derma Flashcards
superficial, elevated, palpable lesion less or equal to 0.5cm; more than 0.5 cm
Papule/Plaque
circumscribed color change without elevation or non palpable depression
Macule/Patch
like a papule but containing fluid
Vesicle/Bulla
dew drop vesicle
Chicken Pox
palpable, solid, deeper than papule; more than 0.5cm
Nodule
pale red, palpable, superficial lesion, evanescent, disappearing in 1-2 days. From edema in the papillary layer of the dermis. Allergy
Wheal
like vesicle, only with purulent exudate as the fluid
Pustule
an elevated lesion, fluid filled
Blister
depressed lesion with loss of surface epithelium
Ulcer
mixture of scale and serum- yellowish accretions on the surface of a lesion
Crust
non raised red-brown non blanchable lesions - Dengue fever
Petechiae
epidermal hyperplasia, colon CA
Acanthosis
premature keratinization of cells below stratum granulosum
Dyskeratosis
outer, waterproof, protective layer. Melanocytes and keratinocytes
Epidermis
collagen and elastin for toughness and elasticity
Dermis
subcutaneous tissue, mainly fat. Padding, blood supply
Hypodermis
horney cell layer
stratum corneum
basal cell layer
stratum germinativum
goose bumps
arrector pili muscle
body odor
apocrine, eccrine, sebaceous
Simple, coiled, tubular
sweat gland
A beta hemolytic strep, S aureus, or combo. Spread through close contact
Impetigo Contagiosa
Mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust
Impetigo Contagiosa
Generally develops in body folds that are subject to FRICTION
Impetigo Contagiosa
Infection of hair follicle that results in pustule formation - Staph aureus
Furunculosis (boils)
Inflammation of hair follicle resulting 2nd blockage of apocrine gland
Hidradenitis Suppurativa
Begins as small papule that develop into deep dermal inflammation
Hidradenitis Suppurativa
Avoid use of antiperspirants, deodorants and shaving creams
Hidradenitis Suppurativa
Use medicated soaps and systemic antibiotics
Hidradenitis Suppurativa
Desquamation of keratinocytes within pilosebaceous unit, increased sebum production, proliferation of Propionibacterium acnes
Acne vulgaris
1st treatment line of Acne vulgaris
Topical retinoid
2nd treatment line of Acne vulgaris
Salicylic acid
Imflammation disease of hair follicle and sebaceous glands, sex hormone contributes
Acne vulgaris
whiteheads, blackheads, flesh or red colored papules, pustures or cysts
Acne vulgaris
Chronic Acneform disorder of middle aged and older adults; period of exarcebation and remission
Acne Rosacea
Vascular dilation of the central face(nose, cheek, eyelids, and forehead) Facial Erythema, Telangiectasias
Acne Rosacea
Increased in hot or spicy food, drinking alcohol, temperature extremes and emotional reaction
Acne Rosacea
Atopic, Varicose, Irritant contact dermatitis eg ring, Nummular
Eczema
arises from direct skin exposure to an substance. Allergic or irritant
Allergic contact dermatitis
Most common sensitizer of allergic contact dermatitis
plant oleoresin urushiol in poison ivy, oak, sumac
Dermatographism
Urticaria
a type of allergic contact dermatitis
nickel dermatitis
type of hypersensitivity reaction
Type 4
Test for allergic contact dermatitis
patch test
How long does allergic contact dermatitis take
72 hours
Genetic factors plays a role
Psoriasis
Reddish papules that progress to plaque and progress to yellowish white scaly condition that tends to be located on the elbow, knees, trunk, genitalia, and umbilicus
Psoriasis
Mgt psoriasis that also modifies antireumatic drug
methotrexate
Additional mgt for psoriasis
glucocorticoids and kerolytic agents
symmetrically distributed plaques involving the scalp, extensor elbows, knees and back
Plaque psoriasis
abupt appearance of multiple small psoriatic lesions
Guttate psoriasis
most severe form of psoriasis; erythema, scaling, sheets of superficial pustules with erosion
Pustular psoriasis
Intetriginous area
Inverse psoriasis
More severe, need dermatologist, need oral therapy
erythrodermic and pustular psoriasis
erythema multiforme (mucous membrane involvement)
Steven Johnson syndrome
number one reason for SJS
Sulfonamides (Co-trimoxazole)
number two reason for SJS
Anticonvulsants(phenytoin, phenobarbital, carbamazepine)
Another reasons for SJS
Allopurinol, Trimetoprin Sulfa
Rodent Ulcer
Basal cell carcinoma
Pearly papules. Palisading nuclei
Basal cell carcinoma
Treatment of Basal cell carcinoma
excision
Basal cell carcinoma features
sun exposed area, whipcord edge, central ulceration, locally invasive only, slow growing, danger near eyes
Keratin pearls
Squamous cell carcinoma
area of repeated trauma, chronic non healing wound
Marjolin’s ulcer
Treatment of Squamous cell carcinoma
excision
Features of Squmous cell carcinoma
Poorly defined edge, presistent scaly patch, metastasize, non pigmented, sun exposed area, nodular
Melanoma in women area
legs
Melanoma in men area
back
Features of melanoma
asymmetry, varied pigments, change in shape or coulour or size, bleeding itching, satellite lesions
Progenosis of melanoma
depends of depth
Cure of Melanoma
early excision
Can Melanoma spread
Yes spreads easily
locally invasive
Basal cell carcinoma
May metastasize
Squamous cell carcinoma
non usually pigmented
Squamous cell carcinoma
varied pigment
Melanoma
Whipcord edge
Basal cell carcinoma
persistent scaly patch
Squamous cell carcinoma
Asymmetry
Melanoma
Danger near eye
Basal cell carcinoma
Poorly defined edge
Squamous cell carcinoma
central ulceration
Basal cell carcinoma
bleeding, itching, change in shape, colour or size
Melanoma
Most common type of melanoma
Superficial spreading
What is precursor lesion
Dysplastic nevus
What are the two classification used for prognosis of melanoma
Clack and Breslow classification
Kawasaki rash resembles what
measles
Kawasaki previously known as
mucocutaneous lymph node syndrome
morbillform, maculopapular (red patch and bumps)
Kawasaki
1st most common vasculitis
Henoch
2nd most common vasculitits
Kawasaki
Skin peeling and periungual desquamation
Kawasaki
Most serious complication of Kawasaki
coronary artery ds/ aneurysm
txt of cad
aspirin
aspirin don’t give to febrile child due to
Reye’s syndrome
txt of kawasaki
IVIG
Kawasaki fever lasts
more or equal to 5 days.
Marked irritability
child
How does skin of extremities affected
erythema, swelling, desquamation
How is the eye affected in Kawasaki fever
Bilateral conjunctivitis
Inflammation of lips, mouth and or tongue
Strawberry tongue.
Strawberry tongue found also in?
Scarlet fever
Cervical Lymphadenopathy unilateral or bilateral
unilateral
7 yr itchy rash and fever for 1 day, feels unwell. Blisters on red base. New lesions are still appearing. Dx?
Chicken pox
whats another name for chicken pox
varicella
when is varicella infectious?
from 1 to 2 days before rash develops, until after last lesion scaps over
Thin vesicle with honey colored crusting
Impetigo
etiology of impetigo
Staph or strep
how is impetigo spread
contact from fingers, towels, clothing
whats treatment for impetigo
topical antibiotics, severe infection needs oral
rash appears as small, dome shaped yellow pustules with hair shaft in the center
folliculitis
as a result of contact/plugging with oil, dirt, sweat
folliculitis
etiology of folliculities
staph
deep or superficial infx of hair follicle (barbae, hot tub)
folliculitis
deep extension of superficial folliculities into the dermis and subcutaneous tissue
furuncle boils
cause of furuncle
staph
1-5cm red/tender nodule with pus
furuncle boils
treatment of furuncle simple lesion
warm compress
treatment of furuncle severe lesion
drainage and antibiotics
large deep abscess that is a progression of furuncle
carbuncle
size 3-10cm
carbuncle
associated symptoms of carbuncle
fever and chills
treatment of carbuncle
drainage and antibiotics
acute inflammation of skin
cellutitis
redness, swelling, warmth and tenderness of affected area within 1-2 days of injury
cellutitis
etilogy of cellulitis
staph or strep, complication of wound and trauma
border of cellutitis
defined and change rapidly
Super bug caused by staph
methicillin resistant staphylococcus aureus
treatment of mrsa
vancomycin
risks factor of mrsa
recent hospitalization, long term care, recent antibiotic use, young age, contact sports, sharing towel,
most severe staph scaled skin syndrom
Ritter’s syndrom
Splitting of the skin destruction of basal layer
exfoliating toxin
itchy red bown scaling annular plaque expands peripherally in extremities and trunk
tinea corporis
vesicles/erosion on the soles of the foot and between toes
tina pedis athlete foot
athlete foot txt
antifungal cream/powder (micronazole), keep feet dry
red brown scaling plaque with snake like border
tinea cruris tinea of groins
another name of tinea cruris
jock itch
red/scaly rash on inner thighs/inguinal creases on buttock, no scrotum or labia. Common in obese, athlete
tinea cruris tinea of groins
dark lines between fingers and toes, body flexures, nipples and genitalia.
scabies
excoriation, pustules and papules caused by itching tends hide true cause
scabies
extreme nocturnal itching (tunnels and lays egg)
scabies
mgt of scabies
permethrin 5%
treat itching
topical corticosteroids
other mgt of scabies
washing of bedding and cloths
rash 2-4 days after prodrome, 14 days after exposure, maculo papular becomes confluent, begins on face and head. Persists 5-6 days. Fades in order of appearance.
measles
etiology of varicella
herpes virus DNA
primary infection results in varicella
chicken pox
recurrent infection results in
herpes zoster(shingles)
txt of varicella
acyclovir
dew drop rose petal
varicella
incubation of varicella
14-16 days (10-21 days range)
mild prodrome of varicella
1-2 days
predilection fo varicella
appear first on head; most concentrated on trunk
sccessive crops of pruritic vesicles
2-4 days
Hallmark of varicella rash
vesicular lesions
series of varicella
macules-maculopapular-vesicular-crusting-scab formation
predilection of varicella
lesions first on scalp, face or trunk. At any point in time lesion in various stages are observed
clear papules c superficial ulcerations/erosions
Herpes Simplex
What types of herpes simplex
viral infection either type 1 or type 2
treatment of herpes simplex
oral antiviral acyclovir
predilection in wrestler
herpes gladiatorum
predilection in lips
herpes labialis
reactivation of varicella virus
herpes zoster(shingles)
varicella zoster associatios
aging, immunosupression,intrauterine exposure, varicella at
reactivation of varicella virus
shingles
another name for varicella virus
Chicken pox
painful rash, prickly nerve pain along dermatomal distribution
herpes zoster(shingles)
Usual demartome location
thoracic dermatome
treatment of herpes zoster
symptomatic pain, calamine lotion, carbamazepine, gabapentin
Herpes virus 6
Roseola infantum
Roseola infantum timing
non seasonal but peaks during summer
Roseola infantum age
peak age 7 to 13 months (virtually all cases in less than 2 years)
Mild illness in children; adults may have arthralgia and arthritis
erythema infectiosum
etilogy of erythema infectiosum
parvovirus B19
OB complication of parvovirus
intrauterine infection - fetal hydrops, fetal death, miscariage, no congenital malformation associated
Hallmark sign of erythema infectiosum
slapped cheek appearance and circumoral pallor
how does this rash happen in erythema infectiosum?
rash, erythematous, maculopapular on trunks and limbs -> fluctuation in intensity of rash, pruritic over extensors (1-3 weeks)
Where does it goes pruritic?
extensor?
how does extensor look like?
lace like pattern on the extensor surface of arm
how can you diagnose?
clinically
treatment of erythema infectionsum
no specific anti viral drug
for chronic infection in immunodeficient patient what treatment?
IVIG
When is erythema infectiosum the most infectious?
before illness onset
when is erythema infectiosum the least infectious?
after onset of rash
maculopapular rash starts as petechia rash on ankles and wrist and then spreads to the trunk, palms, soles and face in a centripetal rash
rocky mountain spotted fever
what is the vector
tick: dermacentor
mode of action of tick
invades endothelial lining of capillaries and vasculitis
where does the rash start?
ankles and wrist
where does it spread?
trunk, palms, soles and face
in what fasion does it spread
centripetal rash
in what day does the rash start
day 6
what is the etiology agent of syphilis
treponema pallidum
how is it transmitted
sexually
how many stages does syphilis have?
3 stages
what is the first stage of syphilis?
classic chancre.
whats the characteristic of the classic chancre?
1-2 cm ulcer with raised indulated border
how is the pain scale?
usually painless
where does the painless happen
occurs at site of innoculation
how does it heal
heals spontaneously
premalignant lesions that develop only on sun damaged skin
actinic keratoses (ak)
how does ak appear?
patches of hyperkeratosis
how does the surrounding look like?
with some surrounding erythema on sun exposed area
where do you see this the most?
head and neck, forearm and hands and upper back
vesicular bullous eruptions of palms and soles
Pemphigus syphiliticus
what is the general name of pemphigus syphliticus
early congenital syphilis
what is the characteristics of skin for pemphigus syphiliticus
desquamation
what are the other associated symptoms of pemphigus syphiliticus
bony lesion, osteochondritis, periostitis, pseudoparalysis
what are the lesions found in the eye
chorioretinitis, salt and pepper fundus
where do you eight nerve deafness, interstitial keratitis, hutchinson teeth
late congenital syphilis
what is the triad of hutchinson’s triad
eighth nerve deafness, interstitial keratitis, hutchinson’s teeth
what is the joint lesion for late congenital syphilis
clutton’s joint
what is facial lesions for late congenital syphilis
frontal bossae of parrot, short maxilla, saddle nose
what is the wrong with the mandible in late congenital syphilis
relative protuberant mandible
what’s wrong with the extremities in late congenital syphilis
saber shin
what’s wrong with the teeth in late congenital syphilis
hutchinson’s teeth and Mulberry molars
what is the hutchingson’s triad
eighth nerve deafness, interstitial keratitis, hutchinson’s teeth
what is vesicular bullous eruption of palms and soles and where do u see that
pemphigus syphiliticus and early congenital syphilis.
normal reticulated mottling of the skin caused by vascular response to cold
Cutis marmorata harlequin color change in newborn
thrombocytopenia and eczema
wiskott aldrich
malar rash - butterfly rash
SLE
Heliotrope rash
dermatomyositis
dermatomyositis associated with
breast cancer
helitrope rash associated with
periorbital eyelids
shagreen patch and ash leaf spot and adenoma sebaceum
tuberus sclerosis
tuberus sclerosis presents with
epilepsy
spider cells
rhabdomyoma
portwine stain v1 -v2-v3 presents with brain tumor
surge weber syndrome
long arm of chromosome 17
von recklinghousen disease
von recklinghousen disease associated with
neurofibromatosis 1 and lisch nodule
lesions on langer’s line
pityrisiasis rosea
loss of melanocytes
vitiligo
moa of loss of melanocytes
autosomal, neurohumoral, self destruction by melanocytes
absense of melanin; lack of defect in tyrosinase/ tyrosine hydroxynase
albinism
immunodeficiency and albanism
chediak higashi
depletion of melanosomes in keratinocytes. Fungal infection
pityriasis vesicolor
melanocytes lives where
stratum basale/ germinativum
hypopigmentations
vitiligo,albanism, chediak higashi, pityriasis vesicolor
hyperpigmentation
freckles, melasma, lentigo
worst form ? Balness
alopecia areata
boiled lobster appearance and sand paper rash
Scarlet fever
etiology of scarlet fever
strep pyogenes
strep pyogenes belongs to what group
group A
rheumatic fever
erythema nodosum
iris lesion
erythema multiforme
nocturnal itching
scabies
scabies official name
sarcoptes scabie
drug of choise of scabies
permethrine
koplik’s spot
measles
koplik’s spot location
oppsite the 2nd molar tooth, near the stensen duct
measles associated symptoms
cough, colds, conjuntivitis
black eschar and malignant pustule
cutaneous anthrax
wool sorter’s disease
pulmonary anthrax
hot tub folliculitis
pseudomonas aeroginosa
itchyma gangrenosum
pseudomonas aeroginosa
bull’s eye/ target lesion
lime disease
erythema chronicum migrans
borrelia brugdoferi.
etiology of borrelia
ixodes tick- anthropod vector
blue berry muffin rash
congenital rubella
herman’s rash
hemorragic dengue fever
vascular response to cold in new born
harlequin rash
coxsackie A
hand foot mouth disease
purpuric ezcema
langerhan’s histiocytosis
birbeck granules
tenis racket apperance
purpuric ezcema , birdbeck granule
langerhan’s histiocytosis
malasezzia furfur
tinea vesicolor
