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Clinical review > Derm > Flashcards

Derm Flashcards

1
Q

Macule

A

Flat, colored lesion, not raised above the skin, less than 2 cm diameter

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2
Q

Patch

A

Large flat lesion with color different than the skin

Greater than 2 cm diameter

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3
Q

Nodule

A

firm lesion raised above the surface
Rounded with diameter and thickness roughly equal
Greater than 0.5 cm

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4
Q

Papule

A

Small elevated solid lesion

Less than 0.5cm

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5
Q

Plaque

A

Circumscribed, flat-topped lesion (plateau-like)
Greater than 1 cm
(Big papule)

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6
Q

Tumor

A

solid raised growth

Greater than 5 cm

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7
Q

Wheal

A

Rounded or flat-topped
Pale red papule or plaque that is characteristically evanescent
(disappearing within 24-48h)

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8
Q

Vesicle-Bulla

A

Vesicle: less than 0.5 cm
Bulla: greater than 0.5 cm
Circumscribed, elevated, superficial cavity containing fluid

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9
Q

Pustule

A

Circumscribed superficial cavity of skin containing purulent exudate

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10
Q

Crusts

A

Develop when serum, blood or purulent exudate dries on the skin surface

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11
Q

Scale

A

Flakes of stratum corneum

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12
Q

Erosion

A

Defect of only the epidermis, not involving the dermis

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13
Q

Ulcer

A

Skin defect that extends into the dermis or deeper

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14
Q

Cyst

A

Soft, raised, encapsulated lesion filled with semisolid or liquid contents

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15
Q

Purpura

A

Red-purple nonblanchable discoloration

Greater than 0.5cm in diameter

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16
Q

Petechiae

A

Red-purple nonblanchable discoloration

Less than 0.5cm in diameter

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17
Q

Telangiectasia

A

Dialated, superficial blood vessel presenting as fine, irregular, red lines

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18
Q

Fissure

A

Linear crack or break from the epidermis to the dermis

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19
Q

Lichenification

A

Distinctive thickening of the skin that is characterized by accentuated skin-fold markings

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20
Q

Milla

A

Small, firm, white papules filled with keratin

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21
Q

Seborrheic keratoses

A

Basal-like cells, hyperkeratosis, keratin-filled cysts
Most common benign skin tumor
Velvety warty lesion with “greasy/stuck on appearance”

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22
Q

Tinea corporis

A

dermatophyte (fungal) infection

Corporis: ring shaped lesions, advancing scaly border with central clearing and scaly patches (on exposed skin or trunk

23
Q

Tinea capitis

A

dermatophyte (fungal) infection
Non-inflammatory: alopecia, hair breakage at level of scalp
Inflammatory: follicular pustules to furunculoisis or kerion, possible posterior lymphandenopathy

24
Q

Tinea barbae

A

Affects face unilaterally
Superficial: perifollicular papules and pustules with erythema
Inflammatory: most common, boggy-crusted plaques and seropurulent discharge,

25
Q

Actinic keratosis

A

or Solar keratosis
Discrete, dry, rough, adherent scaly lesions
Occur on habitually sun-exposed skin
Can progress to SCCIS

26
Q

Tinea cruris

A 
dermatophytosis of the groin region
well marginated annular plaques with a scaly raised border which extends from the inguinal fold
Pruritus and pain common
Can have central clearing
Dx: KOH prep (buds and hyphae)
Tx: oral or topical antifungals
27
Q

Sebaceous cysts

A

Blocked glands or swollen hair follicles
Lump is usuallly not painful
Dx: clinical
Tx: Steroid, I&D, excision

28
Q

Tinea versicolor

A

Overgrowth of yeast (malassezia furfur)
AKA: pityriasis versicolor
Effects trunk, neck, arms.
May be hypo or hyperpigmented

29
Q

Dermatofibroma

A

Benign, very common, button-like dermal nodule, usually occurring on the extremities
Dimple sign

30
Q

Psoriasis

A

Chronic multisystem inflammatory immune disorder
Raise, dark red plaque/papules with silver scales
- Nail pitting, oil drop under nail
- Auspitz sign (punctate bleeding with removal of plaque)
- Koebner phenomenon: skin lesions at lines of trauma
- Psoriatic arthritis: 30% of patients (hands, wrist, especially DIP)
- Sausage digit - pencil and cup deformity on x-ray

31
Q

Treatment of psoriasis

A

Mild to moderate:
Vitamin D analogs (calcipotriene), topical retinoids
Potent topical Corticosteroids
UVB phototherapy

32
Q

Candidiasis

A

Most common in: esophagus, vagina, mouth, cutaneous, GI tract
Dx: KOH
Tx: fluconazole

33
Q

MRSA in SSTI (skin and soft tissue infection)

Treatment?

A

I&D
ABX: clindamycin, trimethoprim-sulfamethoxazole
tetracyclines and linezolid

34
Q

Difference between erysipelas and cellulitis

A

Erysipelas involves upper dermis and superficial lymphatics

Cellulitis involves deeper dermis and subcutaneous fat

35
Q

Microbe causing erysipelas

A

Vast majority caused by beta-hemolytic streptococci

36
Q

Microbe causing cellulitis

A

Most common are beta-hemolytic streptococci

37
Q

Erythrasma

A

Superficial infection of the skin caused by Corynebacterium minutissimum
Gram positive, bacillus
Often found between toes typically macerated, scaly plaques
Or erythematous to brown patches or thin plaque in intertriginous areas
Dx: coral-red fluorescence with Wood’s lamp

38
Q

Signs and symptoms of cellulitis

A

Local: macular erythema (margins flat, NOT sharply demarcated)
-Swelling
- Warmth
- Tenderness
Systemic: fevers, chill +/- tender lymphadenopathy
+/- lymphangitis
myalgias, vesicles, bullae, hemorrhge, necrosis

39
Q

Treatment of cellulitis

A

Abx 7-10 days: cephalexin, dicolzacillin…, if MRSA: vanco
if dog or cat bite: augmentin
if puncture: cover for pseudomonas: cipro

40
Q

Basal cell carcinoma description

A

5 clinical types:
nodular, ulcerating, pigmented, sclerosing and superfical
Typical: Papule with pearly telangiectatic border on sun damaged skin

41
Q

Lichen planus

A

4 P’s: purple, polygonal, papules, pruritis

Gray lines: wickham’s striae

42
Q

Squamous cell carcinoma

A

Indurated and possibly hyperkeratotic lesions

Often showing ulceration and or crusting

43
Q

Rosacea

A

s/sx: erythema, telangiectases, papules, pustules
Blush area of cheeks, nose, forehead and chin
Tx: topical metronidazole, sunscreen

44
Q

Hidradentitis Suppurativa

A

Chronic abscess of apocrine sweat glands or sebaceous cysts with tract formation
S/sx: red inflammatory nodules/abcessess most commonly found in axilla, under breasts, groin or buttucks
Tx: I&D, systemic abx, surgical if recurrrent

45
Q

Dyshidrotic eczema

A

AKA: pompholyx (which means bubble)
Vesicular hand dermatitis
Triggered by sweating, emotional stress, warm weather, metals
S/sx: deep vesicles on palms, soles, sides of fingers and toes. “TAPIOCA PUDDING”
Tx: topical steroids, cold compresses

46
Q

Furuncles

Carbuncles

A

Localized skin infection usually by S. aureaus
Furuncle: boil
Carbuncle: coalescing furuncles
Tx: less than 2.5cm treat with moist heat
Larger require drainage

47
Q

Benzoyl peroixide

A

1st line tx of mild-moderate acne vulgaris w/o inflammation

48
Q

retinoids

A

Vitamin A derivatives
Tretinoin: used for acne vulgaris and solar lentigines
Adapalene: 1st line for comedones and inflam acne
AE: irritation, dryness, peeling skin, photosensitivity

49
Q

Topical antibiotics

A

Clindamycin: Indic: BV, severe acne
AE: dryness/itching/burning, HA, back pain, constipation, oily skin
Erythromycin: Indic: Acne vulgaris use with BPO
AE: erythema, dryness/oiliness/itching/peeling/burining
Tetracycline: Indic: BV, rosacea
CI: use with ETOH
AE: vaginal discharge, HA, vaginal candidiasis, GI upset, skin irritation, metallic taste, only if have adult teeth
Remember to use together with topical retinoids

50
Q

Keratolytics

A

salicylic acid: indic: Seb derm, psoriasis, dandruff, remove warts, mild acne
AE: burning, peeling, scaling, dryness
Pt ed: mood changes, nausea, hearing issues, dizziness

51
Q

Permethrin

A

Indication: scabies, live lice
CI: don’t use in kids younger than 2 months

52
Q

Crotamiton

A

Indications: 2nd line treatment for scabies

53
Q

Lindane

A

Indications: 2nd line treatment for scabies, use after all else has failed
CI: xeizure disorders
AE: neurologic toxicity

54
Q

Ivermectin

A

Anthelminthic

Indication: resistant lice and crusted Norwegian scabies

Clinical review (18 decks)

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