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CPD > derm conditions week 1 > Flashcards

derm conditions week 1 Flashcards

1
Q

pruritis (Desc)

A

itching from internal or external stimulus of cutaneous nerve endings…… mediators: histamine, kallikrein (vasodilation), peptidases

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2
Q

pruritis (Etiology)

A

dry skin

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3
Q

pruritis (Hx)

A

drug/occ/hobby exposures

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4
Q

pruritis (Testing)

A

biopsy, CBC, liver/kidney/thyroid fx test

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5
Q

urticaria (Desc)

A

migratory, erythematous, pruritic plaques….. mediators: histamine

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6
Q

urticaria (Etiology)

A

viral,bact infx; IgE allergy; NSAIDs; rare autoimmune dz

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7
Q

urticaria (Hx)

A

duration, triggers, freq, concomitatnts (GI esp), resp. system, drug use, travel, FHx

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8
Q

urticaria (Testing)

A

CBC, Ig to foods, thyroid, ANA

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9
Q

acne vulgaris (Desc)

A

obstruction of pilosebaceous unit…. Presents with: comedones (black/whiteheads), pustules, papules, inflamed nodules, superficial pus sacs and sometimes deep purulent sacs

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10
Q

acne vulgaris (Etiology)

A

androgen stim, food sensitivities, sebum, stress

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11
Q

acne vulgaris (Distribution)

A

face, chest, back, upper arms

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12
Q

acne vulgaris (Hx)

A

age puberty~35, M>F.

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13
Q

acne vulgaris (S/Sx)

A

comedones, papules, pustules, nodules

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14
Q

acne vulgaris (Dx)

A

H&P….comedones and several stages of lesions

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15
Q

acne vulgaris (Testing)

A

total/free testosterone w/ other sex hormones (FSH, LH, progesterone, estrogen)

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16
Q

acne vulgaris (Ddx)

A

rosacea (no comedones); folliculitis; perioral dermatitis; keratosis pilaris

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17
Q

rosacea (Desc)

A

chronic inflamx d/o featuring facial fushing, telangiectasia, erythema, papules, and pustules

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18
Q

rosacea (Etiology)

A

idiopathic (GI issues more common)

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19
Q

rosacea (Distribution)

A

central face and scalp

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20
Q

rosacea (Hx)

A

Recurrent flushing (from spicy food, alcohol, emotional rxn); eye involvement (foreign body sensation, telangiectasia of lids, keratitis, conjunctivitis, episcleritis); age 30-60

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21
Q

rosacea (S/Sx)

A

Stages: pre-rosacea; vascular phase; inflamx phase (papules, pustules, etc presen); late-stage/rhinophyma

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22
Q

rosacea (Dx)

A

one primary: flushing, nontransient erythema, papules & pustules, telangiectasia AND one secondary: burning, plaque, dry appearance, edema, ocular manifestation, peripheral loc

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23
Q

rosacea (Ddx)

A

acne vulgaris; SLE; discoid lupus

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24
Q

bullous pemphigoid (Desc)

A

chronic pruritic bullous eruptions. uncommon.

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25
Q

bullous pemphigoid (Etiology)

A

autoimmune; drug induced (furosemide, NSAIDs)

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26
Q

bullous pemphigoid (Distribution)

A

trunk, lower legs, extremity flexures, axillary & inguinal folds

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27
Q

bullous pemphigoid (Hx)

A

assoc. w/ dementia, Parkinson’s, unipolar/bipolar; age >60

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28
Q

bullous pemphigoid (Dx)

A

H&P….must biopsy. Shows: subepidermal bulla w/ eosinophil infiltrate (direct immunofluresence), skin with IgG and/or C3 in linear band in basement membrane

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29
Q

bullous pemphigoid (Testing)

A

biopsy

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30
Q

bullous pemphigoid (Ddx)

A

pemphigus vulgaris, dermatitis herpatiformis, erythema multiforme, drg eruption

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31
Q

dermatitis herpetiformis (Desc)

A

autoimmune, chronic recurring, intensely pruritic skin with symmetrical groups of inflamed vesicles, papules and hives

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32
Q

dermatitis herpetiformis (Etiology)

A

autimmune, celiac dz (asx)

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33
Q

dermatitis herpetiformis (Distribution)

A

symmetrical over extensor aspects, sacrum, and/or base of head

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34
Q

dermatitis herpetiformis (Hx)

A

assoc. w/ celiac/thyroid d/os; age 20-50, M:F 2:1

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35
Q

dermatitis herpetiformis (S/Sx)

A

burning, severe stinging and itching, freqquently transient…lasts weeks to years

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36
Q

dermatitis herpetiformis (Dx)

A

H&P, skin biopsy of lesion and adjacent normal skin (immunofluoresence); will see pinpoint bleeding from shave biopsy, subepidermal clefting and papillary dermal tips w/ PMNs and eosinophils; IgA deposition

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37
Q

dermatitis herpetiformis (Testing)

A

biopsy, TTG, anti-endomysial Ab, jejunal bx for celiac

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38
Q

dermatitis herpetiformis (Ddx)

A

pemphigus, bullous pemphigoid, (contact) dermatitis, herpes (vesicular rashes)

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39
Q

pemphigus vulgaris (Desc)

A

potentially fatal blistering dz. Rare.

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40
Q

pemphigus vulgaris (Etiology)

A

autoimmune

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41
Q

pemphigus vulgaris (Distribution)

A

oral lesions often precede skin lesions. Groin, scalp, abd, back, upper legs, axilla

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42
Q

pemphigus vulgaris (Hx)

A

age>60, F>M; highest incidence amongst ashkenazi

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43
Q

pemphigus vulgaris (Dx)

A

H&P and punch biopsy of lesion and normal skin (immunofluoresence); biopsy shows intraepidermal bulla, eosinophil infiltration, IgG, nikolsky’s sign positive.

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44
Q

pemphigus vulgaris (Ddx)

A

HS1, HZ, bullous pemphigoid, canker sores, paraneoplastic pemphigus (must do bx to exclude)

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45
Q

callouses and corns (Desc)

A

epidermal thickening from pressure/friction …. Callouses: usu asx, intact skin lines …. Corns: pain from pressure, yellow core, interrupts skin lines

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46
Q

callouses and corns (Distribution)

A

feet and toes

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47
Q

callouses and corns (Dx)

A

H&P

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48
Q

ichthyosis (Desc)

A

scaling and flaking of skin. ‘fish scale skin.’ resembles cracked pavement

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49
Q

ichthyosis (Etiology)

A

autosomal dominant x-linked

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50
Q

ichthyosis (Distribution)

A

shins and outer arms

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51
Q

ichthyosis (Hx)

A

infx or systemic dz (acquired ichthyosis has sudden onset)

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52
Q

ichthyosis (Dx)

A

H&P

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53
Q

ichthyosis (Ddx)

A

dry skin (which is less severe)

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54
Q

keratosis pilaris (Desc)

A

keratinization d/o where horny plugs fill the openings of hair follicles

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55
Q

keratosis pilaris (Etiology)

A

nutritional deficiency (omega-3, Zn, biotin)

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56
Q

keratosis pilaris (Distribution)

A

lateral aspects of upper arms, thighs, buttocks. Kids may have on face (confusion w/acne)

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57
Q

keratosis pilaris (Hx)

A

eczema, asthma, hayfever triad through the family

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58
Q

keratosis pilaris (S/Sx)

A

keratotic follicular papules, skin feels rough like sandpaper

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59
Q

keratosis pilaris (Dx)

A

H&P

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60
Q

atopic dermatitis (Desc)

A

aka eczema…. Immune-mediated skin inflamx. Very common. Aggravated by: dry skin, wool sweating, allergens, tight clothing, emotional stress, notritional def., SIBO

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61
Q

atopic dermatitis (Etiology)

A

genetic (atopy), food & envt allergies

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62
Q

atopic dermatitis (Distribution)

A

face, neck, extremities, abd, flexor surfaces, hands, buttocks

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63
Q

atopic dermatitis (S/Sx)

A

variation in colors; weeping crusted lesions, intensely pruritic, lichenification

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64
Q

atopic dermatitis (Dx)

A

H&P

65
Q

atopic dermatitis (Testing)

A

food/allergy testing; vit D and GI assessment

66
Q

atopic dermatitis (Ddx)

A

seborrhic dermatitis, contact derm, nummular derm, candida, tinea

67
Q

contact dermatitis (Desc)

A

acute inflamx caused by irritants/allergens…..hypersensitivity rxn w/ initial exposure and rxn on re-exposure

68
Q

contact dermatitis (Etiology)

A

exposure (chemicals, metals, woods, dust, soaps, cosmetics, poison oak, drugs - neomycin, bacitracin, hydrocortisone)

69
Q

contact dermatitis (Distribution)

A

hands (both dorsal and palmer), around the mouths of chronic lip lickers

70
Q

contact dermatitis (Hx)

A

occupation, hobbies, household duties, travel, topical exposure)

71
Q

contact dermatitis (S/Sx)

A

erythema, dryness, cracking….acute: weeping papules w/edema; chronic: lichenification, excoriation, scaling

72
Q

contact dermatitis (Dx)

A

H&P

73
Q

contact dermatitis (Ddx)

A

seborrhic dermatitis, atopic derm, nummular derm, candida, tinea

74
Q

neurodermatitis (Desc)

A

chronic pruritis w/o demonstrable external cause (nervous system is getting queued up)

75
Q

neurodermatitis (Distribution)

A

back of neck, wrists, ankles, pubic … usu NOT seen on back, abd, face, upper legs

76
Q

neurodermatitis (S/Sx)

A

dry scaling skin; hyperpigmentation (won’t be seen w/ eczema); eryhthematous lichenified plaques in irregular shapes

77
Q

neurodermatitis (Dx)

A

H&P …. KOH to exclude tinea

78
Q

neurodermatitis (Testing)

A

patch test to identify allergens, biopsy

79
Q

neurodermatitis (Ddx)

A

tinea, lichen planus, psoriasis

80
Q

nummular dermatitis (Desc)

A

coin-shaped skin inflamx

81
Q

nummular dermatitis (Etiology)

A

idiopathic

82
Q

nummular dermatitis (Distribution)

A

extensor surfaces, buttocks, trunk; usu begins on legs

83
Q

nummular dermatitis (S/Sx)

A

1-50 excessively pruritic, coin-shaped, vesicular lesions; crusting and scaling.

84
Q

nummular dermatitis (Dx)

A

H & P

85
Q

nummular dermatitis (Testing)

A

patch test to identify allergens, biopsy, KOH, culture (Staph Aureus)

86
Q

nummular dermatitis (Ddx)

A

psoriasis, tinea, T cell lymphoma

87
Q

seborrheic dermatitis (Desc)

A

inflamx of skin in high-density area of sebaceous glands (like face dandruff)

88
Q

seborrheic dermatitis (Etiology)

A

nutritional deficiency; possibly fungal

89
Q

seborrheic dermatitis (Distribution)

A

scalp, eyelids, eyebrows, face

90
Q

seborrheic dermatitis (Hx)

A

increased susceptibility w/ HIV+, parkinson’s, neuroleptic medication use

91
Q

seborrheic dermatitis (S/Sx)

A

gradual onset; erythematous plaques with yellowish greasy scales; no hair loss (fungi can cause hair loss); cradle cap in newborns

92
Q

seborrheic dermatitis (Dx)

A

H&P

93
Q

seborrheic dermatitis (Testing)

A

KOH and fungal culture

94
Q

seborrheic dermatitis (Ddx)

A

atopic dermatitis, rosacea, contact dermatitis, psoriasis

95
Q

stasis dermatitis (Desc)

A

persistent dermatitis of lower legs, especially ankle

96
Q

stasis dermatitis (Etiology)

A

secondary to chronic venous insufficiency (poor circulation) - skin is starving for oxygen

97
Q

stasis dermatitis (Distribution)

A

low legs…ankle

98
Q

stasis dermatitis (Hx)

A

Pt complaint of heaviness in the leg that is aggravated by standing/walking; legs swollen at end of the day. Hx of DVT, ulceration

99
Q

stasis dermatitis (S/Sx)

A

bronzing pigment over time; edema nd petechiae (blood stuck outside the vessels); erythema; fissuring; dry or weeping crusting; stasis ulcers that don’t heal;

100
Q

stasis dermatitis (Dx)

A

H&P; ankle brachial index

101
Q

stasis dermatitis (Ddx)

A

cellulitis, contact dermatitis, tinea

102
Q

polymorphous light eruption (Desc)

A

acute recurrent photodermatitis following sun exposure

103
Q

polymorphous light eruption (Etiology)

A

sun exposure

104
Q

polymorphous light eruption (Hx)

A

all ages, races, genders

105
Q

polymorphous light eruption (S/Sx)

A

lesions appear 2 hrs to 5 days after exposure and last 7-10 days. Burning, itching, erythema…..three types: plaque, papular, papulovesicular

106
Q

polymorphous light eruption (Dx)

A

H&P

107
Q

polymorphous light eruption (Testing)

A

ANA, anti-SSA/B to distinguish from SLE

108
Q

polymorphous light eruption (Ddx)

A

SLE, photodrug rxn, solar urticaria

109
Q

actinic keratosis (Desc)

A

chronic…. Precancerous neoplasm from UV exposure

110
Q

actinic keratosis (Etiology)

A

chronic UV exposure

111
Q

actinic keratosis (Distribution)

A

face, lips, back of hand, shoulders, legs (wherever sun can get to)

112
Q

actinic keratosis (Hx)

A

increases with age, fair-skinned blondes/gingers

113
Q

actinic keratosis (S/Sx)

A

rough scaling macule, papule, or plaque; develops a thin-transparent scale that becomes thicker and yellow over time….horny lesion

114
Q

actinic keratosis (Dx)

A

bx to differentiate SCC

115
Q

actinic keratosis (Ddx)

A

seborrheic keratoses; SCC (will be more thick)

116
Q

psoriasis (Desc)

A

immune-mediated chronic recurring inflamx of epidermis with increased epidermal proliferation resulting in scaling

117
Q

psoriasis (Etiology)

A

genetics, env’t triggers, stress, medication

118
Q

psoriasis (Distribution)

A

scalp, extensor surfaces, buttocks and back

119
Q

psoriasis (Hx)

A

smoking, obesity, and HIV predispose

120
Q

psoriasis (S/Sx)

A

dry, sharply demarcated, erythematous plaques and papules topped with silvery scales (seven subtypes)

121
Q

psoriasis (Dx)

A

H&P, auspitz’ sign

122
Q

psoriasis (Ddx)

A

seborrheic dermatitis, eczema, tinea, SCC

123
Q

pityriasis rosea (Desc)

A

acute, self-limited, mild-inflamx, scaling skin dz

124
Q

pityriasis rosea (Etiology)

A

reactivation of HH7, primary infx HH6

125
Q

pityriasis rosea (Distribution)

A

trunk (usu back)

126
Q

pityriasis rosea (S/Sx)

A

usu asx; oval, minimally elevated papules and plaques….starts with ‘herald patch’ followed by xmas tree distribution

127
Q

pityriasis rosea (Dx)

A

PE

128
Q

pityriasis rosea (Ddx)

A

tinea, drug eruptions, psoriasis, syphilis

129
Q

lichen planus (Desc)

A

recurrent itching/inflamx w/ small, discrete angular papules. Uncommon.

130
Q

lichen planus (Etiology)

A

idiopathic, maybe Hep C

131
Q

lichen planus (Distribution)

A

ankles, wrists, pubic region, lips, mouth

132
Q

lichen planus (S/Sx)

A

2-4 mm papules w/ angular border - PPPP: purple polygonal pruritic papules

133
Q

lichen planus (Dx)

A

PE and bx

134
Q

lichen planus (Testing)

A

biopsy (accumulation of PMNs and t-cell mediated cytotoxic rxn against basal cell keratinocytes)

135
Q

lichen planus (Ddx)

A

leukoplakia, candida, herpes stomatitis, aphthous ulcers, erythema multiforme

136
Q

drug eruptions (Desc)

A

immune mediated

137
Q

drug eruptions (Etiology)

A

penicillin, sulfonamides, qunidine

138
Q

drug eruptions (S/Sx)

A

exanthems (from Abx - pruritic rash, symmetric distribution on trunk/extremities); urticaria (from abx/NSAIDs - pruritis on palms/soles); pigmentation (melasma from birth control)

139
Q

drug eruptions (Dx)

A

H&P

140
Q

drug eruptions (Testing)

A

CBC - eosinophils

141
Q

erythema multiforme (Desc)

A

inflamx reaction w/ target lesions

142
Q

erythema multiforme (Etiology)

A

drugs, infx, immunization, autoimmune, idiopathic

143
Q

erythema multiforme (Distribution)

A

dorsal/palmar hands, soles, forearms, feet, face, elbows, knees, genitals, mucus membranes

144
Q

erythema multiforme (Hx)

A

M>F; more than half

145
Q

erythema multiforme (S/Sx)

A

3-5 day onset, resolves in 2 wks; erythema, edema, bullous lesions on face and extremities; pruritic, painful; sometimes with systemic sxs (fever, weakness, malaise)

146
Q

erythema multiforme (Dx)

A

H&P

147
Q

erythema multiforme (Ddx)

A

urticaria, drug eruptions, bullous pemphigoid, pemphigus, dermatitis herpetiformis, herpes stomatitis

148
Q

erythema nodosum (Desc)

A

inflamx of skin and subQ tissue - characterized by tender, red, swollen shins

149
Q

erythema nodosum (Etiology)

A

infx, drug, malignancy, sarcoidosis

150
Q

erythema nodosum (S/Sx)

A

indurated nodules that look like bruises; painful; systemic sxs (fever, malaise, joint pain); spontaneous resolution ~6 wks

151
Q

erythema nodosum (Dx)

A

H&P …. But must look for underlying d/o

152
Q

erythema nodosum (Testing)

A

blood work

153
Q

erythema nodosum (Ddx)

A

vasculitis, lymphoma, pretibial myxedema

154
Q

miliara (Desc)

A

heat rash

155
Q

miliara (Etiology)

A

sweat accumulates beneath ducts b/c of keratin obstruction at level of corneum

156
Q

miliara (Hx)

A

common in babies/kids

157
Q

miliara (S/Sx)

A

pruritis; small red papules (occasional pustules)

158
Q

miliara (Dx)

A

H&P

159
Q

miliara (Ddx)

A

baby acne

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