Derm Flashcards
Pink, Pearly/waxy, rolled border, bleeding, ulceration
BCC = no mets but invades
Invasive cluster of spindle cells surrounded by palisaded basal cells
BCC –> wide resection 1mm
Chronic scar –> non-healing, painless, bleeding ulcer?
SCC –> punch bx
Non-healing ulcer on arm, scaling plaque w/ central ulceration, polygonal cells
SCC = UV exposure
Hyperpigmented lesion, non-healing ulcer
SCC = Marjolin ulcer
Invasive cords of squamous cells with keratin pearls, partially encrusted ulcer
SCC –> wide resection 0.5-2cm + LN dissection d/t mets
Precursor to SCC
Actinic keratosis
Hyperpigmented lesion, asymmetric, irregular, >5mm, NO HAIR
Melanoma –> mets a lot, refractory to chemo/rad, relapsing & remitting
Tx for malignent melanoma
Breslow’s depth - local resection; 1-2mm wide + LN
Malignant melanoma >4mm tx
Mets, resection and supportive care, poor prognosis
Volcano-like nodule w/ central keratotic plug
Keratoacanthoma
Scabies tx
Permthrin cream
Intergidital, groin pruritic, thread-like burrows
Scabies = 5% permethrin
Tx Lice
Permethrin 1% cream rinse
Centrally umbilicated papules on face, neck, anogential regions
Molluscum contagiosum - Poxvirus = impaired cellular immunity
Dome w/ central umbilication tx
Molluscum –> obs, liq-N, extrode plug or canthardin 0.9%
Thin hair in pre-term
Lanugo
Thick, white creamy skin in newborn
Vernix caseosa
Benign, small and dry vesicles
Pustular melanosis
Salmon patch
Nevus simplex
Port wine stain, IC calcifications
Nevus flammeus
Shallow fibrin-coated ulcer w/ mononuclear infiltrate
Aphthous ulcer
Whitish macules w/ hyperpigmented borders, mouth, breasts
Vitiligo = destruction of melanocytes
Hypopigmentation + anesthesia
Leprosy = get skin bx
Velvety pink or whit macules, less pigmentation
Fungal infection
Acanthosis nigricans assoc
GI malignancy, PCOS, DM
Skin tags assoc
DM, pregnancy, crohn’s
Vitiligo, hypotension, dehydration, hyperpigmented areas assoc
Addison’s disease
Tx for human bites
Augmentin or erythromycin + open
Sharp edge, head & neck spot, orange
Subcutaneous nevi
Present at birth, PITS, ecchymoses, subsides w/in 1 day, Hematoma crosses sutures
Caput succedanuem
Few days after birth, no pitting, Hematoma NOT cross sutures = 1 cranial bone, no discoloration
Cephalohematoma –> resorbs on its own
Pulsations on scalp, inc pressure w/ crying
Cranial meningocele
“Ping-pong ball,” rickets –> resolves
craniotabes
Lateral neck cysts
Brachial cleft, cystic hygromas
Anterior edge SCM, base of neck mass
Brachial cleft cyst
Base of neck, large, mushy, ill-defined mass
Cystic hygroma –> CT b4 excision
INC COSTOCHONDRAL JUNCTIONS, craniotabes, sciolosis, pigeon breast, hyperpigment, genu varum
Rickets
Cough, pink eyes, bluish spots in mouth, blanching, erythematous macropapular rash
Measles = live vaccine, supportive, VitA if hospitalized
Cough, coryza, conjunctivitis + High fever and red-brown macropapular rash for 9 days
Measles –> Vit A reduces M&M
Rash face –> extermities, cough, conjuctivitis, white spots on tonsils
Measles
Clustered white lesions in mouth –> rash on forehead –> trunk –> limbs
Measles
Rash starting on face –> chest and limbs, occipital and post. Cervical LAD
Rubella
Congestion, low fever, pink rash on face –> trunk, cervical adenopathy, patchy palate erythema
Rubella
Fever, sore throat –> rash on face/neck –> trunk –> limbs
Rubella
URI –> erythema on face sparing nose, orbits –> lacy pruritic body rash for 1-2wk, resp spread
B-19 “fifths disease”
B19 in sickle cell; pregnancy
aplastic crisis; hydrops fetalis
Fever/URI + rash on cheeks, worse in sun
Erythema infectiosum (5ths) –> aplastic crisis, arthopathy, hydrops
High fever 3d –> red blanching macules, papules on trunk –> limbs, sparing face
Roseola (HHV-6) = supportive tx
High Fever –> rash - trunk –> limbs/head
Roseola (HHV6,7)
Impetigo or pharyngitis –> tiny blanching rash on trunk to limbs
Scarlet fever - late desquamation
Pharyngitis –> neck, axilla, groin rash finely papular erythematous rash blanches, circumoral pallor
Scarlet fever –> PCN V or erythromycin
Sore throat, fever –> 2d later rough raised rash upper trunk –> limbs & tongue
Scarlet fever (strep)
Tx for strep
PCN or cephalosporins or macrolides –> fever free 24hrs = return to work
Fever 5d, B/L conjuctivitis, mucositis, swelling and erythema on palms and soles
Kawasaki - cervical LN >1.5cm
Hx strep + amoxicillin, 103, strawberry tonuge, B/L conjunctivitis, cervical LN 1.5cm
Kawasaki –> Aspirin + IVIG