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SBL 2 > Clinical Perspectives in Skin Changes > Flashcards

Clinical Perspectives in Skin Changes Flashcards

1
Q

What are the DDx for a maculopapular rash?

A
  • port wine stains
  • rickettsial infectionis
  • rubella
  • measles
  • allergic drug eruptions
  • lichen planus
  • seborrheic keratoses
  • actinic keratoses
  • acne
  • skin cancer
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2
Q

What is a macule?

A

flat discolored less than cm

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3
Q

papule?

A

small solid lesion less than cm in diameter raised above srace of skin

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4
Q

Nodule?

A

larger soid lesion up to 5 cm in diameter

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5
Q

Plaque

A

flat topped elevation of skin greater than 1 cm

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6
Q

Bulla?

A

large clear fluid filled lesion greater than 1 cm

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7
Q

Vesicle?

A

small clear fluid filled lesion less than 1 cm and rasied

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8
Q

wheal?

A

Transient erythematous and edematous papule or plaque

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9
Q

DDx for nodules?

A
  • cysts
  • lipomas
  • fibromas
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10
Q

Vesicular rash ddx?

A
  • acute allergic contact dermatitis
  • autoimmmune bistering disorders dermatitis herpetiformis
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11
Q

Bullae ddx?

A
  • irritatnt contact dermatitis
  • allergic contact dermatitis
  • drug reactions
  • autoimmune bullous diseases
  • pemphigus vulgaris
  • bullous pemphigoid
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12
Q

Petechiae vs Purpura

A

Petechiae:

  • non blanchable foci of hemorrhage
  • platelet abnormalities
  • vasculitis
  • rocky mountain spotted fever

Purpura:

  • palpable purpura are hallmark of leukocytoclastic vasculitis
  • non palpable are hemorrhage or microvascular occlusion with ischemic hemorrhage
  • Coagulopathy indicated
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13
Q

Urticaria?

A
  • wheals or hives
  • elevated lesions caused by localized edema
  • pruritis and red wheals
  • hypersensitivity to drugs, stings, bites, AI and physical stimuli like temp pressure and sunlight
  • last less than 24 hrs
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14
Q

Full thickness destruction of epidermis into underlying dermis?

A

Ulcer

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15
Q

Lichenification?

A

Visible thickening of skin resulting in accentuated skin fold markings

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16
Q

What causes papular rashes?

A
  • Viral
  • Bacterial
  • Toxin induced
  • Drug induced
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17
Q

Herpes 1 and 2?

A
  • Specrum of illnesses involving stomatitis, urogenital lesions, bells palsy and encephalitis
18
Q

Herpes zoster?

A
  • Varicella rash:
    • pruritic centrifugal papular changing to vesicular rash, pustular crusting rash lesions are at all stages
  • Zoster rash:
    • Tingling pain eruption of vesiclese in a dermatomal distribution evolving to pustules and then crusting
    • concerned with potential for post herpetic neuralgia
19
Q

Skin manifestations of meningitis?

A
  • Petechial rash on skin and mucous membrane
  • Purulent spinal fluid with gram neg intracellular and extracellular diplococci
  • Culture of CSF fluid, blood, or petechial aspiration confirms diagnosis
20
Q

DIC in memingitis presents with what type of skin manifestation?

A
  • Purpura fulminans
21
Q

Seborrheic keratosis?

A
  • benign papules and plaques beige to brown 3-20mm in diameter velvety or warty surface
  • Look stuck onto skin
  • Extremely common in onder adults may be mistake for melanomas
  • no tx is needed
22
Q

actinic keratoses?

A
  • small macules or papules
  • Flesh colored pink or slightly hyperpigmented, feels like sand paper and tender to palpation
  • occur on sun exposed parts of body fair complexion people
  • Premalignant and may progress to SCC
23
Q

Describe BCC

A
  • pearly papule
  • Erythematous patch greater than 6mm or a non healing ulcer in sun eposed areas
  • History of bleeding
  • Fair skin people
  • Can see telangectasisa in them
24
Q

SCC ?

A
  • non helaing ulcer or warty nodule
  • Skin damage with long term sun exposure
  • SCC of ear temple lip oral cavity tongue genitalia
    *
25
Q

What is psoriasis What are its comorbidities?

A
  • Chronic inflammatory papulosquamous and immune mediated skin disorder
  • associated with joint and cardio comorbidities
  • Psoriasis can presnet in many different patterns from scalp to feet and causes psychiatric distress and physical disabilities
26
Q

What triggers psoriasis?

A
  • Stress
  • physical trauma (Koebner phenomenon)
  • Cold weather
  • Sun or hot weather
  • Infections
  • Meds
27
Q

Screening for melanoma>

A
  • Asymmetry
  • Border
  • Color
    • white ischemic
    • black necrotic
    • blue- superficial but getting deeper
  • Diameter
    • bigger than 6mm
  • Evolution
  • Tissue depth (color is related to this) is most significant determinant in prognosis
28
Q

Erythema migrans is seen in what disease

A

Borrelia burgdorferia lyme disease

29
Q

When do you see erythema multiforme?

A
  • Herpes simplex and mycoplasma pneumonia
30
Q

what is erythema multiforme?

A
  • Target lesion is round pink to red patch
  • Three concentric rigns
31
Q

SLE skin sx?

A
  • Pruritis or increased sun sensitivity
  • Cutaneous lesions can appear in discoid lupus and are diffuse non scarring and nondescripit
  • Butterfly rash

Systemic sx are arthralgia, myalgia, fatigue, malaise, fevers, chills, night sweats, weight loss, HA, vision changes, diffuse hair loss

32
Q

What is dermatomyositis?

A
  • Rare chronic immune mediated disorder that affects the skin or proximal skeletal muscles
    • dx is missed or delayed bc pruritus and rash are similar to other dermatitis
  • Increased risk of malignancy and assoc with Celiac dz
  • Pathognomic findings include periorbital erythema (heliotrope), violaceous papuples ofver joints of hands (Gottron’s papules)
33
Q

Pretibial myxedema?

A

Pnk waxy indurated plaque on lower legs of patient with Graves dz and hyperthyroidism

34
Q

Erythema nodosum?

A

Classic non granulomatous lesion assoc with sarcoidosis, usually on lower extremity on anterior tibial surface

35
Q

Erythema infectiosum?

A
  • Fiery red slapped cheeks circumoral pallor, and lacy maculopapular rash on trunk and limbs
36
Q

Scarlet fever?

A
  • toxin producing group A Beta hemolytic streptococci
    • evolves from exudative pharyngitis
  • Rash of scarlet fever is diffusely erythematous an looks like sunburn with sand papery rash
  • Groin and axilla most intense
  • Blanches on pressure
  • Strawberry tongue
37
Q

Measles?

A
  • Fever malaise conjunctivitis coryza cough rash Koplik spots
    • Koplik spots appear during prodrome phase and are pathognomoic for measles
38
Q

Nikolsky sign?

A
  • Slight lateral pressure on skin causing sloughing of epidermis
  • Positive in pemphigus vulgaris
  • Negative in bulllous pemphigoid
39
Q

Pemphigus vulgaris

A
  • AI
  • Results in formation of large superficial loose bullae that peel off and leave denuded skin
  • Kickolsky sign positive
  • oral mucosal involvment is common
40
Q

Vasculitis?

A
  • Group of DO characterized by inflammation and damage in blood vessels walls
  • Limited to skin or multisystem DO
  • Cutaneous vasculaitic diseases are classified small med large and type of vessel
41
Q

Large vessel vasculitis

A
  • Giant cell arthritis
  • Polymyalgia rheumatica
  • Takayasu arteritis
  • Aortitis
42
Q

Medium small artery vasculitis?

A
  • Most common anad frequently tested ones:
    • Polyarteritis nodosa
      • only nodosa not associated with ANCA auto abs
    • Eosinophilic granulomaatosis with polyangiitis
    • Microscopic polyangiitis
    • Microscopic polyangiitis

SBL 2 (9 decks)

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