Dermatology Flashcards
Lofgren syndrome is a tetrad of what symptoms?
Erythema nodosum
Anterior uveitis
Hilar adenopathy
Arthritis
Seen as part of sarcoidosis–this has a good prognosis
What is pyoderma gangrenosum? How is it treated?
Cutaneous sterile ulcers that start off as an erythematous papule and expands into a deep ulcer with a grey border.
Associated with IBD– for example Crohn’s.
Treated with systemic steroids.
Trichophyton is responsible for causing what type of tinea rash?
Tinea capitis and cruris (head and jock itch)– areas with hair because this fungus is an endothrix, or it invades the hair shaft. Also causes tinea pedis.
Hypopigmented rash that starts on the trunk, scaly and becomes more visible when surrounding skin tans; what kind of rash is this?
Malassezia (tinea corporis)
What is a kerion?
A pus filled abscess caused by an immune system response to an endothrix infection (such as trichophyton); treat with oral griseofulvin (systemic anti-fungal agent)
Transient neonatal pustular melanosis is associated with which ethnicity?
African Americans
True or False. The pustular lesions of TNPM can often form before birth and are common distributed along the neck folds, anterior/posterior trunk and proximal upper extremities.
True
Name the rash. Often occurs due to an infectious trigger, papular or papulovesicular rash that occurs along the face, buttocks, and extensor surfaces of arms and legs. Spares the trunk.
Gianotti-Crosti syndrome or papular acrodermatitis.
Koebner phenomenon– lesions occur along areas of trauma.
Name the rash. Hypopigmented, flat-topped papules that follow a curvilinear pattern along previous embryonic ectodermal lines of migration. Treatment of rash?
Lichen striatus. Will resolve on its own, corticosteroids don’t really hasten the process of healing. Supportive care.
Name the rash. Red papules that can coalesce into vesicles and bullae, notably on the lateral aspects of fingers, palms and soles. Maybe has a history of excessively sweaty palms. What is the treatment?
Dyshidrotic eczema. Topical corticosteroids.
Name the rash. Recurrent episodes of erythema over the face, nose and cheeks. Can be triggered by photosensitivity, stress/extremes in emotion, etc. Can see telangiectasis over these areas, may also have some ocular involvement. What treatment can be used?
Rosacea. Topical metronidazole surprisingly, especially if papulopustular component to it.
Which medication used for acne can present with generalized arthralgias and myalgias? What labs do you have to monitor for this medication?
Isotretinoin. Monitor CBC (concern for myelosuppression), fasting triglycerides and liver-related labs (cholesterol, liver enzymes– concerns about hepatotoxicity).
Name the rash. Child with history of eczema presenting with vesiculo or vesiculopustular lesions over areas of previous eczema.
Eczema herpeticum, complication of eczema caused by activation of HSV1/2.
Diffuse brown maculopapular rash, also noted over the palms and soles. Generalized LAD and painless ulcer noted on the shaft of the penis. Diagnosis and treatment?
Syphilis and PCN. If concern about PCN allergy, you want to desensitize to PCN and still treat.
Diffuse angiofibromas with multisystem involvement and history of seizure disorder. What notable skin findings do you see with this disorder? Genetic mode of inheritance?
Tuberous sclerosis.
Ash-leaf spots, shagreen patches, periungual fibromas.
Autosomal dominant.
Difference between SJS and TEN?
SJS <10% epidermal detachment
TEN >30% epidermal detachment
What is telogen effluvium? What is the treatment?
Hair loss secondary to a stressful event (death, illness, pregnancy). Reassurance, hair will grow back in a few months.
Name the disorder. Parchment-like skin around the vulva/perineal region with complaints of itching and occasional bleeding in underwear area.
Lichen sclerosis.
Name the disorder. Rash present at birth. Description of vesicular lesions along embryonal lines of distribution, then changes to swirls of hyperpigmented skin. Findings involve skin, teeth (peg teeth), nails and CNS (MR). Marked by prominent eosinophilia. What is the mode of inheritance of this disorder?
X-linked dominant, usually lethal to males.
Name the rash. Discrete firm annular plaques, smooth without scale. Treatment?
Granuloma Annulare. Reassurance.
What is ichthyosis vulgaris?
Excessive keratin deposition leading to fish-scale appearing dry skin on extensor surfaces, as well as hyperpigmentation of skin creases.
Oculodermal melanocytosis is associated with which eye complication? Which ethnicity does it prefer?
Glaucoma; Asian and African American descent
Preceding prodromal symptoms of fever and cough, now presenting with mucositis (eyes, mouth, anal mucosa)–diagnosis?
Mycoplasma-induced rash and mucositis.
Port-Wine Stain syndromes?
Sturge-Weber: involves V1 branch of the trigeminal nerve PHACES syndrome-- Posterior fossa anomalies Hemangiomas (segmental) Arterial anomalies Cardiac anomalies Eye anomalies
Name the condition. Diffuse rash from head to toe, significant delays in developmental milestones, poor wound healing, poor growth milestones. What nutritional deficiency do they have?
Essential fatty acid deficiency. Linoleic acid deficiency, impairs fatty acid metabolism.
Cutis aplasia management?
Conservative management mostly, will re-epithelialize within several weeks to months.
Difference between juvenile plantar dermatosis and tinea pedis?
JPD does not involve the interdigital spaces vs tinea pedis does; also JPD usually before adolescence and tinea pedis does not occur until onset of adolescence
Description of rash as scaly papules that appear drop-like with a preceding history of sore throat. What is the diagnosis?
Guttate psoriasis (post-strep infection).
Acne in an infant after the immediate post-natal period, with cystic acne/comedones prompts you to check what lab?
17-hydroxyprogesterone (check level of androgens), infantile acne
True or False. You cannot use both benzoyl peroxide and retinoids benzoyl peroxide inactivates retinoids.
True to an extent. You cannot use both at the same time, but you can use one during the day and the other at night.
True or False. Antibiotics are paired with topical acne treatment for its anti-infectious capabilities.
False, paired for its anti-inflammatory effects (topical erythromycin, clindamycin, etc).
Topical retinoids have a keratolytic/comedolytic effect.
True.
Skin and joint findings in reactive arthritis
Can’t see (uveitis/conjunctivitis), can’t pee (urethritis), can’t climb a tree (arthritis).
Will have enthesitis or TTP of ligaments that attach to major joints.
GU skin findings– white hyperkeratotic plaques/lesions that cover the entire glans.
Hot-tub folliculitis is caused by which bacteria?
Peudomonas
