5 Derm Flashcards

0
Q

Red swollen foot DDX

A

Cellulitis, DVT, gout, CPPD, stasis dermatitis, septic arthritis (must r/o)

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1
Q

PE to do with cellulitis…

A

Check lymph! Check regional lymph nodes and look for streaking (lymphangitis)

Guaranteed quiz question

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2
Q

Erythema Nodosum

A

Indurated nodules that look like bruises, slowly change color. Shins. must look for underlying disorder.
Inflammation of skin and subQ tissue (panniculitis)

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3
Q

Intertriginous

A

Creases: armpits, inguinal folds, under the breasts, between toes/fingers
(Erythasma lives here)

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4
Q

Balanitis

A

Candidiasis on penis/groin

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5
Q

Miliaria

A

Heat rash. Accumulation of sweat beneath eccrine sweat ducts –> keratin obstruction. Pruritis. Small red papules. Children/babies

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6
Q

Cellulitis

A

Acute bacterial infection of the skin. PE…

Immuno compromised. Distribution: lower leg, children–cheeks, perioribital (EMERGENCY), head, neck

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7
Q

Cutaneous abscess

A

Localized collection of pus under skin. Painful, tender, induration

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8
Q

Erysipelas

A

Superficial cellulitis with dermal lymphatic involvement (streaking). Shiny, raised, indurated, plaque like lesions. Legs (then face)

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9
Q

Erysipeloid

A

Violaceous on hands and forearms. Rare

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10
Q

Erythasma

A

Superficial intertriginous infxn with Corynebacterium. Dx: Wood’s lamp, skin scraping

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11
Q

Folliculitis

A

Inflammation of hair follicle. S aureus, fungal, trauma, corticosteroids. Pustule or inflammatory nodule. If from hot tub–pseudomonas

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12
Q

Furuncle

A

Boil. Acute tender nodules. S aureus. Drains to the surface. Culture to r/o MRSA.

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13
Q

Carbuncle

A

Cluster of furuncles with multiple draining orifices. More systemic symptoms.

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14
Q

Impetigo

A

Superficial acute skin infection with honey colored crusting. Clusters of vesicles or pustules that rupture.

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15
Q

Candidiasis

A

Intertriginous, erythematous, well-demarcated, pruritic patches. Satellite lesions.

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16
Q

Dermatophytoses

A

Fungal infxn of keratin in skin and nails. Tinea….

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17
Q

Tinea barbae

A

Beard fungus. Pruritic, painful, swollen

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18
Q

Tinea capitis

A

Fungus that can cause hair loss. More common in African and Hispanic descent

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19
Q

Tinea corporis

A

Pruritic, circular/oval, erythematous, scaling. Slightly raised, pale in middle

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20
Q

Tinea cruris

A

Jock itch. Causes: obesity, diabetes, immunodeficient. Partial central clearing, slightly elevated, erythematous active border

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21
Q

Tinea pedis

A

Athletes foot. Common. Intensely pruritic. Erythematous vesicles or bullae between toes or on soles.

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22
Q

Tinea versicolor

A

Superficial fungus infection with Melassezia furfur. Hypo/hyper pigmented macules with scaling patches. Trunk and proximal upper extremities.

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23
Q

Cutaneous larva migrans

A

Creeping eruption. Caused by hookworm larva. Intensely pruritic, erythema, serpinginous. DDX: scabies

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24
Q

Lice

A

Pediculosis. Wingless, blood sucking insects. Head. Nits “glued on” shaft 1cm from scalp.m

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25
Q

Scabies

A

Infection of skin with mite. Burrows are pathognomic. Wavy lines with papules.
Hands, arms (feet, gluteal fold, axilla, back of knees)

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26
Q

Molluscum contagiosum

A

2-10 lesions. Caused by pox virus in epidermal cells. Esp ages 3-9yrs. Smooth, flesh colored, umbilicated, indurated. Self-limiting

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27
Q

Warts

A

Verrucae vulgaris. Benign, contagious, caused by HPV.

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28
Q

Common wart

A

Dome, round, or irregular. 2-10mm. Usually asx. Skin lines interrupted by hyper keratosis. Black puncta when scraped with pinpoint bleeding.

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29
Q

Filiform wart

A

Long, narrow, soft. Eyelids, face, neck

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30
Q

Flat wart

A

Smooth, flat, yellow, brown, flesh colored. 2-3mm

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31
Q

Plantar wart

A

Soles of feet. Single or multiple. Painful and callused. Black puncta present.

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32
Q

Mosaic wart

A

Multiple plantar warts

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33
Q

Condylloma accuminata

A

Genital warts. Soft, moist papules or plaques on perineum, external genitalia, anus, vagina, cervix

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34
Q

Varicella

A

Chicken pox. Acute, highly contagious vesicular eruption caused by primary infxn with HHV. Papules, macules, vesicles, pustules, crusts.

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35
Q

Herpes simplex

A

Recurrent viral infxn w intraepidermal infxn by HSV. Herpes hurt. Ulcerated/weakling lesions. Outbreaks following stress.

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36
Q

Herpes zoster

A

Shingles. Latent varicella infxn. Virus remains in nerve roots and erupts along the dermatome. Systems sxs, severe pain.

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37
Q

Roseola infantum

A

Infxn of infants or young children. 3-5 days high fever –>rash on chest and abdomen (only for few hours)

38
Q

Hand Foot and Mouth Disease

A

Febrile disorder caused by Coxsackie virus. Vesicular eruptions of skin and mucosa. Fever, myalgia, abdominal pain, loss of appetite

39
Q

Viral exanthems

A

Blood borne viruses–> vascular response. Raised maculopapular rash, e.g. Rosella infantum.
DDX: hives

40
Q

Measles

A

One of most communicable dzs! Spread by secretions from nose, mouth, throat. Prodrome with fever, coryza, conjuctivitis, photophobia, cough, Koplik spots.
Rash is morbilliform, maculopapular, blanching

41
Q

Rubella

A

Mild incubation, brief prod rime of fever/malaise. Rash is pinpoint pink maculopapular, may have petechiae on soft palate.

A teratogen!

42
Q

Vitiligo

A

Idiopathic condition lacking in melanocytes. Sharply demarcated, patchy and irregular. Spots are white with no scale.
Assoc w auto immune dzs, e.g. Thyroid, pernicious anemia, systemic lupus erythematosus, Addisons

43
Q

Hyperpigmentation

A

Melasma/chloasma: macular, pregnant women or OCP. Sharply delineated patches on face. “Mask of pregnancy”
Lentigines: flat, tan or brown spots dt chronic sun exposure

44
Q

Alopecia

A

Male/female pattern–androgen excess (“load of hooey”)
Diffuse– weight loss, nutritional def, thyroid disorder, stress, pregnancy
Toxic–chemo
Alopecia areata–autoimmune, toxic, drugs, infxns, severe stress

45
Q

Scarring aplopecia

A

Cutaneous lupus, deep bacterial infxn, ulcers, granulomas, syphilis, tinea

46
Q

Hirsutism

A

Excess hair in females. Dx by serum free testosterone

47
Q

Onychomycosis

A

Fungal infxn of nail plate or bed. Caused by dermatophytes or yeast

48
Q

Paronychial infxns

A

Periungual infxn. Develops along nail margin, becomes painful, warm, erythematous, swollen.

49
Q

Dermatofibroma

A

Benign proliferation of fibroblasts. Epidermal thickening and hyperpigmentation, small red to brown papule

50
Q

Epidermal cyst

A

Cyst w keratinous material in the dermis. Firm, flesh colored, movable nodule its central punctum

51
Q

Keloid

A

Excess fibroblastic proliferation following trauma and scarring. E,elated, shiny, firm protuberant nodule. African and Asian descent prone

52
Q

Lipoma

A

Subcutaneous nodules of adipocytes. More common in F. Rubbery, movable nodule, below dermis.

53
Q

Nevi

A

Moles. Pigmented or flesh colored macules, papules, or nodules composed of melanocytes.

54
Q

Lentigo

A

Hyper pigmented macule dt increased melanocytes. Darker, sparser, does not darken with sun

55
Q

Junctional nevus

A

Light brown-black. Usu flat but can be raised. 1-10mm. Palms, soles, genitals

56
Q

Compound nevus

A

Light to dark brown, smooth and dome shaped or papillomatous.

57
Q

Intradermal nevus

A

Elevated, flesh colored to brown. May have speckles of brown pigmentation, 3-6mm

58
Q

Halo nevus

A

Pigmented compound or intrudermal nevus, halo of depigmented skin. Immune phenomenon

59
Q

Atypical/dysplastic nevus

A

Irregular, pigmented nevus from tan to dark brown. Irregular pigment. ABCDEF. Large, >6mm on covered areas

60
Q

Seborrheic keratosis

A

Benign neoplasm—>pigmented superficial lesions that appear warty or smooth papules. “Stuck on”, scaly.

61
Q

Acrochordon

A

Pendunculated fibroma, soft. “Skin tag”. Perianal common in pts with Chron’s

62
Q

Basal cell carcinoma

A

Superficial, slow growing papule or nodule. Small, shiny, firm translucent–> crusty, flat lesions.
Nodular-60%. Papule that –> rodent ulcer
Superficial-30%
Morpheaform-10%

63
Q

Malignant melanoma

A

Arises in melanocytes in skin and mucus membranes, eyes or CNS. ABCDEF. Usu pigmented
Glasgow 7 point checklist: (1 major, or 2 minor = referral)
Major: change in size/new lesion, change in shape, in color
Minor: diameters >=7mm, inflammation, crusting/bleeding, sensory change

64
Q

Lentigo-malignant melanoma

A

15%. Slow onset and progression on face or sun exposed areas. 2-6cm, flat, tan or brown w darker spots

65
Q

Superficial spreading melanoma

A

2/3 of melanoma. Arise from preexisting lesion. Mostly on women’s legs and men’s torsos. Plaque

66
Q

Nodular melanoma

A

Dark protuberant papule or plaque varying in color. Grows fast. May not be pigmented

67
Q

Acrolentiginous

A

Arise in areas of non-hair bearing skin: soles, palms, subungual skin

68
Q

Squamous cell carcinoma

A

Malignant tumor of epithelial keratinocytes that invades the dermis. Usu on sun exposed areas. Starts as red papule with scaly rough surface or is nodular. Can form horns. Eventually ulcerates/bleeds and can metastasize

69
Q

Big lump DDX

A

Cutaneous abcess, ruptured epidermal cyst, lipoma, keloid

70
Q

Small red papules DDX

A

Baby acne, miliaria

71
Q

Plaques on face DDX

A

Herpes zoster, Rosacea, erysipelas, contact dermatitis

72
Q

Intertriginous DDx

A

Erythrasma, tinea (pedis, cruris), candidiasis

73
Q

Pustules

A

Acne vulgaris, Rosacea, impetigo, folliculitis, candidiasis, insect bite, furuncles, carbuncle, drug eruption

74
Q

Crusting vesicles

A

Impetigo, herpes simplex, herpes zoster, atopic dermatitis

75
Q

Scalp DDX

A

Tinea capitis, love, seborrheic dermatitis

76
Q

Groin DDX

A

Tinea cruris, candidiasis, molloscum, erythrasma, warts

77
Q

Body DDX

A

Drug eruptions, pityriasis rosea, tinea versicolor, erythema multiforme, vitiligo

78
Q

Serpinginous DDX

A

Cutaneous larva migrans, scabies

79
Q

Feet DDX

A

Plantar wart, tinea pedis

80
Q

Eyelids DDX

A

Filiform wart, acrochordon

81
Q

Flat brown macule DDX

A

Flat wart, lentigo

82
Q

Warty thing DDX

A

Mosaic wart, seborrheic keratosis, actinic keratosis

83
Q

Vesicular rash DDX

A

Varicella, contact dermatitis, herpes zoster, acne vulgaris, impetigo, drug eruption, herpes simplex

84
Q

Red macular rash DDX

A

Roseola infantum, measles, rubella, drug eruption

85
Q

Vesicular eruption DDX

A

Varicella, herpes, aphthous stomatitis

86
Q

Hypopigmented DDX

A

Tinea versicolor, vitiligo, pityriasis alba

87
Q

Hyper pigmented DDX

A

Pregnancy, OCP, lentigines

88
Q

Alopecia DDX

A

Male pattern, female pattern, alopecia areata, tinea capitis, trichotillomania

89
Q

Nails DDX

A

Onychomycosis, trauma, psoriasis

90
Q

Red brown papules DDX

A

Dermatofibroma, nevi, basal cell carcinoma, keloid, acrochordons

91
Q

Tumors DDx

A

Nevi, seborrheic keratosis, molloscum, scc, malignant melanoma, bcc, actinic keratosis

92
Q

Morbilliform

A

Looks like measles