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CD 3305 (mod 11/12) > Dermatological disease! > Flashcards

Dermatological disease! Flashcards

1
Q

A 50yo patient is concerned about a plaque her husband noticed on her back. It is flat/brownish, sharply demarcated, and appears “stuck on” with a grainy appearing surface, almost like a raisin.
What is the most likely cause? POM?

A 
Sebborheic Keratosis (benign)
POM: shave biopsy, excision, curretage
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2
Q

What is solar lentigo?

A

hyperpigmented round macules on sun damaged skin

Benign (not prelamlignant) though larger ones ca be difficult to distinguish from malignant melanoma

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3
Q

What is an epidermal cyst? POM? What is the smaller version of this called?

A

vSlowly growing round firm yellow or flesh-coloured intradermal or subcutaneous tumour
POM: incision to remove
Smaller version: millium

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4
Q

In which population are milliums MC?

A

Newborns (self-limiting)

Can also arise sponteously following trauma)

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5
Q

What is a keratocanthoma? POM?

A

Rapidly growing, firm, dome-shaped nodule 1-2cm with central keratin filled crater
Located on sun-exposed skin of elderly
Grows to full-size in 2-4mo, then regresses
POM: excision/cauterization
Image: What is a keratocanthoma? POM?

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6
Q

What is the name for the benign soft yellow papules 2-5mm usually found on the face? What malignant condition are they commonly mistaken for?

A

Sebaceous hyperplasia

BCC

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7
Q

A patient is worried because the hyper-pigmented papillomatous birth mark on their stomach has slowly become more prominant with age. It is well-demarcated and linearly arranged. What is the most likely cause? POM?

A 
Epiderma nevus (benign)
POM: laser, electrodessication, or cryotherapy
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8
Q

There are 2 types of benign melanocytic lesions which are characterized by multple small macules. What are the 2 types and how can you tell the difference between them?

A
  1. Simple lentigo: do not darken or miltiply with sun exposure, more scattered
  2. Ephelis (freckles): darken & multiple with sun exposure, concentrated on sun-exposed surfaces
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9
Q

MC locations for mongolian spot/nevus ito/ota

A

Lumbosacral region (mongolian spot)
Face (nevus of ota)
Shoulder (nevus of ito)

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10
Q

True or false: mongolian spots can change significantly throughout childhood

A

True - usually present at birth and disappears within 5 years, second peak in appearance in adolescence

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11
Q

Cafe-au-lait spots are associated with which condition?

A

Neurofibromatosis (if >6 spots >1.5cm)

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12
Q

Which benign melanocyte lesion appears in the 2nd decade in males and can enlarge in the 4th decade?

A

Becker’s melanosis/nevus

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13
Q

What are the 7 types of melanocyte nevi? At what ages are they seen?

A
  1. Congenital: present at birth
  2. Junctional (1.5-4y): flat, well-circumsribed nests of nevus cells at the interface of the epidermis and dermis
  3. Compound (5-40y): nevus cells migrate to dermis, lesion becomes elevated
  4. Dermal (10-50yo): nevus loses all connection with overlying epidermis, becomes flesh coloured
  5. Dysplastic nevus (8-80yo): starts flat-irregular elevation and outline, expands
  6. Blue nevus (1.5-40yo): common in persons of asian descent
  7. Halo navus (2-30yo): may remain same or mole may disappear
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14
Q

Patients with Turner syndrome have an increased incidence of which type of nevus?

A

Halo

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15
Q

What is the medical term for the port wine stain birth mark MC seen at the nape of the neck?

A

Nevus flammeus

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16
Q

What is the name for the soft, round, compressible dark blue papule commonly seen on the face, lips, and ears of >65yo?

A

Venous lake

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17
Q

What is a senile hamangioma?

A

AKA cherry angioma
idiopathic, usually on trunk beginning in early adulthood and increasing in number with age-frequency
Bright red dome shaped papules 1-5mm

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18
Q

How can you tell the difference between capillary hemangioma (strawberry mark) and nevus flammeus (port wine stain)?

A

Hemangioma will blanch when pressed

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19
Q

Which benign vascular skin lesion may require surgical intervention?

A 
Cavernous hemangioma (AKA Bag of worms)
Caused by proliferation of thick-walled blood vessels
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20
Q

Which 3 benign vascular lesions require excision?

A

Pyogenic granuloma (photo)
Angiokeratoma
Lymphangioma

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21
Q

What are the 3 benign tumours of fibrous tissue? What is their etiology?

A
  1. Dermatofibroma: trauma (splinter, insect bite, cyst)
  2. Keloid: trauma
  3. Acrochordon: AKA skin tag - idiopathic
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22
Q

What are the MC complications of chicken pox in children? In adults?

A

Children: encephalitis
Adults: pneumonia

23
Q

Tc for herpes zoster

A

Compress
Corticosteroids
IV acyclovir
Opthalmological consult

24
Q

What is molluscum contagiosum? How is it transmitted? Treatment?

A

Asymptomatic, shiny whitish pearly umbilicated papules caused by DNA Pox virus
Transmission: Direct contact
Tx: curretage/liquid nitrogen

25
Q

How is tinea capitis diagnosed?

A

Wood’s Lamp: filtered by Wood’s glass containing 9% nickel oxide that transmits rays of a wavelength >365nm which in a darkened room causes hairs to fluoresce bright green

26
Q

Which infection is associated with poor hygeine with shaving?

A

Tinea barbae

27
Q

S&S Tinea corporis

A
  • Red to pink annular patches and plaques
  • Raised scaly borders that tend to clear centally
    MC in farm children with infected animals
28
Q

What is the medical term for “jock itch”? What causes it?

A

Tinea cruris
Caused by wearing tight-fitting clothes for extended periods, sharing clothing with others
Contagious infection transmitted by contaminated towels, hotel bedroom sheets, or autoinoculation from hands or feet

29
Q

2 MC causative organism of tinea pedis/manis/cruris

A

T. Rubrum

T mentagrophytes

30
Q

What is the skin lesion associated with HIV infection? Prognosis?

A

Kaposi’s sarcoma

Mean survival rate 15-24mo

31
Q

MC presentation of psoriasis

A

Scaly plaques on extensor surfaces, BL, symmetric

Nails may also exhibit pitting

32
Q

Risk factors for psoriasis aggravation

A 
Age: 16-22, 57-60 (bimodal)
Female
Family hx (one parent = 30% chance, 2 parents = 50-70%)
IBD
Local Trauma
Infection
HIV
Drugs
Psychogenic/emotiona factors
Smoking/alcohol
Endocrine (puberty, menopause)
33
Q

Your 18yo female patient reports that she noticed a salmon-coloured macule which has enlarged over the past few days and has formed a collar of fine scale. It is ithcy but otherwise doesn’t bother her.
What is this condition? Prognosis?

A

Pityriasis Rosea: idiopathic condition thought to be caused by a virus
Prognosis: self-resolving within 6wks, but first will form a christmas tree pattern on torso

34
Q

What is Lichen Planus?

A

Itchy, papular eruption characterized by purple colour, polygonal shape, and fine scale.
MC on flexor surfaces of upper extremities, genetalia, and mucous membranes (tongue, buccal mucosa)
Self-resolving in 8-12mo

35
Q

What are the 2 types of premalignant epithelial tumours?

A
  1. Solar (actinic) keratosis

2. SCC in situ

36
Q

Biggest risk factor for actinic keratosis

A

Sun exposure - 60% of individuals older than 40 who are predisposed have at least one actinic keratosis

37
Q

S&S of Actinic Keratosis

A

Erythematous, slightly elevated or wart-ike papules/plaques covered by adherent scale
Black/black in colour and can be single or multiple

38
Q

S&S squamous cell carcinoma in situ (AKA Bowen disease)

A

Solitary, sharply marginated, slightly elevated erythematous plaque with surface scaling/crusting

39
Q

3 MC malignant epithelial tumours

A

Basal cell carcinoma (MC)
Squamous cell carcinoma (2nd MC)
Malignant melanoma

40
Q

S&S Basal cell carcinoma

A

Cherry danish (skin coloured papule/plaque with rolled translucent outer border and depressed, eroded centre)

41
Q

3 Variants of BCC

A
  1. Superficial: scaly plaque slowly enlarging wiht thread-like telangiectasia, usually on trunk
  2. Sclerosing: flesh-coloured shiny papule/plaque with appendages that can extend beyind the lesion margins
  3. Pigmented: Flecks/stipples of pigment
42
Q

S&S SCC

A

Begins as scaly red papule which eventually ulcerates and invades underlying tissue

43
Q

True or false: SCC that arise from sun exposure rarely metastasize

A

True! Only 1%. Other causes have higher rate (up to 25%)

44
Q

Risk factors for malignant melanoma

A 
Dysplastic nevi
Family hx
Blonde/redhead
Multiple melanocytic nevi (>100)
Hx blistering sunburns
45
Q

MC age to get malignant melanoma?

A

30-40yo (66%)

46
Q

ABCDEs of melanoma

A

asymmetry, border (irregular), color (variable), diameter (>6mm), evolution

47
Q

Types of malignant melanoma

A
  1. Superficial spreading melaoma (MC) - usu extremities and back
  2. Lentigo maligna melanoma - elderly, but least likely to go vertical
  3. Nodular melanoma - UV exposed areas. Only vertical phase usu at presentation
  4. Acral lentiginous melanoma - AA, Asia, no relaton to sun. Palms, soles, beneath nails. POOR PROGNOSIS.
48
Q

Impetigo is caused by which 2 organisms?

A

Beta-hemolytic strep

Staph aureus

49
Q

True or false: impetigo is contagious

A

True! Spread through contact with clothing, bed linens, close contact

50
Q

MC cause of folliculitis

A

Staph aureus

51
Q

What is paronychia?

A

infection of the nail bed (disruption between seal of proximal nail fold and nail plate)

52
Q

What is erysipelas? MC causative organism?

A

infection of the skin and subcutaneous tissues
requires immediate antibiotic therapy
MC: B-hemolytic strep

53
Q

S&S cellulitis

A

Red linear streaks (lymphangitis) may extend proximally up affected limb
Fever, elevated WBC, regional lymphadenopathy
Poorly demarcated, erythematous, tender, warm edematous

CD 3305 (mod 11/12) (8 decks)

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