All pictures together for ID Flashcards

1
Q

What disease is this

A

Cellulitis
Caused by Group A strep
Treat with Diclox 500mg (bacterial) PO
Systemic symptoms

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2
Q

What disease is this

A

Erysipelas
Caused by Strep A pyrogens
Treat with Amoxicillin 300mg PO
IF Staph, treat with azithro or IV abx
Systemic symptoms

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3
Q

What disease is this

A

Impetigo- Bullous- honey colored crust
weakness, fever, diarrhea in young kids. Warm temperatures cause it
Treat with Mupirocin (Ointment)
Bullous caused by strep

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4
Q

What disease is this

A

Impetigo- non bullous- Honey colored crust, caused by staph
Treat with Muprocin

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5
Q

What disease is this

A

Follliculitis
Staph aureus most common cause from shaving, etc
Pseudomonas aerginosa (hot tub folliculitis) common
TENDER and ITCHY, NO systemic Sx

Treatment:
Treat with Mupirocin (IF staph), if Pseudomonas, treat with Ciprofloxacin PO

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6
Q

What disease is this

A

Condyloma acuminatum
HPV- genital warts
100 types of HPV

Diagnosis: Viral culture to confirm and PCR

Treat with Topical imiquimod or Liquid nitrogen therapy

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7
Q

What disease is this

A

HSV type 1
Single or grouped vesicular lesions

Labs: Cell culture, tzanck smear, antibody detection, PCR

Treatment: Acyclovir, Valcyclovir (IV acyclovir needed for encephalitis)

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8
Q

What disease is this

A

HSV type 2
Papules>vesicles> pustules, may have fever, headache, malaise
Fluid filled vesicles, shallow

Diagnosis:
Cell culture, Tzanck smear, antibody detection, PCR

Treatment: Acyclovir, valcyclovir (IV acyclovir if encephalitis)

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9
Q

What disease is this

A

Molluscum contagiosum
Asymptomatic, firm, umbilicated, pearly papules
painful
MolluscUM=UMbillicated

Diagnosis:
Viral culture
Histologic culture shows Henderson-paterson bodies

Treatment:
Self resolving in 6-9 months, curettage to remove infectious central core
Topical cantharidin

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10
Q

What disease is this

A

Varicella-zoster (Chickenpox)
Caused by stress, radiation, contact, infection
VERY sick, widespread vesicles, cough

Diagnosis: Viral culture, PCR, Tzanck smear

Treatment: Acyclovir PO, Valacyclovir
Gabapentin for pain

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11
Q

What disease is this

A

Vericella Zoster (Shingles)
Can be dormant in spine for years after chickenpox infection
VERY painful, acute pain along dermatome, Hutchison’s Sign: Vesicle tip of side of nose (Trigeminal nerve- EMERGENCY)
Ramsay Hunt- Facial nerve palsey

Diagnosis: Viral Culture, PCR, Tzanck smear

Treatment:
Acyclovir, Valacyclovir, Gabapentin for Pain
NO oral steroids Work

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12
Q

What disease is this

A

Viral Exanthem, 5th disease (Erythema infectiosum)
Red facial rash with lacy, pink, macular rash on torso and extremities
Usually young kids, caused by PARVOVIRUS 19
Spread by Respiratory transmission

Clinical presentation:
Can cause Aplastic crisis, Arthritis in adults

LABS:
Clinical findings, IgM antibodies for Parvovirus, CBC, Culture
Treatment:
Antipyretics, analgesics, hydration

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13
Q

What disease is this

A

Coxsackievirus A16 infection (Hand foot and mouth disease)
Painful oral ulcers, low grade fever, grey-red vesicles, Erosion, 1 week recovery

Labs:
Clinical diagnosis, Viral culture for IgA (Coxsackievirus) CBC

Treatment:
Magic Mouthwash, hydration

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14
Q

What disease is this

A

Measles
Koplik’s Spots(FIRST before rash)- Grey-White papules on buccal mucosae
3 C’s: Cough, Coryza, Conjunctavitis
Erythmatous rash that goes from head to toes

Diagnosis:
PCR, Measle’s Virus IgM antibodies, CBC

Treatment: Vitamin A, Magic Mouthwash, Hydration

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15
Q

What disease is this

A

Tinea Capitis (fungus)
Trichophyton tonsurans causes 90% of cases
Spread from person to person
Ranges from mild puritis to Kerions, alopecia, scales, posterior cervical lymphadenopathy

Diagnosis:
KOH, Wood’s Lamp (can be -), Lab Culture

Treatment: Griseofulvin PO for 4-6 weeks.
CMP for Liver Fx before giving Antifungals
Ketoconazole shampoo

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16
Q

What disease is this

A

Tinea Corporis (ringworm)
Infection of trunk and limbs
Trichophyton rubrum
Bulls eye center, red scaly papule, annular plaque, demarcated border

Diagnosis: KOH exam (Branched septate hyphae, spores)
Cultures from border of lesion
DTM cultures- 2 weeks
Skin Biopsy (PAS- periodic acid schiff- hyphae in skin)

Treatment:
Terbinafine, miconazole

Oral antifungals

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17
Q

What disease is this

A

Tinea Cruris
Jock Itch
Annular, hyperpigmented patches or plaques, sharpley demarcated, raised border
Diagnosis: Fungal cultures
Treatment: Topical antifungals (first-line), Avoid Tight-fitting clothing

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18
Q

What disease is this

A

Tinea Pedis
Interdigital toe web infections
Superficial fungal infection
Itching and scaling of feet, moccasin style pattern

Diagnosis:
KOH (branched septate hyphae, segmented hyphae)
DTM( Fungal fulture)
PAS (Hyphae)
Biopsy (confirm Dx)

Treatment: Terbinafine (topical)

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19
Q

What disease is this

A

Tinea Unguium (onychomycosis) (yeast infection)
Candida albicans
Most commonly on big toe

Diagnosis: KOH
Cultures
Biopsy

Treatment: Fluconazole

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20
Q

What disease is this

A

Tinea Versicolor
Yeast infection
Surfer’s spots
Spaghetti and meatballs
White scaley powder on skin

Diagnosis:
Wood lamp- Green-yellow flourescence
KOH shows spaghetti and meatballs
Cultures
Treatment:
Ketoconazole lotion, or pigmentation resolves with sun exposure

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21
Q

What Disease is this

A

Candidiasis
Yeast infection
Diaper rash, budding leash, satellite lesions
Angular cheilitis
Plaques with scalling, purietic

Diagnosis:
KOH shows budding yeast

Traetment: Nystatin, ketoconazole

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22
Q

What Disease is this

A

Candidiasis
Yeast infection
Diaper rash, budding leash, satellite lesions
Angular cheilitis
Plaques with scalling, purietic

Diagnosis:
KOH shows budding yeast

Traetment: Nystatin, ketoconazole

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23
Q

What Disease is this

A

Photosensitivity reaction
Exogenous photodermatoses- reaction by photosensitizer
Can be drug induced (NSAIDS, hydrochlorathiazide, antifungals)

LABS:
CBC, ANA (if its autoimmune), Urine test for polyphyrins

Treatment: Sun protection, treat underlying disorder

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24
Q

What Disease is this

A

Acne Vulgaris
Papules and pustules, comedones on forehead

Diagnosis: History and clinical findings

Treatment:
Benzoyl peroxide, retanoids- Trentanoin

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25
Q

What Disease is this

A

Acne Vulgaris
Moderate with comedones, papules and pustules
Treatment:
Benzoyl peroxide, doxycycline, YAZ (estrogen and peresterone)

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26
Q

What Disease is this

A

Acne Vulgaris
Severe (Nodular and cystic acne)
Treatment:
Oral contraceptives (YAZ), Isotrentin (For severe)

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27
Q

What Disease is this

A

Rosacea
Chronic inflammatory disorder
Vasomotor instability
Triggers: Alcohol, hot or cold weather, hot drinks, hot baths, sun exposure

Treatment:
Avoid Triggers
Topical Antibiotics
Oral antibiotics (tetracycline if BAD)

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28
Q

What Disease is this

A

Phymatous roscea

Rhinophyma with nodules

Treatment: Oral antibiotics (tetracycline)
Topical antibiotics (Clindamycin)

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29
Q

What Disease is this

A

erythematotelangiectatic rosacea
Chronic inflammatory disorder
Vasomotor instability
Triggers: Alcohol, hot or cold weather, hot drinks, hot baths, sun exposure

Treatment:
Avoid Triggers
Topical Antibiotics
Oral antibiotics (tetracycline if BAD)

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30
Q

What Disease is this?

A

Perioral Dermatitis
Not on lips
Rash and acne like

Diagnosis: history and clinical findings, skin biopsy in atypical cases

Treatment:
Topical calcineurin inhibitors, Cyclosporin gel

Give Doxycycline daily for 6 weeks orally

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31
Q

What Disease is this?

A

Hidradenitis suppurativa
Chronic inflammatory skin condiiton from hair follicle obstruction
Tombstone and rope like scarring

Diagnosis: Recurrent abscesses and lesions, typical distribution and presence, Diffuse connections

Treatment:
Weight loss, topical medications, loose fitting clothing, Retinoids

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32
Q

What Disease is this?

A

Dishydrotic eczema
Recurrent puritic rash on hands and palms

Triggers: Sweating, emotional stress, humid weather
Sudden onset of the development of puritic vesicles

Labs:
KOH
Patch testing to ensure no allergy

Treatment: Wet dressings (Burrow solution) to dry dressings
Alternate steroids (medium-High with wet dressings)
Resolves on own, but leaves BROWN spots

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33
Q

What Disease is this?

A

Atopic Dermatitis
Pruretic inflammation of dermis via epidermal barrier
Dry skin, plaques
ATOPIC triad:
Allergy, Atopic Dermatitis, Allergic Rhinitis

Diagnosis:
IgE increased
Swab and culture
CBC

Treatment:
Avoid triggers
Diphenhydramine
Aquaphor
Topical Steroids
Dicloxacillin (oral)

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34
Q

What Disease is this?

A

Contact Dermatitis
Scales, plaques, Exposure to irratant
Burning and itching after exposure
Linear lesions

Labs:
CBC, Culture/Swab, Scraping to rule out anything else

Treatment:
Remove Irratant
Topical Steroids
Cool compresses/oatmeal baths
Oral staroids if SEVERE

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35
Q

What Disease is this

A

Seborrheic keratosis
Common, Benigh, epidermal lesions
Around 50 years of age

Labs:
Shave or punch biopsy

Treatment:
Cryosurgery
Cautery and curettage

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36
Q

Sign of Leser-Trelat is associated with what disorder

A

internal malignancy
Sudden apperance of SKs

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37
Q

What is this

A

Dysplastic nevi

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38
Q

What is this

A

Spitz Nevi

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39
Q

What is this

A

Lipoma
Very common, non cancerous tumor made of fat cells
Slow growing, symptomless

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40
Q

What is this

A

Lipomas and epithelial inclusion cysts

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41
Q

What is this

A

Pilinodal disease

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42
Q

What is this

A

Cherry angioma

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43
Q

What is this

A

Spider Angioma

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44
Q

What is this

A

Actinic keratosis
Diagnosis:
Based on clinical findings and biopsy results

Treatment:
Follow up with skin exam (complete skin exam)
Single lesions- treated with cryotherapy
Multiple lesions- Treated with 5-flouracil to decrease lesions, imiquimod

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45
Q

What disease is this

A

Squamous cell carcinoma

Diagnosis:
Excisional or Punch biopsy

Treatment:
Surgical Excision, MOHS surgery

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46
Q

What disease is this

A

Squamous cell carcinoma

Diagnosis:
Excisional or Punch biopsy

Treatment:
Surgical Excision, MOHS surgery

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47
Q

What disease is this

A

Keratoacanthoma

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48
Q

What is this

A

Melanoma

Diagnosis:
Excisional biopsy

Treatment:
Excision of the lesion with margins
MOHS surgery
Keytruda (immunotherapy)

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49
Q

What is this

50
Q

How do you measure thickness of the tumor

A

Breslow score

51
Q

What is this

A

Kaposi’s sarcoma

Associated with HIV

Diagnosis:
Biopsy: angiogenesis, inflammation, and proliferation (whorls of spindle-shaped cells with leukocytic infiltration and neovascularization), and immunohistologic staining.

Treatment:
HIV-associated KS: antiretroviral therapy.
Intralesional chemo (vinblastine)
Extensive disease: radiation
If biopsy is +, must get HIV test.
Radiation therapy, excision, cryotherapy, laser ablation, intralesional, topical therapy, chemotherapy.

52
Q

What is this

A

Mycosis Fungioides
Also called cutaneous T cell Lymphoma
Localized or generalized erythematous scaly patches or plaques, on trunk
Severe pruritus w/ follicular involvement and hair loss
Local or diffuse lymph node enlargement
Plaques >5cm

Diagnostics:
Skin biopsy
CBC w Sezary count

Treatment: Stage 1-2: Radiation
Topical chemotherapy

53
Q

What is this disease, and describe diagnosis/treatment

A

Nummular eczema/dermatitis

Diagnosis: History and clinical
Biopsy/culture to rule out
KOH to rule out fungus

Treatment:
Hydrated petrolium/aquaphor, topical steroids

54
Q

What is this disease, and describe diagnosis/treatment

A

Lichen Simplex chronicus

Skin thickening from chronic skin scratching
Thick and scaly, well demarcated

Dx:
KOH, History and clinical, culture to rule out something else
Treatment:
Stop rubbing and scratching,
occlusive dressings at night over high potency topical steroids or low potency on face

55
Q

What is this disease, and describe diagnosis/treatment

A

Stasis dermatitis

Edema and hyperpigmentation

Labs: History and clinical findings, Viral to rule out other cause, KOH to rule out fungus
Treatment
Elevation and compression, Cool water dressings for inflammation, oral antihistamines for puritis

56
Q

What is this disease, and describe diagnosis/treatment

A

Seborrheic dermatitis
Inflammatory papulosquamous disease
Sebaceous glands make hypersensativity reaction
Pink, red patches with areas with sebaceous glands (or scalp itching, dandruff)
Cradle cap Yellow, greasy adherance scales

Treatment:
Dandruff shampoos (selenium sulfide or zinc pyrithione)
1% hydrocortisone decreases itching and redness
Topical antifungals (ketoconazole)– mild to moderate

57
Q

What is this disease, and describe diagnosis/treatment

A

Alopecia areata
Nonscarring immune mediated hair loss

Diagnosis:
Clinical diagnosis, biopsy can be performed when diagnosis is uncertain.
Punch biopsy- definitive, peritubular lymphocytic inflammatory infiltraties sourrounding follicles

Treatment:
Intralesional corticosteroids (topical corticosteroids)

JAK inhibitors (Bactrin)

58
Q

What is this disease, and describe diagnosis/treatment

A

Onchomycosis
Labs:
KOH and fungal culture
PCR
PAS (periodic acid schiff test)
Check LFTs before perscribing antifungals

Treatment: Management if KOH or PAS are positive
Systemic antifungals- oral terbinafine, fluconazole

59
Q

What is this disease, and describe diagnosis/treatment

A

Paronychia
Acute infection of the nail folds
Staph infection

Labs:
Bacterial culture to determine cause
CBC to make sure not systemic

Treatment:
Warm water with antiseptic soaks, Bactrin and mupirocin
Moderate: Oral abx
MRSA risk: TMP-SMX
I&D for treatment if severe

60
Q

What is this disease, and describe diagnosis/treatment

A

SLE- can look like anything (Butterfly rash, maculopapular, annular polycyclic lesions, ring-shaped)

Labs:
DIF- positive for lupus
CBC, ANA (autoimmune antibody)
CRP
RFTs

Treatment:
Topical steroid
Antimalarials (Hydrochloroquine, methotrexate

Refer to rheum

61
Q

What is this disease, and describe diagnosis/treatment

A

Dermatomyositis,
Autoimmune, attacks skin, muscles, joints, lungs
Photodistributed on face

Sholder weakness, joint weakness, systemic symptoms of muscle weakness

Labs:
CBC, CMP, Skin biopsy (Shows increased mucosin), muscle biopsy
Possible malignancy before or after diagnosis
PSA, PAP to rule out malignancy

Treatment:
Systemic steroids, Methotrexate, JAK inhibitors, IvIG
Refer to rheum

62
Q

What is this disease, and describe diagnosis/treatment

A

Vasculitis-
Caused by medication, infection, environment, malignancy. Elderly women

May Itch or burn, or have no symptoms

Jaw Claudication, vision changes

LABS:
CMP, CBC, UA (blood)
DIF skin biopsy

Treatment: Resolves over 1 week with RICE and NSAIDS, dapsone

63
Q

What is this disease, and describe diagnosis/treatment

A

Acanthosis Nigricans

Linked to insulin resistance (obesity, PCOS, diabetes)

Brown, velvety patches and plaques on axilla, groin, back of neck

Puritis common

LABS: Biopsy, Fasting glucose, HgA1C

Treatment:
Manage underlying disease Retinoids (trentonin)

64
Q

What is this disease, and describe diagnosis/treatment

A

Xanthelasma
caused by high cholesterol, age, bad diet, Yellow deposits around eyes

LABS:
Increased cholestorol

Treamtent: Lipid control, cosmetic removal, recurrence is common

65
Q

What is this disease, and describe diagnosis/treatment

A

Dermatitis herpitiformis
Autoimmune (gluten sensitive, celiac)
Intense puritis papules, vesicles, on extensor surfaces
LABS: Blood test, biopsy
Treatment: Stop gluten ingestion

66
Q

A patient has Spider angiomas, talengiectasia on palms, Terry’s nails, and porphyria. What condition is this likely to be?

A

Liver disease and the associated symptoms

67
Q

What dermatologic symptoms are associated with liver disease

A

Terry’s nails, porphyria (sores on hands), spider angiomas and telangiectasia on palms

68
Q

What dermatologic symptoms are associated with lung disease

A

Sarcoidosis (granulomatous disease)
Lupus pernio (large blue/red and dusky purple nodules, plaque-like lesions on nose, cheeks, ears, fingers, toes. Purple-red or borwn plaques, or circular lesions
Thickening of old scars (sarcoidosis)
Erythema nodosum (Bumps on shins, plaques of red-purple or brown, thickened, circular skin lesions)
LABS:
Biopsy shows granuloma on organs and lungs
Treatment: Biopsy of skin, corticosteroids, Methotrexate, tetracycline

69
Q

What is this disease, and describe diagnosis/treatment

A

Lung disease/ granulomatous disease
Also has erythema nordosum

Etiology: 20-40, black women and men, maculopapular eruptions, subcutaneous nodules, sarcoid plaques and papules

LABS:
Biopsy shows granuloma on organs and lungs

Treatment: Tetracycline, NSAIDS, self limited

NO DOSE
No cause
Oral contraceptives/ Pregnancy
Drugs (Sulfa, NSAIDs)
Other infections (strep, TB, histoplasmosis)
Sarcoidosis
Enteropathies (IBD– Crohns’s, Ulcerative colitis)

^ or NODOSUM

70
Q

What is this disease, and describe diagnosis/treatment

A

RMSF (Rocky moutnain spotted fever)
Tick borne (Rickettsia rickettsii (attached for 24 hours)
Spring/Summer, North/South America

Rash: Ankles, limbs, and trunk rash, Start as macules, then become papules, petechiae, and ecchymotic

Labs: Antibody test (Serology)
Indirect flourescence
Ab test 10-14 days after

Treatment: Doxycycline, Chloramphenicol

71
Q

What is this disease, and describe diagnosis/treatment

A

Chancroid
STI
Caused by Haemophilius ducreyi
PAINFUL

LABS:
Swab for everything (syphillis)
PCR test

Treatment:
Azithromycin, cipro

72
Q

What is this disease, and describe diagnosis/treatment

A

Lyme disease
Deer tick (Borrelia burgdorfi)
Fever, Malaise, aches

Erythema migrans skin lesion
Targetoid lesion (LARGE, takes up all of trunk)

Labs: Antibody test (Serology)
Indirect flourescence
Ab test 10-14 days after

Treatment:
Doxycycline, chloramphenicol

73
Q

What is this disease, and describe diagnosis/treatment

A

Chancre lesion
Caused by syphilis infection
PAINLESS
BUT comes back over time (1-10 years) and causes damage to brain, nerves, eyes, heart
Labs:
PCR test
Treatment:
Benzathine penicillin G

74
Q

What is this disease, and describe diagnosis/treatment

A

Granuloma Inguinale caused by Klebsiella granulomatis
STI
PAINLESS
Bad smelling
LABS: Examine fluid from sore
STI swab
Viral culture
Treatment:
Oral antibiotics 3 weeks or more, TMP-SMX, Azithromycin, IM or IV abx

75
Q

What is this disease, and describe diagnosis/treatment

A

Lymphogranuloma venerum
STI caused by chlamydia trachomatis
Symptoms begin 3 days after infection
SYSTEMIC symptoms ( fever, lymph nodes swollen, skin broken down, forms sinus tract)
LABS: Blood test
NAATS (nucleic acid amplicication) from sores

Treatment
ABX 3 weeks, Doxycycline, Erythromycin, Tetracycline

76
Q

What is this disease, and describe diagnosis/treatment

A

Psoriasis
Inflammatory papulosquamous disease
Abnormal T cells that are joined in skin, nails, joints, can be above ears or near hair
Silvery-white plaques that bleed when removed (Auspitz sign)
Nail pitting (90%)

Strep bacteria associated with guttate psoriasis

30% of psoriasis patients develop psoriatic arthritis

Labs: History and clinical findings, Punch biopsy if warrented to show acanthosis ( thickening of skin)

Treatment: Topical (TAR)
Phototherapy (UVB light)

Systemic: Methotrexate, cyclosporin steroids over thick plaques with occlusion

77
Q

What phenomenon is this

A

Koebner phenomenon
Injury or irritation to skin induces psoriasis

78
Q

What is this disease, and describe diagnosis/treatment

A

Lichen sclerosis
Acute or chronic inflammatory mucocutaneous, papulosquamous dermatitis (skin, nails, mucous membranes)
Biopsy shows atrophic, hypopigmented skin that is thinned
White patches, fine cigarette paper
Labs: Biopsy (shows hypopigmented skin that is thinned)
Treatment: High potency steroids (Clobestasol)
Increases chance of SCC
Can be mistaken for abuse in children because of itching

79
Q

What is this disease, and describe diagnosis/treatment

A

Purigo nodularis
Puritic chronic dermatitis (result of scratch-itch cycle)
LABS:
Biopsy- shows increased nerve fibers in dermis, neural hyperplasia

Treatment:
High potency steroids with occlusion
Azathioprine, Gabapentin for pain

80
Q

What is this disease, and describe diagnosis/treatment

A

Purigo nodularis
Puritic chronic dermatitis (result of scratch-itch cycle)
LABS:
Biopsy- shows increased nerve fibers in dermis, neural hyperplasia

Treatment:
High potency steroids with occlusion
Azathioprine, Gabapentin for pain

81
Q

What is this disease, and describe diagnosis/treatment

A

Purigo nodularis
Puritic chronic dermatitis (result of scratch-itch cycle)
LABS:
Biopsy- shows increased nerve fibers in dermis, neural hyperplasia

Treatment:
High potency steroids with occlusion
Azathioprine, Gabapentin for pain

82
Q

What is this disease, and describe diagnosis/treatment

A

Pityriasis rosea
Pink, oval plaques, with scales
Onset related to URI within 1 month
Herald patch- FIRST- Largest- Appears first on trunk, christmas tree pattern
LABS:
History and clinical findings, rule out syphillis
Treatment: Self-limited, Topical steroids if purietic

83
Q

What is this disease, and describe diagnosis/treatment

A

Lichen Planus
Inflammatory papular squamous disorder
Middle age adults
ITCHY lesions, planar, purple, plaques, Wikhams striae (white lines with magnificatoin)
Treatment: Antihistamines for itching, Topical steroids
Systemic retinoids (spironalactone)

84
Q

What is this disease, and describe diagnosis/treatment

A

Urticaria (HIVES)
Allergy to drugs (penicillin, ASA, radiographic dye), Foods
Anaphylaxis in minutes (IgE)
Swelling of lips, trouble breathing

LABS:CBC- High eosinophils
RAST testing

Treatment: Antihistamines, H1 blockers (loratidine), H2 blockers (ranitidine)
Steroids (oral)

85
Q

What is this

A

Angioedema

86
Q

What is this

A

Angioedema

87
Q

What is this disease, and describe diagnosis/treatment

A

Vitiligo
Autosomal recessive
Type A- symmetric pattern
Type B- Segmental (one area of the body)

LABS:
Wood’s lamp (hypopigmentation, bright blue/white light)
Biopsy: Abscence of melanocytes and pigment
Check TSH, CBC, CMP

Treatment:
Mild to low potency topical steroids
Calcineurin inhibitors (tacrolimus)

88
Q

What is this disease, and describe diagnosis/treatment

A

Post inflammatory hyperpigmentation
Acne can cause it after inflammation or lazer treatments

Risk factor: darker skin types, areas resolving erythema multiforme

Treatment:
SPF, Hydroquinone (bleaching agent)
Azelaic acid

89
Q

What is this disease, and describe diagnosis/treatment

A

Brown pigmentation on face, macular, brown, hyperpigmentation caused by sun exposure, oral contraceptives, pregnancy

Treatment: Fades after pregnancy, hydroquinone or azelaic acid (skin lighteners)

90
Q

What is this

A

Merkel Cell carcinoma

Diagnosis:
Excisional biopsy

Treatment:
Surgery
Lymph node drainage
Excision of leson and sourrounding lymph nodes

Spreads VERY quickly, so biopsy LNs

91
Q

What is this

A

Mycosis Fungoides (T cell lymphoma)

Diagnosis: Skin biopsy, CBC shows eosinophilia and malignant T cells

Treatment: UV radiation, chemotherapy (topical)

92
Q

What disease is this

A

Drug eruption
Single or multiple round, demarcated, red plaques with GREY center
Itches and burns
Systemic fever and rash, hives

Diagnosis:
Ask about history/drugs currently on
Usually spares face

Treatment:
Stop medications, antihistamines, cooling lotions

93
Q

What is this disease

A

Urticaria
**Wheeles
SUPER itchy

ASA, PCN, BP meds, Radiographic dye causes
Type 1 Reaction– Anaphylaxis (IgE mediated)

Diagnosis:
CBC- high eosinophils
RAST testing

Treatment: Antihistamines, cooling lotions

94
Q

What disease is this

A

Seborrheic Keratoses

Diagnosis:
Sign of lesser trelalt- apperance of many of them at the same time
Biopsy if ANY question about melanoma

Treatment:
Benign, no treatment needed. But, cryotherapy if desired for visual apperance

95
Q

What Disorder is this

A

Vitiligo

Diagnosis: Wood’s lamp (depigmented, bright white and blue apperance)
Biopsy: absence of melanocytes

Treatment:
Low potency topical corticosteroids
Tacrolimus (calcineurin)

96
Q

What disease is this?

A

Linchen Planus
6 P’s
Planus
Puiruitic
Planar
Plaques
Purple
Polygonal

Diagnosis: history and clinical findings (ideopathic, inflammatory condition)

Treatment: Antihistamines for itching, steroids for local disease

97
Q

What disease is this? Diagnosis and treatment?

A

Erythroderma/ Exfoliation

Inflammatory disease
30% idiopathic
>90% of body erythema

Can occur because of psoriasis
Males>females

Diagnosis:
DIF/Biopsy- autoimmune
CBC

Treatment:
LIFE THREATENING
Maintain fluid and temperature, wet to dry dressing, antibiotics, treat underlying disease, antihistamines
IVs if loss of fluids
Keep warm (loss of body temp due to widespread erythema)

98
Q

What is this? Diagnosis? Treatment?

A

DRESS syndrome
Clinical triad:
High fever, extensive skin rash, organ involvement
Develops over many days and weeks
Have Fever
Mibiliform rash
Erythroderma or exfoliative
Facial swelling

Diagnosis:
CBC, LFTs

WBC, LFTs, Fever, Skin rash
Lymphatenopathy usually
Eosinophilia
Hepatomegaly (FEEL LIVER ON PE)

Treatment: Stop medication, supportive care, corticosteroids, antibiotics. IvIG
8% mortality rate

99
Q

What is this? Diagnosis Labs? Treatment?

A

Erythema Multiforme
Target lesions
HSV
Commonly caused by URI, mycoplasma pneumona

Dusty center of lesion

Diagnosis:
Biopsy or direct IF studies
Negative Niklosky’s sign (no epidermal detatchment)
Often febrile
Palms, soles, arms, legs

Treatment:
Remove offending drugs
Topical steroids, oral antihistamines, analgesics, skin care

100
Q

What disease is this?

A

Erythema Multiforme
TARGETOID on palms and soles
HSV causes it

101
Q

What is the most common reaction in a patient who has HSV?

A

Erythema multiforme

102
Q

If you suspect a patient has erythema multiforme that is caused by Herpes, what test do you run to see if they have had it recently?

A

Run a Titer test for HSV

103
Q

What disease is this? What labs do you order? Treatment?

A

SJS/TEN
Also in mouth and mucosae surfaces

Diagnosis:
Blood culture and blister
Biopsy (shows full tissue necrosis)

CBC, CMP

Treatment:
Supportive therapy, airway management
Treat like severe burns (pain control, withdrawal medications, electrolytes)

104
Q

What disease is this? What labs diagnose it?
Treatment?

A

SJS/TEN
Also in mouth and mucosae surfaces

Diagnosis:
Blood culture and blister
Biopsy (shows full tissue necrosis)

CBC, CMP

Treatment:
Supportive therapy, airway management
Treat like severe burns (pain control, withdrawal medications, electrolytes)

105
Q

Erythroderma is caused by which diseases

A

HIV, Eczema, Psoriasis

106
Q

The most common virus that causes erythema multiforme is

107
Q

Most common cause of SJS in kids

108
Q

Lesions in SJS and EM are described as

109
Q

What disease is this? What labs do you order to diagnose it? Treatment?

A

Bullous pemphigoid
ITCHY, TENSE Blisters

Caused by sulfa drugs, penacillin, or IgG caused
Erythema or purietic papules that form plaques, on skin folds and flexural areas

Plaques turn dark red after 1-3 weeks, vesicles and bullae appear rapidly
Bullae are tense and rupture in around 1 week

Labs:
DIF+, IIF+, Skin biopsy shows subepidermal bullae with infiltration of eosinophils

Treatment:
Oral/topical steroids, immunosuppressive drugs, minocycline

110
Q

Itchy tense blisters vs flaccid, painful blisters

A

Itchy and tense= bullous pemphigoid
Flaccid and Painful= pemphigus vulgaris

111
Q

What disease is this? What labs do you order to diagnose it? Treatment?

A

Pemphigus vulgaris
IgG autoimmune disorder
Flaccid, easily ruptured, erosions, mucosal involvement, head, upper trunk, +Niolsky’s sign
Armpits are involved

Diagnosis:
Skin biopsy shows Intraepidermal bulla
+DIF, +IIF
Treatment:
Eroded areas covered with petrolatum and dressings
Fatal if untreated– send to burn unit or ICU
Rituximab to treat, IVIG

112
Q

What is the deepest skin structure involved in a superficial burn

A

Epidermis

first degree burn

113
Q

What is the deepest skin structure involved in a superficial partial thickness

A

upper dermis

2nd degree

114
Q

What is the deepest skin structure involved in a deep partial thickness burn

A

lower dermis

2nd degree

115
Q

What is the deepest skin structure involved in a full thickness burn

A

3rd degree

subcutaneous structures

116
Q

What classification of burn is this

A

first degree, superficial, epidermis involvement

117
Q

What classification of burn is this

A

Epidermis and superficial dermis
Blistered
Very painful
Minimal scarring

118
Q

What classification of burn is this

A

Deep partial thickness burn
Epidermis and deep dermis
Blistered dermis is pale or white
Scarring
No pain, 3 weeks -2 months to heal
May need surgery or graft

119
Q

What classification of burn is this

A

Partial/full thickness
Treat with sterile, clean gauze, pain control (opioids), burn center for sure

120
Q

What procedure is done in full thickness burns to increase blood flow

A

escherotomy (cut skin so it doesn’t restrict blood flow)

121
Q

Most common causes of chemical burns

A

Cement
Concrete
Lime-fertilizer
TAR (roofing and asphalt)
Brush off dry chemicals
Irrigate with water
use proper PE