260 Seborrheic tinea capitis, 193, 193f Segmental infantile hemangiomas, 286, 287f, 289 Selenium sulfide shampoo seborrheic dermatitis, 259, 260 tinea capitis, 196 tinea versicolor, 213 Serositis, 491 Serum sickness erythema multiforme/SJS lookalike, 268 urticaria look-alike, 276 Serum sickness–like reactions diagnosing, 471 etiology/epidemiology, 469 Kawasaki disease look-alike, 499 look-alikes, 470 prognosis and referrals, 471 signs and symptoms, 469, 469f, 470f treatment, 471 urticarial drug reaction look-alike, 463 Sexual abuse anogenital warts, 83 herpes simplex virus 2, 63 lichen sclerosus et atrophicus lookalike, 504 perianal streptococcal dermatitis, 144, 145 Sexually transmitted diseases, 75, 76 Shagreen patches, 404, 404f Shingles, 66, 71–73, 71f 00 Index PED DERM 8/18/06 2:46 PM Page 545 Index Short hyphae and spores potassium hydroxide preps, 9, 9f tinea versicolor, 212, 212f Silver-Russell syndrome café au lait macules, 342 neurofibromatosis look-alike, 399 Silvery “micaceous” scale, 253, 253f Sjögren syndrome, 487 SJS See Stevens-Johnson syndrome (SJS) Skeletal muscle enzymes, 479 Skeletal system café au lait macules, 342 cutis marmorata telangiectatica congenita, 282 ichthyosis, 391 McCune-Albright syndrome, 342 neurofibromatosis type 1, 342, 398 Skin cancer, 321 See also specific types of skin cancers Skin test antigen intralesional injections, 82 “Slapped-cheek” appearance, 87, 87f SLE See systemic lupus erythematosus (SLE) “Spaghetti and meatballs” appearance, 9, 9f, 212, 212f Spider angiomas pyogenic granuloma look-alike, 300 telangiectasias, 303, 303f, 306 Spironolactone, 48, 49 Spitz nevus juvenile xanthogranuloma lookalike, 368 pyogenic granuloma look-alike, 300 telangiectasia look-alike, 305 Squamous cell carcinoma epidermolysis bullosa, 380 lichen sclerosus et atrophicus, 505 Squaric acid alopecia areata, 415 545 warts, 82 Staphylococcal folliculitis erythema toxicum look-alike, 442 miliaria look-alike, 450 neonatal/congenital candidiasis look-alike, 184 transient neonatal pustular melanosis look-alike, 454 Staphylococcal scalded skin syndrome associated conditions and prognosis, 166 diagnosing, 166 etiology/epidemiology, 165 look-alikes, 167 referrals and resources, 168 scarlet fever look-alike, 163 signs and symptoms, 165, 165f, 166f toxic epidermal necrolysis lookalike, 272 toxic shock syndrome look-alike, 170 treatment, 166 Staphylococcal scarlet fever scarlet fever look-alike, 163 staphylococcal scalded skin syndrome look-alike, 167 toxic shock syndrome look-alike, 170 Staphylococcus aureus atopic dermatitis, 21 blistering dactylitis, 129 ecthyma, 131, 133 folliculitis/furunculosis/carbunculosis, 135 impetigo, 139 methicillin-resistant, 121, 126, 130, 133, 141, 166 paronychia, acute, 125 perianal streptococcal dermatitis, 143, 145 00 Index PED DERM 546 8/18/06 2:46 PM Page 546 Index Staphylococcus aureus (continued) scabies, secondary infection, 233 staphylococcal scalded skin syndrome, 165 tinea capitis, 197 toxic shock syndrome, 169, 171 varicella, and secondary bacterial infections, 120, 121, 122 Sterile folliculitis, 425, 426 Steroid acne, 44 Steroid rosacea, 44 Steroids, aerosolized, 121 Steroids, anabolic, 41 Steroids, intralesional, 364 Steroids, systemic, 383 Steroids, topical Gianotti-Crosti syndrome, 93 granuloma annulare, 364 juvenile dermatomyositis, 480 Stevens-Johnson syndrome (SJS) associated conditions, 270 diagnosing, 268 etiology/epidemiology, 267 herpes simplex virus, 68 Kawasaki disease look-alike, 499 look-alikes, 268 prognosis and referrals, 270 resources for families, 270 signs and symptoms, 268, 269f toxic epidermal necrolysis lookalike, 272 treatment, 269–270 Stork bites See salmon patches Strawberry tongue Kawasaki disease, 497, 497f scarlet fever, 162, 162f Streptococcal perianal dermatitis, 32 Streptococcal toxic shock syndrome, 170 Streptococcus infections blistering dactylitis, 129 ecthyma, 131, 133 perianal streptococcal dermatitis, 143, 145 rapid strep test, 162 Streptococcus pneumoniae bacteremia meningococcemia look-alike, 155 Rocky Mountain spotted fever look-alike, 159 Streptococcus pyogenes diaper dermatitis, 434 guttate psoriasis, 254, 256 impetigo, 139, 141 intertrigo, 447 scabies, secondary infection, 233 scarlet fever, 161 toxic shock syndrome, 169 varicella, and secondary bacterial infections, 120, 121, 122 Sturge-Weber syndrome, 314 Subacute cutaneous lupus erythematosus, 485–486, 485f, 487 Subungual onychomycosis, 189, 190–191, 190f “Suffocation” therapy, for head lice, 223 Sulfacetamide, topical, 59 Sulfapyridine childhood dermatitis herpetiformis, 373 linear IgA dermatosis, 383 Sulfonamides drug hypersensitivity syndrome, 457, 488 exanthematous drug reactions, 461 fixed drug eruptions, 465, 465f serum sickness–like reactions, 469 toxic epidermal necrolysis, 271, 273 urticarial drug reactions, 462, 462f Sulfur in petrolatum, for scabies, 236 00 Index PED DERM 8/18/06 2:46 PM Page 547 Index “Summer penile syndrome,” 227 “Sunburst” appearance of bullae, 165, 166f Sunglasses, 18 Superficial hemangiomas, 285, 285f Superficial white onychomycosis, 189, 190f, 191 Surgery congenital melanocytic nevi, 346 cutaneous mastocytosis, 362 folliculitis/furunculosis/carbunculosis, 138 infantile hemangioma, 291 juvenile xanthogranuloma, 368 lichen sclerosus et atrophicus, 505 nevus sebaceous (of Jadassohn), 452 pyogenic granuloma, 300 tick bite granulomas, 231 warts, 82 Synalar, 260 Syndactyly, 264 Syphilis, congenital congenital rubella look-alike, 113 diaper dermatitis, 435, 437f Syphilis, secondary angular cheilitis look-alike, 177 pityriasis rosea, 251, 252 Systemic lupus erythematosus (SLE) associated conditions, 492–493 diagnosing, 490–491 etiology/epidemiology, 483 juvenile dermatomyositis lookalike, 478 look-alikes, 487–489 neonatal lupus erythematosus, 487 prognosis and referrals, 493 resources for families, 493 signs and symptoms, 483–487, 483f, 484f, 485f, 486f treatment, 492 547 variants of, 483f, 484f, 485–487, 485f, 486f Systemic-onset juvenile rheumatoid arthritis, 499 T Tacrolimus alopecia areata, 415 atopic dermatitis, 28 juvenile dermatomyositis, 480 lichen sclerosus et atrophicus, 505 systemic lupus erythematosus, 492 vitiligo, 328 Tar preparations psoriasis, 256 seborrheic dermatitis, 260 Teeth, abnormalities of cutis marmorata telangiectatica congenita, 264 incontinentia pigmenti, 394 Telangiectasias diagnosing, 306 etiology/epidemiology, 303 juvenile dermatomyositis, 476, 476f look-alikes, 305 prognosis, 306 referrals and resources, 307 signs and symptoms, 303–305, 303f, 304f treatment, 306 Telogen effluvium alopecia areata look-alike, 413, 414 diagnosing, 423–424 etiology/epidemiology, 421 look-alikes, 423 loose anagen syndrome look-alike, 418 prognosis and referrals, 424 resources for families, 424 signs and symptoms, 422, 422f treatment, 424 00 Index PED DERM 548 8/18/06 2:46 PM Page 548 Index Temperature, environmental cutis marmorata, 263, 264 miliaria, 450 urticaria, 275 Terbinafine onychomycosis, 190, 191 tinea capitis, 196 tinea corporis, 201 tinea cruris, 204 tinea pedis, 209 Testicular cancer, 388 Testosterone, 505 Tetracycline acne vulgaris, 48 fixed drug eruptions, 465 periorificial dermatitis, 59 serum sickness–like reactions, 469 Thalidomide, 492 Therapeutics corticosteroids, topical, 13–16, 13t, 14t cryotherapy, 17 moisturizers, 16 sun protection, 18 Thiabendazole, 218 Thrombocytopenia congenital rubella, 112, 113 Kasabach-Merritt phenomenon, 295, 295f Rocky Mountain spotted fever, 159 Thrush candidal diaper dermatitis, 180 diagnosing, 178f, 188 etiology/epidemiology, 187 look-alikes, 187–188 prognosis and referrals, 188 signs and symptoms, 187, 187f treatment, 188 Thumb sucking chronic paronychia, 181, 182 dermatitis, 31 Thyroid disorders cutis marmorata telangiectatica congenita, 264 drug hypersensitivity syndrome, 459 telogen effluvium, 424 Tick bites granulomas, 231 Lyme disease, 149, 151 Rocky Mountain spotted fever, 157 signs and symptoms, 228 Tinactin onychomycosis, 191 tinea cruris, 204 tinea pedis, 209 Tinea capitis alopecia areata look-alike, 413 associated conditions, 197 diagnosing, 195–196, 195f, 196f etiology/epidemiology, 193 look-alikes, 194 potassium hydroxide preps, 8, 8f prognosis and referrals, 197 resources for families, 197 signs and symptoms, 193–194, 193f, 195f telogen effluvium look-alike, 423 traction alopecia look-alike, 425 treatment, 196 trichotillomania look-alike, 429 Wood light examination, 11 Tinea corporis annular arrangement of lesions, 6, 6f atopic dermatitis look-alike, 25 cutaneous larva migrans look-alike, 218 diagnosing, 200, 201f etiology/epidemiology, 199 granuloma annulare look-alike, 364 look-alikes, 200 00 Index PED DERM 8/18/06 2:46 PM Page 549 Index Lyme disease look-alike, 150 neonatal lupus erythematosus, 486, 489 pityriasis rosea look-alike, 251 prognosis and referrals, 201 resources for families, 201 signs and symptoms, 199, 199f subacute cutaneous lupus erythematosus look-alike, 489 treatment, 201 unilateral laterothoracic exanthem look-alike, 118 Tinea cruris diagnosing, 204 etiology/epidemiology, 203 intertrigo look-alike, 448 look-alikes, 204 prognosis, 204 referrals and resources, 205 signs and symptoms, 203, 203f treatment, 204 Tinea pedis associated conditions, 209 diagnosing, 208, 208f etiology/epidemiology, 207 look-alikes, 208 onychomycosis, 189, 209 prognosis and referrals, 209 resources for families, 209 signs and symptoms, 207, 207f treatment, 209 Tinea unguium (onychomycosis) See onychomycosis Tinea versicolor diagnosing, 212, 212f etiology/epidemiology, 211 look-alikes, 212 pityriasis alba look-alike, 323 post-inflammatory hypopigmentation look-alike, 325 549 prognosis and referrals, 213 resources for families, 213 short hyphae and spores, 9, 9f signs and symptoms, 211, 211f treatment, 213 tuberous sclerosis complex lookalike, 405 vitiligo look-alike, 328 Wood light examination, 11 TMP-SMX See trimethoprimsulfamethoxazole (TMP-SMX) Tolnaftate tinea corporis, 201 tinea cruris, 204 tinea pedis, 209 Toxic epidermal necrolysis associated conditions, 274 diagnosing, 273 drug hypersensitivity syndrome, 457 etiology/epidemiology, 271 look-alikes, 272–273 prognosis and referrals, 274 resources for families, 274 signs and symptoms, 271–272, 271f, 272f treatment, 273 Toxic shock syndrome associated conditions and prognosis, 172 diagnosing, 171 etiology/epidemiology, 169 Kawasaki disease look-alike, 499 look-alikes, 170–171 referrals and resources, 172 scarlet fever look-alike, 163 signs and symptoms, 169–170, 170f staphylococcal scalded skin syndrome look-alike, 167 toxic epidermal necrolysis lookalike, 273 treatment, 171–172 00 Index PED DERM 550 8/18/06 2:46 PM Page 550 Index Toxins, and toxic shock syndrome, 169, 172 Toxoplasmosis, 113 Trachyonychia alopecia areata, 413 onychomycosis look-alike, 189 Traction alopecia alopecia areata look-alike, 413 associated conditions, 426 diagnosing, 426 etiology/epidemiology, 425 look-alikes, 425–426 prognosis and referrals, 426 signs and symptoms, 425, 425f telogen effluvium look-alike, 423 tinea capitis look-alike, 194 treatment, 426 trichotillomania look-alike, 429 Transient neonatal pustular melanosis diagnosing, 454 eosinophilic pustular folliculitis look-alike, 439 erythema toxicum look-alike, 442 etiology/epidemiology, 453 look-alikes, 454 neonatal/congenital candidiasis look-alike, 183 prognosis and referrals, 454 resources for families, 454 signs and symptoms, 453, 453f Trauma acute paronychia look-alike, 126 angular cheilitis look-alike, 177 birth, trauma from, 312 Traumatic herpes simplex virus infection, 66 Treponema pallidum, 435 Tretinoin, topical molluscum contagiosum, 77 neonatal acne, 56 Triamcinolone atopic dermatitis, 26, 27 topical corticosteroids, 13t Trichobezoar, 430 Trichophagia, 430 Trichophyton mentagrophytes onychomycosis, 189 tinea corporis, 199 tinea cruris, 203 tinea pedis, 207 Trichophyton rubrum onychomycosis, 189 tinea corporis, 199 tinea pedis, 207 Trichophyton tonsurans tinea capitis, 193, 195, 195f, 196 tinea corporis, 199 Trichotillomania alopecia areata look-alike, 414 etiology/epidemiology, 427 loose anagen syndrome look-alike, 418 signs and symptoms, 427–428, 427f, 428f telogen effluvium look-alike, 423 tinea capitis look-alike, 195 traction alopecia look-alike, 426 Triclosan, 137 Trigger agents See also allergens cutaneous mastocytosis, 361 exanthematous and urticarial drug reactions, 461, 461f, 462, 462f urticaria, 275, 276 Trimethoprim-sulfamethoxazole (TMP-SMX) blistering dactylitis, 130 folliculitis/furunculosis/ carbunculosis, 138 head lice, 223 impetigo, 141 paronychia, acute, 126 00 Index PED DERM 8/18/06 2:46 PM Page 551 Index varicella, and secondary bacterial infections, 121 Trypanosomiasis, 228 Tuberous sclerosis complex associated conditions, 407–408 diagnosing, 407 etiology/epidemiology, 403 look-alikes, 405–406 prognosis and referrals, 408 resources for families, 408 signs and symptoms, 403–404, 403f, 404f treatment, 407 Wood light examination, 11 Tufted angiomas, 295, 296 Tularemia, 228 Tumor necrosis factor-alpha antagonists, 480 Turner syndrome, 311 Tzanck smears herpes simplex virus, 67, 67f herpes zoster, 72 varicella, 121 U Ulcerations cutis marmorata telangiectatica congenita, 264, 265 infantile hemangioma, 291–292 primary lesion types, systemic lupus erythematosus, 484, 490, 491 Ultrasonography infantile hemangioma, 290 tuberous sclerosis complex, 407, 408 vascular malformations, 313 Ultraviolet therapy lichen planus, 245 pityriasis rosea, 251 psoriasis, 256 PUVA, 256, 328 551 vitiligo, 328 Ungual fibromas, 404, 404f Unilateral laterothoracic exanthem diagnosis, 118 etiology/epidemiology, 117 look-alikes, 118 prognosis and referrals, 118 signs and symptoms, 117, 117f treatment, 118 Unilateral nevoid telangiectasia, 304, 304f, 306 Urticaria associated conditions, 277 cutaneous mastocytosis look-alike, 360 diagnosing, 276–277 erythema multiforme/SJS lookalike, 268 etiology/epidemiology, 275 fixed drug eruption look-alike, 466 insect bite look-alike, 229 look-alikes, 276 Lyme disease look-alike, 150 prognosis, 277 purple, and serum sickness–like reactions, 469, 470, 470f referrals and resources, 278 signs and symptoms, 275, 275f treatment, 277 Urticarial drug reactions associated conditions, 464 diagnosing, 464 etiology/epidemiology, 461 look-alikes, 463 prognosis and referrals, 464 resources for families, 464 signs and symptoms, 462, 462f treatment, 464 Urticarial vasculitis, 276 Urticaria pigmentosa, 359, 360–361, 362 00 Index PED DERM 552 8/18/06 2:46 PM Page 552 Index V Valacyclovir herpes simplex virus, 68 herpes zoster, 73 Vancomycin staphylococcal scalded skin syndrome, 166 toxic shock syndrome, 171 Varicella diagnosing, 121 etiology/epidemiology, 119 look-alikes, 120 prognosis, 121 referrals and resources, 122 signs and symptoms, 119–120, 119f treatment, 121 Varicella-zoster virus infection herpes zoster, 71 impetigo look-alike, 140 varicella, 119 Vascular malformations associated conditions, 314, 315f diagnosing, 313 etiology/epidemiology, 309 look-alikes, 312 prognosis and referrals, 315 resources for families, 316 signs and symptoms, 309–312, 309f, 310f, 311f, 312f treatment, 313 Vasculitis ecthyma look-alike, 132 systemic lupus erythematosus, 485, 490 Vasoactive agents meningococcemia, 155 Rocky Mountain spotted fever, 159 toxic shock syndrome, 171 Velvety thickening of the skin, 333, 333f, 334 Venous malformations infantile hemangioma look-alike, 289 signs and symptoms, 310–311, 310f treatment, 313 Vesicles allergic contact dermatitis, 35, 35f, 36 primary lesion types, 2, 3f varicella, 119, 119f Vesicular tinea pedis, 207, 207f Vesiculopustules eosinophilic pustular folliculitis, 439 look-alikes, 442–443 Vincristine infantile hemangioma, 291 Kasabach-Merritt phenomenon, 296 Viral exanthems drug hypersensitivity syndrome look-alike, 458 exanthematous drug reaction lookalike, 462 folliculitis/furunculosis/carbunculosis look-alike, 136 guttate psoriasis, 254, 254f Kawasaki disease look-alike, 499 scabies look-alike, 235 Viscous lidocaine solution, 68 Vitamin A, and measles, 102 Vitiligo albinism look-alike, 320 associated conditions, 329 diagnosing, 328 etiology/epidemiology, 327 lichen sclerosus et atrophicus lookalike, 504 look-alikes, 328 pityriasis alba look-alike, 323 00 Index PED DERM 8/18/06 2:46 PM Page 553 Index post-inflammatory hypopigmentation look-alike, 325 prognosis and referrals, 329 resources for families, 329 signs and symptoms, 327, 327f tinea versicolor look-alike, 212 treatment, 328 tuberous sclerosis complex lookalike, 405 Wood light examination, 11, 328 Vulvovaginitis, 143, 145 W “Walking dandruff,” 227 Warts cryotherapy, 17 etiology/epidemiology, 79 incontinentia pigmenti lesions, 393, 393f lesion arrangement, look-alikes, 80–81 molluscum warts, 312 referrals and resources, 83 signs and symptoms, 79–80, 79f, 80f treatment, 81–82, 82t Watson syndrome café au lait macules, 342 neurofibromatosis look-alike, 399 Weber-Cockayne epidermolysis bullosa simplex, 375 Western immunoblot test, 151 Wheals primary lesion types, 2, 2f urticaria, 275, 275f, 276 553 “White strawberry tongue,” 162 Wickham’s striae, 243 Wiskott-Aldrich syndrome, 113 Witch hazel, 464 Wood light examination diagnostic techniques, 11 tinea capitis, 196 tinea versicolor, 212 vitiligo, 11, 328 Wound care epidermolysis bullosa, 379 infantile hemangioma, 290 Wright stain erythema toxicum, 443 infantile acropustulosis, 446 transient neonatal pustular melanosis, 454 X Xeroderma pigmentosum, 350 Xerosis, 23 X-linked recessive ichthyosis, 387–388, 388f Z Zeasorb AF powder onychomycosis, 191 tinea cruris, 204 tinea pedis, 209 Zinc oxide, topical irritant diaper dermatitis, 34 lichen sclerosus et atrophicus, 505 Zinc supplements, oral, 434 Zosteriform herpes simplex virus infection, 66 00 Index PED DERM 8/30/06 8:52 AM Page 554 Figure Credits All figures not included in the following list are courtesy of the American Academy of Pediatrics Special thanks to Daniel P Krowchuk, MD; Anthony J Mancini, MD; J Thomas Badgett, MD, PhD; Amy J Nopper, MD; Steven D Resnick, MD; Michael L Smith, MD; and Patricia A Treadwell, MD Centers for Disease Control and Prevention: Figure 19.1 Elsevier: Figures 2.6, 18.1, 34A.2, 36.2, 36.3, 43.3, 44.4, 56.8, 58.1, 58.2, 87.9, 101.3, 101.5 Reprinted with permission from Elsevier From Paller AS, Mancini AJ Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence 3rd ed Philadelphia, PA Elsevier Saunders; 2006 Figure 50.4 Reprinted with permission from Elsevier From Lee DJ, Eichenfield LF Atopic, contact, and seborrheic dermatitis in adolescents Adolesc Med State Art Rev 2001;12:269-283 Figure 101.4 Reprinted with permission from Elsevier From Mancini AJ Childhood exanthems: a primer and update for the dermatologist Adv Dermatol 2000;16:3-37 Alan B Fleischer, Jr, MD: Figure 75.1 Laurence Givner, MD: Figure 87.11 Kimberly Horii, MD: Figures 82.2, 82.4, 85.1, 100.1 Brandon Newell, MD: Figures 82.5, 84.1, 100.2, 102.1 Howard Pride, MD: Figures 12.1, 12.2, 14.1, 14.2, 16.2, 21.1, 21.2, 57.1 Mary Rimsza, MD: Figures 19.2, 94.1 Paul J Sagerman, MD: Figures 89.2, 94.3 Thomson Professional Postgraduate Services: Figures 6.5, 6.6, 6.7 Developed by Thomson Professional Postgraduate Services® Adapted with permission All Rights Reserved Copyright © 2003 Thomson Professional Postgraduate Services Walt W Tunnesen, Jr, MD: Figure 1.10 Albert Yan, MD: Figures 6.9, 87.5 Dermatology Cover Spread:Layout 2/24/10 9:56 AM Page A QUICK REFERENCE GUIDE American Academy of Pediatrics Section on Dermatology Editors: Daniel P Krowchuk, MD, FAAP, and Anthony J Mancini, MD, FAAP Now you can consult a single authoritative AAP resource for the guidance you need to evaluate, diagnose, treat, and manage more than 100 pediatric and adolescent skin conditions More than 250 full-color images aid in accurate recognition and differential diagnosis Bullous Diseases Genodermatoses Hair Disorders Skin Disorders in Neonates/Infants Drug Eruptions Cutaneous Manifestations of Rheumatologic Diseases Other Disorders Daniel P Krowchuk, MD, FAAP Anthony J Mancini, MD, FAAP Selected content highlights Dermatitis Acne Skin Infections Infestations Papulosquamous Diseases Vascular Reactions Vascular Lesions Disorders of Pigmentation Lumps and Bumps Pediatric Dermatology P Dermatology y Pediatric Dermatology Custom-built for efficient, confident problem-solving Essential information on each condition is presented in the precise sequence in which you need it in the clinical setting • • • • Etiology/Epidemiology Signs and Symptoms Look-alikes How to Make the Diagnosis • • • • Treatment Prognosis When to Worry or Refer Resources for Families For other pediatric resources, visit the American Academy of Pediatrics online Bookstore at www.aap.org/bookstore AAP Pediatric Dermatology A QUICK REFERENCE GUIDE Editors Daniel P Krowchuk, MD, FAAP Anthony J Mancini, MD, FAAP ...00 Front Matter PED DERM 8/17/06 11:03 PM Page i Pediatric Dermatology A Quick Reference Guide Section on Dermatology American Academy of Pediatrics Editors Daniel P Krowchuk, MD, FAAP Anthony... RP, et al Dermatology London, UK: Elsevier; 2003 Cohen BA Pediatric Dermatology 3rd ed Edinburgh, UK: Elevier Mosby; 2005 Eichenfield LF, Frieden IJ, Esterly NB Textbook of Neonatal Dermatology. .. 2001 Paller AS, Mancini AJ Hurwitz Clinical Pediatric Dermatology 3rd ed London, UK: Elsevier; 2006 Schachner LA, Hansen RC, Happle R, et al Pediatric Dermatology 3rd ed London, UK: Mosby; 2003