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Dermatology - Chapters > Chapter 9 - Scaling Papules, Plaques, and Patches > Flashcards

Chapter 9 - Scaling Papules, Plaques, and Patches Flashcards

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Dermatology Board Prep flashcards
1
Q

etiology of Discoid Lupus

A

autoimmune

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2
Q

etiology of Fungus

A

dermatophyte infection

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3
Q

etiology of Mycosis fungoides

A

Neoplastic lymphoma

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4
Q

Etiology of Pityriasis Rosea

A

humuan herpesvirus 6 & 7

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5
Q

etiology of psoriasis

A

unknown

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6
Q

etiology of Secondary syphilis

A

spirochete infection

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7
Q

fungal infection - erythematous round annular patch with clear center and scaling serpiginous border, commonly found on trunk and extremities

A

Tinea capitis

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8
Q

classic ____ = Tinea corporis

A

ringworm

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9
Q

How do you differentiate between lesions of nummular eczema and a ring worm?

A

nummular lesions = coin shaped & usually multiple, located on extremities. But usually no central central clearing as seen in a ringworm. KOH prep will be negative for nummular lesions.

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10
Q

How do you differentiate between Pityriasis rose and tine?

A

Pityriasis rose starts with a single herald patch. The diagnosis will become evident when the generalized eruption develops within a few weeks. KOH negative

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11
Q

Uncommonly impetigo presents in an annular configuration. How would u differentiate this from ringworm?

A

vesicles, pustules, and crusts in annular lesions should lead one to suspect bacterial rather than fungal.

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12
Q

How do you differentiate Erythema annular centrifugum from ring worm?

A

Erythema annular centrifugum = scale is inside the elevated border

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13
Q

how do you differentiate granuloma annulare from ringworm?

A

In granuloma annulare, the border is indurate and is NOT scaling

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14
Q

what is the name of the generalized version of erythema annulare centrifugum

A

erythema gyratum repens - associated with an internal malignant disease - sometimes diabetes mellitus

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15
Q

Jock Itch - groin rash with erythematous well demarcated patch with a serpiginous scaling border. does not involve the scrotum and penis.

A

Tinea cruris

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16
Q

Patients with Tinea cruris frequently also have what?

A

Tinea Pedis (athletes foot)

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17
Q

what are the three major causes of groin rash?

A
  1. Tinea cruris
  2. Candidiasis
  3. Intertrigo
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18
Q

how would you differentiate between candidiasis and tine cruris?

A

candidiasis appears bright, intensely erythematous (beefy red) eruptions with poorly defined borders and satellite papules and pustules; scrotum is often affected unlike tine cruris
BOTH KOH POSITIVE

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19
Q

how would you differentiate between intertigo and tinea cruris?

A

intertigo represents simple irritant dermatitis, most often found in obese patients in whom moisture accumulates between skin folds in the inguinal area, along with friction causes skin irritation. The eruption is not as erythematous as that of candidiassis, and not as sharply demarcated as tine cruris. KOH prep negative

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20
Q

one hand & two feet are involved - dry, unilateral, diffuse scale on one palm always see in conjunction with tine pedis; border on wrist side is often sharply demarcated.

A

Tinea manuum

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21
Q

how would u differentiate between chronic irritant contact dermatitis, xerosis, and Tinea manuum?

A

Chronic Irritant Contact Dermatitis & Xerosis =
chronic scaling of the palms, however these conditions involve both hands and the border is generally not well demarcated

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22
Q

How do you differentiate between psoriasis and Tinea manuum?

A

Psoriasis can affect the palms with sharply demarcated scaling plaques. Usually these plaques are bilateral and more elevated and erythematous than in tines manuum. Often lesions of psoriasis elsewhere on the body support the diagnosis.

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23
Q

the most often involved dermatophytic infection

A

feet - Tinea pedis

24
Q

maceration found in the web space (especially last toes) ;interdigital, diffuse, plantar scaling, and vesiculopustular forms = _____ fungal dermatophytic infection

A

Tinea pedis

25
Q

appears as a macerated scaling process between the toes - common in patients with sweaty feet

A

interdigital tinea pedis

26
Q

extremely common in old patient; asymptomatic; skin of the feet appears dry with diffuse scaling on the soles extending into the sides of the feet; not a sharp demarcated border; moccasin like; nail involvement

A

Diffuse plantar scaling

27
Q

vesicles and pustules on the instep of the feet should lead to a suspicion of this type of tine pedis = _____

A

vesiculopustular form of Tinea Pedis

**rarely see pustules on instep

28
Q

How can you differentiate between Contact dermatitis and dyshidrotic eczema and Tinea Pedis?

A

Contact dermatitis and dyshidrotic eczema have vesicles usually smaller and rarely progress to pustules

29
Q

salmon colored patch usually largest lesion, on trunk, multiple pink/oval patches with “coleratte” scale. Distribution has been likened to that of a CHRISTMAS TREE!!

A

Pityriasis Rosea

30
Q

The generalized eruption of Pityriasis Rosea is precede by _____.

A

a single lesion called the Herald Patch

31
Q

T/F Pityriasis Rosea is always itchy.

A

false. can be itchy or not

32
Q

What is the mosts important diagnosis to consider in the differential diagnosis of Pytyrasis Rosea?

A

Secondary syphilis - if a patient has no herald patch, if the distal extremities (particularly palms and soles) are involved, or if the patient is systemically ill, a serologic test should be ordered for syphilis

33
Q

T/F Pityriasis rosea clears spontaneously within 2 week.s

A

true

34
Q

The rash of Pityriasis rosea appears to be mediated by ________.

A

cellular (type 4) immune reaction a possible viral trigger, human herpes viruses 6 & 7

35
Q

inflammatory response in the skin and mucous membranes to the hematogenously disseminated Treponema palladium spirochete. Rash can appear is MANY WAYS!

A

Secondary syphilis

36
Q

What is secondary syphilis known to be called?

A

the great imitator

37
Q

secondary syphilis - secondary phase starts ____ weeks after appearance of primary chancre (ulcer). Might have systemic symptoms.

A

6-12 weeks

38
Q

when are vesicles and bullae present in secondary syphilis?

A

in newborn with congenital disease and occasionally in patients with HIV infection

39
Q

what is the most common lesion of secondary syphilis

A

scaling papules and small plaques

40
Q

what color is secondary syphilis and where is it located?

A

reddish/brown or copper colored; almost always involved palms and soles “HAM COLORED”

41
Q

What is the general guideline to remember for patients with a generalized rash of unknown origin and systemic complaints,

A

secondary syphilis should be considered and the patient should be tested!!!!!!
ALWAYS

42
Q

Secondary syphilis resolves spontaneously within 1-3 months in the immunocompetent host. What diseases are associated with secondary syphilis?

A

Hepatitis and CNS involvement

if the disease goes to tertiary syphilis = cardiovascular and CNS manifestations

43
Q

uncommon lymphoma of the skin: lesions result from proliferation of malignant T lymphocytes in dermis which can migrate to the epidermis

A

Mycosis Fungoides

44
Q

What is Mycosis Fungoides commonly known as?

A

Cutaneous T-cell Lymphoma

45
Q

T/F Mycosis Fungoides is a fungal infection.

A

FALSE! is NOT!

46
Q

Who does mycosis fungicides commonly occur in?

A

adults

47
Q

When examining of Mycosis Fungoides what would u expect to see?

A

irregular in shape, peculiar in color (reddish brown, violaceous, or orange) and asymmetric in distribution. elevation depends on stage. patch stage looks like cigarette paper wrinking of the surface.

48
Q

Other lesions of Mycosis Fungoides may show _______ - a term used to describe a reticulate pattern of hyper pigmentation, hypo pigmentation, and erythema with telangiectasioa.

A

Poikiloderma

49
Q

In poikiloderma the epidermis shows _____.

A

atrophy

50
Q

____ is very common in advanced disease of Mycosis Fungoides.

A

Lymphadenopathy; nodules appear and frequently ulcerate

51
Q

_____ represents a leukemic variant of mycosis fungicides; characterized by total body erythema, lymphadenopathy, high number of mycosis cells in the peripheral circulation.

A

Sezary syndrome

*Sezary cells = mycosis cells

52
Q

The most important histological feature is the presence of ______. THese represent collections of lymphocytes many of which are atypical

A

Pautrier’s microabceses

53
Q

how long is survival of patients with systemic disease of mycosis fungicides

A

2 years

54
Q

uncommon rash, autoimmune diseases that appear as disk shaped purple/pink plaque which accumulates scale as it matures.
White Scale and usually cohesive, so it can be removed in one piece,
SCARING plaques in SUN EXPOSED areas; also involves the hair follicles

A

Discoid Lupus Erythematosus (DLE)

55
Q

Who does Discoid Lupus Erthematosus (DLE) is found primarily in _____

A

young middle aged population

56
Q

what is the patients complaint with DLE

A

non-healing lesions usually on sun exposed surface. face is common - look like a scar

57
Q

DLE is also seen in the scalp which causes a ______.

A

Scarring alopecia

Dermatology - Chapters (18 decks)

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