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Dermatology & Minor Surgery > Derm Final > Flashcards

Derm Final Flashcards

1
Q
  • Group A beta-hemolytic streptococci.
    Infection extends into dermis.
  • Heals with scar (because ulcerative)
A

Ulcerative bullous impetigo

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2
Q
  • Chronic itch in a postmenopausal women
  • Negative KOH
  • Presents as chronic itch-scratch- cycle
A

lichen simplex chronicus

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3
Q

Dimple sign with lateral pressure

A

Dermatofibroma

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4
Q
  • Painful itchy condition
  • Recurrent and lasts 2-3 weeks then clears.
  • Starts with deep seated blisters between the fingers
    no other lesions can be found.
  • Not infectious in its cause
A

Irritant contact dermatitis (clue is stand alone lesion, confined to hands & fingers, vesicular or blistering

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5
Q
  • Pruritic inflammatory condition.
  • Often with a personal or Fhx of similar eruptions.
  • Diffuse erythema, some vesicular eruption and mild overlying scaling on the face, scalp, flexural surfaces
A

Atopic dermatitis

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6
Q

Infected area tender, deep, red and swollen

A

Cellulitis

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7
Q

superficial infection of the dermis

A

Erysipelas

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8
Q
  • Sun exposed areas of skin
  • Male > Females
  • Pre-malignant
  • 1 out of 1000 lesions develop into SCC annually
  • 5-10% over a lifetime
A

Actinic keratosis

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9
Q

Is this patient with AK amenable for surgical removal of lesions?
If not, what is the standard of care 1st line tx?

A

No. too many lesions
5 fluorouracil applied topically 5% cream for 4 weeks

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10
Q
  • Acquired light or dark-brown hyperpigmentation
  • Age of onset - young adults
  • Female > male (10%)
  • Race - brown or black skin type
    Incidence/etiology: hyperinsulinemia, pregnancy, combo hormone replacement, thyroid dysfunction, genetics, UV radiation, cosmetics, anti seizure medication
A

Melasma/ chloasma

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11
Q
  • Presentation: maculopapular, urticarial, pustular and nodular eruptions
  • Prevention: sunblock should be used, but not always helpful
  • Systemic tx:
  • Beta-carotene, 60 mg tid 2 weeks before sun
  • Niacinamide, 2-3 g/day (helped 60% of pts in one study)
  • Vit B-6, 150-200 mg, taken 30 min before sun, or 100 mg/hr for 8-10 hrs before sun
  • Antimalarial drugs
A

Polymorphous light eruption

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12
Q
  • Nodular mass of dilated vessels
  • 80-90% resolves spontaneously within 5-8 years
A

Superficial hemangioma

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13
Q
  • Superficial bacterial infection of the hair follicles
  • Most commonly S. aureus
  • Caused by friction blockage of follicle, shaving
  • Papule or pustule confined to hair follicle, often surrounded by erythematous halo
  • No scarring
A

Folliculitis

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14
Q
  • Fair-skinned individuals with excessive sun exposure in childhood at highest risk
  • Location: top of the ear and crossing vermillion borders of the lips
  • Exposure to chemical carcinogens (pitch, tar, crude paraffin oil, creosote, lubricating oil)
  • Arsenic (flower’s soln. for psoriasis)
  • Other etiologies (HPV, immunosuppression)
A

SCC

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15
Q
  • Most common areas:
    lower legs, scrotum, vulva, anus pubis, wrists, ankle and elbow, upper eyelids, back and side of neck, ear-orifice and fold
  • Scalp-picker’s nodules
A

Lichen simplex chronicus

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16
Q

HT for scalp-picker nodule that bleeds

A

Calc carb

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17
Q
  • Caused by gram positive cocci
  • Bollus condition (blisters)
  • Ulcers
  • Tx with topical mupirocin
A

Bullous impetigo

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18
Q
  • Single or scattered discrete lesions on sun exposed areas
  • Adherent hyperkeratotic scales “rough texture”
  • Better felt than seen
  • A sore that doesn’t heal
A

Actinic keratosis

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19
Q

An acute, deep-seated, red, hot tender nodule or abscess

A

Furuncle

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20
Q
  • Lesion present for 20 years
  • Superficial
  • Asymmetrical
  • Poorly demarcated orders
  • Punch biopsy was malignant
A

Superficial spreading melanoma

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21
Q

Infection of the dermis and subcutaneous tissue
- Caused by group A Streptococcus and s. aureus in adults
- Hemophilus influenza B - kids
- Most often on legs and face
- Port of entry- crack, abrasion, bite, or other wound to skin
- Warm, tender, swollen, red area
- Possible fever, enlarged nodes, red streak

A

Cellulitis

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22
Q

What is the HT remedy for a pt presenting with:
- woke up with bright red cheeks, super hot, red, minimally swollen, accompanied by a h/a, very dry
- Mental emotional predisposition went from normally calm individual to an extremely violently oriented person this morning due to the inconvenience of her condition.

A

Belladona

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23
Q

Belladonna acute can appear like a ______ , Ht remedy that is chronic

A

Calc carb

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24
Q
  • Painful swollen sweat glands in the axilla
A

hidradenitis suppurativa

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25
Q
  • Hutchinson’s sign present
  • Periungual spread from nail towards the proximal finger
A

Acral lentiginous melanoma

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26
Q
  • Scaling to ulcer
  • Elevated nodule to tumor
  • indurated, eroded nodule that ulcerates and bleeds easily
  • Common on lower lip, top of ears, tongue, head, neck, back of hands
A

SCC

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27
Q
  • Maceration of toes and knees
  • Often malodorous
  • Tx - wear cotton socks (change frequently)
  • Consider agents to reduce moisture- powder
  • Topical antibiotic may be necessary
A

Pitted keratolysis

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28
Q
  • Papule or nodule
  • Pearly or translucent
  • Telangiectasia - haphazard
  • Can be pigmented/sclerotic
  • Translucent when stretched
A

BCC

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29
Q
  • Bacterial infection (corynebacterium minutissimum) - Gram positive rod
  • Diffuse brown, scaly plaque resembles tinea
  • 3rd and 4th toe web most common, also genital-crural region
A

Erythrasma

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30
Q

What could be identified on a wood’s lamp exam with Erythrasma

A

A coral red fluorescence

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31
Q

Which pre-malignant (1 out of 1000 lesion annually) develop into SCC, 10% over lifetime?

A

AK (Actinic Keratosis)

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32
Q
  • For smaller and isolated lesions- Tx includes: cryosurgery, radio surgery, hypercation or electrodes desiccation
    5-Fluorouracil- 5% applied bid for 2-4 weeks- very irritating
  • Acetaminophen with codeine often given for pain
  • Petrolatum often used between applications to soothe skin
A

AK

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33
Q
  • Red, swollen, painful periorbital
A

Periorbital cellulitus

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34
Q
  • Condition managed with gluten free diet, topical dapsone and sulfapyridine
  • Vesicular eruptions that mimics a herpes simplex but with diffuse involvement in a non contiguous pattern across the body
A

Dermatitis herpetiformis

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35
Q
  • Pinpoint papules
  • Desquamation fo the tips and toes
  • Strawberry tongue- day 4-7 in untreated cases
  • Pastia’s sign
A

Scarlatina/scarlet fever

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36
Q
  • Primary-painless chancre (contagious)
  • Secondary (contagious) disseminated
A

Syphilis

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37
Q
  • Possible association with fluoride and sodium lauryl sulfate
A

Perioral dermatitis?

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38
Q
  • Locally invasive, aggressive, destructive
  • On the face
A

BCC

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39
Q

Associated with an acute inflammatory process at a distal site

A

ID reaction

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40
Q
  • No radial growth, so early metastasis
  • Most common in 6th decade of life
A

Nodular melanoma?

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41
Q

Herald patch

A

Pityriasis rosea

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42
Q
  • Itchy since the introduction of food 3 months ago
  • Both parents have asthma
A

Atopic dermatitis

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43
Q

Spilled oven cleaner

A

Irritant contact dermatitis

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44
Q
  • 1 year duration
  • Moderate pruritus
  • Wickham’s striae
A

Lichen planus

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45
Q
  • Culture positive for pseudomonas
A

Folliculitis

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46
Q

Caused by gram positive rod from raw fish or meat contact

A

Cellulitis

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47
Q

Delayed abnormal reaction to UV radiation

A

Polymorphous light eruption

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48
Q

What is this condition?

A

Psoriasis

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49
Q
  • Chronic itch rash
  • Remembers having a rash in cubital and popliteal fossa as a child
A

Atopic dermatitis

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50
Q
  • Hyper proliferative skin disorder in generally predisposed individuals
  • 2% of world pop (range 0.4-4.7%)
A

Psoriasis

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51
Q
  • Chronic lesion on elbow
  • Picking at it reveals pinpoint bleeding
A

Psoriasis

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52
Q
  • No pruritus
  • Neg KOH
  • Neg ANA
A

seborrheic dermatitis

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53
Q

Oil accentuates the lacy, white Wickham’s striae

A

Lichen planus

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54
Q

ID. by looking at the characteristic sites

A

Lichen simplex chronicus

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55
Q
  • Chronic itchy lesions
  • Resistant to tx
  • Neg KOH
  • Neg culture
  • Biopsy-spongiosis
A

Nummular dermatitis

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56
Q

Hyperproliferative skin disorder in genetically predisposed individuals

A

Psoriasis

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57
Q
  • Usually Fhx of eczema, hayfever or asthma (60-70%)
  • 7-15% of general population
A

Atopic dermatitis

58
Q

End result of what condition?

A

Rosacea

59
Q

A women had this reaction after using neomycin ointment

A

Allergic contact dermatitis

60
Q
  • Common (2-5%)
  • Chronic inflammatory disease
  • Pityrosporum ovale
  • Genetics, stress, and dietary factors affect onset of disease
A

Seborrheic dermatitis

61
Q
  • Sites: wrists (MC), forearm, ankles, ant legs, lumbar regions, and genitals
  • Up to 5% have mucous membrane and 10% nail (split ridge etc)
A

Lichen planus

62
Q
  • All skin types (10-20%)
  • Females > male, around age 20 first onset
  • Spring, early summer - 2-24 hours after 1st sun exposure - lasts 7-10 days
A

Polymorphous light eruption

63
Q
  • Lip licking
  • oven cleaner
A

Irritant contact dermatitis

64
Q

ID the condition on the image

A

Erythema multiforme

65
Q

ID the condition on the image

A

polymorphous light eruption?

66
Q
  • Like acne protocol
  • Loose clothing
  • Avoidance of heat, humidity, shaving, depilation, deodorants
  • Warm compresses
  • Zinc- 90mg/day- 2 months
A

Hidradenitis suppurativa?

67
Q
  • Centrally affects the face, forehead, cheeks, nose, and chin
  • May include iritis or blepharoconjunctivitis
A

Rosacea

68
Q
  • Five p’s: pruritic, planar (flat-topped), polygonal, purple papules, 2-10mm in diameter
A

Lichen planus

69
Q
  • Papulopustules on an erythematous base that may have occasional itching, burning, feeling of tightness
A

Perioral dermatitis

70
Q
  • Triggers include drugs, infection or unknown
A

Erythema multiforme

71
Q
  • Acute inflammatory/immunologic rx of subcutaneous fat leading to painful, red, swollen nodules on the extensor aspec of the extremities
  • Prodrome: fever, malaise, later arthralgias, arthritis and hilar adenopathy
A

Erythema nodosum

72
Q
  • Pruritic, papulovesicular or scaly coin-shaped lesions
  • Negative KOH test
A

Nummular eczema

73
Q

ID the condition in the image

A

Psoriasis

74
Q
  • A pt. noticed a correlation with wearing a bra and these lesions
A

Type lv delayed. HS- allergic dermatits

75
Q

30-35% have ocular symptoms (iritis, scleritis, keratitis, chalazia, blepharoconjunctivitis)

A

Rosacea

76
Q

Top 10 list: Nickel sulfate (10-15%), neomycin sulfate, balsam of peru, fragrance mix, thimerosal, sodium gold thiosulfate, formaldehyde, quaternium-15, cobalt chloride, bacitracin

A

Allergic contact dermatitis

77
Q

Cradle cap

A

Seborrheic dermatitis

78
Q

This phenomenon results from the release of cytokines that develop in a distal primary dermatitis i.e. tinea pedis, stasis derm etc

A

ID reaction

79
Q

Tx- first try warm, moist compresses, it may resolve, if not consider incision/drainage

A

Boil/furuncle

80
Q

Tx- Topical tx- Mupirocin (pseudomonic acid)

A

Bollous impetigo

81
Q

Dietary recommendations may include: whole foods high in fat, low to moderate protein, high complex carbohydrates, low glycemic diet to stabilize blood glucose, dairy and wheat elimination

A

Acne vulgaris?

82
Q

Triggers include drugs, infection or unknown

A

Erythema multiforme

83
Q
  • Recurrent
  • Self resolving condition of unknown etiology
A

Pompholyx/Dyshidrotic eczema

84
Q

Caused by beta-hemolytic strep

A

Ecthyma

85
Q

Fluoresces coral- red w/ wood’s lamp

A

Erythrasma

86
Q

Telangiectasia is commonly found in association with what condition?

A

Rosacea

87
Q

Herald patch

A

Pityriasis rosacea

88
Q

Chronic itch-rash-scratch cycle
- Negative for fungal, bacterial or viral

A

Lichen simplex chronicus

89
Q
  • Older woman claims this scaly dry rash on her leg returns every winter. She has no other dermatitis hx, with hx yo determine she is deficient in EFA’s
A

Asteatotic eczema

90
Q

This chronic skin condition is a minor feature in what condition?

A

Keratosis Pilaris

91
Q

ID condition in the image

A

Impetigo

92
Q

Enlarged swollen mass with purulent material begining to exude from several points on the surface

A

curbuncle?

93
Q

Possibly associated with fluoride and sodium lauryl sulfate, but not considered ACD.

A

Perioral dermatitis

94
Q
  • Recent sore throat
  • Numerous papules giving a sandpaper- like texture to the skin
A

Scarlet fever

95
Q
  • Relevant food allergies (70-80%) of cases
  • Major: eggs, milk, peanuts, soy, fish, wheat
  • Minor: citrus, tomato, strawberries, corn, chocolate, food preservatives and coloring
  • Inhalants: aeroallergens, animal dander, dust mites
A

Atopic dermatitis

96
Q
  • Negative KOH
  • Negative Hx of topical creams
  • Negative blood tests
A

Rosacea

97
Q
  • Streptococcal pharyngitis 1 week before rash
  • Resolves spontaneously in weeks to months
  • Teardrop shaped spots, red, small, scaly
  • Acute onset 1-2 days
  • Self resolve in 3-4 mo
A

Guttate psoriasis

98
Q

What is the most common cause of this dermatitis?

A

Nickel allergy

99
Q

Common condition for what condition?

A

Psoriasis

100
Q
  • Acute vesicles
  • linear lesion is a sign of dragged over the skin while scratching
A

Allergic contact dermatitis

101
Q

Present in 5-20% of FST I-II

A

Atypical nevi

102
Q
  • Chronic, unchanging macular lesions
  • Benign on biopsy
A

Junctional melanocytic nevi

103
Q
  • Over 50 y/o,, Male:Female ratio 2:1
  • Possible viral etiology
  • Rapid growth 2-5 cm w/in a few weeks to months
  • Can self-resolve in months to years (bad scar)
  • Removal recommended- r/o BCC, SCC, wart, AK
  • Single lesion-mc cheeks, nose, ears, hands (post), but can be any location
A

Keratoacanthoma

104
Q
  • Acquired loss of pigmentation
  • Pathogenesis is not known
  • Theories: autoimmune, neurogenic, self-destruct, genetic background (30%)
  • Age of onset any, 10-30 yrs (50%)
  • Incidence: common up to 1%
  • All skin types, equal in all sexes
  • lesion- white macules, sharple marginated, 5mm- 5cm
  • Can affect any area most common on face and extremities. Accentuated with sun exposure
A

Vitiligo

105
Q
  • Exclamation point hairs
  • Course: remission is common (80%)
  • Management: Stress reduction, topical onion juice, topical intralesional or systemic glucocorticoids, can add topical minoxidil, wig in severe cases, or refer for topical immunotherapy
A

Alopecia Areata

106
Q

White horn cysts

A

Seborrheic Keratosis (sign that this may not be melanoma). But Bx still indicated.

107
Q

ID this condition in the image

A

Stork bite lesion

108
Q
  • Can arrise with no known cause, or it may appear in people with a genetic
  • Mc in people ages 20-40
  • solitary lesions that are: infrequent, inconsequential, represent spontaneous mutations
  • On compression, invaginate into a slit-like defect in the skin = “buttonhole” sign
A

Neurofibroma

109
Q

Rapid growth within few weeks, can self-resolve within month-year

A

keratoacanthoma

110
Q
  • Very common, button-like dermal nodule
  • Pink, brown, tan, darker at center
  • Leg > arms > trunk
  • Few mm to 1 cm
  • ‘Dimple sign’ with lateral compression
  • Tx- leave alone, excision, cryotherapy
A

Dermatofibroma

111
Q

Multiple benign lesions- ID

A

Seborrheic Keratosis (rough type)

112
Q

Treated 5-FU or Curaderm - ID

A

BCC superficial

113
Q

Benign condition - ID

A

Intradermal nevi

114
Q
  • Dilated vessels deep in dermis and subcutaneous tissue
  • Spontaneous resolution, surgery, interferon, propranolol, intralesional and topical corticosteroids, vincristine and cyclophosphamide
A

Hemangiomas of infancy (deep)

115
Q
  • Painful lesions
  • Early central crust
  • Apex- mc
  • Long standing
  • Dense rolled edge
A

Chondritis nodularis helicis

116
Q
  • Vascular malformation
  • Flat, unilateral patches
  • Irregular, reddish-blue color
  • MC face, neck
  • Prominent, macular hemangioma
A

Port-wine stain (nevus flammeus)

117
Q

Filled with clear gelatinous viscous fluid

A

Digital mucous cyst

118
Q

Asymptomatic, soft benign papule, from dilated venule

A

venous lake

119
Q
  • Develops after a minor trauma
  • Bleeds easily
  • <30 y/o
A

Pyogenic granuloma

120
Q

ID condition in this image

A

Spider Angioma

121
Q
  • 25% remit with decrease sun exposure
  • Antioxidants, fruit, vegetables, green tea etc.
  • 5-FU
  • Black salve (iris, red clover, sanguinaria)
  • Vitamin A
  • Curaderm
  • Cryotherapy (3-10 sec max/3 w/5FU)
  • Sunscreen Type I &II skin
  • Excision for large lesions
A

Actinic keratosis

122
Q

Black horn cyst - ID

A

Seborrheic Keratosis

123
Q
  • A reactive hypermelanosis of the skin that occurs as a sequela of cutaneous inflammation
  • A common disorder that can occur at any age and has an equivalent incidence in males and females
  • May occur regardless of skin color, but is clinically more significant with darker skin pigmentation
A

postinflammatory hyperpigmentation (PIH)

124
Q

ID image

A

Milia

125
Q

Painless slow growing mass in the lid
Tx hot compresses 10-15 min qid/2-3 wks

A

Meibomian cyst

126
Q
  • Most common tumor of the intraepidermal eccrine sweat glands
  • Women > Men
  • Autosomal dominant
  • Usually symmetrical distribution
A

Serangioma

127
Q
  • Most common skin disorder in adolescents
  • Typical age range 12-25 years
  • 79 - 95% of adolescents aged 16-18
A

Acne?

128
Q
  • Filled with clear gelatinous mucin
  • Dorsal wrist MC
A

Ganglion cyst

129
Q

ID image

A

Lipoma

130
Q
  • Small tumors of enlarged sebaceous glands
  • 1-3mm
  • Telangiectasia
  • Central umbilication
  • Soft
  • > age 30 (25%pop)
  • Unknown etiology
A

Sebaceous hyperplasia

131
Q
  • Very common fibrous lesion
  • Begin in second decade
  • Soft, skin-colored to slightly pigmented
  • Pedunculated papule-neck, axilla, groin, eye, mouth
A

Skin tags / Chordons

132
Q

ID condition in the image

A

Epidermal incusion cyst

133
Q
  • Present in 5-20% of Northern European heritage population
  • Can occur anywhere
  • Acral and mucosal surface of other FST
  • Potential precursors to superficial spreading melanoma (SSM)
  • Increase risk for developing primary melanoma
A

Atypical nevi

134
Q
  • Usually deeper than an epidermal inclusion cyst
  • May feel rubbery but is usually not malleable
  • If lesin feels quite firm, a malignant tumor must be considered
A

Lipoma

135
Q
  • Abnormal scarring in susceptible individuals
  • More common in darker skin types
  • 1% - 6% of the population in response to trauma (acne, body piercing, tattoos, insect bites, vaccinations, surgery)
  • Age 10-30 years
A

Keloid

136
Q

ID condition in the image

A

Skin tag / Chordon

137
Q
  • Wheals-transient edematous papules and plaques
  • Usually pruritic
  • 15-25% of pop will have at least one episode at during their lifetime
  • Duration: hours-months
  • Histamine is the most important mediator
A

Urticaria

138
Q
  • Autoimmune disease causing localized hair loss w/o signs of inflammation(asymptomatic)
  • About 2% of population have at least one episode
  • Etiology-autoimmune, can be assoc with Hashimoto’s thyroiditis, vitiligo, myasthenia gravis
A

Alopecia areata

139
Q
  • Chronic, recurrent, intensely pruritic vesicles, papules, and urticarial plaques that are arranged in groups
  • Can resemble hrepes: therefore the designation of herpetiformis
  • Almost universally associated with celiac disease (1% of pop)
  • Age on onset 20-60 years
  • Prevalence in Caucasians, M:F 2:1, 10-39 per 100,000 persons
A

Dermatitis herpatiformis

140
Q
  • Thickened, hyperpigmented skin in the axillae and groin
  • Often associated with obesity and hyperinsulinemia
  • Can be congenital
  • Increased circulating insulin causes dermal fibroblast and keratinocyte
A

Acantosis nigricans

141
Q
  • Localized proliferation of melanocytes due to chronic sun exposure (esp. sunburns)
  • 1-3 cm macules
  • > 40 y/o esp. Type I-III skin
  • Roughly 75% of FST I-III people over 60 have one or more
A

Solar lentigo (liver spots, senile freckles)

142
Q
A

Dermatology & Minor Surgery (1 decks)

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