Derm Diagnosis Flashcards
Central redness, flushing of face with bumps x 3 mo
Papulopustular eruption
Telangiectasia, skin coarseness
Rosacea
erythamateous papules around the mouth
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
Diffuse non-scarring alopecia
Bitemporal hair loss
<50% hair loss
No balding
Telogen Effluvium
Progressive loss of terminal hairs on anterior, mid, temporal and vertex scalp
Androgenic Alopecia
psych condition where pick at hairs on body (scalp is MC)
Trichotillomania
Chest, back and shoulders
Patchy red, darker or lighter spots
Asymptomatic, cosmetic concern
Pityriasis (tinea) Versicolor
Infection or 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
ringworm
Infection of groin
Erythematous, scaley patches
Tinea Cruris
jock itch
Foot infection
Interdigital-
Hyperkeratosis-
Vesiculobullous-
Tinea Pedis athletes foot Interdigital-btwn toes Hyperkeratosis-soles, merial and lateral surfaces of foot Vesiculobullous-medial foot
nail infection
onychomycosis
Diffuse non-scarring alopecia
Bitemporal hair loss
<50% hair loss
No balding
Telogen Effluvium
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
Redding, scaling, itching, dandruff
Localized to nasolabial folds, eyebrows, upper chest and scalp
Seborrheic Dermatitis
Elevated papules, patches with scaling mostly on extensor surface of knees, elbows, face and scalp, intergluteal cleft, glans penis
Symmetrically on body
Psoriasis
Pustules, erythematous papules
Furuncles-deep, tender nodules/abscesses (boils)
Carbuncles-interconnecting abscesses in several contiguous hair follicles
Folliculitis
Razor bumps
Occurs over any shaved area
Pseudofolliculitis Barbae
Swollen erythematous nail fold
Pustule may be present
Acute Paronychia
Loss of cuticle, proximal nail fold becomes boggy, nail plate becomes irregular/discolored
Worsened by water, irritant, nail dermatoes, grooming & biting
Chronic Paronychia
Highly contagious
Face & extremities
1-3 cm erythematous macules/papules → vesicles/pustules → rupture → honey-colored crusts
Nonbullous Impetigo
vesicles enlarge to form bullae
Clear yellow fluid
Rupture→crust
trunk & folds (less common on face)
Bullous Impetigo
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
