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Multisystems > CM- Common Skin Disorders > Flashcards

CM- Common Skin Disorders Flashcards

1
Q

What are the 3 major factors involved in the production of acne?

A
  1. excessive sebum production [usually by stimulation by androgenic hormones]
  2. abnormal follicular keratinization causing comedo formation and pilosebaceous duct obstruction
  3. Propionibacterium acnes - convert lipids from sebum into FFA that incite inflammation
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2
Q

What are the 2 ways acne vulgaris can present?

A
  1. Inflammatory
    - erythematous papules, pustules, nodules, cysts
  2. non-inflammatory
    - closed comedones [white head] 1-2mm that get more evident when skin is stretched
    - open comedones [blackheads] 2-3mm that are dark and clogged follicle content
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3
Q

What is the most commonly affected sites for acne vulgaris?

A
  1. face

2. chest, shoulders, back

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4
Q

How is the diagnosis of acne vulgaris made?

A

clinical recognition of classic lesions in typical areas

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5
Q

What is tinea?

A

Infection of the superficial layers of the epidermis by dermatophyte fungi [microsporum [capitis], trichophyton [microconidia], epidermophyton [pedis] ]

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6
Q

A child presents with patchy hair loss and inflammation, scaling and “black dot” hairs. What is the likely diagnosis?
What is kerion?

A

Tinea capitis

Kerion is when the inflammation is so severe, it gets boggy and looks like an abscess.

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7
Q

A man presents with erythematous, annular or arciform lesion with a well defined scaly/vesicular border and a central area of clearing on his trunk [or extremities]. What is the likely diagnosis?

A

Tinea corporis

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8
Q

A man presents with an erythematous annular lesion with a scaly/vesicular advancing edge and central area of clearing. The lesion is located on his groin and buttocks. What is the diagnosis?

A

Tinea cruris

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9
Q

A patient has interdigital scaling and maceration on their feet. It is very itchy. What is the diagnosis?

A

Tinea pedis

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10
Q

What is tinea unguium ?

A

dermatophyte infection of nails that results in discoloration and thickening of the nail plate

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11
Q

How does tinea versicolor differ from the other tinea?

A

It is not a dermatophyte infection, but rather a yeast [dimorphic=pityrosporum ovale; filamentous = M. furfur]

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12
Q

Describe the presentation of tinea versicolor.

A

erythematous hypo or hyperpigmented patches with slight desquamation on the back and chest.

“sun spots”

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13
Q

What tests are ordered to confirm the diagnosis of tinea?

A
  1. microscopic KOH prep with scales from the lesion
    - septate [branching] hyphae = dermatophyte
    - short hyphae/spores [spaghetti/meatball] = tinea versicolor
  2. fungal culture for difficult to diagnose or particular hair/nail infections
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14
Q

What causes warts?

A

they are intraepidermal tumors caused by infection by HPV

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15
Q

A patient has flesh-brown colored hyperkeratotic papules whose surface reveals black specks of pigment. Hand and feet are most frequently involved. What is the diagnosis?
What is the reason for the “black specks”?

A

Common wart [verruca vulgaris]

Black specks are pigment caused by thrombosed capillary loops

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16
Q

A person of color comes to the office with a finger-like slender projection on her face [or neck]. What type of wart is this?

A

Filiform

17
Q

Describe a flat wart [verruca plana]

  • size, color
  • papule/macule
  • what body parts?
  • arrangement?
A

small, 1-3mm flesh/tan colored papule on the face, neck, extensors.
distributed in a linear pattern [koeberization].

18
Q

Describe condyloma acuminata.

A

Warts growing in the moist areas of genital/perianal skin.
Most common cause of STD.
More common in uncircumscribed

19
Q

How is molluscum contagiosum similar to a wart?

How is it different?

A

Molluscum contagiosum and warts are both intraepidermal tumors caused by viruses.

Warts = HPV
M. contagiosum = poxvirus

20
Q

A child presents with flesh-pearly white, waxy papules 1-5mm thick with umbilication on her face and flexures.
Based on appearance, what would you guess this lesion was?

A

Molluscum contagiosum

21
Q

A patient presents with a painful red wheal with central punctum. The wheal fades in hours, but swelling around the puntum arises.
What is the most likely cause of this presentation?
What would happen if the person was severely allergic?

A

Bee, wasp, yellow jacket sting

If severely allergic, they would go into anaphylaxis

22
Q

Describe a fire ant sting.

A

Wheal with 2 hemorrhagic puncta.
Red base, bright white, uniform, same stages of evolution
The lesion evolves into pustules within hours.

23
Q

A patient presents with fever, headache, arthralgias, vomiting and a maculopapular rash. There is an area of skin necrosis with a “red white and blue pattern” [rushing blood, ischemia, infarct]. What is the cause?
How do you avoid getting this?

A

Spider bite by a brown recluse.

Identify the spider based on “fiddle” marking on the cephalothorax

24
Q

A middle-aged/elderly patient presents with hyperkeratotic epidermal papules. She said it started small, yellowish and waxy, but has become larger, brown/black, wart-like and greasy. It has a well-defined border and looks like it is stuck on like a sticker.
There are white and black dots on the surface.

What is the likely diagnosis?
What are the white and black dots?
What 3 areas of the body are most affected?

A

Seborrheic keratosis
White dots = keratin pearls
Black dots = horn cysts

  1. face
  2. chest
  3. back
25
Q

What is dermatosis papulosa nigra?

A

multiple small, dark papules on cheeks and around the eyes of people of color [like morgan freeman]

26
Q

What may be necessary if you cannot 100% conclude that something is seborrheic keratosis and not melanoma?

A

biopsy

27
Q

Seborrheic keratoses arose abruptly and are in crops. What is this situation called?
What is it a cutaneous marker for?

A

It is Leser-Trelat and is a cutaneous marker for internal malignancy

28
Q

What are the 2 main causes of contact dermatitis?

A
  1. irritant [80%]- non allergic reaction due to chemical or physical agents
  2. allergic [20%] - delayed [type 4] hypersensitivity that requires prior exposure [sensitization]
29
Q

What is the difference between mild and strong irritants for the presentation of contact dermatitis?

A

Mild- requires multiple exposures or prolonged contact to cause dermatitis [soap, detergent, etc]. Erythema with blisters/oozing that later dry into thick fissured pattern

Severe- single exposure- blistering, erosion, ulceration

30
Q

A patient presents with vesicular dermatitis in a distinctly linear pattern. What was the probable cause ?

A

plants - Rhus, poison ivy, poison oak

31
Q

What provides the chief clue to diagnose contact dermatitis?

A

distribution and pattern of the dermatitis

ex. sharp margin, acute angle, linear = external agent

32
Q

What test is ordered if no clear source of allergen is identified for someone with allergic contact dermatitis?

A

Patch testing

33
Q

Distinguish changes attributable to sun exposure from those normal to aging.

A

Normal aging- loss of elasticity, thinning

Due to sun exposure: texture, vascular, pigment, papular changes

34
Q

What are the 3 texture changes associated with photo-aging?

A
  1. solar elastosis- thick, yellow, wrinkles
  2. atrophy
  3. cutis rhomboidosis nuchae [diamonds on the back of necks]
35
Q

What 2 vascular changes are associated with photo-aging?

A
  1. telangectasias
  2. venous lakes

both are due to loss of collagen around the vessels

36
Q

What 2 pigment changes are associated with photo-aging?

A
  1. hyperpigmentation - freckles [sun-exposed skin of youths], lentigines [brown, macules], mottled dyspigmentation
  2. hypopigmentation
    white macules [guttate]
37
Q

What are the 3 main papular changes associated with photo-aging?

A
  1. actinic keratoses: pre-malignant lesion on face, ear, neck, back of hands that are raised, rough, and sand-paper
  2. solar elastosis of papulonodular type- yellow papules that coalesce to plaques
  3. comedones with cysts around the eyes [blackheads w/ yellow papules]

Multisystems (29 decks)

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