Deficiency of Interleukin 1 Receptor Antagonist (DIRA), Deficiency of interleukin 36 receptor antagonist (DITRA), Pityriasis rubra pilaris (PRP), Disseminated Superficial Actinic Porokeratosis (DSAP), Autoinflammation LipoDystrophy and Dermatosis syndrome (ALDD). Classic lesions consist of round, well-circumscribed erythematous plaques covered by a thick silver scale with a predilection for elbows, knees, scalp, lumbosacral and anogenital regions. The skin appears edematous and inflamed causing the infant to be irritable. Superficial Staphylococcal infection most common with 1-2mm fragile pustules and honey-colored, crusted lesions. Classic presentation: Well circumscribed, erythematous papules and plaques with greasy yellow scale most prominent in the skin folds. Bullous impetigo with circumscribed lesions with a thin collarette of scale. The initial lesions are small vesicles or pustules ( 2 cm) that rupture and become a honey-colored crust with a moist erythematous base.
Prevalence is highest among black children 1 with age-related gender variation. Skin lesions are typically diffuse and very pruritic. Psoriasis vulgaris, or plaque psoriasis, is the most common form of psoriasis and is characterized by sharply circumscribed, persistent erythematous, indurated plaques with silvery-white, adherent scale and a predilection for extensor surfaces of the elbows or knees, or for the thumb in infants who suck their thumb ( thumb sign ) via the K ebner phenomenon (localization to areas of micro-trauma; Figure 3). In one study, PsE responded well to psoriasis treatment strategies including TCS 34. Pediatric psoriasis is subdivided into congenital, infantile, and childhood, defined as psoriasis presenting at birth, in the first year of life, and between ages 1 and 18 years, respectively. Individual lesions of typical psoriasis consist of erythematous, well-demarcated plaques with silvery-white scale. Affected infants are often 12 months old and otherwise well. Type III classic juvenile PRP and type IV circumscribed juvenile PRP are more common in older children but can occur early in life. Erythematous, serpiginous lesions with well-demarcated edges (A) and conjunctival edema (B) associated with wheezing were seen in this patient. The main form of treatment includes H1 blockers (eg, diphenhydramine) given intravenously (IV) or orally.
Dermal and subcutaneous growths result from (1) reactive or neoplastic proliferation of cellular components of the dermis or subcutaneous tissue, or (2) neoplasms invading or aberrantly present in the dermis. Infantile myofibromatosis (congenital generalized fibromatosis, congenital multicentric fibromatosis). Epidermal nevi, neoplasms, cysts are skin lesions that develop from the epidermal layer of the skin. Atopic, dermatitis, eczema, erythema, hand foot and mouth disease, impetigo, infant rash, measles, morbilliform rash. Psoriasis: well circumscribed, pink/red plaques, silvery scale. Fungal infection: annular lesion, often with raised, scaly edge and central clearing. Classic lesion is target-shaped (red with pale center). Infantile atopic dermatitis.
1. Ad Diagnosis
Psoriasis, lichen planus, p. rosea, pityriasis lichenoides, seb. dermatitis, lichen nitidus, lichen striatus, pityriasis rubra pilaris, erythroderma, exfoliati. Intense in ltrate situated immediately below epidermis and is well circumscribed. Morphology of papules/plaques in papulosquamous disorders Psoriasis Erythematous papules and plaques Lichen planus Violaceous papules with Wickham’s striae Pityriasis rosea Annular plaques Seborrheic dermatitis Yellowish, follicular papules Pityriasis rubra pilaris Erythematous follicular papules Secondary syphilis Dusky erythematous papules Pityriasis lichenoides et varioliformis acuta Erythematous edematous papules surmounted with vesicles/crust Pityriasis lichenoides chronica Erythematous papules surmounted with micalike scales. EB has an incidence of 1 in every 50,000 births, consisting mostly of the milder EB Simplex (EBS) type. Dowling-Meara (DM) EBS is most severe in the neonate and infant, and can be fatal in the neonatal period. Skin or mucosal lesions are present in 60 of cases. Fixed Drug Eruption A fixed drug eruption is characterized by a few well-circumscribed, oval, erythematous or hyperpigmented plaques that recur at the same sites with repeat drug administration. The initial lesions of different skin diseases are known as primary lesions. Macule: a macule is a circumscribed area of skin discoloration. As an example, we see red papules in psoriasis and yellow papules in xanthomas. The results of infection with the tubercle bacillus depend on (1) number and virulence of the bacilli, (2) mode and site of inoculation, and (3) natural resistance and immunologic response of the host. Edema, warmth, erythema, tenderness, with indistinct lateral marginsMost commonly Staph aureus and GAS. Transient, well circumscribed erythematous, pruritic, raised lesions (wheals)Individual wheals rarely last longer than 24hrsPrincipal mechanism is interaction of antigen with mast cell or basophil bound IgE antibodiesHistamine is released, which causes vasodilation and vascular permeabilityComplement and plasma kinin-forming systemTreatment: Identification of etiologic factor and its elimination. Primary lesions may include papules, erythematous macules, and vesicles, which can coalesce to form patches and plaques. Some of the features of atopic eczema are shown in Table -1. The infantile pattern is characterized by weeping inflammatory patches and crusted plaques that occur on the face, neck, and extensor surfaces. It consists of a well-circumscribed plaque or plaques with lichenified or thickened skin due to chronic scratching or rubbing. Irritant napkin dermatitis: well-demarcated variable erythema, oedema, dryness and scaling. Infantile seborrhoeic dermatitis: cradle cap and bilateral salmon pink patches, often desquamating, in skin folds. Psoriasis: persistent, well-circumscribed, symmetrical, shiny, red, scaly or macerated plaques; other sites may be involved; family history common.