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Step 2 > Derm 1 > Flashcards

Derm 1 Flashcards

1
Q

What should be considered in abscesses in the lower back and perineal regions?

A

Anaerobic bacteria

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2
Q

A patient comes in concerned about recurrent abscesses in the axilla, groin, and perineum. What is this? What causes it? Treatment?

A

Hidradenitis suppurativa

Caused by chronic follicular occlusion and apocrine gland inflammation

Often antibiotics and surgery

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3
Q

What causes dry gangrene?

A

Gradual necrosis of skin from vascular insufficiency…features hard, dry skin

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4
Q

What causes wet gangrene?

A

Vascular obstruction or infection –> swelling and blistering

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5
Q

Kid comes in with yellow crusted lesions. What is this? What causes it? Treatment?

A

Impetigo

Staph a or GAS

Wash affected area
Erythromycin, cephalosporin, or topical antibiotic

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6
Q

What causes acne vulgarism? Treatment

A

Propionibacterium acnes

Topical retinoids (first line; decrease sebaceous gland activity)
Antibiotics (topical or oral)
Oral contraceptives (decrease androgen production)
Oral isotretinoin (watch liver and pregnancy...two negative urine tests before starting treatment)
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7
Q

What can cause acne vulgaris, usually seen in adolescents, in adults?

A

Corticosteroid use and androgen production

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8
Q

When are chickenpox and shingles no longer infective?

A

When lesions crust over

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9
Q

During a pelvic exam (or testicular exam) you notice shiny papules with central umbilication. What are the lesions? What should you be concerned about?

A

Molluscum contagiosum

HIV

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10
Q

A patient comes in with itchy feet that is worse after a hot shower. What should be looked for? Treatment?

A

Mites and eggs on skin scraping under microscope

Permethrin cream

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11
Q

A patient comes in with salmon-colored, light brown, or hypopigmented macules, with evidence of scaling where scraped, on chest and back. What is this? What causes it? How is it diagnosed? Treatment?

A

Tinea versicolor (pityriasis versicolor)

Caused by Malassezia furfur

Diagnosed by short hyphae and spores on KOH prep

Topical antifungal for several weeks or oral ketoconazole for 1-5 days

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12
Q

Patient presents with pruritic, erythematous, scaly plaques with central clearing. What is this? What causes it? How is it diagnosed? Treatment?

A

Tinea…body part

Microsporum
Trichophyton
Epidermophyton

KOH prep shows hyphae

Topical antifungal for multiple weeks…oral antifungal for resistant

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13
Q

A patient presents with pruritic, painful erythematous plaques with pustules in a skin crease. What is this? What causes it? How is it diagnosed? Treatment?

A

Intertrigo

Candida albicans

KOH prep shows pseudohyphae

Topical antifungal agent
Topical corticosteroid

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14
Q

Are most allergic contact dermatitis caused by type I or type IV hypersensitivity reactions?

A

Most are type IV (lymphocyte activity several days after 2nd+ exposure)

Type I is caused by mast cell degranulation (urticaria)

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15
Q

A patient was recently started on a drug for some reason or another. Now presents with malaise, myalgia, pruritus with a rash (macule, plaques, or vesicles; target lesions). What is going on? What would be seen on labs/biopsy?

A

Erythema multiforme

Increased eosinophils
Increased lymphocytes and necrotic keratinocytes

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16
Q

What drugs are associated with erythema multiforme? What kind of infections? What else?

A

PCN, Sulfonamides, NSAIDs, OCTs, Anticonvulsants

HSV and mycoplasma pneumonia

Vaccinations

17
Q

Stevens-Johnson is essentially really bad erythema multiforme. What is present in SJS that isn’t seen with EM? What symptoms are more common? Treatment?

A

Skin sloughing, oral lesions

Myalgia, fever, N/V, oral pain, eye pain

Stop offending agent, corticosteroids, analgesics, IV fluids…often treated in burn unit

18
Q

What is seen with Toxic Epidermal Necrolysis (TEN)?

A

Significant skin sloughing
Full-thickness epidermal necrosis

Decreased WBC, Hgb, and Hct
Increased ALT and AST

19
Q

An adolescent or an infant presents with pruritic, erythematous plaques with yellow, greasy scales. What is going on? Treatment?

A

Seborrheic dermatitis (cradle cap in infants)

Shampoo containing selenium, tar, or ketoconazole (for scalp)
Topical corticosteroids and antifungals (other areas)

20
Q

A patient presents with something that looks/sounds like eczema, but eczema isn’t on the list. What is another name for eczema?

A

Atopic dermatitis

21
Q

Erythematous rash with silvery scales that bleed when picked off. What is it? How is it treated?

A

Psoriasis

Topical corticosteroids, tar, retinoids, tacrolimus, or antifungal; phototherapy, methotrexate, cyclosporine, anti-TNF drugs

22
Q

A patient comes in with an “Christmas tree” eruption of oval erythematous papillose covered with white scales on chest/back/extremities and says that a few days before it had been a single round lesion. What is this? How is it treated?

A

Pityriasis rosea

Often self limited

23
Q

Patient has painful erythematous nodules over her tibia. What are they? What is it associated with? Treatment?

A

Erythema nodosum

Delayed immunologic reaction to infection, collagen-vascular diseases, IBD, drugs

Self-limited

24
Q

Patient comes in with painful, fragile, blisters in oropharynx and on chest, face, and/or perineal regions. On exam, the blisters rupture easily. What is going on? What causes it? Treatment? Complications?

A

Pemphigus vulgaris

Autoantibodies to adhesion molecules in epidermis

Corticosteroids, azathioprine, or cyclophosphamide

Sepsis, high mortality w/o treatment
Osteoporosis (chronic corticosteroid use)

25
Q

An older patient (>60yo) comes in with widespread blisters (especially on flexor surfaces and perineal region) that itch. On exam, you notice that erosions have formed where blisters have ruptured. What is going on? What causes it? Treatment?

A

Bullous pemphigoid

Autoantibodies to epidermal basement membrane

Oral or topical corticosteroids or azathioprine

26
Q

A patient with chronic blistering lesions on sun-exposed skin (with lots of scars), hyperpigmented skin, and facial hypertrichosis (hair). What is going on? What causes it? What is it associated with? Treatment?

A

Porphyria cutanea tarda

Deficiency of hepatic uroporphyrinogen decarboxylase…part of heme metabolism

Liver disease

Periodic phlebotomy, low dose chloroquine or hydroxychloroquine; sunscreen use; avoidance of triggers (alcohol, estrogens, tobacco, iron supplements)

27
Q

A person comes in with a rough papule with yellow-brown scales. What is it? Biopsy? Treatment? Complication?

A

Actinic keratosis

dysplasia of epithelium…deeper epithelial cells show variation in shape and nuclei

Topical 5-FU or imiquimod, or cryotherapy

SCC

28
Q

A person comes in concerned about a pearly papule with telangiectasia or central herniation. What could it be? Biopsy? Treatment?

A

BCC (most common type of skin cancer)

Basophilic-staining basal epidermal cells arranged in palisades

Excision, radiation, or cryotherapy

29
Q

Which melanoma grows vertically…making it rapidly invasive and difficult to detect?

A

Nodular melanoma

30
Q

Where do acral lentiginous melanomas form?

A

Palms, soles, or nail beds

31
Q

Which melanoma has a long lasting in situ stage before vertical growth?

A

Lentigo maligna

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