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Dermatology Flashcards

1
Q

Scale

A

type of surface change resulting from excess stratum corneum (superficial layer of skin) that accumulates flakes or plates

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2
Q

Crust

A

hardened layer that results when serum, blood or exudate dries on skin surface

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3
Q

Pathophysiology of acne

A

Androgens in the circulation
Bacteria in the hair follicle
Follicular plugging
Sebum secretion

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4
Q

Rosacea

A

Rosacea is a common skin condition with characteristic symptoms and signs, including symmetric flushing, stinging sensation, inflammatory lesions (papules and pustules), and telangiectasias on the face.

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5
Q

Acrochordon

A

small, soft, common, benign, usually pedunculated neoplasm

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6
Q

AK definition

A

Actinic keratoses (AKs) are premalignant inflammatory skin lesions with the potential to transform into squamous cell carcinoma (SCC).

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7
Q

AK treatment

A

Liquid nitrogen (Cryosurgery) – freezing the affected tissue
5-Flurouracil (5-FU)
Aldara - has been approved in Canada and the US.
View the A-Detail™ on Aldara™.
Solaraze - Currently approved in the US only
Curettage / electro-desiccation
Excision – surgically removing the affected tissue (rare)
Photodynamic therapy

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8
Q

Lentigines description

A

A brown, sharply circumscribed macule resembling a freckle

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9
Q

AK description

A

a premalignant condition of thick, scaly, or crusty patches of skin
Ex: Well-circumscribed, 2cm, erythematous nodule with central ulceration and crust. The lesion is firm with palpation.

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10
Q

BCC

A
  • malignancy of the basal cells of the epidermis

- most common human malignancy

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11
Q

BCC RF

A
  • major risk factor is cumulative sun exposure, eighty-five percent occur on the head and neck, with the nose being the most common site
  • Usually in pt 40-80
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12
Q

BCC description (nodular)

A

translucent, waxy papule with a rolled, pearly border, telangiectasia, and often central ulceration.

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13
Q

Recurrence rates for surgical options for BCC

A

curettage and desiccation 10%
cryotherapy 10%
excision 2 - 5%
Mohs <1%

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14
Q

BCC superficial description

A

Superficial BCC occurs as irregularly shaped, slow-growing, circumscribed, round-to-oval, red, scaling plaque

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15
Q

Indications for TBSE

A

Personal history of skin cancer
Inc. Risk for melanoma - 2 first degree relatives, over 100 nevi
New rash on body
New patient with undiagnosed skin condition
F/u in patients with extensive skin conditions (ie psoriasis)

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16
Q

Frequently missed spots to look for skin problems

A

Medial canthi
Alar creases
Conchal bowl
Postauricular fold

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17
Q

Plaques

A

proliferation of cells in superficial dermis or epidermis

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18
Q

Acral distribution

A

distal aspects of the head (ears, nose) and the extremeties

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19
Q

Intertriginous distribution

A

in skin folds (axilla, crural, gluteal)

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20
Q

distribution pattern that follows sun exposed skin

A

Photodistributed

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21
Q

Random lesions in many body locations

A

scattered

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22
Q

superficial loss of the dermis

A

erosion

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23
Q

Erosion that involves the dermis

A

ulcer

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24
Q

Epidermis consists of

A

The epidermis is the topmost layer, and consists primarily of keratinocytes.

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25
Dermis consists of
The dermis lies below the epidermis, and consists primarily of fibroblasts, collagen, and elastic fibers.
26
Beneath the dermis...
Subcutis
27
4 layers of epidermis
``` Stratum corneum Stratum granulosum (granular cell layer) Stratum spinosum (spiny layer) Stratum basale (basal cell layer) ```
28
Think of stratum corneum as a wall of bricks and mortar
Bricks: flattened keratinocytes filled with keratin and filaggrin Mortar: lipid mixture, which surrounds the keratinocytes and provides the water barrier (lipids produced by granular layer)
29
Filagrin protein
retains water in the kerationocytes - mutations cause atopic dermatitis, other diseases of the skin
30
Psoriasis pathophysiology
rapid epidermal turnover (not enough time for differentiation at each level)
31
3 types of cells that make up the epidermis
Keratinocytes Melanocytes Langerhans cells
32
Melanocytes function
pigment producing cells, transfer their pigment to the keratinocytes in the basal cell layer
33
Langerhans cells function
provide recognition, uptake procession and presentation of antigens to T cells for induction of delayed type hypersensitivity
34
Dermis layers
Papillary and reticular
35
Dermis function
support structure contains blood and lymph vessels + nerves that supply the skin contains sweat glands and hair follicles
36
Cells of the dermis
fibroblasts and mast cells
37
fibroblasts function
important for wound healing
38
mast cells function
responsible for immediate type hypersensitivity reactions in the skin
39
Sebaceous hyperplasia versus BCC
Yellow color, umbilication, and multiple similar papules help identify sebaceous hyperplasia • BCC tends to be solitary and more friable (bleeds, scabs) – also more pearly translucent, often with telangiectasia
40
Epidermal inclusion cyst
mobile subcutaneous nodule, often with an overlying punctum - arise from hair follicles, not oil glands Debris (dead skin cells, oil, etc.) collects within a sack
41
Actinic keratosis differential
``` Actinic keratosis Basal cell carcinoma Melanoma Seborrheic keratosis Squamous cell carcinoma Verruca vulgaris ```
42
verruca vulgaris
Hyperkeratotic, exophytic (growing outward), dome- shaped papules or nodules Punctateblackdots representing thrombosed capillaries
43
type of wart morphologies
Verruca vulgaris: common warts Verrucae planae: flat warts Palmoplantar warts Condylomata acuminata: external genital warts
44
Side effect of cryotherapy
post inflammatory hyperpigmentation
45
flat warts first line treatment
Cryotherapy Salicylic acid (caution using on face) Topical tretinoin
46
external genital warts description
broad-based papules or large confluent plaques | HPV 11, 6
47
molluscum contagiosum
smooth, dome-shaped papules with central umbilication
48
Genital wart treatment
Cryotherapy Imiquimod Salicylic acid
49
Classification of acne
Comedonal: open and closed comedones Inflammatory: papules and pustules Nodulocystic: nodules and cysts
50
benzoyl peroxide MOA
antibacterial and comedolytic
51
topical antibiotics
reduces P acnes and reduces inflammatory acne | Erythromycin 2% (solution, gel) Clindamycin 1% (lotion, solution, gel, foam)
52
topical retinoids SE
dryness, pruritis, erythema, scaling, photosensitivity
53
benzoyl peroxide SE
bleaching of hair, clothes, etc
54
Topical agents for acne time of action
2-3 months
55
Oral antibiotics for acne, uses
tetracycline, doxycycline, minocycline | Used for moderate to severe acne
56
Tetracycline side effects
Are contraindicated in pregnancy and in children <8 years old May cause GI upset (epigastric burning, nausea, vomiting and diarrhea can occur) Can cause photosensitivity (patients may burn easier, which can be easily managed with better sun protection). Recommend sun block with UVA coverage for all acne patients on tetracyclines tetracyclines DO NOT interfere with OCP Takes 2-3 months for improvement
57
Minocycline side effects
GI upset, vertigo, hyperpigmentation
58
Acutane SE
``` xerosis cheilitis elevated LFTs hypertriglyceridemia mood changes pseudotumor cerebri ```
59
seborrheic dermatitis
erythematous patches with greasy scale on the central face
60
Tactuo
0.1% Adapalene (topical retinoid) and 2.5% benzoyl peroxide (60g), applied qHS or qAM
61
Dovobet (Betamethasone dipropionate/Calcipotriol)
Psoriasis treatment
62
tinea versicolor treatment
Ketoconazole 2% (Nizoral) Shampoo to skin x 5 minutes x 1 month Topical 2.5% selenium sulfide solution (Selsun shampoo) x 10 min bid x 2 weeks Canesten cream
63
tinea capitis
- Griseofulvin (Fulvicin U/F 15-20mg/kg) x 8wks | - Creams, Shampoos are ineffective, MUST have ORAL therapy
64
Topical benzoyl peroxide with clindamycin
(BenzaClin® by Dermik)
65
Topical benzoyl peroxide with erythromycin
(Benzamycin® by Dermik)
66
Topical retinoid with erythromycin
(Stievamycin® by Stiefel
67
Topical retinoid (tretinoin) plus erythromycin (Stievamycin® by Stiefel)
It should be applied to the affected areas once/day before bedtime after the skin has been thoroughly washed, rinsed and patted dry.
68
Topical benzoyl peroxide plus erythromycin (Benzamycin® by Dermik)
A thin layer should be applied to the affected areas 1 to 2 times/day after the skin has been thoroughly washed, rinsed and patted dry. This product must be refrigerated and may bleach clothing.
69
Topical benzoyl peroxide plus clindamycin (Clindoxyl® by Stiefel in Canada, Benzaclin® by Dermik)
It should be applied to skin that has been washed, rinsed and patted dry. This product does not need to be refrigerated.
70
superficial basal cell carcinoma differential
basal cell carcinoma, nodular; eczema, nummular; tinea corporis
71
dysplastic nevus differential
melanoma, superficial spreading; seborrheic keratosis
72
nodular BCC differential
melanoma, amelanotic; nevus, intradermal; squamous cell carcinoma
73
Eczema versus dermatitis
Eczema refers to an inflammatory process primarily involving the first layer of the skin. Dermatitis simply means inflammation of the skin by any cause.

Medicine (5 decks)

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