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PAM Semester 4 > Clin Med Derm Exam 1 > Flashcards

Clin Med Derm Exam 1 Flashcards

1
Q

Functions of the skin

A 
Protects the underlying structures
Barrier against microbes
Prevents loss of fluids
Regulates body temp
Helps rid body of excess water and salt
Sensation, temp, pain, touch
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2
Q

3 layers of skin

A

Epidermis
Dermis
Subcutaneous

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3
Q

Layers of epidermis

outer to inner

A

Stratum corneum
Squamous cells
Basal layer

(melanin is also present)

thin 0.2mm

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4
Q

Melanin

A

Protects the deeper layers of the skin against the sun

Located in the epidermis

Produced by melanocytes

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5
Q

Stratum corneum

A

Horny layer

outermost layer

made up of dead keratinocytes

main cell of the epidermis (continually shed)

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6
Q

Squamous cells

A

Living keratinocytes

below the stratum corneum

in epidermis

these cells form keratin (a protein)

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7
Q

Basal layer

A

is the lowest part of the epidermis

formed from basal cells

these cells continually divide and form new keratinocytes

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8
Q

Taking a history (lesions)

evolution of lesion

A

Site of onset
Manner in which it progressed or spread
duration
periods of resolution in chronic cases

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9
Q

Taking a history (lesions)

S/S

A

Itching, burning, pain, numbness

does anything relieve it

time of day when worst

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10
Q

Taking a history (lesions)

Taking meds

A

Sulfa - SJS
Staph - rash - scalded skin
Amox +mono - Rash

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11
Q

Taking a history (lesions)

Associated systemic S/S

A

Malaise
fever
arthralgias
etc

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12
Q

Taking a history (lesions)

Exposures

A 
Plants
metals
detergents
soaps
etc
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13
Q

Taking a history (lesions)

Other….

A

Chronic or previous illnesses

History of allergies

Photosensitivity

Review of systems

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14
Q

Examination of skin

A

Inspection should be in well lit room
completely undressed patient

Exam is inspection heavy

Labs and biopsies can be used to confirm

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15
Q

Four basic features of cutaneous lesions

A

Type of primary lesions

Shape of individual lesions

Distribution of eruptions

Arrangement of eruptions

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16
Q

Characteristic’s of lesion

A 
size
shape
color
texture
elevation
exudates
configuration
location and distribution
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17
Q

Macule

A

Flat
less than 1 cm
change in normal skin color

freckles, flat moles, measles, petechiae

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18
Q

Patch

A

A large flat lesion
over 1 cm

vitiligo, port wine stains, Mongolian spots cafe au lait patches

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19
Q

Papule

A

Raised
superficial lesion
less than 1 cm

raised mole, white head, acne

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20
Q

Nodule

A

Raised

usually round

solid round ellipsoidal

over 1 cm

can be benign or malignant

(tumor over 2cm)

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21
Q

Tumor

A

Nodule over 2cm

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22
Q

Vesicle and bulla

A 
Circumscribed
elevated
superficial cavity
containing fluid
less than 1 cm

Bulla is over 1cm

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23
Q

Cyst

A

soft raised encapsulated lesion

semisolid/liquid content

isnt transparent like bulla

(cant unroof, pop)

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24
Q

Pustule

A

Circumscribed superficial cavity
contains purulent exudate

can vary in size and shape

(does not signify the existence of infection

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25
Q

plaque

A

a plateau like elevation
over 1 cm in diameter
wider than it is high

psoriasis

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26
Q

Wheal

A

Rounded pale red papule or plaque

usually disappears within hours

various sizes and shapes

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27
Q

Crusts

A

Develop when serum, blood, exudate dry on skin surface

Impetigo
ecthyma

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28
Q

Impetigo

A

Crust (honey colored)
crust may be delicate thin and friable

Can happen in adults but usually kids

ABX

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29
Q

Ecthyma

A

Crust that involves the entire epidermis

crust may be adherent and thick

accompanied by necrosis of deeper tissues

Ecthyma involves dermis

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30
Q

Desquamation

A

Desquamation (scaling)

scales are flakes of the stratum corneum

psoriasis

actinic keratosis (solar)

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31
Q

Ulcer

A

Skin defect where there is a loss of epidermis and upper papillary dermis

may extend to the subcutis

(an erosion is a defect only involving the epidermis and heals without a scar)

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32
Q

Erosion

A

an erosion is a defect only involving the epidermis and heals without a scar

secondary lesions

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33
Q

Scale

A

Flaky accumulation of excess keratin

secondary lesions

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34
Q

excoriation

A

linear angular erosions caused by scratching

secondary lesions

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35
Q

atrophy

A

epidermal thinning of skin with loss of normal skin surface markings

dermal depression of skin surface due to loss of underlying collagen or dermal ground substance

secondary lesions

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36
Q

scar

A

collection of fibrous tissue replacing normal dermal constituents

secondary lesions

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37
Q

Maceration

A

Maceration occurs when skin is in contact with moisture for too long.

Macerated skin looks lighter in color and wrinkly

In addition to the pain and discomfort it causes, maceration can also slow wound healing and make skin more vulnerable to infection

secondary lesions

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38
Q

secondary lesions

A

lichenification

thickening of skin with accentuation of normal skin surface markings most commonly due to chronic rubbing

secondary lesions

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39
Q

Keloids

A

secondary lesion

some people are predisposed

very bad scarring

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40
Q

spider hemangioma

A

common in liver disease

central arteriole with radiating thin walled vessels

Blanches when compressed

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41
Q

telangiectasia

A

dilated superficial blood vessels

Blanches when compressed

can appear in older people

only cosmetic

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42
Q

Cherry hemangiomas

A

do not blanch

discrete papules

benign proliferation of endothelial cells

generally no tx

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43
Q

Dermatographism

A

A from of urticaria in which whealing occurs in the site and in the configuration of stroking of the skin

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44
Q

Lymphangitis

A

Red streak extends from the ankle to the groin

Follows lymph channels

IV ABX

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45
Q

Pedunculated

A

On a stalk

Squamous cell carcinoma

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46
Q

Verrucous

A

Wart like

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47
Q

Umbilicated

A

Containing a central depression

Basal Cell Carcinoma

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48
Q

Darier sign

A

Rubbing a lesion causes a urticarial flare

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49
Q

Auspitz sign

A

pin point bleeding after scale is removed

psoriasis

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50
Q

Nikolsky sign

A

Pushing a blister causes further separation of the dermis

TEN

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51
Q

Photopatch test

A

Documents photoallergy

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52
Q

Patch test

A

Demonstrates hypersensitivity reaction

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53
Q

koebner phenonmenon

A

Minor trauma leads to new lesions at the site of trauma

Psoriasis

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54
Q

Shagreen skin

A

An oval nevoid plaque

Skin is colored or pigmented on the trunk and back and is associated with tuberous sclerosis

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55
Q

Types of eczematous eruptions

A 
Atopic Dermatitis
Contact Dermatitis
Perioral Dermatitis
Seborrheic Dermatitis
Stasis Dermatitis
Nummular Dermatitis
Dyshidrosis
Lichen simplex chronicus
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56
Q

Atopic dermatitis

A

Strong correlation with asthma

poorly defined pruritic erythematous patches, papules and plaques

edema with widespread involvement

flexor surfaces, neck, eyelids, forehead, face, dorsum of hands and feet

often begins in childhood

Tx hydration, topical lotions, ointments, creams
topical steroids, antihistamines

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57
Q

Lichen simplex chronicus

A

lichenification
thickening of skin with accentuation of skin markings

well defined lichenified plaques and or papules occurring in areas of chronic scratching

Progression from atopic derm due to scratching

topical steroids or tar preparations

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58
Q

Contact dermatitis

A

Acute well defined areas of erythema and plaques
Can have vesicles, crusts and urticaria

Itching and burning

Exposure to metals, fake jewelry, nickel
solvents, oils, dust, enzymes etc

Patch testing

Avoid offending agent
treat itching
Steroids if severe

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59
Q

Nummular Dermatitis

A

Coin shaped lesion
plaque
small vesicles that have joined together
may have crust

Pruritic and inflammatory
occurs in winter

Emollients and topical steroids
Triamcinolone
Crude coal tar

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60
Q

Perioral Dermatitis

A

Papulopustules around mouth

May have satellite lesions

Rule out staph with culture

Tx: metronidazole or erythromycin

Avoid steroids (will worsen)

61
Q

Seborrheic dermatitis

A

Yellowish red often greasy or white dry scaling
varying sizes

Very greased

Dandruff is this on scalp

Occurs where sebaceous glands are most active
scalp, face, ears, chest, groin

Tx: Topical steroids, ketoconazole, topical sulfa

62
Q

Stasis Dermatitis

A

Inflammatory scales, papules, crusting
edema and varicosities

Ulcers in 30%

Seen in CHF
Swollen and weeping (dry is better)

Doppler / venography
biopsy

Tx compression stockings and topical steroids

63
Q

Dyshidrosis

A

Dishwasher dermatitis

Small vesicles under the skin

Tapioca appearance

Can crack and become painful

Burrows cool dressing

Potent steroids used under occlusive dressing x 2 weeks
Oral steroids if severe

64
Q

KOH Lab

A

To rule out fungus

65
Q

Papulosquamous diseases

A 
Acrochordons
Drug eruptions
Lichen planus
Pityriasis Rosea
Psoriasis
66
Q

Acrochordons

A

Skin tags

In areas of friction

Obese and diabetic

No need to remove but can

67
Q

Drug eruptions

A

itchy rash
symmetric measles like eruption

Can also be a fixed eruption violaceous pruritic sharply demarcated patch

Remove offending agent

Systemic prednisone
antihistamines

ie mono + amox = rash
AIDs + Sulfa = reaction

68
Q

Drug induced photosensitivity

A

Rash limited to sun exposed areas

Carbamazepine, amiodarone, doxy, furosemide, phenothiazines, sulfonamides

69
Q

Sun exposed Distribution porphyria cutanea tarda

A

Associated with hep C

Blisters and erosions

70
Q

Lichen planus

A

Flat topped shiny violaceous papules with surface lines

Wickham striae

Flexor aspects of wrists lumbar area, eyelids, shins scalp

Can e on mucosa or glans penis (may ulcerate)

Biopsy and immunofluorescence

Tx: Topical steroids
Systemic steroids

71
Q

Pityriasis Rosea

A

Herald patch (largest) (forms first)

Dull pink, fawn colored plaques
Round
Christmas tree pattern

most likely viral, will resolve in 3-8 weeks
treat itching

72
Q

Pityriasis Alba

A

White scaly macular
Worsens with sun
indistinct borders

Tx low potent steroids topical

73
Q

Psoriasis

A

Well marginated
erythematous plaques
Silvery white scales
Removal will result in blood droplet (auspitz)

common on Joints, may have arthritis

Pruritic
Scratching leads to more lesions
Koebners phenomenon

2% of population
Chronic, recurrent

Topical glucocorticoids
Coal tar
Phototherapy
Methotrexate
acitretin
Biologics - enbrel, remicade, humira, stelara
74
Q

Psoriasis Variant

Psoriatic erythroderma

A

Lesions involving entire skin and is an exfoliative and serious condition

75
Q

Psoriasis Variant

Guttate

A

drop like

acute eruption disseminated pattern

typically appearing after strep pharyngitis

76
Q

Pustular (von zumbuschs syndrome)

A

an abrupt life threatening condition

characterized by widespread pustules that join to form lakes of pus

Fever, malaise, leukocytosis

77
Q

Psoriasis

Severity

A

Mild <2% BSA
Moderate 3-10%
Severe >10%

Most patient have mild

25% have mod/severe

78
Q

Cream vs ointment

A

Cream no as effective as ointment

Good for dry rashes

ointments penetrate deeper

79
Q

Desquamation

A

Staph TSS & SSS
Erythema Multiforme
SJS
TEN

80
Q

Staph toxic shock syndrome

A

s. aureus is normal flora

Super antigens: cause an exaggerated dysregulated hyperimmune cytokine response

Macular erythroderma

Usually not purulent, but can desquamate

Multi systemic infection

CDC Definition
Fever over 102
Rash - Diffuse macular erythroderma
Hypotension SBP <90 or drop of 15
Desquamation 3-7 days after onset (palms/soles)
Check labs - CBC, CMP,CPK, LDH, cultures
Tx: Consult ID
ICU admit
Shock management
ABX - Vanc, zosyn, cef, meropenem
Clind usually best if known
81
Q

“Staph” Scalded Skin Syndrome

A

Under 5
Treat Staph with penicillinase-resistant penicillin

Treat skin like burn
usually to burn unit

Can be drug induced

82
Q

Erythema multiforme

A

Target lesion eruptions

usually on hands and feet

fever malaise weakness

Drug reactions (pen, sulfons)
HSV
Mycoplasma

other drugs: phenytoin, barbs, allopurinol

avoid trigger
if hsv use antivirals
Antihistamines and nsaids
Systemic steroids if severe

83
Q

SJS

A

Desquamation
Generalized macular eruption which rapidly become necrotic

Positive nikolsky sign

mouth, lips, genitalia = 90%
SJS = 10% BSA
SJS/TEN = 10-30%
TEN >30%

Drugs that can cause
Sulfonamides, quinolones, cephs, tetra, barbs, carbamazepine, phenytoin, valproic acid, allopurinol, steroids

Dx: clinical or biopsy

Tx Burn unit if necrotic
Pain control, fluids, electrolytes

Steroids and ABX are controversial

84
Q

Vesicular bullae

A

Bullous Pemphigoid

Pemphigus Vulgaris

85
Q

Bullous Pemphigoid

A

vesicles and bulla
Generalized or local
some may be hemorrhagic

severe pruritis progresses to tenderness

Axilla, thighs, groin, mucous membranes

autoimmune
patients over 60

Biopsy, immunofluorescence to confirm

High dose prednisone

86
Q

Pemphigus Vulgaris

A

vesicles or bulla that rupture and leave a crust

oral lesions appear first

skin lesions 6-12 months later

Nikolskys sign

weakness, malaise, pain, burning sensation

No pruritus

Auto immune

Middle aged adults

Biopsy, immunofluorescence to confirm

Prednisone then add immunosuppressant azathioprine or methotrexate

87
Q

Acneiform lesions

A

Acne vulgaris
Rosacea
Folliculitis

88
Q

Acne vulgaris

A

Open and closed comedones, inflammatory papules and pustules, nodules and cysts.

common, genetic component

considered an inflammatory disease

Labs

Tx: cleaning, antibacterials, clinda
Systemic isotretinoin (accutane)
oral contraceptives

89
Q

isotretinoin (accutane) monitoring

A 
Triglycerides q 4-8 wks, stop if >800
CBC
LFTs
Cat X
prescribe 2 types of contraception
doesnt affect fetus with men taking it
90
Q

Rosacea

A

chronic inflammatory disease

Scattered small inflammatory papulopustules

cheeks, chin, forehead, nose
enlarged nose

face appears flushed
telangiectasia

Triggers- heat, sun, alcohol, spicy food

metronidazole
oral abx tetra

91
Q

Folliculitis

A

papules and pustules at hair follicles

clean
topical - clinda, erythromycin, mupirocin
oral ABX if severe

Staph or strep

Barbae is from shaving
Hairs curl in

92
Q

Verrucous lesions

A

Seborrheic keratosis

Actinic keratosis

93
Q

Seborrheic keratosis

A

Verrucated, velvety
stuck on beige, brown or black plaque

Benign
No tx

Can be linked to gastric cancer

94
Q

Actinic keratosis

A

scaly erythematous
sun exposed skin
can be painful
fair skinned people

is precancer and will progress to squamous cell carcinoma

Tx: cryosurg
fluorocil
Aldara cream
electrodessication
peels
95
Q

Neoplasms

A

Basal cell carcinoma
Squamous cell carcinoma
Kaposi Sarcoma
Melanoma

96
Q

Basal cell carcinoma

A

Most common skin cancer

Doesn’t usually metastasize (just destroys surrounding tissue)

Donut sign

Pearly papule with telangiectasias
sun damaged skin
Commonly bleed

Surgery, Mohs, cryo, electro

97
Q

Basal cell carcinoma Types

A

Noduloulcerative (most common)

Superficial (mimics eczema)

Pigmented (may be mistaken for melanoma)

Morpheaform (plaquelike lesion with telangiectasia)

Keratotic (basosquamous carcinoma)

98
Q

Squamous cell carcinoma

A

indurated and keratotic papules or nodules
ulcerating and or crusting

Second most common type of skin cancer

Rarely metastasize but can in immunocompromised

Surgery, Mohs, cryo, electro

99
Q

Kaposi sarcoma

A

Oval purple papule with faint yellow green halo

Aids/HIV
3rd world

violaceous papules and nodules with edema

Violaceous nodules on the upper gingiva, covering the teeth

Human Herpesvirus type 8

Biopsy, Labs for HIV, Hep
CXR, stool occult

Tx no cure, palliative excision,
Systemic treatment interferon

100
Q

Classic Kaposi sarcoma

A

middle-aged men of Southern and Eastern European origin

violaceous, or bluish-black macules and patches

Abdomen, lymph nodes, usually starts on legs,

101
Q

Kaposi sarcoma

subtypes

A

Subtypes

Classic KS
African Cutaneous KS
African Lymphadenopathic KS
AIDS-Associated KS
Immunosuppression-Associated KS
102
Q

African cutaneous Karposi sarcoma

A

Nodular, infiltrating, vascular masses occur on the extremities, mostly men between the ages of 20-50

Endemic in tropical Africa

103
Q

African Lymphadenopathic Karposi sarcoma

A

Lymph node involvement
with or without skin lesions

can happen in children under 10

aggressive and often fatal within 2 years

104
Q

AIDS-Associated Karposi Sarcoma

A

Cutaneous lesions
Red to purple macules rapidly progress
head, neck, trunk, mucous membranes
systemic involvement

HIV

105
Q

Immunosuppression-Associated Karposi sarcoma

A

similar to classic

renal transplants

cancer patients

chemo treatments

106
Q

Melanoma

A 
ABCD
Black brown pink colored macule, papule, nodule >6mm in diameter
Asymmetric
irregular border
color variation

25% arise from exisiting moles

75% from normal skin

Early detection is key

Tumor markers, Lactate dehydrogenase and S100B marker

US for lymph nodes

Tx: excision
Iplilmumab Metastatic stage 3 melanoma

107
Q

Types of melanoma

A
  1. Superficial Spreading Melanoma
  2. Lentigo Maligna Melanoma
  3. Acral Lentiginous
  4. Nodular
108
Q

Superficial Spreading Melanoma

A

Most common type of malignant melanoma

demonstrates color variegation (black, blue, brown, pink, and white) and irregular borders.

109
Q

Lentigo Maligna Melanoma

A

Characterized by a single, flat, freckle-like macule with an irregular border, usually on the face.

Very long radial growth phase before invasion

Lentigo maligna(hutchinson’s melanotic freckle) is precursor lesion
Most common in elderly and in sun-exposed areas(esp face)

Often confused with a solar lentigo or a seborrheic keratosis

110
Q

Acral Lentiginous Melanoma

A

Occurs on palms and soles, mucosal surfaces, in nail beds and mucocutaneous junctions

Similar to lentigo maligna melanoma but with more aggressive biologic behavior

Metastasize easily, are often mistaken for plantar warts or subungual hematomas

111
Q

Nodular melanoma

A

Starts as a papule which becomes an elevated nodule with irregular borders and variegation in color.

Generally poor prognosis because of invasive growth from onset

Must be differentiated from a hemangioma, angiokeratoma, or pigmented basal cell carcinoma.

Rapidly growing

112
Q

Melanoma staging

A

Sentinel lymph no biopsy

best baseline

Stage 1 & 2 5-10 year survival

Stage 3 38-78% survival

Stage 4 metastasis 6-9 month survival without treatment

113
Q

Insects and parasites

A

Lice
Bedbugs
Scabies
Spiders

114
Q

Lice

A

scalp, body, pubic hair

Can see under microscope

nits on hairshaft

Permethrin, malathion, ivermectin

Special combs petroleum jelly suffocates lice

reapply in 7-10 days to kill newly hatched lice

115
Q

Bed bugs

A

Bugs feed at night on blood

bites do not transmit disease or infection

can survive up to a year without a host

116
Q

Scabies

A

burrows, pruritic vesicles

web spaces of hands and feet, genitalia, axillary

Mineral oil on burrow, scrape, look at under microscope

5% permethrin

117
Q

Spider bites

A

Black widow causes pain prick at bite

Brown recluse does not cause pain prick at bite

118
Q

Black widow

A

Black widow cause neurologic overstimulation

Myalgia, spasms, rigidity

Tx with valium & calcium gluconate

119
Q

Brown recluse

A

Lesion is sinking macule
slightly eroded at center

Infarction of the skin
rapid coagulation within vessels

Avoid debridement until completely evolved

Analgesics, clean

Wound decreases in 5 - 10 days

120
Q

Hair and nails

A 
Alopecia areata
Androgenic alopecia
Onychomycosis
Paronychia
Nail conditions recognition
121
Q

Alopecia areata

A

Circular patchy shape

can be seen with SLE

Unknown cause

totalis = complete scalp hair loss

Universalis Total body, scalp ahir loss

Tx: intralesion cortisone, topical

122
Q

Androgenic alopecia

A

progressive balding

normal male pattern baldness with varying patterns

Tx minoxidil
finasteride (propecia)
Hair transplant

Finestaride is androgen inhibitor

Minoxidil is vasodialator

123
Q

Hirsutism

A

male pattern hair in females

cultural and ethnic

genetic connection

Treat cause

124
Q

Onycomycosis

A

Thick discolored nails

T. Rubrum = most common cause

Candida effects finger nails more than toe nails

Lab = KOH, PAS stain

Tx: topical antifungal
Terbinafine (not with liver issues)
Itraconazole

Can be from trauma (long nails), psoriasis, candida pseudomonas infection, hyperthyroid

125
Q

Paronychia

A

erythema, swelling, pain, proximal nail fold

Acute I&D
Oral ABX if needed
Topical steroid if needed

126
Q

Splinter hemorrhages

A

Seen in subacute bacterial endocarditis

Can also be seen in trauma, vasculitis, leukemia, lupus

127
Q

Beaus lines

A

Transverse grooves in nails

Seen in 
infection
poor nutrition
chemotherapy
alcoholism
stress
128
Q

Koilonychia

A

Spoon nail

Irion deficient anemia

129
Q

Terrys nails

A

“White nails”

Seen in Cirrhosis
Heart failure
diabetes mellitus
Hyperthyroid
malnutrition

2/3’s of nailbed is white

130
Q

Mees bands

A

White transverse line

seen in arsenic
thallium
chemotherapy
hodgkins lymphoma

131
Q

Clubbing

A

Smoking

Bronchogenic carcinoma

Seen in bronchiectasis
empyema
pulmonary fibrosis
Bronchogenic carcinoma
Cystic fibrosis
132
Q

Viral diseases

A 
Condyloma Acuminatum
Condyloma Lata
Exanthems
Herpes Simplex
Herpetic Whitlow
Molluscum Contagiosum
Verrucae
Varicella Zoster
Echovirus 9
133
Q

Condyloma Acuminatum

A

Soft skin colored fleshy warts
Ano-genital, oral mucosa

Biopsy with immunofluorescence

No cure for HPV
Trichloroacetic acid or topical podophyllin (hurts)
miquimod cream, podofilox

Cyrosurg, surg, electro, laser, cautery etc

134
Q

Condylomata Lata

A

Verrucous intertriginous plaques seen in secondary syphillis

135
Q

Exanthems

A

Rash

Generalized macular and or papular eruption associated with systemic infection

usually not itchy

Tx symptoms

136
Q

Measles (Rubeola)

A

1st disease
Rash starts on face and spreads down the trunk

4D’S 3 C’s
4 days
cough, Coryza, conjunctivitis

Koplick spots (“O”)

Highly contagious

Dx: igm antibodies

Tx supportive

137
Q

Scarlet fever

A

2nd disease

non itchy rash on trunk and extremities

Erythema marignatum
strawberry tongue
Cause= post strep pharyngitis
untreated can lead to rheumatic heart disease

Tx:ABX

138
Q

German measles (Rubella)

A

3rd disease
milder than measles similar presentation
rash on face then to body
Supportive treatment

coryza type symptoms

supportive treatment

139
Q

Erythema Infectiosum

A

5th disease

Slapped cheek
parvovirus B19

Rash AFTER low grade fever goes away

can cause hepatitis

self limiting

140
Q

Papular purpuric glove and sock syndrome

A

Can come from a variety of viruses
coxsackie, parvo b19, CMV EBV, etc

looks like RMSF

can cause fetalis hydrops

Dx viral serology, IGM, IGG, PCR

Tx symptoms

Looks like hand foot mouth but with no mouth involvement

No wrist involvement (wrist involved with RMSF)

141
Q

Exanthema Subitum (Roseola

A

6th disease

HHV6 and HHV7

<3yrs

Rash after super high fever 104
watch for seizures

142
Q

Hand foot and mouth

A

Coxsackie virus

143
Q

HSV 1

A

Oral

144
Q

HSV 2

A

Genital

145
Q

HSV

A

Labs direct microscopy Tzank smear (gold standard)

Culture must unroof lesion

PCR (not during active phase)

tx: Antivirals acyclovir

if eye keratitis - trifluiridine

146
Q

Herpetic whitlow

A

Cluster of lesion on digits

Very painful and pruritic

dental workers
thumb sucking

Dx viral culture or PCR

tx: Antivirals acyclovir (must be oral)

I&D makes it worse

147
Q

Molluscum contagiosum

A

Discrete flesh colored
waxy, pearly, dome shaped , umbilicated 2-6mm papules

pox virus

biopsy immunofluorescence

self limiting

148
Q

Verrucae

A

Wart
flat with cauliflower surface

biopsy to rule out cancer

Tx salycylic acid is best
cryo, surg, elctro

PAM Semester 4 (7 decks)

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