Cutaneous Symptomatolgy Flashcards
Melanoma vs Seborrheic Keratosis
M: irregular borders, color change, needs to be excised ASAP
SK: nodule or plaque,distinct margins,needs to be cauterized
ex of single vesicles
- Friction blister
- Chicken pox
- insect bite
Grouped vesicles examples
- Herpes simplex
- Allergic contact dermatitis
- Dehydrotic Eczema
Dematomal vesicle example
herpes zoster
Definitive diagnosis of cutaneous conditions
- Complete history, PE,ROS
2. To confirm only - lab tests, histopathological analysis
Common chief complaints to Dermatologists
- itchy skin (most common)
- Painful-inflammed skin
- Skin color change
- ERythematous skin
- Oily skin, dry skin, Sweaty skin,scaly skin
- Scar
- Hair concerns
- Nail concerns
classic location for dermatitis herpetiformis
Extensor surfaces of elbow, knees, buttocks, back.
Scabies location
soft and warm areas (finger webs, wrist, inguinal area, buttocks, periumbilical area, inframammary area)
Blister related to cancer of GIT
Bullous pephigoid
Top 10 common dermatoses in the Philippines (2013)
1 Verruca 2 Superficial Dermatophyte infectons 3 Acne Vulgaris 4 Contact Dermatitis 5 Bacterial infections 6 Psoriasis 7 Lichen Simplex Chronicus 8 Scabies 9 Seborrheic Dermatitis 10 Nummular Dermatitis
Exophytic lesion. can be solitary or multiple
Verruca
Dermatophytosis
1. Erythematous, ring shaped 2 Advancing borders 3 Central Clearing 4. Pruritic 5 Named accdg to Body part affected
Psoriasis
- Sharply Marginated erythematous plaques with silvery scales
2 (+) Auspitz sign
3 Favors Knee, elbows, scalp, nails
common lesions in acne
Papules or specifically Comedones
Types of Contact dermatitis
- Irritant
2. Allergic
Hyperpigmented or hypopigmented hyposthetic patch or plaque
Hansen’s disease
Erythematous nodule with central necrotic plug
furuncle
Carbuncle
Multiple adjacent coalescing furuncles
Erythematous pustules and vesicles with golden yellow crust
Impetigo
Circumscribed plaque from from reptetitve rubbing
Lichen simplex chronicus, can be hyperpigmented and scaly
Erythematous plaques with greasy scale
seborrheic dermatitis
- (+) Burrows
- Present in warm sweaty areas
- Treat the patient from head to toe even if no visible lesions are present
Scabies
- Coin shaped, can start as an insect bite in people with atopic background
- May become exematous with scratching
Nummular dermatitis
- sensation that leads to a desire to scratch or rub the skin
- most common cutaneous sx
Pruritus
Neural pathway of Pain and itch
unmyelinated C fibers
GAte Control
- High centers exert influence on the severity of tich which explains why itching is more severe at night
Receives afferent impulses, but is also subject to powerful descending controls of the brain
Dorsal Horn
Mediators of itch
1, histamine 2 Serotonin 3 endopeptidases 4 Neuropeptidases 5 Eicosanoids
Diffuse and poorly localized itch, intensifies with light touch or other stimulus
Allokinesis
Primary Cutaneous diseases
- infestations
- Dermatitis Herpetiformis
- Bullous pemphigoid
- Cholinergic Urticaria
5/ Miliaria Rubra
6/ Symptomatic dermographism
7 Asteatotic eczema
Picker’s nodule
Pruririgo nodularis, found at the leg area
2 biochromes in the epidermis
Melanin and Carotenoids
2 biochromes in the dermis
Oxyhemoglobin and reduced hemoglobin
Hyperpifmentation found in the nuchal area
PSeudoacanthosis Nigricans
sun spots in children
Pityriasis alba
caused by Malassezia furfur
Pityriasis versicolor
side effect of strong topical steroids
leucoderma
No pigmentation
- vitiligo
- Guttate hypomelanosis
Skin failure with erythema
Chronic cutaneous failure
Exfoliative erythroderma
- excessive amounts of dry surface scales
- Disorder of keratinization or cornification resulting to abnormal epidermal differentiation or metabolism
- Associated with atopic dermatitis
Ichytosis
Causes of abnormal keratinization of epithelial cells
- Pityriasiform
- Psoriasiform
- Ichthyosiform
Parakeratosis
Keratinocytes retain nucleus which reach skin surface
conditions with scaly skin
Pitytriasis rosea, dermatophyte infections
thinning of hair without balding
Telogen effluvium
Circumscribed area without hair
alopecia areata
Beau’s lines
- transverse white lines
- indicate presence of renal or hepatic problems
Nail concerns for SLE
Periungal telagiectasia
Cutaneous signs
- Color
- palpation or lesion
- Shape
4 Margination
5 arrangement
6 distribution
Parts of palpation of lesion
- consistency
- Temperature
- Mobility
- Tenderness
- Depth of lesions
Margination
Well defined or Ill-defined
Arrangement/Grouping
- Herpetiform
- Zosteriform
- Annular
- Reticulated
- Linear
Distribution
- Extent
2. Patterns (symmetrical, photodistribution, dermatomal, intertriginous, pressure sites)
most common morphologic reactions in drugs
Exanthematous eruptions
- can also be related to glutathione deficiency
- 10 days after exposure to drug
- req drug dechallenge
Angioedema vs Wheals
A: Ill defined and involves dermis and subcutaneous tissue
W: Superficial, well defined
3 mechanisms of urticaria
- IgE Dependent
- Immune complex induced
- Non-immunological
Erythema Nodosum
- occurence of tender, non-ulcerative nodules on legs
- inflammation of the subcutaneous fat
Caused by anovulatory drugs
Erythema nodosum
Pathogenesis of Erythema nodosum
Circulating immune complexes
acute life trehetening mucocutaneos reaction characterized by extensive necrosis and detachment of the epidermis
Steven-johnson syndrome, toxic epidermal necrolysis
Epidermal detachment after light touching/light rubbing
Nikolsky sign
Pathogenesis of diseasE: Delayed hypersensitivity reaction where primary target is epidermis
Erythema multiforme
tx for Erythema multiforme
penicillin, sulfonamide
pathogensis of Erythroderma
Type II, Type III, Type IV (allergic contact dermatitis mech)
sign of intestinal polyposis
Peutz-jeghers syndrome
