Derm Flashcards
Most common skin cancer in pts with chronic immunosuppresion?
Squamous cell carcinoma
Thick rough surface in sun exposed area
Can cause regional neuroligc syx (numbness)
Teen being treated for acne has severe sun burn. What is in the med?
Doxycycline
Pt has forearm lesion that has a smooth border but small eccentric nodule.
Next?
Excisional bx
“ugly duckling sign”
Pathophys of vitiligo
Autoimmune destruction of melanocytes
Tx - steroids
Pruritic rash on flexor surface of wrist, fingers
Itching worst at night
Scabies
Tx - TOP permethrin or po ivermectin
Most common skin malignancy in US
Slow growing papule with pearly rolled border
Basal cell
Rarely metastasizes
Condylomata acuminata
HPV of genitals/anus
HPV 16/18
Squamous cell carcinoma of anus, genitalia, throat
Guy bought a cheap watch and has a gnarly scaly rash on his wrist
Nickel allergy
Type IV hypersensitivity
Itching, scaling, lichenification
Tx - corticosteroids
Acute infection of small papules with central umbilication
Malluscum contagiosum (poxvirus)
Self limited in healthy pts
Associated with HIV
Ring shaped, scaly patches iwht central clearing and distinct borders x weeks
Tinea corpis (ringworm)
Dx -KOH prep
Tx - top antifungals, po if severe
elderly woman with purpura and ecchymosa
NL studies
Senile purpura
d/t age related loss of elastic fibers in perivascular connective tissue
Benign
Tx for basal cell carcinoma on the face?
Mohs surgery
thin lays are removed and inspected by path to ensure clear margns
Use in high risk lesions or delicate or cosmetically sensitive ares
Dome shaped, firm, freely movable cyst/nodule with small central punctum
Epidermal inclusion cyst
Benign nodule containing squamous epitherlium that produces kerating
Can be stable or gradually increase in size +/- cheesy white discharge
Resolves spontaneously
Pt has chronic diffuse dermal scaling
Skin appears dry and rough with horny plates
Icthyosis vulgaris chronic, inherited plates resemble fish or reptile scales Mutation in filaggrin gene Tx - emollient, keratolytics, topical retinoids
Most common benign vascular tumor in adults
Cherry angiomas
Strawberry angiomas are only in kids
Dandruff + greasy scaley face rash
Seborrheic dermatitis
1st year of life, and in middle aged
Associated with Parkinson and HIV
Tox - top antifungal
etiology of plantar warts
HPV
Young adults, immunocompromised
HCV pt develops vesicles, erosions of the dorsum of both hands after sun exposure
Porphyria cutanea tarda
Porphyrin accumulation d/t impaired metabolism (heme synthesis)
Deficiency of uroporphyrinogen decarboxylase
Bullous dz
punch bx reveals linear IgG and C3 deposits and dermal-epidermal junction
Bullous pemphigoid
Associated with malignancy, neurologic disorders
IgG against hemidesmosome and basement membrane
Tx - TOP clobetasol
Most common malignancy of lower lip
Squamous cell carcinoma
Bx - invasive cords of squamous cells with keratin pearls
Pt with celiac develops skin rash over the butt. Dx?
Dermatitis herpetiformis
dermal rxn to dietary gluten
Clusters of pruritic papules and vesicles
tx - dapsone and GF diet
Bullous dz
bx - immunofluoresence intracellular deposits of IgG
Pemphigus vulgaris
Antibody against desmosomes
