Derm Diagnosis Flashcards by Julia B

Central redness, flushing of face with bumps x 3 mo
Papulopustular eruption
Telangiectasia, skin coarseness

Rosacea

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erythamateous papules around the mouth

Perioral Dermatitis

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yellowish, whitish enlargement of sebaceous glands

Sebaceous Hyperplasia

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Under arms, breast, groin

Inflamed nodules and abscesses, scarring

Hidradenitis Suppurativa

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Patches on scalp and other hair bearing areas
Exclamation point hairs
Smooth circular discrete area

Alopecia Areata

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Diffuse non-scarring alopecia
Bitemporal hair loss
<50% hair loss
No balding

Telogen Effluvium

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Progressive loss of terminal hairs on anterior, mid, temporal and vertex scalp

Androgenic Alopecia

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psych condition where pick at hairs on body (scalp is MC)

Trichotillomania

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Chest, back and shoulders
Patchy red, darker or lighter spots
Asymptomatic, cosmetic concern

Pityriasis (tinea) Versicolor

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Infection or scalp hair

Alopecia, scaly, erythema, itchy

Tinea Capitis

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Infection of body surfaces

Pruritic circular or oval, erythematous scaling plaque with central clearing and raised border

Tinea Corporis

ringworm

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Infection of groin

Erythematous, scaley patches

Tinea Cruris

jock itch

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Foot infection
Interdigital-
Hyperkeratosis-
Vesiculobullous-

Tinea Pedis
athletes foot
Interdigital-btwn toes
Hyperkeratosis-soles, merial and lateral surfaces of foot
Vesiculobullous-medial foot

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nail infection

onychomycosis

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Diffuse non-scarring alopecia
Bitemporal hair loss
<50% hair loss
No balding

Telogen Effluvium

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What is the difference between erythema multiforme minor and major?

Minor-no mucosal involvement, confined to extremities and face, associated with HSV

Major- always has mucosal involvement, MC due to drug eruption

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Redding, scaling, itching, dandruff

Localized to nasolabial folds, eyebrows, upper chest and scalp

Seborrheic Dermatitis

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Elevated papules, patches with scaling mostly on extensor surface of knees, elbows, face and scalp, intergluteal cleft, glans penis
Symmetrically on body

Psoriasis

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Pustules, erythematous papules

Furuncles-deep, tender nodules/abscesses (boils)

Carbuncles-interconnecting abscesses in several contiguous hair follicles

Folliculitis

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Razor bumps

Occurs over any shaved area

Pseudofolliculitis Barbae

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Swollen erythematous nail fold

Pustule may be present

Acute Paronychia

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Loss of cuticle, proximal nail fold becomes boggy, nail plate becomes irregular/discolored

Worsened by water, irritant, nail dermatoes, grooming & biting

Chronic Paronychia

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Highly contagious

Face & extremities

1-3 cm erythematous macules/papules → vesicles/pustules → rupture → honey-colored crusts

Nonbullous Impetigo

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vesicles enlarge to form bullae
Clear yellow fluid
Rupture→crust

trunk & folds (less common on face)

Bullous Impetigo

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Ulcerative form with hemorrhagic crust Distal extremities Heals with scarring

Ecthyma Impetigo

Acute painful onset Fever, chills, reginal lymphadenopathy Edematous, red, warm plaques with sharply demarcated borders vesicles, bulla, erosions Cheeks and ears MC (less common in extremities)

Erysipelas

Abrupt or gradual onset Swelling, erythema, tenderness, warmth Bulla, vesicles, necrosis Rough borders, less defined Fever, chills, malaise, anorexia, lymphadenopathy, lymphangitis (red streak)

Cellulitis

Behind ears, back of neck Hair shafts Low grade fever, Lymphadenopahty if 2° bacterial

Head Lice

Puritic, papular rash with excoriations Burrowing on hands and wrists Head and neck are typically spared Crusted scabies: less itchy, hyperkeratotic lesions

Scabies

Red -brown fecal staining & nit -like ova common on mattress seams Puritic, erythematous, papules of exposed ateas, central hemorrhagic punctum Linear "breakfast, lunck, dinner" streak

Bed Bugs

Painless bite-red, white & blue sign Erythema, central vesicle or papule, central violaceous surrounded by rum of planched skin then outer ring of erythema Central necrosis begins after 203 days with eschar/ulcer formation btwn 5-7d Fever, chills, HA, N/V from venom toxins

Brown Recluse Spider Bite

Pityriasis Rosea

Prodrome: malaise, headache, mild constitutional sx Herald patch-single, salmon/red oval lesion most commonly found on trunk, with slightly raised scaley border Days to months later exanthem occurs -smaller lesions on trunk/proximal extremities Rash follows Lander's Lines-christmas tree ditribution on back, transverse on abd & v shape on chest Raised 5-10mm pink, oval papules & plaques with collarette scale Rarely on face/palms/soles

Atypical Pityriasis

Herald patch may be absent or sole lesion Multiple herald patches Lesions may be present on face, neck, palms and soles or unilateral presentation Vesicular, pustular or urticarial variants

Lichen Planus

Six Ps: purple, pruritic, polygonal, planar, papules, plaques Violaceous with reticulated white scale Common on flexor surfaces of wrists, shins, lumbar back, feet LP pigmentosus-lighter in ppl of color Spontaneously remit in 1-2 yrs but may have recurrence

White, lacy reticular pattern on buccal mucosa, tongue, lips and gingiva Erosive, painful lesions ↑SCC risk

Oral Lichen Planus

Acute, self-limited rxn 1-3 wks Fever, malaise, myalgia, sore throat, cough Sharply dematcated erythematous macules →papules→plaques Center dark red, prown or purpuric with vesicular or bulla formation that flattens and clears Target or iris lesions (round with 3 concentric zones) Symmetric, pruitic lesions on distal extremities spread proximally Palms, soles, elbows, knees, sometimes face, mucosa and eyes Koebner Phenomenon

Erythema Multiforme

Macular rash → resolves spontaneously →manifests as maculopapular or papular lesions Mucosal lesions Involvement of palms and soles

Secondary Syphillis

Nummular Eczema

Coin shaped, disseminated, pruitic eczema lesions MC on extremities Hx of atopy Repetitive flares

Tinea Corporis

Superficial fungal infection of skin Erythematous scaly plawues with central resolution Scale/crust due to inflammation Pruritus

Pityriasis (Tinea) Versicolor

well-demarcared macules/patches with fine scale Hypo and hyper pigmentation MC on trunk "Didn't tan well" Spaghetti and meatballs on KOH

Acute Guttate Psoriasis

Discrete salmon-pink papules up to 1.0 cm Variable scaling Trunk Palms & soles spared, fewer lesions on face & scalp

Umbilicarted papules Discrete, solid, skin-colored papules If confluent-immune system isn't fighting

Molluscum Contagiosum

Verruca Vulgaris (HPV)

Common wart, plantar wart

Asymptomatic Flesh to grey colored papules → merge into plaques Men on penile shaft & urethra Women on posterior introitus and labia Flat condylomas on cervix & vagina Perianal warts

Condylomata Acuminata (anogenital warts)

erythamateous papules around the mouth and sometiems eyes | no comodones

Perioral Dermatitis

yellowish, whitish enlargement of sebaceous glands

Sebaceous Hyperplasia

Under arms, breast, groin | Inflamed nodules and abscesses, scarring

Hidradenitis Suppurativa

Patches on scalp and other hair bearing areas Exclamation point hairs Smooth circular discrete area

Alopecia Areata

Telogen Effluvium

Diffuse non-scarring alopecia Bitemporal hair loss <50% hair loss No balding

Androgenic Alopecia in Men

Progressive loss of terminal hairs on anterior, mid, temporal and vertex scalp

Chest, back and shoulders Patchy red, darker or lighter spots Asymptomatic, cosmetic concern

Pityriasis (tinea) Versicolor

Infection of scalp hair | Alopecia, scaly, erythema, itchy

Tinea Capitis

Infection of body surfaces | Pruritic circular or oval, erythematous scaling plaque with central clearing and raised border

Tinea Corporis

Infection of groin | Erythematous, scaley patches

Tinea Cruris

Foot infection Interdigital-btwn toes Hyperkeratosis-soles, merial and lateral surfaces of foot Vesiculobullous-medial foot

Tinea Pedis

Intertrigo

rash in skin folds

Atopic Dermatitis

Pruritic rashes Acute: Vesicles, wheeping, crustinc Subacute: Papules, plaques, erythematous, dry and scaly Chronic: lichenification, hyperpigmentation, depigmentation Infant- facial lesions & patches elsewhere Older child- lesions in elbow & knee flexures, wrists & ankles

Medication initiated 7-10 d before rash appears (shorter for repeat exposure) Widespread, symmetric, erythematous macules and papules on trunk and extremities Lesions start on trunk and spread to extremities symmetrically Pruritus

Exanthematous

Fixed Drug Eruption

Solitary erythematous patch or plaque that will recur at the same site with re-exposure to the drug Motuh, genitalia, face and acral areas Sharply demarcated → edematous → plaque → bulla → erosion

Sx begin 3rd wk after start of med (longer than exanthematous) Generalized, wide spread rash Starts on trunk and moves outward Macular, erythematous Fever malaise, lymphadenopathy, liver/kidney involvement Facial swelling

DIHS or DRESS

Begins 8 wks after drug exposure Fever, HA, rhinitis, myalgias may precede Symmetric erythematous, irregularly shaped erosions Dursk red to purpuric macules Localized on face, upper trunk and hands Lesions start as flaccid blisters and will slougth off Extremely painful Extensive necrosis and detacment of epidermis and mucosal surfaces May have ocular involvement → blindness

SJS or TENS

Prodrome usual fever, sorethroa, conjunctivitis, mouth, nose, genitalia Rash within 48 hrs of prodrome Bright red, confluent, painful rash with large blisters Sandpaper texture Flaky, dry skin as lesions heal

Staphlycoccal Scalded Skin Syndrome (SSSS)

Bullous diease Painful, generalized flaccid bilsters with mucosal involvement Blisters coalesce and rupture easily

Pemphigus Vulgaris

Sub-epidermal blister Rare mucosal involvement Prone to relapse

Bullous Pemphigoid

Necrotizing Fasciitis

Fever, intense pain, early pain out of proportion to PE findings Systemic toxicity ±site of introduction Local edema, crepitus, skin abnormality, red or purple or necrotic tissues

Frequently associated with trauma to genitalia Intense pain and tenderness in genitalia Prodromal sx: fever & lethargy Dusky appearance over skin Gangrene of portion of genitalia and purulent drainage

Fournier Gangrene

7-10 day onset after infection Systemically ill, fever, hypotension Large purpuric skin lesions DIC Painful Symmetrical limb involvement-starts distally and progresses proximally Organ dysfunction

Purpura Fulminans

Unpigmented macules (5-50 mm) Sharply defined borders Non-segmental Bilateral acrofacial pattern, symmetrical lesion size, shape and location Evolves over time

Vitiligo

Hyperpigmented, well circumscribed lesion Appear in sun exposed areas

Solar Lentigines

Progressive, macular, nonscaling, hypermelanosis of sun-exposed areas while pregnant or on OCP

Melasma

Dark, hyperkeratotic streaks in skin folds Neck, axilla, groin, body folds

Acanthosis Nigricans

Irregular, darkly pigmentated macules and patches at sites of previous injury or inflammation acne, psoriasis, lichen planus, atopic dermatitis, contact dermatitis, trauma Lesions persist months to years

Post-Inflammatory Hyperpigmentation

Red scaly plaques located on the skin Sun exposed areas tender, burning, itching ot asymptomatic

Actinic Keratosis

Nodule with central pore (punctum) Can originate from invaination of epidermis into dermis or spontaneously

Epidermal Cyst