03-03 Clicker Quiz

Question 1

Which red scaly rash has trailing scale? Leading?

Answer 1

Leading = tinea; trailing = Pityriasis rosea

Question 2

Palmar rash DDx

Answer 2

1. 2° syph, 2. erythema multiforme (targetoid), 3. hand, foot & mouth dz

Question 3

Christmas tree

Answer 3

pityriasis rosea (inverted on chest, right-side up on back)

Question 4

You do a KOH and see “ziti and meatball” hyphae. Dx = ?

Answer 4

Tinea versicolor

Question 5

Eczema vs. Bullous pemphigoid vs Pemphigus vulgaris

Answer 5

Eczema* - skin around bullae erythematous Bullous p - surround. skin spared, bullae in tact Pem vulg - surround spared, bullae eroded **could be really bad sun burn; Bullous impetigo

Question 6

DDx for pityriasis rosea —1 test to tell each apart

Answer 6

—2° syph (RPR), tinea versicolor (KOH scraping), guttate psoriasis (check gluteal folds)

Question 7

• A. Eczema
• B. Bullous impetigo
• C. Granuloma annulare
• D. Bullous pemphigoid

Answer 7

A. Eczema, key: linearity

likely due to poison ivy

Question 8

A. Scale

B. Crust

C. Lichenification

D. Scarring

Answer 8

C: contact dermatitis from the shoes!

Question 9

Honey colored crust on a plaque on a pediatric pt?

Answer 9

impetigo

Question 10

dew drops on a rose petal?

Answer 10

HSV-1 (grouped vesicles by the mouth)

Question 11

Dx (etio)

DDx (difference from this presentation)

Answer 11

Dx = erysipelas, Grp A strep; hot, indurated lesion on face of the geriatric pt

DDx

• malar lesion of SLE (spares nasolabial folds)
• heliotrope of dermatomyositis (purple, localized to upper eyelides)

Question 12

Antibiotic for most superficial bacterial skin infections (impetigo, folliculitis, cellulitis, furunculitis, etc.)? Why?

Answer 12

• Cephalosporin (e.g. cephalexin), b/c they cover staph

Question 13

• Dx?
• Apperance description
• Tx of choice?

Answer 13

Dx = hot tub folliculitis

• Monomorphic, bright-red, flea-bitten looking papules
• aused by pseudomonas
• Tx w/ fluoroquinolone

Question 14

Red scaly rash on the wrist or in between fingers?

Answer 14

think parasitic (e.g. scabies)

Question 15

Red scaly rash on wrist ddx?

Answer 15

Lichen planus (flexor wrist, usually; the gluteal cleft of lichen planus) vs. scabies

Question 16

Dx?

• DDx of common cyclic / polycyclic rashes

Answer 16

SCLE - polycyclic plaque, often 2° to drug rashes

• Erythema migrans (Lyme) - ring of smoke-type; may have multiple but are NOT adjoining
• Erythema multiforme - palms, more solid red; can have orolabial (bloody kid lips)
• Widespread tinea - has scale, check KOH
• Granuloma annulare - smooth (no scale), perfect donuts, coalescing, usu. acral
  
  • pictured here
• Urticaria - effervescent (none last > 24 hrs); move often; no scale; SUPER ITCHY