Chapter 47
Chicken pox virus (varicella) is a highly contagious viral illness caused by the
varicella-zoster virus and is spread by close person-to-person contact and by
airborne droplets. Vesicular lesions occur in the epidermis as infection occurs within
keratinocytes. Children are contagious for at least 1 day before development of the
lesions. 1st sign of illness may be pruritus or appearance of vesicles. Superficial and
rupture easily.
Irritant contact dermatitis due to irritation in the diaper area. It’s initiated by
prolonged exposure to and irritation by urine wetness and feces, maceration by wet
diapers, airtight plastic diaper cover, or use of diaper wipes. Associated with
secondary infection of candida albicans. The resulting inflammation affects the lower
aspect of the abdomen, genitalia, buttocks, and upper portion of the thigh. Lesions
vary from mild erythema to erythematous papular lesions and can affect overall
infant health.
S/S, Pathophysiology, Source of infection and definition
- Impetigo: Most common bacterial skin infection in children and highly
contagious. Characterized by crusted erosions or ulcers that may arise as a
primary or secondary infection. S aureus and Strept pyogenes.
- Tinea: Fungal infections. Can affect scalp, body, foot and nails. Ringworms.
- Thrush: Oral thrush is characterized by formation of white plaques or spots in
the mouth that lead to shallow ulcers, caused by keratolytic proteases from
microorganism. Much higher in bottle fed infants. The disease is often
accompanied by fever and GI irritation.
Allergic contact dermatitis is caused by a delayed hypersensitivity reaction to
contact with the allergen, which is a T-cell mediated, type IV delayed immune
response. Common allergens are nickel exposure and topical products and plants.
In atopic dermatitis, IgE, eosinophils and macrophages are elevated.
Itching is a hallmark of atopic dermatitis, rubbing and scratching to relieve the itch.
Frequently an infant with diaper dermatitis is secondarily infected with C. Albicans
(thrush).
Bullous impetigo is a rare variant of impetigo caused by S. Aureus. Produces
exfoliative toxin.
Impetigo is a common bacterial skin infection. Day care, poor sanitation, crowded
living.
Vesicular impetigo lesions begin as small vesicles with honey-colored serum.
Skin lesions caused by tinea corporis are erythematous, round or oval-scaling
patches.
Contact with kittens and puppies is a common source of tinea corporis.
The poxvirus is the cause of molluscum contagiosum.
Thrush is best defined as the presence of candida in the mouth of infants. C. Albicans
infection is a superficial fungal infection that occurs in kids.
Rubella is a common communicable disease in children and young adults caused by a
virus.
Rubeola is highly contagious and a result of viral infection.
Prodromal symptoms of rubeola include high body temp, malaise, enlarged lymph
nodes, runny nose, conjunctivitis and a barking [Link] symptoms of
rubella include enlarged cervical and postauricular lymph nodes, low-grade fever,
HA, sore throat, runny nose and cough.
Scabies has symptoms that appear 3-5 weeks after infestation. The burrows, papules,
and vesicular lesions cause severe itching that worsens at night.
Only the primary lesion of the body louse (pediculosis) exhibits a pinpoint red
macule, papule, or wheal with a hemorrhagic puncture site.
Scabies is the only contagious disease caused by the itch mite, Sarcoptes scabiei.
A port-wine stain is present at birth or within a few days after birth and doesn’t fade
with age.
Miliaria is characterized by a vesicular eruption after prolonged exposure to
perspiration, with subsequent obstruction of the eccrine ducts.
90% of strawberry hemangiomas are involute by 5-6 years of age, usually w/o
scarring. Self resolution is the best treatment plan.
Virulent group II staphylococci causes scalded skin syndrome, the syndrome results
in separation involving the epidermis and toxins resulting from scalded skin
syndrome are circulated through the bloodstream.
Acne lesions may be divided into inflammatory lesions (pustules, papules, nodules)
and noninflammatory lesions (closed and open comedones).
Rubeola infection begins with characteristic pinpoint white spots surrounded by an
erythematous ring that develops over the buccal mucosa and is known as Koplik
spots.
Rubella: Faint, pink to red coalescing maculopapular rash on scalp or trunk.
Roseola: Erythematous macular rash that lasts 24 hrs and develops over the trunk
and neck.
Varicella: Itching or vesicle appearance on trunk, scalp or face and spread to
extremities.
Herpes Zoster: Group of vesicles on inflammatory base following course of sensory
nerve.
Microscopic hyphae = Mycotic dermal infections include Tinea infections.