Chapter 5 Dermatologic Disorder

Question 1

Papule

Answer 1

Single, uniformly brown-colored, slightly raised, irregularly shaped with defined boarders

Question 2

Macule

Answer 2

Single, flat, non-palpable area of discoloration, irregularly shaped, and 0.5 cm at the widest diameter

Question 3

Cyst

Answer 3

Single, firm, smooth, raised, dome-shaped, fluid-filled, flesh-colored encapsulated lesion of 1.5cm in diameter

Question 4

Fissure

Answer 4

Linear-like cleavage with sharp walls through the epidermis “itchy and cracked”

Question 5

Purpura

Answer 5

Flat, non-blanchable, confluent, purple-colored irregularly-shaped lesions on skin ranging in size

Question 6

Wheal

Answer 6

clustered, smooth, slightly-raised, circumscribed, pruritic skin-colored lesions of various sizes, surrounded by an area of erythema

Question 7

Linear

Answer 7

in streaks such as noted in phytodermatitis, with vesicular lesions forming, typically a number of hours after exposure to plant oil contained in poison ivy, poison oak, poison sumac

Question 8

Clustered

Answer 8

Occurring in a group without pattern, such as the pattern of vesicular lesions seen in an outbreak of herpes simplex

Question 9

Scattered

Answer 9

Generalized over body without a specific pattern or distribution, as seen in a viral exanthem such as rubella

Question 10

Confluent or Coalescent

Answer 10

Multiple lesions blending together, such as plaques seen in severe psoriasis vulgaris

Question 11

Annular

Answer 11

In a ring, seen in the characteristic “Bull’s Eye” lesion, often with central clearing, seen in Lyme Disease

Question 12

Actinic Keratosis

Answer 12

scaling flesh colored lesions in a cluster, ranging in size from 3-10 mm on the dorsal aspect of the hand, present for a number of months, reported by a 78 year old man who worked for 40 years as an exterior house painter

Question 13

Eczema/ Atopic Dermatitis

Answer 13

Intensely pruritic, reddened, thickened, scaly patches 5-10 mm in diameter on the anterior aspects of the lower legs described as being intermittently itchy that has been present for a number of months, reported by a 50 year old man who reports he has had dry and sensitive skin all of his life

Question 14

Painless ulcerated lesion approx 1.5 cm in diameter that has been present for a number of weeks

Answer 14

need to biopsy to rule of malignancy

Question 15

Actinic Keratosis

Answer 15

scaling flesh colored lesions in a cluster, ranging in size from 3-10 mm on the dorsal aspect of the hand, present for a number of months, reported by a 78 year old man who worked for 40 years as an exterior house painter

Red, brown, or flesh tone, scaly, often tender but usually minimally symptomatic

Question 16

Characteristics of basal cell carcinoma

Answer 16

sun-exposed area, more common, new lesion, papule, nodule with or without central erosion, pearly or waxy appearance, usually relatively distinct. low metastatic risk

Question 17

Squamous cell carcinoma characteristics

Answer 17

less common, sun exposed areas, can arise from actinic keratoses, red, conical hard lesions with or without ulcerations. less distinct boarders. looks “angry”. greater metastatic risk

Question 18

Malignant melanoma mnemonic

Answer 18

A- asymmetric
B- irregular borders
C- color not uniform
D- diameter (>6mm)
E- evolving & elevated

Question 19

Treatment for psoriasis vulgaris

Answer 19

medium-potency topical corticosteroid

Question 20

treatment for scabies

Answer 20

permethrin lotion

Question 21

treatment for verruca vulgaris

Answer 21

imiquimod cream

Question 22

treatment for tinea pedis

Answer 22

topical ketoconazole

Question 23

treatment for rosacea

Answer 23

topical metronidazole

Question 24

characteristic of eczema

Answer 24

dry, scaly skin, pruritis, and crusted or weeping sores; usually worse during cold, dry weather

Question 25

characteristic of rosacea

Answer 25

facial redness, swelling and pustular lesions over the nose and cheeks with small visible blood vessles

Question 26

characterisitcs of rosacea

Answer 26

facial redness, swelling and pustular lesions over the nose and cheeks with small visible blood vessels

Question 27

characteristic of scabies

Answer 27

acute onset of pruritic, erythematous papules and burrows located over the wrist and hands

Question 28

Characteristics of pityriasis rosea

Answer 28

solitary salmon-colored patch on the trunk that enlarges over a few days and is followed by a pattern of smaller lesions on the chest, abdomen, and back

Question 29

Topical treatment of poison ivy

Answer 29

optimal for localized acute contact dermatitis mild or high potency topical corticosteroids such as triamcinolone. for areas of thinner skin (eyelids, face, genital) use low-potency such a desonide ointment skin atrophy risk with protracted use

Question 30

systemic treatment of poison ivy

Answer 30

systemic corticosteroid preferred when >20% of total body surface area is affected, severe rash, or if rash impacts face, genitals, hands prednisone 0.5-1 mg/kg/day PO for 5-7 days

Question 31

Adjunctive therapy for both systemic and topical treatment

Answer 31

cool compresses to relieve symptoms, calamine lotion and oatmeal baths OTC analgesics antihistamines

Question 32

presentation of impetigo-nonbullous

Answer 32

erythematous macule that rapidly evolves into vesicle or pustule, ruptures, content dry, leaving a crusted, honey colored exudate

Question 33

treatment of impetigo-nonbullous

Answer 33

topical mupirocin

Question 34

presentation of impetigo- bullous

Answer 34

bulla contains clear, yellow fluid that turns cloudy, dark yellow. bullae rupture easily within 1-3 days leaving a rim of scale around red, moist base, followed by a brown- lcaquered or scalded skin apprearance

Question 35

treatment of impetigo- bullous

Answer 35

usually requires systemic antimicrobial treatment

Question 36

presentation of cellulities

Answer 36

infection of dermis and subcutaneous fat usually includes heat, redness, and discomfort in the region

Question 37

presentation of cellulitis

Answer 37

infection of dermis and subcutaneous fat usually includes heat, redness, and discomfort in the region

Question 38

treatment of cellulitis

Answer 38

requires systemic antimicrobial therapy

Question 39

presentation of cutaneous abscess

Answer 39

skin infection involving a hair follicle and surrounding tissue- heat, redness and discomfort

Question 40

treatment of abscess

Answer 40

treatment varies. moderate- i & D with culture; empiric RX usually TMP or doxycycline mild- I&D; warm compresses