Clinical Care of the Skin, Hair, and Nails

Question 1

abrupt onset of erythematous papules or pustules with pruritus and pain in hairy areas

Hair emanating from the center of the pustule

Answer 1

Folliculitis

Question 2

significant problem in predisposed individuals who are required to shave closely

affects those with curly hair or those with hair follicles oriented at an oblique angle

Answer 2

Pseudofolliculitis Barbae

Question 3

a contagious, superficial, inteaepidermal infection occurring prominently on exposed areas of the face and extremities

formation of vesiculopustules that rupture leading to crusting with characterized golden appearance

Answer 3

non Bullous impetigo

Question 4

a contagious, superficial, inteaepidermal infection occurring prominently on exposed areas of the face and extremities

progresses from small to large flaccid bullae ( newborn/young children) caused by epidermolytic toxin release: ruptured bullae leaving brown crust less lymophadenopathy

Answer 4

Bullous Impetigo

Question 5

Unilateral lower extremity involvement is typical and systemic symptoms are usually absent

typically occurs near surgical wounds and trauma sites

Answer 5

cellulitis

Question 6

rapid progressing infection involving any layer of soft tissue including skin subcutaneous fat, fascia and or muscle

Risk Factors:

Trauma
immunosuppression
malignancy
obesity
Alcoholism

Answer 6

Necrotizing Fasciitis

Question 7

a well circumscribed, painful, supportive inflammatory nodule at any site that contains hair fiollicles

Answer 7

Furuncle (Boil)

Question 8

A coalescene of several inflamed follicles into a single inflammatory amass with purulent drainage from multiple follicles

common on the back of neck upper back and lateral thighs

malaise, chills, and fever precede or occur during height of inflammation

Answer 8

Carbuncle

Question 9

firm fluctuant flesh to yellow colored solitary nodule which often connect with the surface by keratin filled pores

Grow slowly over time and main remain stable for months to years

Answer 9

Stable epidermal Cyst

Question 10

spontaneous inflammation

warm red and boggy mass tender to palpation

Answer 10

Inflamed/ ruptured Epidermal Cysts

Question 11

abscess formation with fluctuant or visible pus involving the proximal and lateral nail folds that been present for less than six weeks

Answer 11

Paronychia

Question 12

sever pain

abscess of the distal phalanx fat pad

Answer 12

Felon

Question 13

Red, denuded, glistening surface with a long cigarette paper like scaling and advancing border

common in intertriginous area such as axillae, groin, digital web spaces, glans penis, beneath breasts

Answer 13

Fungal Infection

Question 14

velvety tan, pink or white macules that do not tan

color is uniform

woods lamp shows hypo pigmented areas

Answer 14

Tinea Versicolor

Question 15

Hx of direct contact of the nail with dermatophytes, yest, or non-dermatophyte molds in the environment

Nail discoloration, subungual kyperkeratosis, splitting of the nail plate and nail destruction

Answer 15

Onychomycosis

Question 16

Contact with another infected person

affected area finger webs, wrists, sides of hand ans feet, penis, buttocks, scrotum

intense puritus that worsens at night

Positive ink test

Answer 16

Scabies

Question 17

Self limiting papulosquamous skin rash common in 10-35yo

C/o malaise, mild fever, headache, sore throat, cough, mild URI or GI symptoms

begins with a solitary herald patch that appears on the trunk or proximal limbs that precede secondary eruption by 7-14days

Lesions are distributed with long axes along cleavage (Langer) lines

“Christmas tree pattern”
V shaped pattern on upper chest

Associated with spontaneous abortion and fetal demise

Answer 17

Pituriasis Rosea

Question 18

Asymptomatic or cause self limiting gingivostomatitis

affects all oral mucousa

last longer that recurrence

Answer 18

Primary Herpes Simplex

Question 19

prodome of perioral tingling, itching, numbness, pain, or burning followed by papukovesicular

affects vemillion boards of lips or mucousa

less sever than primary infection

Answer 19

Recurrent infections

Question 20

preceding rash (1-5) days before onset of paresthesia with allodynia or hyperesthesia describes as deep “burning,” “throbbing,” or “stabbing” sensation

Rash will begin as red macules and papules that progress to clear vesicles within 1-2 days, they will appear unilateral, without mid line crossing thoracic, cranial, lumbar, cervical dermatones

Answer 20

Herpes Zoster (shingle)

Question 21

contact with strong allergens

pt. present w/ vesicles, edema, redness, and extreme pruitus

Answer 21

Allergic Contact Dermatitis (ACD)

Question 22

well demarcated salmon pink to red erythematous papules and placques silvery scales

Nail findings: Pitting, oil, spots, onycholysis

Auspitz sign: Pinpoint bleeding with removal of scale

Answer 22

Psoriasis

Question 23

chronic, superficial recurrent inflammatory rash affecting sebum rich hairy regions of the body especially the scalp eyebrows and face

Answer 23

Seborrgeic Dermatitis (Dandruff)

Question 24

mild erythema to highly painful and erythema with edema, vesiculation, and blistering

increase to heat and mechanical pressure

Answer 24

Sunburn

Question 25

transient, edematous, red plaques, vary in size and shape; typically round or oval. may become confluent polycyclic

Answer 25

Acute Urticaria

Question 26

most common acquired benign epithelial tumor of the skin

begins as circumscribed tan brown patches or thin plaques

Papular or verrucous with greasy scale and a stuck on appearance

Answer 26

Seborrheic Keratosis

Question 27

“rough sandpaper like” lesion

becomes more defined and develops a thin/adherent, yellowish or transparent scale

Answer 27

Sctinic Keratosis (AK)

Question 28

ugly duckling lesion

will be:
Asymmetrical
Boarders Irregular
Color changes
Diameter >6mm
Evolving

Answer 28

Melanoma