D4 Flashcards
Actinic keratosis lesions?
Scaly
Papular/plaque
Surrounding skine show sign of solar damage(Telangiectasia and hyperpigmentation)
The common area affected?
Face
Scalp
Lateral neck
Dorsal surface of the hand
Progression?
May progress to SCC in some patient
managment?
Small: Cryotherapy(liquid nitrogen)
Large: Fluorouracil
Indication for biopsy?
Size >1 cm
Ulceration
Induration
Failure of drug therapy
Molluscum contagiousum etiology?
Poxvirus
Lesion?
Papule
Central umbilication
Surrounding pruritis
Involve all body parts except palm and sole
Risk?
Skin to skin contact
HIV(discriminate)
Treatment of acne vulgaris?
Depend on type
Comedonal acne?
Close or open comedones in forehead, nose, and chine
May progress to inflamatory pustule/nodule
Treatment?
Topical retinoid Biologic agent(Salicylic,azelaic or glycolic acide)
Inflammatory acne?
Inflamed papule/pustule;erythema
Managment?
Mild: Retinoid + Benzoil peroxidase
Moderate: Add topical Ab(clindamycin, erythromycin)
Sever: Add oral antibiotic(Tetracycline)
Nodular(cystic) acne?
Nodule
Cyst
May form sare or sinus
Tx?
M: Topical retinoid + benzoyl peroxidase + topical ab
S: Add oral antibiotic(Tetracycline)
Unresponsive: oral isotretinoin
cause for acne?
hyperkeratinization
Increase sebum production
P.Acne colonization
Indication for oral Ab in acne?
Sever inflammatory and nodulocystic acne
Widspread involvment(Back and upper shoulder)
failure of adding topical Ab in Moderate I/ND acne
Treatment of MC?
curritage
Cryotherapy
Topical agent(podophylotoxine)
Dermatitis herpetiformis (DH)?
rare
chronic, autoimmune skin condition
characterized by the presence of groups of severely itchy blisters and raised red skin lesions.
These are most commonly located on the?
elbows knees buttocks lower back scalp.
Can you have dermatitis herpetiformis without celiac disease?
Dermatitis herpetiformis patients usually don’t have the digestive symptoms that go along with celiac disease.
Almost all patients with dermatitis herpetiformis have celiac disease, though the disease is asymptomatic (they have no gastrointestinal symptoms).
Dermatitis herpetiformis is treatement?
gluten-free diet and an oral antibiotic called dapsone.. If dapsone doesn’t help, prescribe sulfapyridine or sulfasalazine.
Necrobiosis lipoidica diabeticorum (“NLD”) ?
is a rash that occurs on the lower legs. It is more common in women, and there are usually several spots. They are slightly raised shiny red-brown patches. The centers are often yellowish and may develop open sores that are slow to heal.
Discoid lupus lesions?
often red, scaly, and thick.
Usually they do not hurt or itch.
Over time, these lesions can produce scarring and skin discoloration (darkly colored and/or lightly colored areas).
Lesions most often appear?
on the face, ears, scalp, neck, and hands
Herptic witlow?
HSV infection of hand
virus enter on skin defect after contact
Lesion?
Prodrome symptom(fever..) Grouped Vesicular rash on erythemetous base Tingling Pain Burning
managment?
self resolve
acyclovir in immunocompromized
Senile/actnenic/solar purpura cause?
Loss of elastic fiber in perivasculas spese–rapture of vesseles during skine streching
CM?
Common in older
Minley affect posterior forarm and hand
Echemosis
Hemosidrosis in skine(Hyperpigmentation/brown discoloration of akin)
Insidence and severity common in?
Anticoagulation
NSAID
Corticosteroid
Macular skin lesion in NF and TS?
NF:Cafe-au-lait spote/hyperpigmented)
TS:Ash-leaf spote/Hypopigmented/
Lichens panus oral lesion?
White papule/plaque Lesion conected by white lacy lesion(Wickham stria) Mucosal athtophy Ulcer Erythema Can present w/o skine involvment
Pathophysiology of Lichen planus?
CD8 reaxn after triger(Infn,Drug and allergen) exposure
Telogen effluvium CM?
Acte, diffiuse, non-inflamatory hair loss
Scalp and hair fibers apear normal
Hair shaft easily pulled out(>10-15 % once)
MCC of hair loss in adult
Triggers?
Sever illness, fever, and surgery Pregnancy, child birth Emotional stress Endocrine and nutritional problem Wight loss
Pathophysiology?
Most of follicles pass to rest/sheding phase
Normal hair follicle stage?
Growth phase(90%)--anagen Transformation phase(<1%)--catagon rest/sheding phase(<10%)--telogen
managment?
Reasurance/self limited/
Tx underlining cause
Achantosis nigrican Cxs and ass.disease?
Benign: Insulin resistance(DM,PCOS)
Malignant:GU and GI malignancy(rapid onset and can affect unesual are like MM,palm and sole)
Caracterstich?
Hyperkeratotic and hyperpigmented plaque
It typically affects the armpits, groin and neck.
Valvely texture
Addison disease associated skine condition?
Generalized hyperpigmentation(area friction(knee,elboe..) and sun light exposure area(and,face,,)
Bullous pemphigoid CM?
Sever pruritis Bullea Erythematous base Prodrome(Urticarial and eczematous lesion) Mucosal involvment in some pt
Associated disease?
Age >65
Malignancy
Nurologic disease(PD,MS…)
Pathophisiology?
IgG Ab against hemidesmosome
IgG and C3 deposition in DE junction
Managment?
Topical potent CS(Clobetasole..)–effective
Systemic CS not recomended
Biopsy in dermatitis herpitiformis?
Microabsces in dermal papilla
IgA deposition in dermis
When Tinea corporis lesion confluent they form?
Flower petal lesion
SCC in situ CM?
slow growing
red
scaly patch/plaque
Treatment of type 1 drug rxn?
discontinu drug
mild: antihistamin
sever: Im GC and Epiniphrine
smptome in mild case?
Urticaria
Pruritis
Flushing
Sever?
Anaphylaxis
Angioedema of larynex
