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Foundations of Clinical Practice II > Derm II (Babcock) > Flashcards

Derm II (Babcock) Flashcards

1
Q

Most common pre-cancerous skin lesion resulting from chronic, cumulative sun exposure in susceptible individuals?

A

Actinic Keratosis

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2
Q

What cancer typically comes from actinic keratosis

A

squamous cell carcinoma

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3
Q

Actinin keratosis: treatment

A

cryotherapy**

other:
Topical fluorouracil
Topical imiquimod

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4
Q

Actinic keratosis: prevention

A

sunscreen with UVA/UVB

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5
Q

Describe Actinic keratosis

A

erythematous or brown rough, scaly papules and plaques found on sun exposed skin. Coarse, sandpaper-like**

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6
Q

Seborrheic Keratosis

A
  • benign
  • common
  • oval, slighty raised, tan/light brown to black well-demarcated papules or plaques <3cm in size
  • appear to be “stuck-on” waxy greasy verrucous appearance
  • Trunk, scalp, face, neck, extremitities
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7
Q

What is the most common malignancy of the skin?

A

basal cell carcinoma

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8
Q

Basal cell carcinoma: risk factors

A
  • heavy, cumulative sun exposure

- Fair-skinned males 20-40s

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9
Q

Basal cell carcinoma: clinical findings

A
  • translucent
  • telangiectatic pearly papule/nodule
  • rolled border and ulcerated center**
  • 85% on head and neck
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10
Q

Basal cell carcinoma: treatment

A

biopsy for diagnosis…

-excision, curettage, MOHS surgery

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11
Q

What is the second most common skin cancer?

A

squamous cell carcinoma

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12
Q

What do squamous cell carcinoma typically arise from?

A

actinic keratosis

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13
Q

Which antibiotic is associated with side effect of blue discoloration of the gums?

A

minocycline

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14
Q

Squamous cell carcinoma: clinical findings

A

-solitary, slowly evolving keratotic or eroded erythematous, yellowish, or skin-colored papule or plaque found on sun exposed areas

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15
Q

Squamous cell carcinoma: risk factors

A
  • long-term sun exposure
  • Exposure to industrial carcinogens
  • HPV
  • immunosuppression
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16
Q

Any isolated keratotic or eroded papule or plaque present >1 month should be considered _____until proved otherwise by biopsy

A

squamous cell cancer

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17
Q

Most malignant skin cancer

A

melanoma

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18
Q

Most common cancer among women 25-29

A

maligant melanoma

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19
Q

Malignant melanoma: risk factors

A
  • age
  • fair skin
  • blue eyes
  • red or blonde hair
  • freckles
  • multiple nevi
  • atypical nevi
  • blistering sunburns before puberty
  • Tanning bed
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20
Q

Which malignant melanoma is most common?

A

superficial spreading

men: back
women: back and legs

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21
Q

Which malignant melanoma grows fast, vertically and is most aggressive?/

A

Nodular (Breslow’s depth)

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22
Q

The demodex mite is associated with which skin condition?

A

Rosacea

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23
Q

What are the ABCDE of malignant melanoma?

A 
Asymmetry
Border - irregular, jagged
Color-multi
Diameter - >6mm (pencil eraser)
Evolving - changing
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24
Q

What is the single most important prognostic factor for malignant melanoma?

A

Thickness of lesion

Increased breslow’s depth = decreased survival

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25
How often should you perform skin exams for melanoma to look for recurrence?
every 6 months for 2 years
26
Kaposi Sarcoma: general
vascular* neoplastic condition linked to Human Herpes Virus-8
27
Kaposi Sarcoma: clinical findings
red, brown, or purple macules, plaques and nodules on trunk, extremities, face
28
What lab is important to perform for Kaposi Sarcoma?
Test for HIV. Need to know because AIDS is associated with a more aggressive form
29
Kaposi Sarcoma: treatment (non-AIDs)
- cryotherapy - radiation - chemotherapy
30
Name the epidermal dermatophytosis (affect stratum corneum)
1. Tinea pedis 2. Tinea corporis 3. Tinea cruris -red, scaly, maceration, warm moist environment
31
Dermatophytosis of hair and hair follicles
Trichomycosis (ex. Tinea capitis)
32
Dermatophyte of the nail apparatus
onychomycosis -nail thickening, subungual debris
33
How is Tinea pedis, tinea, corporis, tinea cruris treated?
KOH (to see hyphae)
34
Tinea pedis, tinea corporis, tinea cruris: treatment
Clotrimazole, miconazole, terbinafine cream for 4-6 weeks
35
Tinea capitis: diagnosis
fungal culture
36
Tinea capitis: treatment
Griseofulvin (or terbinafine) for 8 weeks
37
Onychomycosis: diagnosis
Fungal culture, KOH of subungual debris
38
Onychomycosis: treatment
Oral terbenafine x12 weeks
39
Tinea Versicolor: infective agent
Malessezia furfur (superficial yeast infection)
40
Tinea versicolor: clinical findings
hypo or hyperpigmented coalescing scaly macules of varying color on trunk, upper extremities (tan, salmon)
41
Tinea versicolor: Diagnosis
KOH: spaghetti and meatballs** | Wood's lamp: blue-green fluorescence
42
Tinea versicolor: treatment
Shampoos: selenium sulfide, ketoconazole, zinc pyrithione Creams: ketoconazole, clotrimazole Oral: fluconazole, itrazonazole
43
Intertrigo
inflammation of skin folds
44
Candidiasis (Candida albicans): general and risk factors
-intertrigo (inflammation of skin folds) | Risk factors: moisture, warmth, breaks in skin barrier, antibiotics, glucocorticoids
45
Candidiasis: clinical findings
papules and pustules on erythematous base ->confluence and erosion ->beefy red patches with satellite lesions**; burning > pruritis
46
Candidiasis (candida albicans): diagnosis
KOH: pseudohyphae, spores, fungal culture (most sensitive)
47
Candidiasis: treatment
-Keep area dry and cool -loose clothing topical antifungal - miconazole, clotrimazole, nystatin -Topical steroid to help burning (low potency 1% hydrocortisone ointment)
48
What should be done for a lesion with suspicion for melanoma?
refer to dermatology for excisional biopsy
49
Condyloma acuminate: treatment
- surgery - electrocautery - laser - Imiquimod
50
Verruca vulgaris: appearance and distribution
hyperkeratotic, exophytic papules on fingers, hands, knees -punctate black dots are thrombosed capillaries
51
What reaction is associated with verruca vulgaris?
Koebner reaction - spreads with skin trauma
52
Verruca plana
flat warts
53
Verruca plana: appearance
skin colored or pink smooth slightly elevated flat-topped papules on dorsal hands, arms and face
54
Describe palmoplantar warts
thick, endophytic papules on palms or soles of feet - can cause callus - pain with walking
55
Palmoplantar warts: treatment
1. can go away on its own 2. Irritate or destroy: Acids, cryotherapy, retinoid crem, surgical removal, duct tape, laser 3. Imiquimod, candida antigen - immune stimulating
56
Herpes Zoster (Shingles)
reactivation of varicella-zoster virus latent in the nerve ganglia
57
Herpes Zoster: describe prodrome
stinging pain
58
Herpes Zoster: treatment
valacyclovir or famciclovir PO within 48-72 hours
59
What is Hutchinson's sign?
herpes zoster with ocular involvement | -nasociliary branch of trigeminal nerve
60
Molluscum contagiosum: description
small (2-6mm) smooth, firm, shiny, dome-shaped flesh-colored papules with central umbilication*
61
Molluscum contagiosum: causitive agent
DNA poxvirus
62
Molluscum contagiosum: treatment
- Cryotherapy - curettage - acids - cantharidin - Retinoids (topical)
63
Impetigo: cause
- staphylococcus aureus | - streptococcus pyogenes
64
Impetigo: clinical findings
small vesicles or pustules rupture ->erosions with yellow honey colored crusts**
65
Impetigo: treatment
mupirocin or retapamulin
66
Erysipelas: cause
Group A strep
67
Erysipelas: describe
upper dermis infection (more superficial than cellulitis) - well demarcated - gets worse fast!
68
Erysipelas: treatment
oral PCN or amoxicillin IV antibiotics if systemic
69
Cellulitis: describe
infection in deep dermis and subcutaneous fat
70
Cellulits: most common pathogens
strep pyogenes
71
Cellulitis: treatment
Alcohol ingestions: recognize s/sx and lab findings IV or cephalexin oral (beta-hemolytic strep and MRSA coverage)
72
Scabies: infective agent
Sarcoptes scabiei -Intense itching especially worse at night**
73
Scabies: treatment
Permethrin 5% topical lotion/cream others: lindane, oral ivermectin
74
Pediculosis (lice): treatment
permethrin 1% OTC or 5% overnight (if resistance) or 5% benzyl alcohol (Ulesfia)
75
Spider bite: most common presentation from non-poisonous spider bites
papular urticaria
76
Brown recluse spider bite: treatment
- Ice/elevation - Antibiotics (erythromycin, cephalosporins) - tetanus toxoid
77
Describe the difference in Brown recluse spider bite and black widow spider?
Brown recluse - necrotizing | Black widow - neurotoxic
78
Alopecia aerata
- focalized hair loss - Autoimmune attack on hair follicles - Exclamation point hairs**
79
Alopecia aerata: treatment
reassurance - spontaneous resolution in 6 months -regrowth is fine, thin, white color - Topical steroid (potent) - Topical minoxidil
80
Paronychia: description
Bacterial infection of the proximal or lateral nail bed -Throbbing pain, swelling, tenderness
81
Paronychia treatment
``` warm compresses (mild) cut it open + antibiotics (severe) ```
82
Vitiligo
- Autoimmune melanocyte destruction | - "chalky" white macules on hands, face, elbows, knees, skin folds, genitals
83
Vitiligo: treatment
sunscreen | repigmentation - topical glucocorticoids and tacrolimus, PUVA, grafting
84
Melasma
"mask of pregnancy" | melanocytes produce large amount of pigment when stimulated by UV light or increase in hormone levels
85
Acanthosis nigricans
hyperpigmented, symmetrical velvety plaques in the neck, skinfolds - obesity is a risk factor - associated with polycystic ovarian syndrome, diabetes
86
Acanthosis nigricans: treatment
- check fasting glucose | - lactic acid cream, urea cream, retinoids, salicylic acid
87
Pressure ulcers (Decubitus ulcers)
"punched out" ulcer -> necrosis with grayish pseudomembrane

Foundations of Clinical Practice II (25 decks)

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