Derm, lect 5 Flashcards
clinical presentation
- frequently seen in sun-exposed areas
- may see permanent hair loss and common to see loss of pigmentation
- lesions are purple-red plaques with scales. pulling off scale reveals small, spiny projections
- common areas: scalp; face; external ears
discoid lupus
if you diagnose a patient with discoid lupus, what is something you should always consider? What tests can you run to rule it out?
systemic lupus erythematous (SLE
- ANA: anti-nuclear antibody
- anti-double stranded DNA
- Anti-smith antibody
treatment for discoid lupus
- protect area from sunlight
- can use high potency steroids but not on face
what diseases/conditions is porphyria cutanea tarda associated with?
- liver disease
- hepatitis
- ingestion of estrogens
clinical presentation
- painless sub-epidermal blistering of skin on dorsum of hands
porphyria cutanea tarda
clinical presentation
- itching and burning in hairy areas
- pustules with hair growing out of them
folliculitis
common bacteria that cause folliculitis
- most common cause is staph aureus
- hot-tub folliculitis is caused by pseudomonas
what organism causes erythema migrans
borrelia burgdorferi
clinical presentation:
- rash usually occurs 3-32 days after tick bite
- rash: slightly raised, warm red with central clearing. resembles target lesion
erythema migrans
- characteristic rash seen in the early stages of lyme disease
treatment of erythema migrans
systemic abx
- usually amoxicillin or doxycycline
- this rash is caused by circulating immune complexes
- involves mucosal surfaces
- may be associated with viral, bacteria, or fungal infections (HSV is most common cause), or medicinal drugs
- target lesions
erythema multiforme
treatment for erythema multiforme
topical or systemic steroids
clinical presentation:
- morbilliform rash
- caused by Abx and sulfonamides
drug eruption
what organism causes erysipelas
B-hemolytic streptococci
clinical presentation
- pain
- malaise
- chills
- moderate fever
- edema
- spreading, well-circumscribed papule/plaque
- warm to touch and red
Erysipelas
treatment for erysipelas
- IV Abx against Group A B-hemolytic strep and staph
clinical presentation
- diffuse, spreading infection with staph or group A strep
- usually involves deeper dermis and subcutanous fat
- swelling, streaking erythema associated with pain
- lesions expand
- associated with fever, chills and malaise
cellulitis
clinical presentation
- lesions begin as papules that progess to vesicles surrounded by erythema
- yellow crust covers ruptured vesicle
- autoinnoculation results in satelitte lesions
- common areas: face, neck and extremities
- may have regional adenopathy
impetigo
what organism causes impetigo
culture and gram stain reveal gram positiv staph aureus 95% of the time
treatment of impetigo
- mild cases: topical abx like bactroban
- mod to severe cases: oral abx like Dicloxacillin
clinical presentation
- prodrome: high fever and flu like symptoms for 1-3 days before skin lesions appear
- bullae and sloughing of epidermal layers
- involves > 30% of skin
- usually caused by medications
toxic epidermal necrolysis
clinical presentation
- intensly pruritic vesicular disease
- vesicles easily rupture due to scratching
- approximately 75% of patients are gluten sensitive
dermatitis herpetiformis
what test can be done to confirm if a rash is caused by dermatitis herpetiformis
direct immunoflurescene shows deposits of IgA in dermal papillae
treatment of dermatitis herpetiformis
clears rapidly after treatment with Dapsone
