Pediatric Dermatosis: Nevi😍

• Port-wine stain in trigeminal distribution

• Leptomeningeal Angiomatosis (ipsilateral)
• cavernous angioma (vascular malformation).
• Convulsions (Focal)
• behavioural problems,
• Mental retardation

• Choroidal Hemangiomas
• Ocular complications
• ipsilateral glaucoma,
• blindness,
• congestion
• Buphthalmos

• Unilateral weakness
• d/t tumor compressing corticospinal pathway.

CT scan:

• S-shaped intracranial calcifications

• S for Sturge-Weber, S for S shaped





 

• Tram track appearance or rail road calcification
• NOTE: Also seen in
• membranoproliferative glomerulonephritis,
• bronchiectasis.

• Mnemonic: Web of storage (Sturg Weber) of Portwine factories () → connected by rail tram tracks (Tram track apearance)

4. Omalizumab

• Monoclonal antibody against IgE

• Used for
• Urticaria
• prophylaxis of severe persistent Bronchial asthma

• Not effective in atopic dermatitis

• Given subcutaneously

• Kochinu asthma (asthma) vannapo maran Om Kreem (Om) kuttichathaennu prnj ammumma

Hereditary Angioedema (HAE)

• Also: Quincke's Disease

• Autosomal dominant

• Bradykinin mediated

• NOT HISTAMINE MEDIATED

• Defect: C1 esterase inhibitor deficiency
• Leads to uncontrolled complement cascade
• C1 inhibitor normally controls C1 pathway.
• Deficiency → uncontrolled complement → episodic swelling (edema).

• Types based on C1 inhibitor:
• Type 1: Low C1 inhibitor protein concentration
• Type 2: Loss of C1 inhibitor function (quantity normal)
• Type 3: Normal C1 inhibitor → Factor 12?? (unknown defects)

• Presentation:
• Recurrent laryngeal edemas
• Colicky abdominal pain
• Recurrent angioedema
• Positive family history

• Evaluation:
• Screening: Low C4 level
• Specific: C1 inhibitor levels

• Treatment:
• Acute: Airway management
• IV C1-esterase inhibitor concentrate (C1-INH)
• Fresh frozen plasma (contains C1 inhibitor)
• DOC: Danazol
• Icatibant, Ecallantide
• Lanadelumab
• Ee kaatile Ee kallan Anade adyil
• Prophylaxis: Tranexamic acid, anabolic steroids
• Anabolic steroid Danazol may help.

• Consequence of visceral leishmaniasis

• Develops 1-2 years after treatment.

• Presents as hypopigmented nodules.

• History of kalazar (fever, splenomegaly, hepatomegaly) in childhood

• Develops years later

• Caused by: L. Infantum, L. Chagasi, L. Donovani

• Endemic to NE India

• Lesions:
1. Raindrop-like hypopigmented lesions on trunk
2. Succulent erythematous papules and nodules around muzzle area of face

• Not leprosy (no loss of sensation)

Smear:

• Leishman in Donovan bodies
• LD bodies, amastigote form in macrophages

Treatment:

• DOC: Oral Miltefosine

• Antimonials,

• Amphotericin B,

• NO (9% Nickel oxide) Bullshit (Barium silicate) in Woods

• 365 days (365nm) in wood

• Woman with green cap (tinea capitis green), yellow beaded pedant (yellow versicolor) around neck and red bikini (red → erythrasma) inside a forest full of wood (Woods lamp)

• Low output mercury arc lamp

• Covered with Wood’s filter (barium silicate + 9% nickel oxide)

• Emits UV light (320–450 nm, peak 365 nm)

• Clinical Uses:

Condition	Wood’s Lamp Finding
Vitiligo	Lesions accentuate
Tinea capitis	Greenish fluorescence
Pityriasis versicolor	Yellow fluorescence
Erythrasma	Coral red fluorescence
Congenital erythropoietic porphyria	Reddish fluorescence
Melasma	Differentiates epidermal vs dermal types

Skin Biopsy Types

1. Incision biopsy:
• Small part of lesion excised

2. Shave biopsy:
• Superficial;
• seborrheic or actinic keratosis

3. Punch biopsy:
• Most common
• Uses circular punch of various sizes
• Area is sutured after removal

4. Excision biopsy:
• For suspected malignancy
• Entire lesion is removed