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Dermatology - Chapters > Ch. 13 - White spots > Flashcards

Ch. 13 - White spots Flashcards

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Dermatology Board Prep flashcards
0
Q

What can cause decreased melanin pigmentation?

A
  • a reduction in the number of melanocytes or

- a decrease in their melanin production

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1
Q

What are white spots in the skin a result of?

A

decreased melanin pigmentation

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2
Q

What should white spots be examined for?

A
  1. partial versus complete pigment loss

2. presence or absence of scale

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3
Q

White spots are seen more easily by the use of what?

A

Wood’s light

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4
Q

an idiopathic hypopigmentary condition that appears clinically as white patches surmounted by fine, ‘bran-like’ scales.

A

pityriasis alba

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5
Q

Who is pityriasis alba most commonly seen in?

A

darkly pigmented children

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6
Q

pityriasis alba is symptomatic or asymptomatic?

A

asymptomatic

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7
Q

What does pityriasis alba most often present as?

A

a 1-4 cm white patch with a fine, powdery scale.

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8
Q

What is pityriasis alba most often misdiagnosed as?

A

tinea versicolor

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9
Q

the result of melanocyte destruction or suppressed melanin production secondary to inflammation of the skin that appears as a hypopigmented macule.

A

post-inflammatory hypopigmentation

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10
Q

What are causes of post-inflammatory hypopigmentation?

A
  1. physical trauma
  2. chemicals
  3. skin diseases
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11
Q

What are some physical agents that can induce post-inflammatory hypopigmentation?

A

X-irradiation & frostbite

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12
Q

What is the therapy for post-inflammatory hypopigmentation?

A

none; repigmentation will sometimes occur

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13
Q

a superficial fungal infection of the stratum corneum that results in altered pigment in the epidermis, with the lesions appearing as finely scaling patches

A

tinea versicolor

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14
Q

What is the most common color that the epidermis becomes with tinea versicolor?

A

white

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15
Q

T/F:Tinea versicolor is an uncommon disease, affecting only 1% of the general population.

A

FALSE: (it’s a common disease)

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16
Q

Where is the incidence of tinea versicolor higher?

A

in tropical climates

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17
Q

What age group is tinea versicolor most common among?

A

young adults

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18
Q

Tinea versicolor is occasionally associated with ___, but more often is asymptomatic.

A

mild pruritis

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19
Q

What is the appearance of the lesions upon physical examination in patients with tinea versicolor?

A

round, hypopigmented, slightly scaling patch that often starts as multiple small follicular macules but become confluent.

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20
Q

What does the use of a wood light reveal in patients with tinea versicolor?

A

the scales fluoresces pale yellow or orange (but not universal or should be relied on)

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21
Q

Where is the usual distribution of tinea versicolor in patients?

A

neck, trunk, and upper arms (face & legs involved in tropical climates)

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22
Q

In adults, the white spots of tinea versicolor is most often misdiagnosed as _____.

A

vitiligo

23
Q

Tinea versicolor appearing as pink or tan scaling patches on the chest may be misdiagnosed as _____.

A

seborrheic dermatitis

24
Q

What is the only examination that works to diagnose tinea versicolor?

A

KOH preparation

25
Q

Which skin disorder gives the appearance of spaghetti & meatballs upon KOH preparation?

A

tinea versicolor

26
Q

What is the simplest most effective therapy for tinea versicolor?

A

oral fluconazole

27
Q

After initial therapy, how long does it take for the white spots to retain pigment?

A

months

28
Q

What is tinea versicolor caused by?

A

infection with the fungus Malassezia

29
Q

a rare, autosomal dominantly inherited, neurocutaneous disorder with several skin manifestations, including macules, caused by mutations in one of two genes, tsc1 & tsc2.

A

tuberous sclerosis

30
Q

What is the classic triad of tuberous sclerosis?

A

seizures, mental retardation, and adenoma sebaceum

31
Q

a misnamed disorder consisting of angiofibromas that begin in childhood and appear clinically as red papules on the face.

A

adenoma sebaceum

32
Q

In which skin disorder do the white spots appear as a thumbprint or ash leaf - oval at one end and pointed at the other?

A

tuberous sclerosis

33
Q

Where are the white spots of tuberous sclerosis most often found?

A

on the trunk and less often the face and extremities

34
Q

T/F: All infants with a seizure disorder should be screened for white spots with a Wood’s light examination.

A

TRUE

35
Q

an acquired condition in which functional melanocytes disappear from affected skin; lesions clinically appear as totally white, non-scaling, sharply demarcated macules.

A

vitiligo

36
Q

Higher incidence rates of vitiligo occurs in what population?

A

dark-skinned individuals within the 10-30 yr. age group

37
Q

Vitiligo is usually asymptomatic/symptomatic?

A

asymptomatic

38
Q

What is the primary lesion of vitiligo present as upon physical examination?

A

a white macule that is usually totally depigmented

39
Q

T/F: scale is present with vitiligo

A

FALSE (NO scaling)

40
Q

Where are the most common areas affected by vitiligo?

A

the extensor bony surfaces (backs of hands, elbows, and knees) and the periorificial areas (around the mouth, eyes, rectum, and genitalia)

41
Q

T/F: the laboratory is not helpful for diagnosing vitiligo?

A

TRUE

42
Q

T/F: There is no cure for vitiligo?

A

TRUE

43
Q

What is the initial therapy for vitiligo?

A

narrow-band UVB or topical steroids

44
Q

What cells are absent in patients with vitiligo?

A

melanocytes

45
Q

What are 3 proposed pathologic mechanisms for vitiligo?

A
  1. autoimmune
  2. neural
  3. self-destruction
46
Q

What is the most common type of cutaneous T-cell lymphoma?

A

Hypopigmented Mycosis Fungoides

47
Q

Where do skin lesions occur in patients with hypopigmentated mycosis fungoides?

A

the buttocks and trunk and can evolve into plaques or tumors

48
Q

A common condition in women that is under-recognized where lesions appears as well demarcated, small macules, like ‘sprinkled confetti’.

A

idiopathic guttate hypomelanosis

49
Q

Where does idiopathic guttate hypomelanosis most commonly appear on the body?

A

the shins, but may also be found on the forearms

50
Q

What skin disorder is caused by the acid-fast organism Mycobacterium leprae?

A

Leprosy

51
Q

Where is leprosy endemic?

A

south-eastern USA & Hawaii

52
Q

What is the earliest sign of leprosy?

A

a solitary hypopigmented macule

53
Q

What is the earliest sensory change with leprosy?

A

loss of feeling to light touch and cold in the hands and feet.

54
Q

Which stain is used to confirm a diagnosis of leprosy?

A

Fite stain

Dermatology - Chapters (18 decks)

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