Dermatology Flashcards
Excoriations?
Fissures?
Linear erosions into the epidermis cause by scratching
Linear cracks into the dermis
Primary irritant contact dermatitis – caused by? Most common? Secondary infection with what organism? Crease involvement suggests? Management?
Caustic substances that irritate the skin; diaper dermatitis
Secondary infection with Candida
Dermatitis does not involve inguinal creases; secondary infection involves inguinal creases
Zinc oxide
Seborrheic dermatitis – potential cause? Clinical features? Type in infants? Management?
Yeast (pityrosporum ovale)
Red scale/crust in areas with high sebaceous glands
Infants – limited to the scalp, called seborrheic capitis
Steroids, sulfur/zinc, antifungals
Pityriasis rosacea – age? Cause? Clinical features? Management?
Older than five; unknown – possibly hypersensitivity to a virus
- Papulosquamous “Herald patch”
- Two weeks later – pruritic erythematous macules/papules forming “Christmas tree” distribution
Antihistamines, ultraviolet light
Psoriasis – Koebner phenomenon? Nail involvement? Extracutaneous finding in children?
New lesions develop at sites of skin trauma
Pits, distal thickening, lifting of the nail bed
Arthritis
Miliaria rubra – A.k.a.? Caused by?, Location? Treatment?
Heat rash; sweat produces inflammatory response
Areas of occlusion – inguinal region, axilla, chest, neck
Decrease sweating
Symptoms of serum sickness? Cause?
Urticaria, fever, arthralgias, adenopathy
Cephalosporins
Fungal infections of the scalp:
- Acquired from human to human contact
- Acquired from cats and dogs
- Hair loss with hair breaking off at scalp
- Hair loss with broken hairs thickened and white
- Kerion
- Occipital/posterior cervical lymphadenopathy
- Wood’s Light
- Trichophyton tonsurans
- Microsporum canis
- Black dot ringworm
- Microsporum canis
- Large red boggy nodule that is a hypersensitivity reaction to dermatophyte
- Tina Capitis
- Identify Microsporum canis
Erythema multiforme minor:
- Major cause?
- skin findings
- Mucus membrane findings
- Systemic findings
- Management
- prognosis
- Herpes Symplex virus
- Symmetric target lesions
- Only one surface – the help
- Prodrome of fever, arthralgias, myalgias
- Supportive, acyclovir
- Possible recurrence
Erythema multiforme major:
- Major cause?
- skin findings
- Mucus membrane findings
- Systemic findings
- Management
- prognosis
- Mycoplasma, drugs
- Symmetric target lesions acral and truncal
- Two mucosal surfaces involved – mouth and eyes
- Prodrome a fever, arthralgias, myalgias,
- Supportive,
- Good
SJS:
- Major cause?
- skin findings
- Mucus membrane findings
- Systemic findings
- Management
- prognosis
- Drugs
- Atypical asymmetric target lesions, blisters, the closest
- At least two mucosal surfaces involved
- Prodrome of high fever, cough, malaise, headache, arthralgias
- Steroids, IVIG, burn unit
- 5% mortality
- Circular scaly erythematous patches with partial central clearing
- Scaling and erythema between the toes
- Scaling and erythema in groin/inguinal creases
- Thickening and yellow discoloration of nails
Diagnose with?
- Tinea corporis – “ringworm”
- Tinea pedis
- Tinea cruris
- Tinea unguium
KOH
Tinea versicolor – causal organism? Invades what skin layer? Microscopic examination will show? Wood’s light evaluation shows?
Pityrosporum orbiculare
Stratum corneum
“Spaghetti and meatballs” appearance; yellow/orange fluorescence
Morbilliform versus scarlatiniform?
Measles-like versus scarlet fever-like (papular, Vesicular, petechial)
Erythema infectiosum – Causal organism? Description of the rash? No longer contagious when?
Parvovirus; lacy, reticular; when rash appears
Roseola infantum – causal organism? Page? Clinical features?
HHV 6/7, adenovirus, echovirus; less than two years old
Few days of high fever followed by pink papillae rash on trunk
Gianotti-Crosti syndrome– AKA? Age? Associated with what viruses? Clinical features? Maybe preceded by?
Papular acrodermatitis; Younger than three years
Hepatitis B, EBV, CMV, Coxsackie
Red papules in acral areas (extremities, but, cheeks) lasting for weeks
URI
Most common HSV infection during infancy/childhood?
Gingivostomatitis – Grouped vesicles and ulcers on lips, and corners of mouth, tongue
Complications of Varicella infection?
- Skin – bacterial superinfection, scarring, necrotizing fasciitis
- CMS – encephalitis, acute cerebellar ataxia
- Lung – pneumonia
Teratogenic effects of varicella?
- Skin – zigzag scarring
- CNS – damage
- Extremities – shortened or malformed
- Eye – cataracts or chorioretinitis
- Neonatal HSV?
2. Herpetic Whitlow
- Vesicles on the scalp, apnea, lethargy, meningioencephalitis
- HSV infection of them/fingers due to finger sucking
Herpangina
Hand-foot-mouth disease, but only oral ulcers are present
Condylomata acuminata – causal organism? Management?
HPV; liquid nitrogen, podophyllin, salicylic acid
Flesh colored papules with central umbilication? Associated with what virus? Tx?
Molluscum contagiosum; poxvirus;
podophyllin, trichloroacetic acid, liquid nitrogen, salicylic acid, cantharidin
Six Legged insect that attaches to skin and ingests blood? Unique finding in pubic variety? Tx?
Pediculus humanus; phthirus pubis
Black crusted papules or blue macules
- Head lice - 1% permethrin shampoo
- Body/pubic lice – 1% gamma-benzene hexachlorophene lotion
Scabies – treatment? Who should be treated? How long does the itching last?
Permethrin lotion or lindane (In adolescents and above)
All household contacts
Up to 30 days after treatment
Causes of hypopigmentation?
- Postinflammatory hypopigmentation
- Pityriasis alba – hypopigmented, dry, scaly patches found on cheeks. Related to atopic dermatitis
- Vitiligo
- Oculocutaneous Albinism – genetic defect in melanin synthesis
Tuberous sclerosis?
HAMARTOMAS Adenoma Sebaceum Mitral regurgitation Ash-leaf spots Cardiac rhabdomyoma Tubers (Cortical or subependymoma) Autosomal dominant Mental retardation Renal angiomyolipoma Seizures/Shagreen patch (Thickened orange peel appearance)
Iris hamartoma – disease?
Lisch nodules – neurofibromatosis
Diagnostic criteria for neurofibromatosis type one?
Two or more:
- 6+ café au lait spots
- 2+ neurofibromas
- Freckling in axilla or grind
- optic glioma
- 2+ Iris hamartomas (Lisch)
- Osseous lesion (scoliosis, sphenoid dysplasia)
- Family history
Increased risk of malignancy with what type of nevi?
Giant nevi> Congenital nevi
> Acquired nevi
Alopecia – treatment?
Most patients and regrow hair within one year
Accelerate with corticosteroids or topical Minoxidil
Causes of hair loss?
- Alopecia areata
- Tinea capitis
- Traumatic alopecia
Types of traumatic alopecia?
- Trichotillomania - hair loss as a result of unconscious or conscious pulling/twisting
- Hair loss caused by constant traction or friction (braids, curling, rubbing)
Telogen effluvium?
Hair loss called by acute stress event
Allergic Contact dermatitis – cell responsible? Management?
T cell mediated; corticosteroids
