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Fall--Derm EENT > Derm Conditions > Flashcards

Derm Conditions Flashcards

1
Q

christmas tree sign think / Herald patch

A

Pityriasis Rosea (not ringworm)

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2
Q

DDX for generalized rash w/ fever (5)

A
  1. measles (viral WILL blanch)
  2. rubella
  3. rocky mtn spotted fever
  4. viral exanthem
  5. scarlet fever
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3
Q

DDX for generalized red rash w/ bullae (4)

A
  1. erythema multiforme (major)
  2. toxic epidermal necrolysis
  3. pemphigus vulgaris
  4. bullous pemphigoid
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4
Q

does the rash blanch?

A

diascopy

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5
Q

scabies test

A

mineral oil preparation

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6
Q

stain for HSV sore

A

Tzanck smear

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7
Q

bathing over 15 min will _____ skin–although soak 10-15 min before ______ application will ^ absorption

A

dry,

steroid

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8
Q

If its ____ wet it, if its _____ dry it.

A

dry,

wet

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9
Q

use of corticosteroids near eye can cause

A

glaucoma

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10
Q

greasy lotions–“moisturizers”

A

emollients

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11
Q

best combo for itchy rash

A

topical antihistamine and oral steroid

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12
Q

most common skin disorder

A

ezcema (atopic dermatitis–itchy rash

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13
Q

the “itch that rashes”

A

eczema (itch-scratch cycle)

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14
Q

eczema is a

A

IgE Type I hypersensitivity rxn

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15
Q

eczema typically on

A

flexeral surfaces

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16
Q

flat red blotches as eczema

A

maculo-papular

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17
Q

eczema sufferer likely to have (3)

A
  1. family hx
  2. allergy
  3. asthma
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18
Q

PRURITUS!

A

eczema (atopic dermatitis)

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19
Q

If eczema goes on too long

A

lichenification (highest potency steroid appropriate for location and pt)

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20
Q

pathogens associated w/ secondary ifx of eczema

A
  1. Staph (yellow crusting)
  2. candida
  3. molluscum contagiosum
  4. HSV
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21
Q

Tx for atopic dermatitis

A

Triamcinolone ointment + anti-itch meds + tx for secondary infx

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22
Q

(2) types of contact dermatitis CD

A
  1. allergic: poison ivy–Type IV hypersensitivity rxn (nickle)
  2. irritant: inflammation due to chemicals
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23
Q

Tx for contact dermatitis

A

high-potency corticosteroid

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24
Q

zit =

A

papule

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25
Q

small flat discolored area of skin–usually less than 1 cm

A

macule

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26
Q

“end stage” disease of a variety of PRURITIC and ECZEMATOUS disorders

A

Lichen Simplex Chronicus esp. atopic dermatitis

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27
Q

Tx for lichen simplex chronicus (3)

A
  1. break itch/scratch cycle
  2. ^ potency flucocorticoid
  3. tight time sedation w/ oral antihistamine
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28
Q

adolescents/young-middle aged rash more common in females, “papulopustular”–aggravated by topical glucocorticoids

A

perioral dermatitis TX w/ METRONIDAZOLE gel (antiinflammatory)

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29
Q

candida think

A

satalite lesions

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30
Q

“cradle cap” similar presentation to lupus

A

seborrheic dermatitis (presents as severe DANDRUFF on head and face/ear canals)

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31
Q

yellowish –> white greasy scales over erythematous patches/plaques

A

seborrheic dermatitis

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32
Q

cause of seborrheic dermatitis

A

Yeast–pityrosporon ovale

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33
Q

^ risk groups for seborrheic dermatitis (3)

A
  1. Parkinson’s
  2. stroke
  3. HIV+
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34
Q

Tx seborrheic dermatitis

A

ketoconazole and selenium sulfide shampoo

-babies: olive oil and shampoo

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35
Q

rash secondary to venous incompetence and chronic edema

A

stasis dermatitis (extremely common)

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36
Q

easily mistaken for cellulitis–rash in pt’s w/ diabetes or DVT

A

stasis dermatitis

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37
Q

stasis dermatits is a

A

cutaneous marker of venous insufficiency

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38
Q

tx for stasis dermatitis

A
  1. leg elevation
  2. compression stockings
  3. emolliants for rash
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39
Q

dyshidrosis aka

A

pompholyx

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40
Q

Atopy

A

hyperallerfic disorder IgE (eczema, allergic rhinitis, asthma)

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41
Q

Dyshidrosis triggers (2)

A
  1. emotional stress

2. hot/humid weather

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42
Q

“tapioca-like” rash of small papules and vesicles

A

pompholyx – always examine soles of feet if lesions found on hands

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43
Q

(2) stages of dyshidrosis

A
  1. vesicular stage

2. fissure stage

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44
Q

treatment for almost all derm disorders

A

topical steroid

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45
Q

morbilliform

A

“measles -like”

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46
Q

drug eruption characteristics (4)

A
  1. utricarial
  2. papulosquamous
  3. pustular
  4. bollous
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47
Q

Tx for drug eruption (IgM thing)

A
  • discontinue offending drug

- oral antihistamine

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48
Q

formation of a solitary erythematous patch or plaque that will recur at same site w/ re-exposure to the drug

A

fixed drug eruption

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49
Q

targe lesions think

A

erythema multiforme minor

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50
Q

erythema multiforme associated w/ (

A
  1. pregnancy
  2. radiation therapy
  3. internal malignancy
  4. mycoplasma pneumonia
  5. herpes
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51
Q

rash plus MUCOSAL INVOLVEMENT think

A

erythema multiforme MAJOR (more groin involvement)

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52
Q

erythema multiforme

A

systemic drug rxn–like steven-johnson syndrome

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53
Q

Tx for erythema multiforme major

A

tx as if burn (like SJS)

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54
Q

type IV hypersensitivity Sulfa drug rxn

A

Steven-Johnson syndrome (around mouth, face, eyes)

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55
Q

Use drug again?
Morbilliform drug rxn:
Fixed drug rxn:
SJS:

A
  • yes (not allergic rxn)
  • no
  • no
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56
Q

chronic inflammation connected w/ drugs, metals, and Hep C–“gray-white lines”

A

Lichen Planus (LP)

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57
Q

gray-white lines

A

Whickham straie (pathognumonic) –Lichen Planus

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58
Q

lichen planus most commonly on (4)

A
  1. wrists
  2. shins
  3. lower back
  4. genitalia
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59
Q

Tx lichen planus

A

topical or systemic glucocorticoids–occlusion dressing

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60
Q

herald patch

A

pityriasis rosea PR – looks like ring worm–“heralds” rash by a week

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61
Q

christmas tree pattern

A

pityriasis rosea–along cleavage lines of trunk

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62
Q

pityriasis rosea course and tx

A

self-limiting,

antipuritics + antihistamine

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63
Q

common chronic inflammatory process w/ acute flairs–“scurf”

A

psoriasis–genetic component T-cells

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64
Q

2 peaks for psoriasis first onset

A
  1. 20-30 yo

2. 50-60 yo

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65
Q

psoriasis typically on

A

extensor surfaces – areas of thick skins

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66
Q

pick off loose skin:
eczema:
psoriasis:

A
  • no bleeding

- bleeding

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67
Q

psoriasis classifications based on morphology (5) slide 93

A
  1. plaque
  2. inverse/flexural
  3. guttate
  4. erythrodermic
  5. pustular
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68
Q

well-demarcated plaque overlying SILVERY SCALE

A

psoriasis

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69
Q

life threatening form of psoriasis

A

pustular psoriasis – DON’T give ORAL CORTICOSTEROIDS

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70
Q

oppposite presentation of normal psoriasis–lack scales

A

Inverse/flexural – don’t confuse w/ candida

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71
Q

“raindrop” type psoriasis–w/ scales –often preceded by strep pharyngitis

A

Guttate psoriasis

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72
Q

bright red entire skin surface–fever, chills, malaise

A

psoriatic erythroderma

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73
Q

psoriasis due to corticosteroid withdrawal, must hospitalize,

A

pustular psoriasis

74
Q
  • don’t prescribe _____ ________ for acute psoriasis
A

oral steroid

75
Q

> 50% of _____ ________ sufferers have fingernail involvement and JOINT PAIN

A

psoriatic arthritis (pitting) – if so ask about joint pain

76
Q

psoriasis tx

A

gauge area of rash–topical steroids–UV therapy – refer to derm
NO ORAL STEROIDS FOR ACUTE FLAIRS

77
Q

autoimmue bullous disorder in elderly pt’s

A

bullous pemphigoid–60-80 yo’s

78
Q

*erythema doesn’t always correspond w/ bullae/vesicels:

erythema always corresponds w/ blisters:

A
  • bullous pemphigoid

- bullous empetigo

79
Q

tx for bullous pemphigoid (2)

A
  1. oral prednisone

2. azathioprine

80
Q

(3) types of acne vulgaris

A
  1. comedonal (non-inflammatory)
  2. papulo-pustular (inflammatory)
  3. nodular (inflammatory)
81
Q

acne vulgaris happens where sebaceous glands are abundant i.e. (4)

A
  1. face (T-zone)
  2. neck
  3. upper trunk
  4. upper arms
82
Q

Comodone type (4)

A
  1. whitehead (closed)
  2. blackhead (open)
  3. inflammed papule
  4. inflammed pustule
83
Q

4 factors leading to acne vulgaris

A
  1. androgens
  2. sebaceous gland activity
  3. plugging of the hair follicle resulting from abnormal keratinization
  4. P. acnes in hair follicles (breaks down oil to free fatty acids –> inflammation)
84
Q

don’t chart acne vulgaris w/

A

“acne” – describe lesions

85
Q

severe nodular and scarring acne vulgaris

A

isotretinoin (acutane)

86
Q

moderate papular, pustular, nodular acne vulgaris w/out scarring

A

oral antibiotic w/ topical retinoid and topical benzoil peroxide

87
Q

acne vulgaris is related to _______ vs. rosacea (not sebaceous gland issue) which is not

A

androgens

88
Q

Nevi

A

BENIGN lesion of skin

89
Q

an inflammatory disorder predominately affecting the CENTRAL FACE

A

Rosacea– NO COMODONES

90
Q

inflammatory disorder related to flushing tendency (heat, emotions, alcohol, hot drinks, spicy foods)

A

rosacea (more Papules than Pustules)

91
Q

Rhinophyma

A

rosacea

92
Q

rosacea tx

A

topical or systemic antibiotics

93
Q

Nevi:

Brown moles, flat or raised, halo, may not pass ABCDE–>bx

A

nevomelanocytic nevus

94
Q

looks black –>

A

blue nevus (resembles melanoma)

95
Q

under diaper, deeper pigmentation, more ethnic individuals, non-blancheable, will fade in 2-3 yrs, painless

A

mongolian spot

96
Q

small bright red moles, vascular related, NON-blanching

A

cherry angioma

97
Q

verrucous

A

“wart” like appearance

98
Q

“stuck-on” appearance

A

seborrheic keratosis

99
Q

benign skin tumor appearing after 30 years mostly in males

A

seborrheic keratosis

100
Q

brown fleshy plaque w/ warty surface–face, trunk, upper extremities

A

seborrheic keratosis–shave bx

101
Q

pre-cancerous to squamous cell carcinoma–sun damage to keratinocytes

A

actinic keratosis–solar keratosis >males

102
Q

1:1000 actinic keratosis will turn into:
tx:

A
  • squamous cell carcinoma-
    1. cryosurg
    2. retinoids
    3. laser
103
Q

most common type of skin cancer

A

basal cell carcinoma BCC–don’t metastasize

104
Q

types of basal cell carcinoma (translucent or “PEARLY”) (5)

A
  1. nodular (translucent–pearly) Only need to know this one
  2. ulcerating (“Rolled borders”)
  3. sclerosing (whitish sclerotic patch)
  4. superficial (slightly scally thin plaque–not sun related)
  5. pigmented (dark lesion–confused w/ melanoma)
105
Q

BSS dx and tx

A
  • biopsy

- Mohs surgery

106
Q

UV / HPV related “non-healing” rough, scally patch resembline actinic keratosis

A

squamous cell carcinoma SCC

107
Q

SCC dx and tx

A
  • bx

- cryosurgery, 5-fluorouracil cream, Mohs surg

108
Q

Melanoma mnemonic

A 
MMRISK
M: mols atypical (dysplastic or large)
M: moles: common moles >50
R: Red hair and freckling
I: inability to tan Types 1-2
S: Sunburn
K: kindred: family history
109
Q

AIDS related, nonpruritic, lesion similar to lichen planus

A

Kaposi sarcoma–purple, fleshy lesions

110
Q

Kaposi sarcoma distribution

A

lower extremities, head, and neck

111
Q

Kaposi sarcoma think

A

HIV–CD4 counts and viral load

112
Q

HAART

A

highly active antiretroviral therapy

113
Q

lice aka

A

pediculosis

114
Q

lice love

A

healthy clean hair

115
Q

nits are _____ if they haven’t hatched, _____ if they’ve hatched

A

black,

white

116
Q

“the great masquerader”

A

scabies

117
Q

tx lice w/ ______and repeat in_________

A

1% permthrine,

7 days for nits

118
Q

ues ______ when resistant to permethrin

A

malathion

119
Q

severe night-time ITCH–spread skin-skin–thick skin bug and tx

A
  1. scabies

2. 5% permethrin–or lindane

120
Q

Itching at night think

A

scabies (high complaints–low physical findings)

-scaby burrows and lays eggs–>^itch

121
Q

dx scabies (2)

A
  1. mineral oil on slide dig out burrow

2. burrows

122
Q

mild utricaria –> full-thickness skin necrosis

A

spider bite

123
Q

concerns w/ spider bites

A

secondary infx–assume worst and treat for bac

124
Q

mild local rxn from arthropod bite feeds only on mammal and bird blood

A

flees and bed bugs,

Dx: PAPULAR URTICARIA

125
Q

multiple, soft, coalescing filiform papules,

A

HPV–Condyloma acuminatum

126
Q

cauliflower on genitals and anus

A

condyloma acuminatum

127
Q

tx for condyloma acuminatum (3)

A
  1. aldara (guardacil)
  2. crysurgery
  3. surgical removal
128
Q

viral exanthems blanket term ex’s (4)

A
  1. measles
  2. rubella
  3. chickenpox
  4. 5th disease
  5. etc.
129
Q

cutaneous eruption, erythematous, diffuse/generalized papules and macules all over body and throat (BLANCHING)

A

viral exanthems

130
Q

with viral exanthems make sure not

A

measles (present w/ fever and mellase) or rubella

131
Q

herpangina–back of throat rather than herpes in front

A

cocksacki

132
Q

Herpes simplex stages (2)

A
  1. primary (asymptomatic or w/ bleeding vesicles)

2. recurrent (cold sore)

133
Q

Tzanck smear–Giant cells think

A

Herpes simplex

134
Q

“central umbilication” – skin-skin

A

molluscum contagiosum (pox) – cottage cheese filled

135
Q

tx molluscum contagiosum (3)

A
  1. aldara cream
  2. cryosurg
  3. supportive
136
Q

“dewdrops on a rose petal” –> papule –> vescicle –> pustule –> crust (vesicles on a erythematous base)

A

Varicella-zoster virus

137
Q

Varicella-zoster virus forms (2)

A
  1. primary–chicken pox

2. recurrent–shingles

138
Q

once VZV lesions crust over…

A

they’re no longer contagious

139
Q

Viral:

  • all at same stage (2)
  • different stages (1)
A
  • Molluscum contagiosum, shingles

- chicken pox

140
Q

verrucae aka

A

warts

141
Q

common wart type

A

verruca vulgaris

142
Q

wart on sole –may turn black

A

Verruca plantaris

143
Q

flat wart

A

verruca plana

144
Q

tx for warts

A

salicylic acid (compound W)

145
Q

bac inflammation of hair follicle aka

A

FURuncle aka boil

146
Q

multiple furuncles

A

carbuncle

147
Q

verrucae etiology

A

HPV

148
Q

can feel the edges of the abscess

A

induration w/ palpation

149
Q

boil tx

A

I&D, antibiotics, pack and leave open if large–culture drainage

150
Q

cellulitis vs

A

erysipelas (both warm, tender, swollen)

151
Q

Sharply demarcated, GLISTENING, smooth skin infection–>strep pyogenes

A

erysipelas

152
Q

common location:
cellulitis:
erysipelas:

A
  • lower leg

- central face/ cheeks

153
Q

infection of hair follicle:

ingrown hair:

A
  • folliculitis

- pseudofolliculitis

154
Q

“hot tub” folliculitis

A

pseudomonas infx–> folliculitis Tx w/ Cipro

155
Q

Folliculitis causes: (gram stain)
DM pts:
chronic antibiotics:

A
  • Staph

- Klebsiella and E. coli

156
Q

“Bright erythematous w/ Satellite lesions”

A

candidiasis

157
Q

moist, dark, warm candidiasis etiology

A

candida albicans –^DM and obesity

158
Q

“White lacy network on erythematous base”

A

candidiasis

159
Q

tx for candidiasis

A

topical: nystatin
oral: nystatin, fluconazole

160
Q

tinea versicolor (not a dermatophyte) aka

A

pityriasis versicolor

161
Q

tinea versicolor etiology

A

pityrosporum ovale (yeast) opportunistic infx

162
Q

tinea versicolor/ pityrosporum ovale dx

A
  • KOH: “spaghetti and meatballs”

- woods lamp

163
Q

tinea aka

A

dermatophyte

164
Q

most common dermatophyte infx–highly contagious –central clearing w/ scale in middle

A

tinea corporis aka ringworm

165
Q

athlete’s foot aka

A

tinea pedis

166
Q

tinea pedis types (6)

A
  1. interdigital
  2. dry
  3. moist (macerated)
  4. moccasin
  5. vesicular
  6. ulcerative
167
Q

confirm tinea unguium w/

A

culture instead of KOH prep

168
Q

See ______ ________ think diabetes

A

acanthosis nigricans –“velvety thickening”

169
Q

painful nodules on shins

A

erythema nodosum

170
Q

suppurative dz w/ open double comedones–Apocrine glands

A

hidradenitis suppurativa–

171
Q

benign subQ fat cell tumor–moveable

A

lipoma

172
Q

epithelia inclusion cyst aka

A

epidermal inclusion cyst –very common

173
Q

cystic enclosure filled w/ keratin and debris

A

epithelial inclusion cysts

174
Q

“black spot” associated w/ pregnancy and oral contraceptive, aka

A

melasma aka cholasma or mask of pregnancy

175
Q

pilosebaceous glands w/ keratin –> folliculitis –> edema/occlusion –> pilonidal abscess

A

pilonidal disease

176
Q

sacrococcygeal region –painful, fluctuant mass

A

pilonidal disease (stinky)

177
Q

wheels think

A

utricaria

178
Q

phototoxic eruption rom contact w/ light-sensitizing botancial subastance and UVR (i.e. lime juice)

A

phytophotodermatitis

179
Q

TRANSIENT EDEMATOUS PAPULES/PLAQUES

A

Hives aka utricaria

180
Q

melanocytes destroyed leading to depigmentation

A

vitilago

181
Q

dx vitilago

A
  1. bx

2. wood’s lamp

Fall--Derm EENT (8 decks)

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