Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
Drug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2lly acute and self-resolving•AntihistaminesUrticaria (hives) is an extremely common condition in children. Published incidences of 10-20% probably underestimate its frequency, as most children with self-limited, brief bouts of urticaria will not seek medical attention. For the most part, it is a min Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2or nuisance that requires little in the way of diagnostic acumen or treatment. Six weeks' duration arbitrarily distinguishes chronic from acute urticaEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
ria.Clinical presentationHives are characterized by erythematous, edematous papules and plaques. As the lesion becomes annular, it develops a pale cenDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2-1). Young children and infants tend to have expansive and unusual lesions, rarely with bulla formation. Lesions evolve and transform almost before one’s eyes and it is not unusual for parents to exclaim how different the lesions appeared just moments before the practitioner's exam. Outlining indivi Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2dual plaques with a marker can dramatically illustrate this phenomenon. The evanescence of the hives is one of its most distinctive features and can bEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
e a very' helpfill historical point when the child has no lesions at the time of tire evaluation. Light bruising may sometimes linger after lesions reDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2oking the skin (Figure 6-2). The child's own scratching may induce linear hives. Demonstrating dermatograph ism may be aclue to the diagnosis of hives when a patient has no lesions at the time of the evaluation. The other physical urticarias are listed in Box 6-1.A serum sickness-like reaction can b Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2e seen after treatment with antibiotics. This is a classic side-effect of cefaclor but its infrequent use makes amoxicillin the most common current prEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
ecipitant. Large serpiginous and polycyclic urticarial plaques with conspicuous bruising are characteristic (Figure 6-3). Arthralgias and fever are coDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2company regular urticaria or occur on its own. In a small minority' of cases, it is a manifestation of autosomal-dominant hereditary angioedema, which is associated with repeated attacks accompanied by abdominal pain and airway edema. Anaphylaxis refers to angioedema or hives accompanied by profound Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2 tissue edema leading to airway compromise, abdominal symptoms, hypotension, and possibly shock, occurring minutes after a sting, ingestion, or medicaEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
tion. Stable hives do not progress to anaphylaxis, as is commonly dreaded by parents.Papular urticaria is a confusing term used for bug bites. LesionsDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2ia. They may be grouped in threes - the so-called breakfast, lunch, and dinner (Figure 6-4) - and tend to cluster in the most exposed areas of the arms, legs, and head. A central punctum may be noted with magnification. Some may form vesicles and bullae. Since lesions tend to occur 1-2 days followin Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2g the bite, cause and effect may not be immediately obvious. Most often, the patient is the only one in the family who is overtly affected, a puzzlingEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
and hard-to-believe feature for parents. Fleas are the most common cause but bed bugs are making a comeback.90Pediatric DermatologyFigure 6-1 UrticarDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2icaria - Iran exposure to cold air or water Aquagenic urticaria - from contact with water or sweat Cholinergic urticaria - smaller papules Irom heat or exercise Solar urticaria - from ultraviolet light exposureFigure 6-2 Dermatographism. Linear urticaria appearing after stroking the skintask at best Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2, with the majority of cases having no identifiable trigger. Common viral infections account for the majority of identifiable causes, with medicationsEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
, especially antibiotics, close behind. Foods, particularly nuts, dairy products, seafood, and berries, are possible causes but this is hard to prove Drug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2tand out. A very thorough history with a complete review of systems and a good physical exam are the most useful diagnostic tools. Laboratory' tests not suggested by signs or symptoms are almost always unhelpful. Radioallergosorbent test or prick testing will likely add to the confusion rather than Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2help clarify a cause. A food and activity' diary kept by the parents may be helpful with chronic urticaria.Hereditary angioedema is a serious conditioEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
n and a specific diagnosis needs to be made in cases of complicated or repeated angioedema. Low levels of C4 and decreased activity of c 1 esterase inDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2e absence of hives.PEARLThe presence of hives virtually excludes a diagnosis of hereditary angioedemaDiagnosisUrticaria is usually an easy clinical diagnosis, recognized by patients and parents before they ever see a physician. Erythema multiforme (EM) and other figurate erythemas, excluding erythem Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2a marginatum, are distinguished by their lack of evanescence. Autoimmune blistering conditions may present with urticaria before becoming overtly bullEbook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2
ous. Biopsy may be needed in atypical urticaria.The greatest challenge comes in diagnosing the underlying cause for the hives, an elusivePapular urticDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•General Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2 prurigo nodularis, pityriasis lichenoides, lymphomatoid papulosis, guttate psoriasis, and Gianotti-Crosti syndrome may enter the differential diagnosis.PathogenesisHives result from the release of inflammatory mediators, particularly histamine, from mast cells through an immunologic immunoglobulinD Ebook Requisites in dermatology - Pediatric dermatology (8th edition): Part 2rug eruptions and inflammatory eruptiFigure 6-3 Serum sickness-hke reaction. Large serpiginous and polycyclic deques With conspicuous bruisingDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•GeneralDrug eruptions and inflammatory eruptionsof the skinHoward B. PrideUrticariaKey Points•Most often from infections, medications, sometimes food•GeneralGọi ngay
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