---DERM---HEENT--- Flashcards
Recent shaving
erythema, Edema
papules/pustules
rash over follicle
folliculitis
usually on face/extremities
multiple lesions
nonbollous-crusty yellow
bullous-brown crusty (trunk kids)
Impetigo
Typically caused by break in skin
4 signs :Erythema, edema, TTP, Elevated skin temp
regional lymphadenopathy
Fever, chills, malaise, pain, itching, burning at site
Drainage- abscess
Cellulitis
Pain out of proportion to physical findings
Mainly in lower extremities, Erythema, edema, fever, cellulitis/abscess
blisters, discoloration , visual ulceration, bullae
Necrotizing fasciitis
Deep SubQ erythematous papule can be stable or fluctuant, most common on back, neck,
tender perifollicular swelling discharge of pus and necrotic plug
SINGLE FOLLICLE
Furuncle
Deep SubQ erythematous papule can be stable or fluctuant, most common on back, neck,
tender perifollicular swelling discharge of pus and necrotic plug
MANY FOLLICLES
Carbuncle
erythema, edema, localized pain, tenderness, abscess in the nail bed, purulent discharge behind the cuticle
inflammation W/O abscess formation involving proximal/lateral nail folds
Paronychia
Trauma distal end of finger (splinter, needle prick)
Severe pain, TTP,
erythema, edema, necrosis
Pain distal pulp of finger
Felon
Primary lesion is a pustule, the contents which dissect horizontally under the strum corneum and then peel away
Glistening surface with long cigarette paper-like scaling and advancing border
Candidiasis
Yellowish nail
thick
caused by trauma, tight fitting shoes
Onychomycosis
Intense itching worse at night
rash for 2-6 weeks
eczema and impetigo appear as secondary lesion
Webs of toes, fingers, in folds of skin
lesions are linear, curved or s shaped elevated vesicle or papule
Scabies
2-5 cm round oval patch
sharply delineated pink salmon colored lesion on chest, neck, back
‘multiple lesions become scaly usually alone lines of CLEAVAGE
7-21 days “FIR TREE” Present on back
Pityriasis Rosea
Deep burning, throbbing, stabbing sensation,
malaise, fever, HA, periorbital burning/itching
Unilateral erythematous papules typically in a singular dermatome or several contiguous dermatomes, vesicle/bullae form become pustular and crust over
Herpes Zoster
2-5mm diameter papules, itchy, dome shaped with shiny surface and central indentation or umbilication
Molluscum contagiosum
usually on hands,
erythema, dryness, painful cracking, fissuring and scaling are typical , possible vesicles, tenderness, burning
hurts more than it itches
Irritant dermatitis
common on hands, forearms, and face
Vesicle, edema, erythema, Extreme pruritus
Itches more than it hurts
possible delayed reaction
allergic contact dermatitis
Lesions on, hands, feet, face, neck, upper chest, genitals,
Eczematous eruption that is distressingly pruritic, recurrent often flexural and symmetric.
dry skin and pruritic, rubbing leads to inflammation and lichenification
Atopic dermatitis
Males > women
Better in summer worse in winter
SCALP/eyebrows/eyelids/ears/ nasolabial folds
burning itching, red greasy/smooth/glazed, scaling rash consisting of patches and plaques
Seborrheic Dermatitis (dandruff)
Transient/recurrent symmetrical vesicular eruptions located on volar and plantar surfaces
FMHX/PMHX asthma, hay fever, atopic eczema
Intense Pruritis
(Positive Otter Sign-not really a sign)
LOOKS LIKE TAPIOCA
Dyshidrosis
Acute- sudden onset, mild to severe pain, erythema, edema
Tender swollen fluctuant nodule located along superior gluteal fold.
Possible infected sinus tract with drainage
Pilonidal Abscess
Intense pruritis, erythematous plaque, lesions may be red/pink or flesh colored with white or red halo
Triggered by food, drug, insect bites, injection, diseases, inhalants
Urticaria
On Face, neck, upper back, chest if on buttocks, palms or planter = trauma
warm, red boggy and tender to palpation lesion
may rupture with purulent material and keratin debris
Inflamed /ruptured epidermal cyst
half moon shaped plaques in crural folds spread to medial thighs
well defined borders
lesions are usually bilateral and do not include Scutum/penis
hyperpigmented
may migrate to perianal, gluteal cleft
Tinea Cruris
Webs of toes and soles of feet
Male>Female
Itching, burning, stinging of interdigital webs and plantar surfaces, may progress to fissuring or macerations in toe web spaces.
Tinea Pedis
Pruritis with excoriation
hair: head, eyebrow, eyelashes
nits hairs that fluorescent
Pediculus humanus capitus
Scaling round/oval pruritic plaques sharply defined annular pattern
Papules/pustules vesicles at border
Tinea Corpus -Ring worm
predominately ages 3-9
males >females
round patches on scal
scaled with little/marked inflammation or alopecia, florescence
Tinea Capitis
Central, upper back, chest and proximal arms
Asymptomatic
Color is uniform, velvety tan, pink or white macules that do not TAN
Tinea Versicolor
Pruritus with excoriation
occasionally sky blue macules on the inner thighs or lower abdomen.
Pediculosis pubis
another name for hair loss due to disorders of hair cycling, inflammatory conditions that damage hair follicles, or inherited or acquired abnormalities in hair shafts
Alopecia
Inflammation, irritation of the eye lid, Tears may be frothy or abnormally greasy,
itching/burning, Foreign body sensation, tearing
erythema, edema, discharge
CRUSTING WHEN AWAKENING
eye lid rolled outward
Blepharitis
EYE—erythema, edema, purulent discharge in morning, LESS itchy,
Yellow/White discharge.
bacterial conjunctivitis
EYE—-Swollen conjunctiva, erythema, edema eyelids, periocular hyper pigmentation,
itching, watery discharge bilateral, history of allergies
Allergic Conjunctivitis
EYE—Itching, burning, tearing gritty foreign body sensation, URI,
Watery discharge, Erythema, edema, pinpoint conjunctival hemorrhage, critical tender periauricular lymph
Viral conjunctivitis
EYE–Severe discharge, HYPER ACUTE onset 12-24 hrs.
Conjunctival papillae, marked chemosis, preauricular adenopathy eyelid swelling
gonococcal conjunctivitis
EYE– erythema, edema, watery discharge, ocular pain, foreign body sensation, photophobia, blurred vision
Extended use of soft contacts
Corneal Ulcer
EYE– Severe pain , tearing photo phobia
POS fluorescein stain due to trauma
Corneal Abrasion
Localized eyelid tenderness, erythema, edema, foreign body sensation
well defined SubQ nodule on eyelid
Infection of sweat gland
Hordeolum
Hard nodule , nontender, usually farther back on eyelid, erythema/edema on upper or lower lid,
blockage of MEIBOBIAN GLAND (Oil gland)
Chalazion
Defined by:
Granulomatous-anterior- blurred vision mildly inflamed eye
Nongranulomatous- pain redness, photophobia and vision loss
Uveitis/Iritis
Trauma
red eye Foreign body sensation, blurred vision/double, swelling of eyelid, nasal congestion/discharge, sinus pressure,
HA, tooth pain
CRITICAL-RESTRICTED EXTRAOCULAR MOVEMENT
Orbital Cellulitis
Accumulation of blood in the subperichondrial space-secondary to trauma.
Commonly associated with boxers/wrestlers
Result deformed auricle referred to as CAULIFLOWER EAR
Auricular Hematoma
Post Auricular pain and erythema accompanied by spiking Fever
Complication of Otitis Media
Edema, tenderness, protrusion of auricle and obliteration of the post auricular crease
Mastoiditis
Painful erythema, edema of ear canal skin, purulent exudate Recent water Exposure: submersion AKA SWIMMERS EAR or Mechanical trauma (scratching with CTA)
Otitis External
Precipitated by URI
Otalgia, aural pressure, decreased hearing, Fever and history of Upper respiratory tract infection
ERYTHEMA/HYPOMOBILITY of TM
TM bulging, mastoid tenderness
Otitis Media
Secondary to middle ear infection or barotrauma, blunt, penetrating, acoustic, lightening strikes
Pain, hearing loss, vertigo, tinnitus, N/V,
Visible TM perforation-blood/pus/clear fluid
Tympanic Membrane Perforation
TM perforation exudes keratin debris or granulation tissue
PROLONGED EUSTACHIAN TUBE DYSFUNCTION
Cholesteatoma
Acute onset-4 weeks Purulent yellow green nasal discharge, facial pain/pressure obstruction
cough, malaise,
fever, HA
Sinusitis
Severe sore throat, odynophagia, inferior and medial displacement of infected tonsil
Moist /translucent contralateral deflection OF SWOLLEN UVULA
Tender cervical lymphadenopathy
drooling and dehydration
Peritonsillar Abscess
Centor Criteria: 1. FEVER over 38c 2. Tender Cervical lymphadenopathy 3. Lack of cough Pharygotonsillar exudates Viral- vesicular and petechial pattern on soft palate and tonsils with rhinorrhea no exudate fungal- whit cheesy can be scraped off
Pharyngitis/ tonsillitis
Acute swelling of salivary gland
Pain increases during meals,
tenderness and erythema of duct opening
Pus may be massaged from duct
Sialadentitis
Putrid/ bad breaths Foreign body sensation in throat pain when swallowing increased pain and swelling with meals white debris bad taste (metallic) earache dysphasia chronic tonsillitis
Tonsilloliths
Flashes of light, floaters, CURTAIN OR SHADOW MOVING OVER FIELD OF VISION
Peripheral/central vision loss
vision may change based on head position due to fluid movement
Retinal detachment
Seasonal
Nose: Clear nasals discharge, pruritis, sneezing, nasal polyps
Eyes: Irritation, pruritis, conjunctival erythema, excessive tearing
cough, bronchospasm, wheezing, eczematous dermatitis
Allergic Rhinitis
red papules or pustules, pruritic/painful,
scalp, posterior neck, groin legs
scarring hyper pigmentation may occur
usually AFRICAN/HISPANIC thick coarse hair
condition caused by ingrown hairs
PFB
Red scaling, CRUSTY PATCH ON NIPPLES AND AREOLA and surrounding, skin eczematous and unilateral
Pagets Disease
