Derm Pics- Common Dermatoses I and II, Skin Cancers

Question 1

Describe

Answer 1

= multiple scattered macuoles on the chest, red and pink in color

Question 2

Diagnose:

Answer 2

Vitiligo

-depigmented patch

Question 3

Describe:

Answer 3

• multiple monomorphic flesh colored papules (elevated < 1 cm)
• umbilicated

Question 4

Diagnose and describe:

Answer 4

Psoriasis

• large salmon colored plques w/ well defined border in a geographic distribution on the lower back and buttocks
• lots of silvery scale (secondary lesion)

Question 5

Describe

Answer 5

Monomorphic pustules

Question 6

Describe:

Answer 6

Erosion with a bit of crust (stuff dried on top)

• erosion loss of some or all of the epidermis
• often from vesicles or bullae

Question 7

Describe:

Answer 7

Fissures on the edges/sides of the mouth

• different from erosions and ulcers
• fissures = linear or wedge shape tears in the epidermis

Question 8

Differentiate the clinical picture of atrophy of the

(a) epidermis
(b) dermis

Answer 8

Atropy of the (a) epidermis = thin, wrinked skin

• attached to answer card
  ex: sun exposure, aging

Atrophy of the (b) dermis => clinically detectable depression in the skin (attached to question card)

Question 9

Describe the process:

Answer 9

= Lichenification

• thickening of the skin (hyperkeratosis) due to chronic scratching or rubbing
• noted by the increased lines and skin markings
• associated w/ eczema

Question 10

Describe and diagnose:

Answer 10

-small flat monomorphic papules, skin colored

= Flat warts

Question 11

Describe and diagnose

Answer 11

= Warts

-periuncal (around the fingers) papules (raised < 1 cm)

Question 12

Describe:

Answer 12

-filiform (thread like) warts on nose

Question 13

Diagnose

Answer 13

Plantars wart

Question 14

Describe and diagnose:

Answer 14

Salmon colored plque w/ sharply defined borders and silvery white plaque = psoriasis

Question 15

Describe and diagnose:

Answer 15

Small, salmon-pink droplets on skin

= Guttate psoriasis

-typically on upper trunk or extremities, in young adults, classically after bacterial infection (ex: strep throat)

Question 16

Describe and diagnose:

Answer 16

Salmon pink plaque with well defined borders in intertrigenous area (where two skin areas touch)

= Inverse psoriasis = very red lesions in body folds

Question 17

What is the white arrow pointing to?

(a) Diagnose
(b) Other nail findings of this disorder

Answer 17

White arrow pointing to a yellow oil spot

(a) Psoriatic nails
(b) Other nail findings in psoriasis = pitting, onycholysis (loosening or separation of nail from the nail beds), subungal debris (crap under the nail)

Question 18

Describe and diagnose:

Answer 18

Hyperpigmented macules (small patches) scattered

= Tinea versicolor

-versicolor b/c color varies- can be either hyper or hypopigmneted compared to background skin

Question 19

Describe and diagnose:

Answer 19

-yellow scale on erethematous border in nasolabial fold

= Seborrheic dermatitis

Question 20

Describe how these three factors play into the pathogenesis of acne

(a) Bacterial
(b) Hormonal
(c) Epidermial

Answer 20

Acne:

(a) Propionibacterium acne releases lipase that hydrolyzes the sebum TGs into FFAs
(b) Hormonal: androgens increase sebaceous gland activity
(c) Epidermial: hyperkeratinization of the hair follicle lining clogs the pore
- get proliferation of the bacteria, regression of the sebaceous lobule, and inflammation

Question 21

Describe and diagnose:

Answer 21

-warty brown papule, well demarcated, verrucous (wart-like), appears ‘stuck on’

= Seborrheic Keratosis

Question 22

Descirbe and diagnose:

Answer 22

Many small oval erethematous macules w/ a collarette of scale (circulation lesion w/ circular rim of scale or peeling edge) in a Christmas tree distribution on the chest and upper extremities

Question 23

Describe and diagnose:

Answer 23

Erethematous macules (flat < 1 cm) w/ honey colored crusts (crap dried on top) = impetigo

Question 24

Describe and diagnose:

Answer 24

-pearly papule with central crater and telangectasia = Basal cell carcinoma

Question 25

Describe and diagnose:

Answer 25

= Sclerosing basal cell carcinoma

-scar-like circular plaque with well defined borders

Question 26

Describe and diagnose:

Answer 26

Small regular firm vesicles (clear fluid) on an erethematous base = Herpes simplex

• multiple grouped round vesicles that eventually become pustules (neutrophils, pus filled) then dry over, heal in 5-10 days
• not contagious once dried over

Question 27

Describe and diagnose:

Answer 27

Erethematous, oozing papules in atecubital fosssa and on face

= Atopic dermatitis = Eczema

-often secondary lichenification and excoriation

Question 28

Describe and diagnose:

Answer 28

Erythematous papules (raised), edematous, NO scale, sharply defined red borders with pale centers (wheals)

= Uticaria/hives

Question 29

Diagnose:

Answer 29

Contact dermatitis- primary irritant type

Question 30

Diagnose

Answer 30

Contact dermatitis- allergic type

ex: poison ivy

Question 31

Answer 31

Basal Cell Carcionma

• central ulcer/crust
• pearly white border and telengectasis on classical BCCs

Question 32

Answer 32

Hyperkeratosis of Squamous cell carcinoma (SCC)

Question 33

Answer 33

Actinic Keratosis = precancerous skin lesions due to chronic sun exposure

-8% of AK transform into SCC