Derm, part 2 Flashcards
Hx/PE of lipomas
Soft, mobile subcutaneous mass with well-defined border
Often multiple, growing/spreading
Lab and workup of lipomas
Bx
DDx of lipomas
Sebaceous cyst-raised subdermal nodule usually with central opening +/- erythema and induration
Dermatofibroma- dermal nodule often result of previous trauma
Abscess
Subcutaneous tumor
Health maintenance of lipomas
None
Tx/meds of lipomas
Watchful waiting
Excision
Hx/PE of lice/scabies
Family members with similar sx
Itching worse at night
Burrows between web spaces
Lab and workup of lice/scabies
Adhesive tape test
No KOH, disrupts mites
Comb through hair looking for eggs
DDx of lice/scabies
Viral exanthem
Eczema
Drug reaction
Health maintenance of lice/scabies
Avoid contact (pets)
Tx/meds for lice/scabies
Permethrin
-Can return to school/work in 24 hrs
Antihistamine for itching
Hx/PE findings of spider bites vs. MRSA
Usually tells the story, i.e., bite vs hx similar
Induration: hardened surrounding tissue
Fluctuance: soft surrounding tissue
+/- fever, LAD, fatigue, myalgia, N/V
Lab and workup of spider bites vs. MRSA
Culture and sensitivity
DDx of spider bite vs. MRSA
Pyogenic granuloma
Black widow vs brown recluse
Abscess (non MRSA)
Health maintenance of spider bite vs MRSA
Hibaclens for MRSA
Hygiene
Tx/meds of spider bite vs MRSA
Antihistamine Antivenin Pain management I and D- therapeutic -Mark margins for monitoring tx Abx Sulfa or doxycycline Steroids
Hx/PE of skin cancer
SCC- scaley erythematous plaque
BCC- pearly flesh colored papule, telangiectasia
Sun exposure, chemical exposure, chemo/transplant
Lab and workup of skin cancer
Bx
DDx of skin cancer
Actinic keratosis
Keratocanthoma
Health maintenance of skin cancer
Protective clothing, sunscreen
Prevention
Tx/meds for skin cancer
Liquid nitro- superficial
Excision and bx
MOHS
F/u for skin cancer
Every 6-12 mos full skin exam
Hx/PE of paronychia
Nail biting, acrylics, trauma
Pain, erythema, pus drainage around nailbed
Lab and diagnostic workup for paronychia
Gram stain
Culture/sensitivity
KOH
Tzanck smear
DDx of paronychia
Herpetic whitlow
Felon
Health maintenance for paronychia
Hygiene
Tx/meds for paronychia
Warm soak
Abx-moderate to severe
Augmentin, cephalexin, clindamycin
I and D
Hx/PE of onychomycosis
Manicure/pedicure, trauma, infections
Thickening, discoloration, cracking
Lab and workup for onychomycosis
KOH
Nail bx
DDx of onychomycosis
Psoriasis
Onycholysis (trauma)
Health maintenance of onychomycosis
Hygiene (bare feet)
Avoid pedicure/manicure
Tx/meds for onychomycosis
Topical antifungal
Systemic antifungal
Nail removal
Hx/PE of tinea
Family with similar, pet, travel Sweating/moisture Erythematous annular lesion with raised borders Caitus, corporis, pedis, crus -Versicolor-hypopigmentation
Lab and workup of tinea
KOH
Bx
DDx of tinea
Atopic dermatitis
Candidiasis
Granuloma annulare
Health maintenance for tinea
Hygiene
Avoid contact
Loose fitting clothing
Tx/meds for tinea
Topical antifungal- clotrimazole, ketoconazole
Systemic antifungal- if widespread or resistant
