Compiled Review Slides Flashcards
Primary lesion?
Plaque
(erythematous, scaling plaque - psoraisis)
primary lesion
Patch
Primary lesion?
Nodule
could also say Tumor
(Pilar cyst)
Describe
•D. RED-BROWN ANNULAR PLAQUE WITH A RAISED BORDER AND CENTRAL CLEARING
primary lesion?
Papule on the nose. Erythematous with a central erosion. Likely a basal cell skin cancer.
primary lesion?
burrow
primary lesion?
macule
This is a oval brown macule. It is a melanocytic nevus. A macule is < 5mm
primary lesion?
vesicle
There are many vesicles on the palm. There is also some erythema, scale and crust. This is a problem called pompholyx, otherwise known as dyshidrotic eczema.
THE PRIMARY CELL TYPE HAS A MULTILOBED NUCLEUS. THE CELL IS?
neutrophil
This is a type of non-infectious neutrophilic dermatosis, sometimes seen in association with inflammatory bowel disease and other conditions. It is called pyoderma gangrenosum, and it is characterized by numerous neutrophils and skin necrosis.
THE PRIMARY CELL TYPE SEEN IN THIS SKIN DISEASE HAS GRANULES CONTAINING SERINE PROTEASES. IT IS A?
Mast cell
This is a mast cell EM. The prior photo of urticaria pigmentosa shows generalized, numerous erythematous macules. These macules will form a wheal (urticate) when stroked. That is typical of mastocytosis, also called urticaria pigmentosa. Each macule contains numerous mast cells, and a biopsy makes the diagnosis
THE PRIMARY ANTIGEN PRESENTING CELL IN THE SKIN IS?
what does it stain for?
what kind of granules?
Langerhans cell
Remember these cells stain with CD1a and S100 and have Birbeck granules. EM photo of Birbeck granules (tennis racket appearance)
most likely diagnosis?
Impetigo
These are heavy crusts. The erosions are NOT sharply punched out and rounded, like you would expect if it were herpes.
most likely dx?
How does patient feel? how does red area feel?
erysipelas
The swelling and sharp demarcation are characteristic of erysipelas. The area involved is usually very tender. The patient usually feels quite ill.
allergic contact dermatitis and rosacea are in the differential diagnosis.
most likely dx?
hot tub folliculitis
Acne is NOT usually this uniform looking. Hot tub folliculitis often has pustules that look very monomorphic (the same) and uniform, with a spread of erythema away from the pustule of a few mm. This is also what staphylococcal folliculitis looks like.
THIS CONDITION IS ASSOCIATED WITH A RO ANTIBODY. WHAT IS THE MOST LIKELY DIAGNOSIS?
subacute lupus erythematosis
Ro/LA antibodies are associated with subacute cutaneous lupus erythematosis. The rash is typically seen in a sun-exposed distribution. It is red and scaling, and some call it psoriasis like or “psoriasiform”.
dx?
dermatomyositis
The tip off here is the upper eyelid location and the so-called “livid” or purple/violet hue. The livid erythema of the eyelids in dermatomyositis is referred to as a heliotrope.
dx?
scleroderma
note how tight and smooth the skin looks, and the contractures of the fingers
ulcerations are a common complication
dx?
lupus erythematosus
Discoid lupus results in this type of erythema, scaling, and in some cases, scarring. Usually the lesions are erythematous, flat topped papules and plaques in a sun exposed distribution.
dx?
lupus erythematosus
The tip off here is a young woman, the butterfly distribution of facial rash, and the violaceous hue (sort of violet-purple), a color characteristic of connective tissue diseases.
THIS MAN HAS ATOPIC DERMATITIS. WHAT OTHER DISEASE IS RELATED TO THIS SKIN DISEASE?
asthma
WHAT INFECTIOUS PROCESS CHARACTERIZED BY HONEY COLORED CRUSTS IS PRESENT IN THIS PATIENT WITH SEVERE ATOPIC DERMATITIS?
impetigo
Remember, impetigo is caused by strep or staph and often complicates atopic dermatitis. The base of the nose is a common place for it. Staph may be carried inside the nose.
WHICH IMMUNOGLOBULIN MIGHT BE ELEVATED IN THIS ATOPIC PATIENT?
IgE
TH2 PHENOTYPE IS SEEN IN WHICH DISEASE?
•A. ECZEMA•B. ALLERGIES•C. ASTHMA•D. ALL OF THE ABOVE
all
THIS SLIDE SHOWS WHAT COMMON PROBLEM IN ATOPICS?
•A. SENSITIVE SKIN•B. DRY SKIN•C. PRURITUS•D. INFECTED SKIN
dry skin
ONE OF THE BEST TREATMENTS FOR DRY SKIN IS:
•A. A LOTION•B. A GEL•C. A CREAM•D. A VITAMIN
A cream
thicker the better for dry skin. Clear bland ointment like plain vaseline petroleum jelly is the ideal moisturizer for an atopic patient.
ONE OF THE BEST TREATMENTS FOR ATOPIC DERMATITIS IS?
•A. AVOID STEROIDS•B. A TOPICAL STEROID•C. A CREAM•D. A VITAMIN
topical steroid
•A. ATOPIC DERMATITIS•B. IMPETIGO•C. PRURITUS•D. ALL OF THE ABOVE
all
dx?
psoraisis
Note the primary lesions: papules and plaques. Description: Multiple erythematous , scaling papules and plaques diffusely on the back.
THIS PATIENT ALSO HAS MARKED NAIL PITTING AND PLAQUES ON THE ELBOWS ANSD KNEES. WHAT IS THE DIAGNOSIS?
psoraisis
Description: Confluent erythema with scale and fissures on the palms.
THIS PATIENT HAS A PAINFUL JOINT AND NAIL CHANGES.WHAT IS THE DIAGNOSIS?
psoriatic arthritis
ALL FACTORS BELOW WORSEN PSORIASIS EXCEPT?
•A. PREDNISONE WITHDRAWAL•B. LITHIUM•C. HEPATITIS•D. STREPTOCOCCUS•E. TRAUMA
hepatitis
THE LARGE PLAQUE CAME FIRST, THEN THE DIFFUSE FLAT TOPPED SCALING PAPULES. WHAT IS THE DIAGNOSIS?
The first lesion was the herald patch of pityriasis rosea. This usually has a “Christmas Tree” distribution on the trunk of erythematous, scaling papules. The differential diagnosis is usually psoriasis and secondary syphilis.
NOTE THE VIOLACEOUS PAPULES WITH RETICULATE WHITE LACY PATTERN. WHAT IS THE DIAGNOSIS?
lichen planus
The lacy pattern seen in these violaceous papules is often referred to as Wickham’s striae.
dx?
pityriasis rubra pilaris
Pityriasis rubra pilaris is a “papulosquamous” dermatosis. It shows scaling erythema with typical islands of sparing where there is completely normal skin. It usually starts on the head and spreads inferiorly, resulting in erythroderma, or total body redness. The hands and feet show marked scaling, “keratoderma”
dx?
Herpes simplex
These vesicles are grouped and some are in varying stages, some grouped, some pustules.
dx?
molluscum
Molluscum are well defined papules that are smooth, with a rolled border and central crater containing infectious molluscum bodies.
cause?
HPV
dx?
Herpes simplex
Sharply demarcated, “punched out” erosions are typical of herpes simplex. Note how the center in some cases looks depressed, or “umbilicated”.