Derm Flashcards
How do you treat Dermatitis Herpetiformis?
Dapsone + Gluten free diet
Dermatitis Herpetiformis:
- associated with celiac disease
- erythematous papules, vesicles, bullae in grouped “herpetiform” arrangement - often excoriated.
Dermatofibroma - classic appearance?
Nontender, firm, hyperpigmented nodule - due to fibroblast proliferation
central area dimples when pinched at edges due to fibroblasts
Tinea Capitis
Sx: children, african american
- scaly, erythematous patch of hair loss on scalp
- lymphadenopathy
- human to human or fomite (combs) transmission
Dx: KOH - spores
Tx: Oral griseofulvin
VS: alopecia areata - smooth and discrete area of alopecia without scarring
Warfarin induced necrosis
Sx:
- pain -> bullae -> necrosis
- breast, thigh, buttocks, abdomen (F > M)
- wks after starting warfarin
Tx:
- Vit K
- Stop warfarin, heparin until necrotic lesions heal.
Cherry Hemangioma
Small, red, cutaneous papules
3-4th decade of life; aging adults
Do not regress spontaneously. Do not need treatment
VS: strawberry hemangioma - infants, regress by 5-8
Kaposi sarcoma
Reddish, purple plaque/nodule
HHV8 in HIV pts
Hyperkeratotic papules on the plantar surface?
Plantar warts = HPV
- painful when walking
- young adults, immunocomp’ed
- enter thru abrasion after contact with HPV infected individual
HPV: plantar, palmar, genital warts
Ichthyosis Vulgaris
“lizard skin:” Dry, Rough skin w. horny plates over extensor surfaces
normal skin at birth -> gradual progression to dry, scaly skin
Graft versus Host Disease: Manifestations
Donor T cells recognize major and minor HLA antigens:
- Skin: maculopapular rash involving palms, soles, face that generalizes
- Intestines: blood positive diarrhea
- Liver: Abnl LFTS, jaundice
Scabies
- Flexor surfaces of wrist, Finger webs, Lateral surfaces of fingers
- Excoriations with small, crusted, red papules and linear burrows. BUT can also have vesicles, pustules, etc.
Dx: scrapings -> mites, ova, feces
Tx: Topical permethrin 5%. or oral ivermectin; bedding and clothing in bag.
VS: bed bugs: pruritic, purpuric macules in clusters of 2-3 over exposed areas.
SJS vs. TEN
30% = TEN
Sx: after trigger allopurinol abx (sulfonamides like bactrim) anticonvulsants - carbamazepine NSAIDS, sulfasalazine
erythematous macules, papules, bullae
+ systemic signs - influenza like prodrome
+ mucosal involvement
+ nikolsky’s
VS: Erythema Multiforme - erythematous rash, targetoid lesions, usually after HSV. (-) nikolsky, (-) mucous membrane, less systemic signs
Molluscum Contagiosum
Poxvirus!
Firm, Flesh colored, Dome shaped, Umbilicated papules
Predisposition: cellular immunodeficiency, HIV corticosteroids, chemotherapy
Diagnosis of Melanoma
Excisional biopsy with narrow margins (need to confirm it’s melanoma before cutting out margins)
- if depth 1 = sentinal LN study
Vitiligo
Macular depigmentation - acral, perioral
Autoimmune destruction of melanocytes
20-30s
VS: tinea versicolor - just lessening of pigmentation - velvety pink/whitish
Tinea Versicolor
+/- Hypopigmented, Hyperpigmented, Salmon colored (doesn’t tan) - face children, trunk/ext adults
+/- fine scale
+/- pruritis
KOH: spaghetti and meatballs - yeast and hyphae
Tx: Topical ketoconazole, Selenium sulfide
