Derm Images (ONLY IMAGES) Flashcards
- Traumatized skin-usually butcher handling raw fish, shellfish, poultry, pork and beef
- Usually on fingers, webs, can spread proximally w/in 1 week of injury,
- distinctive elevated, violaceous indurated maculopapule lesion
- Burning and itching, not as bad as cellulitis
Erysipeloid Erysipelothrix gram positive rod
What is this?
Hemangioma of infancy
What type of vascular malformation is this?
port wine stain/ nevus flammeus
White to yellow, single or multiple, small epidermoid cysts that occur throughout life, mostly on the face
milia
What type of psoriasis is this? What are some treatment options? And what diet would you suggest?
Inverse psoriasis
Vitamin A, omega-3s, digestive aids
Anti-inflammatory and gluten-free
This skin condition affects individuals in the 7th decade of life and has very slow radial growht primarily on the nose and cheeks
lentigo maligna melanoma
What skin condition is pictured here? It is characterized by a papule/nodule that can be pigmented/necrotic and telangectasia?
ulceratvie basal cell carcinoma
What is this dermatological presentation called?
erythema infectiosum
(from parvo b19, 5th disease, “slapped cheek disease”)
What stage of eczema/dermatitis is characterized by redness, scaling, fissuring, parched appearance, scaled appearance, slight to moderate itch, pain, stinging and burning?
subacute
- Males>Females
- Usually associated with hyperhidrosis and occlusive footwear
what causes it? Dx? Tx?
Pitted keratolysis
Caused by Micrococcus sedentarius
dx: Negtive KOH, woods lamp
Tx- Wear cotton socks (change frequently), consider agents to reduce moisture, topically antibiotic may be necessary
single dry, thick scaly lesion with a chronic itch-scratch cycle
Lichen Simplex Chronicus
ABCDE “red flags” of melanoma
Asymmetry
Borders (irregular)
Color (variation)
Diameter (>6 mm)
Elevation/enlargement/evolving
What is this “spaghetti and meatball” presentation?
Tinea versicolor
What are the five Ps of this condition?
lichen planus
5 Ps:
Pruritic (itchy)
Planar (flat-topped)
Polygonal (the shape)
Purple
Papules
2-10 mm in diameter
Infection of the dermis and subcutaneous tissue
Cellulitis/Erysipelas
An itchy, dyhidrotic-like vesicular eruption on the fingers, forearms, thighs, legs, trunk
Id reaction
What is acute, chronic, recurrent dermatitis of the hands and soles that affects F>M?
Pompholyx/dyshidrotic eczema
“Pompholyx” = bubble
What is this sharply demarcated rough surface, round or irregular, firm, light gray, yellow, brown or grayish black that is mildly contagious?
common wart or verruca vulgaris
What are these pearly spots in the mouth associated with rubeola?
Koplick’s spots
These are areas of alopecia with scale but no inflammation.
Trichophyton tonsuring, Black dot ringworm
Stress stimulates this condition, what is it? Also, what common treatment is a possibility?
herpes simplex
Drugs: acyclovir (antiviral)
Aloe Vera, rhubarb, sage, honey, lysine
What is this?
psoriasis
What is this DDX for tinea cruris that does cross the genital border?
Candidiasis
Mgmt/treatment for this condition that has an onset after sun exposure?
Condition: polymorphous light eruption
Prevention: sun block (though not always helpful)
CAM: beta-carotene, niacinamide, vit b6
Prednisone, trimcinolone
photochemotherapy (PUVA)
- Pinpoint papules, Numerous papules giving a sandpaper-like texture to the skin
- Pastia’s sign, Desquamation of the tips and toes
- Strawberry tongue day 4-7 in untreated cases
what is the tx?
scarlet fever
tx- antibiotics
What is characterized by flaky skin and has risk factors that include moisture, warmth, contact with infected person, animal, soil, fomite and tight clothing?
What will a gram stain detect?
Dermatophytes infections (tinea pedis, cruris, corporis, facialis, barbae, capitis)
gram stain will detect Candida
What kind of secondary lesion is this?
scar
What age group and sex is most affected by this condition?
Condition: erythema multiforme syndrome
Greater than fifty percent are under 20 yo and M>F
What is this DDX for tinea cruris that is dIffuse, brown, scaly and turns coral red with Wood’s lamp?
Erythrasma
- what is the tx for cellulitis?
- if no fever, small area, and otherwise healthy adult elevation, heat, oral antibiotics; follow up in 24-48 hours, treat for 10 days
What is this skin condition that scales off if you scrape at it “fingernail scratch sign.” Is it communicable?
Tinea versicolor
No, its not communicable.
Early eruptive stage associated with measles is called what?
Morbilliform rash
Characterized by sudden onset of multiple scaling red papules that self-resolves in 3-4 months and does NOT benefit from antibiotics. What is this?
guttate psoriasis
What is this relatively common acute and often recurrent inflammatory condition that contains circles within circles?
Erythema multiforme syndrome
Soft skin colored to slightly pigmented, pedunculated papule
Skin tag
What is this condition? And what kind of treatment would you do for moderate-severe cases?
Condition: erythema multiforme syndrome
Prednisone.
soft cystic mass filled with clear gelatinous mucin produced by fibroblasts
* often communicates with tendon or joint capsule
ganglion cyst
What is this nail bed lesion called and what does it suggest?
Oil spot lesion; psoriasis show up in 1/3 of patients
What kind of secondary lesion is this?
erosion
If you press on this laterally it will increase or cause pain, what is it?
Plantar wart
because they are growing inward toward the body
Characterized by the presentation of vesicles, papules, erythematous macules, urticaria plaques. Pink to red in color. Onset after sun exposure.
Polymorphous light eruption
Salmon-pink papules and plaques, sharply marginated with silvery-white scales. Removal of scales-reveals punctate bleeding called ________
Auspitz’s sign (suggestive of psoriasis)
What are A and B?
A. Venous lake will blanch with pressure
B. Melanoma will not blanch
dermatitis at site of contact (watchband, earrings) that appears 24-48 hours after contact
allergic contact dermatitis
slow growing yellow-brown macule, papule, plaque or nodule of lipid deposts in the skin and tendons
xanthoma
What skin condition is characterized by irregular, asymmetric raised nodules that are often multicolored?
melanoma
(Acral lentiginous melanoma pictured here)
Photo is early and later stage. Macule, papules, painful, itchy vesicles, crusts within 8-12 hours (multiple crops). Crusts 1-3 wks, can leave scar
Highly contagious
chicken poxi
non invasive, benign tumor originating in the epidermis and affecting individuals after age 30
seborrheic keratosis
What is this?
lichen planus
What is characterized by yellowish oily patches near nose and scalp?
Seborrheic dermatitis
More images: Left is cradle cap and Right is periorbital S.D.
What type of HPV is this? (Most common)
6, 11
What skin condition is pictured here? It is characterized by threadlike borders and central crust, often with superficial plaques?
superficial basal cell carcinoma
diffuse, yellowish oily patches near nose or scalp that are less itchy
seborrheic dermatitis (AKA dandruff)
What is this fungal infection of the body that is characterized by scaling, redness, itchiness with a lesion that gradually expands in a red ring with raised margin?
(why isn’t it nummular eczema)
Tinea corporis
DDX: nummular eczema is a group of coin-shaped lesions while tinea corporis/ring worm is one expanding ring that will start to heal at the original starting point.
well demarcated dermal nodule filled with keratin and lipid debris (can smell) that may have thin walled central punctum
Sebaceous (Epidermoid) cyst
AKA sebaceous, infundibular or epidermal inclusion cyst
Delayed abnormal reaction to UV light.
Polymorphous light eruption
What is this epidemic disease that happens more in the summer months? Incubation 3-6 days, prodrome 12-24 hours with low fever, malaise, abdominal pain or respiratory symptoms
Hand-foot-and-mouth disease
granulomatous enlargement of lid with edema and initial irritation that then become painless as it grows
meibomian cyst
AKA chalazion, tarsal cyst
acute, recurring, pruritic, weeping vesicles on hands and feet
pompholyx/ dyshidrosis eczema
What are some tx for tinea versicolor?
Anti inflammatory diet.
bar soap or something that is hydrating
selenium sulfide OTC will eradicate the yeast
- Infection of the dermis and subcutaneous tissue
- Most often legs or face.
- Typically follows a crack, abrasion, bite or other wound to skin.
- Warm, tender, swollen, red area Possible fever, enlarged nodes, red streak
What causes it?
Cellulitis/ Erysipelas
Group A streptococcus and S. aureus - adults
Haemophilus influenzae B - kids
smooth firm dome-shaped nodule, filled with keratin and often calcified cholesterol
trichilemmal cyst
AKA pilar cyst, wen, isthmus-catagen cyst
What kind of primary lesion is this?
macule
* flat
- An acute, deep-seated, red, hot tender nodule or abscess
- Axilla, groin, buttocks & neck common locations.
- Avoid local massage. Bench likely infectious.
What causes it? Tx?
Boils Furuncles
from Staph infection of follicle or oil gland
tx: warm, moist compress, referral for incision/drainage. Lifestyle modification, nasal mupirocin, vit c
Associated with chronic venous insufficiency from venous return failure and increased capillary pressure.
Mgmt/tx = improve venous return
What is this?
rhynophoma as seen in rosacea
Note: Chronic rosacea of the nose has caused irreversible hypertrophy. More common in men.
What hyperproliferative skin condition is this that occurs in genetically predisposed individuals usually by age 40?
psoriasis
- Superficial bacterial infection of the hair follicles
- Caused by friction, blockage of follicle, shaving.
- Papule or pustule confined to hair follicle, often surrounded by erythematous halo
- No scarring
What causes it?
folliculitis
Most common S. aureus
What is this condition that is characterized by erythema, single or grouped uniform vesicles, often umbilicated that evolve to pustules then erode and ulcerate and then crust over?
What are ways to test for this?
Herpes Simplex
Test: visual, viral or under microscope you’ll see giant cells
Infection extends into dermis Heals with scar
what causes it?
Ecthyma (Ulcerative Impetigo)
Group A beta-hemolytic streptococci
What kind of primary lesion is this if the collections of free fluid are more than 0.5 cm in diameter?
bulla
painful papule/macule that ulcerates in the oropharyngeal region however can also occur anywhere in GI
aphthous ulcer
AKA canker sore
Sudden, fixed, symmetrical or generalized skin eruption occurring after starting a new drug or OTC
Drug dermatitis (Drug-related eczema)
What skin condition is this?
dermal nevus
What kind of secondary lesion is this?
ulcer
Koebner’s phenomenon is associated with lichen planus. If someone shows up with Wickman’s striae on their wrist, where else will you look?
Mouth.
Also common to see on forearm, ankles, anterior legs, lumbar regions, genitals.
What is the 1-10 cm lesion that pre-dates the remainder of the lesions by hours to 14 days?
Condition: pityriasis rosa
First lesion called: Herald Patch
What is this with “spotty” satellite irritations?
Candidiasis
What skin condition is this?
compound nevus
What is this and what is the concern?
a pigmented band that is normal in 90% of black individuals but if suddenly appears, could suggest acral lentiginous melanoma
- Sexually transmitted
- Treponema pallidum (spirochete)
- Primary-painless chancre (contagious)
- Secondary (contagious) disseminated maculopapular lesions, condylomata lata
- Latent cutaneous, vascular, neurologic
syphilis
tx: antibiotics
central arteriole with radiating telagectasia
spider angioma
AKA: spide nevus, spider telangectasia, vascular spider
What stage of eczema/dermatitis is characterized by well demarcated plaques of erythema and edema with vesicles, blisters and intense itch?
acute
What is the name of the yeast that causes tinea versicolor?
malassezia furfur - hyphal form
note: tinea versicolor can be hyper- or hypo-pigmented
This skin condition has telangectasia, is soft, small and shows central umbilication. What is it and what is the DDX?
sebaceous hyperplasia
DDX = basal cell carcinoma which would be firmer on palpation
What is this condition characterized by acute inflammatory/immunologic subcutaneous fat leading to red swollen nodules on the extensor aspect of the extremities?
Erythema nodosum
Dark blue to violet soft papule with dilated venule
venous lake
What is this?
telangectasia
What is this?
tinea barbae
fungal infection of the beard hair
What are these fungal infections?
B’s fungal infection is causing a tender, swollen abscess that can ulcerate and leave a scare that is called what?
A. Non-inflammatory tinea capitis
B. Inflammatory tinea capitis with kerion
- Develops a few hours to 2 days after using tub.
- Often more prominent under swimsuit.
What causes it? What is tx?
Hot tub folliculitis
Caused by Pseudomonas bacteria in contaminated tub.
Tx: Usually clears in 7-10 days without treatment, if not, do culture/sensitivity and tx with 5% acetic acid (white vinegar) compresses bid to qid
1-3 mm macules of local proliferation of melanocytes due to chronic sun exposure
solar lentigo
AKA liver spots, senile freckles
What are some reasons people end up with this skin condition?
Condition: tinea versicolor
Causes: soaps, humidity, heat, deceased immunity, sun
What is this asymptomatic and self-limiting skin thing? (Can you see the Harold Patch?)
pityriasis rosea
(forearm of pediatric patient, larger mark on the other patient)
What is this with an initial pustule and a red center?
Candidiasis in the interdigital area
What is this characterized as scaling, redness, itchiness, burning and often presents as a unilateral half-moon shaped plaque that does not extend onto the scrotum
Tinea cruris
Note: candidiasis DOES cross the genital border
This skin condition affects ages 30-50 and is characterized by radial growth with nodular formation when 2.5 cm or more
superficial spreading melanoma
What skin condition is pictured here? It is characterized by a papule/nodule, telangectasia and often described as pearly?
nodular basal cell carcioma
What are some treatments you might suggest for this condition?
Condition: lichen planus
Treatment: natural sunlight, vitamin A
pruritic papulovesicular or scaly coin-shaped lesions
nummular eczema
What is this characterized by larger several cm in diameter?
Plaque psoriasis
guttate psoriasis is characterized by being smaller
What is Hutchinson’s sign?
periungual spread from nail as seen in acral lentiginous melanoma
The fingernail scratch test shows up positive. Is this vitiligo or tinea versicolor?
Tinea versicolor
Vitiligo is very sharply demarcated and the fingernail scratch test would be negative.
What asymptomatic skin condition is often characterized by accentuated “pebbling”?
atypical/Clark’s malnocytic/dysplastic nevus
rapidly developing hemangioma with recurrent bleeding, often at site of trauma
pyogenic granuloma
What is this chronic toe web and dorsal foot fungal infection that can become secondarily infected with ____________? And what web of the foot is most common?
Tinea pedis
2˚ Infection: staphylococci
4th web is most commonly involved web space
What are treatment options for this highly contagious virus
chicken pox
tx: vaccine 80% effective. Calamine lotion, oatmeal bath. Acyclovir within 24 hours
What presentation is this that is epidemic every 3 years especially in the warmer months
hand - foot - and - mouth disease
What kind of secondary lesion is this?
striae
What is this that is erythematous and possibly oozing and often covering the genitals (as in this photo)
candidiasis
recall that tinea cruris does not cross the genitals
What kind of secondary lesion is this?
crust
What is this highly contagious condition?
3 Cs: Cough, coryza, conjunctivitis and koplik’s spot on the mouth
Rubeola (measles)
What is this?
Plaque psoriasis
What is characterized by sudden deep-seated pruritic, clear “tapioca-like” vesicles on palms and sides of fingers that later lead to scaling fissures and lichenification?
Pompholyx/dyshidrotic eczema
Define: lichenified skin means skin that has become thickened and leathery. This often results from continuously rubbing or scratching the skin.
Photo: 2-4 weeks complications may occur with 2˚ infections
Chronic, suppuration, often fibrous tissue disease of the apocrine gland on the skin of axilla and anogenital region that can result in tender lesions, scarring and contractures
hidradenitis suppurativa
This skin condition affects individuals in the 6th decade of life, usually on the head, neck or trunk and has no radial growth
nodular melanoma
Prodrome 3-5 days intense dermatomal pain with paresthesia
Eruptive stage 7-10 days with a linear patch of group vesicles on an erythematous base
What are Dx and Tx?
Shingles
zoster virus
Dx: tzanck smear
Tx: bed rest, NSAIDs, sleep aids, acyclovir
Condylomata acuminata. Sexual contact (60% transmission rate), skin-to-skin contact, autoinoculation; vertical and fomite transmission have been reported as causative agents.
Genital warts
What is this characterized by bright red macular rash on cheese 1-4 days, followed by lacy, reticulated rash on arms.
erythema infectiosum
“Slapped cheek disease” - 5th disease - parvo b19
- Consist of clustered, interconnected boils (furuncles)
- Multiple sinuses
- Same precautions as furuncles
carbuncles
What is this fungal infection?
How do you treat a fungal infection?
Tinea capitis, scalp/head ringworm
Treatment: OTC anti-fungal (if it was bacterial, you’d give it an antibiotic)
type of eczema that can be acute or chronic and is often vesicular and oozing with positive history of contact
contact dermatitis
What skin condition primarily affects Asians and dark skinned people on the palms, soles and subungual regions?
Acral lentiginous melanoma
What kind of inflammatory condition might you see in the folds of skin?
Candidiasis
What skin condition has a posible viral etiology, is characterized by a dome shoped papule or nodule with central keratin plug and shows rapid growth?
keratocanthoma
What is the treatment for pyogenic granuloma?
- excision/biopsy (to rule out melanoma if suspicious - see image)
- electrodesiccation of base to prevent recurrence
- results from host response to infection
- begins as single red macule or papule
- vesicle develops erosion follows vesicle rupture
- characteristic honey-colored crust forms from exudate
What is tx?
non- bullous impetigo
Tx: self resolves, Mupirocin (pseudomonic acid)
A physical trauma triggered _________ phenomenon. The injury and bandage being removed triggered their underlying chronic disease which is what?
Koebner’s phenomenon; psoriasis
What condition is characterized by common, chronic, coin-shaped plaques?
Nummular eczema (or numular dermatitis)
“Nummular” = coin-shaped
What kind of primary lesion is this?
pustule
* collection of leukocytes and free fluid
What is this condition and what kind of dietary recommendations might you make?
What are these fungal infections?
dermatophytes infections: tinea manus and pedis
Why is this NOT hand, food and mouth disease?
This is usually more flatter. This is erythema multiforme syndrome and usually has circles within circles.
Fever, pharyngitis followed by nausea, vomiting, headache, and abdominal pain
Ages 1-10 Incubation 2-4 days
What causes it?
Scarlet fever
Uncommon Streptococcal erythrogenic toxin
What kind of primary lesion is this?
plaque
* elevated and more than 0.5 cm in diameter
* often formed by confluence of papules
What is this?
tinea facialis
soft, subcutaneous nodule of fat that occurs mostly on neck, trunk, arms and buttock
lipoma
What is the condition that is characterized by an initial onset of closely grouped, small vesicles and papules that coalesce into plaques where the itching is moderate to severe?
Nummular eczema
What is this viral skin issue that can also show up genitally?
Herpes simplex virus
What is this that can show up orally or on the genitals?
Herpes simplex
What kind of primary lesion is this?
papule
* elevated and must be 0.5 cm in diameter or less
bright red, dome-shaped to polypoid papule with dilated, congested capillaries
cherry angioma
- most commonly effects neonates
- superficial vesicles rapidly enlarge and become flaccid, sharply defined bullae
- bullae NOT surrounded by erythema
- ruptured bullae result in yellow crusts and oozing
what causes this?
Bullous impetigo: staph aureus
What is this fungal infectino?
Tinea manus
What kind of primary lesion is this if the collections of free fluid are less than 0.5 cm in diameter?
vesicle
What is the treatment for this condition that affects females more than males and is characterized by thick plaques (usually 1 lesion) with severe pruritus and lasts indefinitely and recurs frequently?
What is this virus, characterized by fleshcolored bumps with a hole in the middle?
Molluscum contagiosum
What is this fungal infection?
Tinea capitis: scalp/head ringworm
Note: on the final exam pay attention to if she is asking for Kerion or Tinea Capitis as an answer. A kerion is an abscess caused by the fungal infection.
soft nodule with mucous filled cavity that arises from ruptured salivary gland. sometimes has a bluish hue and tastes slaty when it pops
mucocele
what is this?
Plaque psoriasis
inflammation of the dermis and epidermis with unknown cause
atopic dermatitis
Tender nodule on the pinnae that is usually unilateral and occurs over 50 years of age
chondrodermatitis nodularis chronica helicis
*early stages present with a central crust at apex of nodule
*long standing presents with dense rolled edges
What stage of eczema/dermatitis is characterized by thickened skin, skin lines accentuated (lichenified), excoriations, fissuring and moderate to intense itch
chronic
What is this cream-colored part that adheres to mucosa and bleeds when you scrape it off?
Candidiasis in the mouth - thrush.
different from lichen planus (photo) which cannot be scraped off and has Wickham’s striae.
What kind of treatment would you do for this wart?
antiviral
What is this highly contagious disease with an incubation period of 9-21 days
varicella - chicken pox
What is this non-inflammatory fungal infection?
Caused by a normal fungus found on the skin converting into a parasitic form
Caused by Malassezia furfur - hyphal form
(Pityriasis) tinea versicolor
What is this?
candidiasis
Nonhealing shallow painful ulcer in LE above ankle or at malleolus. Sharply demarcated ulcer surrounded by atrophied Blanche. Pale plaques of scar tissue surrounded by stasis dermatitis
Venous leg ulcers
What skin condition is this?
junctional nevus
What is this condition?
What sex/age range is affected?
What is the prodrome:
How would you treat this?
Erythema nodosum
F > M and 18-34 yo
Prodrome: fever, malaise, arthralgias, arthritis
Tx: NSAID’s or herbs, elevate legs, compression
Characterized by progressive complication of CVI (chronic venous insufficiency). Non-healing shallow painful ulcer in the lower extremities above the ankle or at the malleolus.
Venous leg ulcers
What kind of secondary lesion is this?
fissure
This lesion is associated with condylomata acuminata, what is the dermatological presentation?
Genital warts
(condylomata lata is associated with syphilis)
What kind of primary lesion is this?
nodule
* elevated and more than 0.5 cm in diameter
* large nodule = tumor
What is this?
Tinea axilla
What’s another name for 6th disease and what are symptoms
roseola infantum, human herpes virus 6 (HHV6)
symptoms: high fever 3-5 days, post auricular and cervical lymph nodes
sensitization and dermatitis 7-10 days after exposure fo toxicodendron haptens
allergic contact dermatitis due to plants (APD)
* poison oak/ivy
What time of year does this condition that is typically characterized by a plaque decrease in symptoms?
with natural sunlight - so during the summer months
What is this condition? And what is it called when you apply a basic oil you notice surface scales that are lacy fine white lines called ________
lichen planus
wickham’s striae
What kind of secondary lesion is this?
scales
* produced by abnormal keratinization and shedding
What kind of secondary lesion is this?
atrophy
What is the differential diagnosis for solar lentigo?
melanoma (B)
* monitor if there are multiple shades and border changes and refer or biopsy
(A) is solar lentigo
What kind of primary lesion is this?
Wheal (hives)
What kind of diet would you suggest for plaque psoriasis?
Anti-inflammatatory diet
Characterized by macule, papules, painful, itchy vesicles, crusts within 8-12 hours (multiple crops). Can leave scar
chicken pox
What condition is this characterized by dull red, iris or targetlike lesions, macules to papules, localized or generalized, often symmetric.
Erythema multiforme syndrome
What technique is done for is not specific for testing for genital warts, also seen with candida, psoriasis, lichen planus, or eczema? (Photo: cervix)
Acetowhitening technique
solitary, translucent, viscous fluid filled cyst over DIP or nail base that occurs in middle aged and elderly
digital mucous cyst
AKA myxoid cyst, synovial cyst, myxoid pseudocyst
What is this unilateral hand infection?
tinea manus
Infection of hair follicle
_______ vs ______
Folliculitis
superficial hair follicle vs. Deep aka sycosis barbae
What is this characterized by scaling, redness, itchiness, burning?
Tinea pedis
This is benefited by vitamin D3 and sunlight. What is it?
psoriasis
Sudden onset
tapioca-like vesicles
unknown etiology
A) _______ is a precursor to B) __________
A) Nevi - Atypical/Dysplastic/Clark
B) Melanoma - Superficial Spreading
Dermal nodule with positive “dimple sign”.
dermatofibroma
What phenomenon is associated with trauma that shows up in the mouth? And what is this condition called?
Koebner’s phenomenon
Condition: Lichen planus
What is this?
Tinea barbae, fungal infection of the beard hair
Condition that occurs from venous return failure and increased presssure of capillaries where multiple progressive dermatological changes occur
Stasis Dermatitis
What is this?
psoriasis
Common papulosquamous disease of the skin, hair, nails and mucous membrane
lichen planus
Exanthem of rose pink macules with cephalocaudad spread that fades in 3 days. Major complications to fetus in utero
Rubella, german measles
Facial dermatosis characterized by papulopustules on erythematous base
perioral dermatitis
What is this epidemic disease that happens more in the summer months and is very painful with refusal to eat?
hand-foot-and-mouth disease
What are the risk factors for cellulitis?
- trauma, peripheral edema, tinea pedis
- lymphedema and skin breakdown
- intertrigo may result in secondary bacterial or fungal infections
Characterized by cracked porcelain pattern. Erythema, inflammation and scaling with pruritus.
Asteatotic dermatitis
acute, dry, scaly, itchy skin at joints
typically has allergic or family history
atopic dermatitis
What is this harmless fleshcolored bump with a hole in the middle?
Treatment?
Molluscum contagiosum
Tx: calcarea carbonica (homeopathic), beetle juice
- Diffuse brown, scaly plaque resembles tinea cruris
- 3rd an 4th toe web m.c., also genital- crural region
What causes it, dx, tx?
Erythrasma
cause: Bacterial infection (Corynebacterium minutissimum). Gram-positive rod
Dx: Bacteria produces porphyrin, fluoresces bright orange-pink (coral red with woods light)
Tx- erythromycin, clarithromycin
What type of vascular malformation is this?
stork bite/ salmon patch lesion
What skin condition (pictured here) is often described as the “sore that won’t heal” and is more common in males than females?
actinic keratosis (AK)
What is this and what is it suggestive of?
splinter hemorrhages could suggest acral lentiginous melanoma
What is this dermatological presentation that is contagious and is a reactivation of a latent virus?
shingles
herpes zoster virus
What skin condition pictured here is often tender, ulcerates and bleeds?
squamous cell carcinoma
- Usually spread by skin to skin contact, but mite can live longer than 2 days on clothing, bedding, sleeping bags, etc.
What is it? What causes it?
Scabies
Mite-Sarcoptes scabiei
Severe, persistent pruritus, worse after bathing, worse at night in bed
What is it? Where can it be located?
Scabies
Common sites: lower abdomen, back, pubic area, penis, scrotum, anterior axillary fold, finger webs and sides, flexor of wrist, points of elbows and knee, legs, and areola in women (rarely above neck)
What is this issue caused by mites? When do symptoms begin?
Scabies
Symptoms begin 2-6 week after 1st exposure • 1-4 days if previous exposure dt antibodies
What is this? What causes the itching
Scabies
Itching is due to autoimmunization from scabies feces and body parts
- might have 100s of itching papules, but fewer than 12 mites at any time
Female mite inhabit burrow in stratum corneum, lays her eggs and dies
What is this? How is it tx?
Scabies
Tx: hot bath then 5% permethrin, wash all clothes and linen with hot water
*itching may continue after treatment
What is this? What technique was used to make the issue visible?
Scabies
Ink drop test: Felt-tipped ink pen has penetrated and highlighted a burrow. The ink is retained after the surface is wiped clean with an alcohol swab
WHat are these?
Crab louse and body louse
What is this?
Louse egg (nit) is cemented to a hair shaft
These are secondary infections from what?
Pediculosis- Lice, Crab, Cooties
This is an eyelash infestation of what?
Pediculosis- Lice, Crab, Cooties
What is it called when you have lice in the hair? How is this tx?
Pediculosis capitis
- Pomades (petrolatum, mayonnaise and pomades) for 10 minutes to kill lice, but not eggs (nit),
- Nit combing daily, neem (Koodies shampoo), 1% permethrin (Nix), pyrethrins (Rid), lindane, malathion
- Fomite control-clean and vacuumed
- tea tree and lavender
What is it called when you get lice in the groin area?
Pediculosis Pubis
- a spirochetal infection, Borrelia burgdorferi (identified in 1982)
- The spirochete can burrow into tendons, muscles, ligaments, and directly into organs
WHat is this? What causes it?
Lyme disease
deer tick
WHat does this deer tick cause? What are the three stages is the disease?
Lyme disease
Disease onset is 3-28 days after tick bite
stage 1 –flu-like symptoms (fever, headache, arthralgias), local spread in skin
stage 2 - skin, heart, joints, lymphatics, eyes, liver, respiratory system, kidney, CNS, follows stage 1 by days to months
stage 3 - joints, skin, CNS, eye, persistent infection, follows stage 2 by months to years
What is this mark called and what disease can it signify?
How do you test for it?
macular dermatitis, also called erythema chronicum migrans “Bull’s eye”
Lyme disease
- (ELISA)-CDC recommended
- indirect fluorescent antibody (IFA)
- Western blot - confirmatory, or if indeterminate ELISA/IFA
- polymerase chain reaction (PCR) for DNA detection skin,
blood, cerebrospinal fluid, synovial fluid (not routinely
recommended ) - Warthin-Starry
What is the treatment for this disease?
Lyme disease
- empiric antibiotics without serological testing is recommended for patient with rash resembling erythema migrans and high probability of having Lyme disease
- doxycycline 100 mg PO twice daily for 10-21 days or amoxicillin 500 mg PO 3 times daily for 14-21 days
- Anti inflammatory/elimination diet, probiotic, samento (ts w) nms
What is this spider with yellow chevron markings on the abdomen? What are the sx from it’s bite? How is it tx?
Tegenaria (hobo spiders)
Symptoms: 24 hrs warmth & edema at bite develops into blister then 1-2 days ruptures
to ulceration that becomes necrotic and may take weeks to months to recover RE- scars
Tx: pain reliever, cold compress, remove venom if bite is observed, steroids & antibiotics
What type of insects cause this?
What is the response? What are allergic systemic symptoms?
Hymenoptera (bees, wasps, hornets, ants and other stinging insects)
The females sting venom and lay their eggs
Response: histamine wheal & pruritus, Rare risk fatal anaphylactic shock
Allergic: development of petechial hemorrhages, malaise, weakness, nausea, vomiting, abdominal cramps, dyspnea, vascular collapse, and death.
