2025 – PAGE 163 – DERMATOLOGY

2025 – Core Study Guide 06 – Dermatology 2025 – PAGE 163 – DERMATOLOGY

NEONATAL ACNE (AKA NEONATAL CEPHALIC PUSTULOSIS)

Neonatal acne (AKA Neonatal Cephalic Pustulosis) occurs within the first month of life and resolves by 4 months of age. Look for inflammatory pustules on the cheeks and forehead without comedones. This is a benign rash that requires no treatment.

IMAGE: www.pbrlinks.com/NCP1

MNEMONIC: NEONATal = FIRST MONTH OF LIFE!

INFANTILE ACNE

Infantile acne looks like typical pubertal acne, but it is found in babies. Onset is usually around 2–3 months of age, and it is due to androgenic stimulation. There can be COMEDONES (whiteheads and blackheads). The rash can resolve in a few weeks or it can take up to a year to resolve.

MNEMONIC: INFANTile = Infants. Don’t choose this if the baby is 4 weeks old.

IMAGE: www.pbrlinks.com/INFANTILE1

LIVEDO RETICULARIS (AKA CUTIS MARMORATA)

Livedo reticularis (AKA cutis marmorata) presents as a mottled, reticulate patterned rash and may be described as a lacy rash. It is benign and resolves by 1 month.

IMAGE: www.pbrlinks.com/LIVEDO1
IMAGE: www.pbrlinks.com/LIVEDO2

PEARL: If the baby is healthy and without any concerning symptoms, choose this. If not, consider sepsis in your differential.

ALOPECIA & HAIR FINDINGS

ALOPECIA AREATA

In alopecia areata, there are round/well-circumscribed area(s) of alopecia. Alopecia can be on the scalp or in other areas. Hairs at the periphery of the areas are short, pluckable, and may resemble an exclamation point!

IMAGE: www.pbrlinks.com/ALOPECIA-A1
IMAGE: www.pbrlinks.com/ALOPECIA-A2
IMAGE: www.pbrlinks.com/ALOPECIA-A3

ALOPECIA TOTALIS

Alopecia totalis is the loss of all hair on the HEAD.

IMAGE: www.pbrlinks.com/ALOPECIA-T1

ALOPECIA UNIVERSALIS

Alopecia universalis is the loss of all hair on the entire BODY. There is usually a SYSTEMIC etiology such as hypothyroidism, a nutritional deficiency, or even lupus (SLE).

(DOUBLE TAKE) ZINC DEFICIENCY

Breastfeeding helps with zinc absorption. If a child begins having medical problems once weaned from breast milk, consider zinc deficiency in your differential. Zinc deficiency causes a SCALY and EXTREMELY ERYTHEMATOUS dermatitis in the perioral and perianal area (around the natural orifices) that can DESQUAMATE. The rash is sometimes described as erosive and eczematous. It can also be associated with ALOPECIA and poor taste.

  • MNEMONIC: Poor taste, huh? Have you ever had Zinc lozenges? They are disgusting! It’s probably a good thing that you have hypogeusia when you are eating Zinc lozenges!
  • IMAGE: www.pbrlinks.com/ZINC1
  • IMAGE: www.pbrlinks.com/ZINC2
  • IMAGE: www.pbrlinks.com/ZINC3
  • IMAGE: www.pbrlinks.com/ZINC4
  • PEARLS:
    • CROHN’S DISEASE: If a Crohn’s patient is suffering from diarrhea, they may have zinc deficiencysince Zn is lost in the stool.
    • (DOUBLE TAKE) STRICT VEGETARIANSAND VEGANS may be susceptible to multiple nutritional deficiencies, including deficiencies in IRON, ZINC, CALCIUM, and VITAMIN B12. Vegans avoid all animal-derived products (including milk and eggs). B12 deficiency can result in megaloblastic anemia, vitiligo, peripheral neuropathy, and even regression of milestones.
      • MNEMONIC: Did you know giraffes are vegetarian? Imagine a giraffe standing in Times Square reaching its long neck into the sunroof of a FUZZY CAB that has green, grass-like seats and fuzzy floor mats. FUZZYCAB = FeZi CaB12!
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