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Family Medicine EOR > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

What rare condition can acanthosis Nigricans be a warning sign of?

A

Gastric adenocarcinoma

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2
Q

What characterizes acne vulgaris?

A

Open comedones (black heads)
Closed comedones (white heads)
Papules
Pustules
Nodules
Cysts

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3
Q

What are the grades of acne vulgaris?

A

Grade 1: mild acne (comedones) —> open comedones or blackheads
Grade 2: moderate acne —> greater numbers with occasional papules and pustules
Grade 3: severe acne —> large numbers and pronounced inflammation. Risk of scarring high
Grade 4: cystic acne —> large angry blemishes on face and jawline, can also affect neck arms, shoulders, and back

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4
Q

Closed comedones have ______ blockage

A

Complete

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5
Q

Treatment of acne vulgaris

A

Topical retinoids
Cystic acne: tetracyclines then oral retinoids (isotretinoin)

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6
Q

Side effects of isotretinoin?

A

Dry lips
Liver damage
Increased triglycerides/cholesterol, pregnancy category X

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7
Q

What must you obtain with isotretinoin use?

A

Pregnancy test

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8
Q

Description of actinic keratosis?

A

Flesh colored, pink or yellow-brown
sand paper feel
Occurs on sun-exposed surfaces

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9
Q

What is actinic keratosis a precursor to?

A

Squamous cell carcinoma`=

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10
Q

Treatment of actinic keratosis

A

Observation
Cryosurgery
5-FU cream
Electrodessication
Imiquimod

Usually removed as precaution

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11
Q

Tinea capitis

A

Hair loss due to fungal infection of the scalp

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12
Q

What is alopecia areata?

A

Oval-shaped, well-demarcated hair loss
Usually autoimmune attack against hair follicles
Onset prior to 30 yo

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13
Q

What is traction alopecia?

A

Hair loss due to pulling force to hair

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14
Q

What is telegenic effluvium?

A

Thinning or shedding of hair from early entry of hair into telegenic phase
Preceded by psychological or physically stressful event 6-16 weeks prior to hair loss
Growing hairs convert to resting

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15
Q

Appearance of basal cell carcinoma

A

White waxy lump or brown scaly patch
Raised pearly and rolled borders
Telangiectasias
Central ulcer on sun-exposed areas, such as face and neck

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16
Q

Treatment of basal cell carcinoma

A

Fluorouracil
Imiquimod
Photodynamic therapy
Surgical excision with clear margins

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17
Q

What is bulbous pemphigoid?

A

Rare
Chronic acquired autoimmune subdermal blistering skin disorder
Caused by linear deposition of autoantibodies against hemidesmosomes in epidermal-dermal junction

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18
Q

How does bulbous pemphigoid compare to pemphigus vulgaris?

A

Does not affect mucous membranes
Negative nikolsky sign
More tense, less fragile, and deeper than pemphigus vulgaris

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19
Q

Characteristics of bullous pemphigoid

A

Large bullae and crusts
Located on axillae, thighs, groin, and abdomen

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20
Q

How is bullous pemphigoid diagnosed?

A

Skin biopsy with direct immunofluorescence exam showing deposition of IgG and C3 basement membrane

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21
Q

Treatment of bullous pemphigoid

A

Corticosteroids

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22
Q

What is cellulitis

A

Acute bacterial skin infection of dermis and subcutaneous tissue

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23
Q

Characteristics of cellulitis

A

Pain
Erythema
Warmth
Swelling
Margins flat and no well demarcated

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24
Q

Causes of cellulitis in adults

A

Staphylococcus
Streptococcus

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25
Q

Causes of cellulitis in children

A

H. Influenza
Strep pneumoniae

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26
Q

Treatment of cellulitis

A

Mild with MSSA: cephalexin or dicloxacillin

MRSA
Bactrim
Clindamycin
Doxycycline
IV vancomycin or linezolid

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27
Q

Characteristics of condyloma acuminatum

A

Soft
Skin colored
Fleshy

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28
Q

What types of HPV causes >90% of genital warts

A

6 and 11

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29
Q

What types of HPV are associated with cervical cancer?

A

16
18
31
33
35

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30
Q

What subtypes of HPV does the gardasil 9 vaccine protect against?

A

6, 11, 16, 18, 31, 33, 45, 52, 58

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31
Q

The CDC recommends gardasil-9 starting at what age

A

11 (can be started at 9)

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32
Q

When do patients need to get only a 2 dose series for HPV?

A

9-14 years of age

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33
Q

How is condyloma acuminatum diagnosed?

A

Clinical evaluation
Colposcopy
Anoscopy

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34
Q

Treatment of condyloma acuminatum

A

Imiquimod
Podofilox
Cryotherapy
Surgery
TCA

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35
Q

Characteristics of contact dermatitis

A

Well-demarcated erythema
Erosions
Vesicles

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36
Q

What can cause allergic dermatitis?

A

Type 4 hypersensitivity
Nickel
Poison ivy

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37
Q

What can cause irritant contact dermatitis

A

Cleaners
Solvents
Detergents
Urine
Feces

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38
Q

Treatment of contact dermatitis

A

Avoid offending agent
Burrow’s solution
Topical steroids
Zinc oxide

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39
Q

Characteristics of atopic dermatitis

A

Pruritic
Eczematous lesions
Lichenification
Common on flexor creases
Infant-face and scalp
Adolescent- flexural surfaces

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40
Q

What causes atopic dermatitis

A

IgE type 1 hypersensitivity

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41
Q

Treatment of atopic dermatitis

A

Topical corticosteroids and emollients
Topical calcineurin inhibitor

42
Q

What is nummular eczema?

A

Coin-shaped/disc-shaped

43
Q

Treatment of nummular eczema

A

High or ultra-high potency topical corticosteroids

44
Q

Characteristics of seborrheic dermatitis

A

Erythematous
Yellowish greasy scales
Crusted lesions

Infants: scalp (cradle cap)
Adults/adolescents: face, chest, scalp

45
Q

Treatment of seborrheic dermatitis

A

Ketoconazole shampoo

46
Q

Presentation of perioral dermatitis

A

Young women
Papulopustular
Plaques
Scales around mouth

47
Q

Treatment of perioral dermatitis

A

Topical metronidazole
Avoid steroids

48
Q

What is a drug eruptions

A

Cutaneous reaction to administration of drug usually within last 6 weeks
Range from mild eruption that resolve when agent removed to severe skin damage with organ involvement

49
Q

Diagnosis of drug eruptions

A

Clinical

50
Q

Treatment of drug eruptions

A

Monitor for cardiovascular collapse (anaphylaxis)
DRESS (drug rash with eosinophilia and systemic symptoms)
SJS/TEN (extensive bullous reaction/generalized erythroderma)
Withdraw offending agent
If anaphylaxis or widespread urticaria —> epinephrine .2-.5 mg and prednisone to prevent recurrence
Antihistamines

51
Q

Characteristics of dyshidrosis

A

Pruritic vesicular eruption
Clear, deep seated vesicles without erythema
On lateral aspects of fingers, central palm, and plantar surfaces
Resembles tapioca pudding

52
Q

Treatment of dyshidrosis

A

Petroleum jelly
Moisturizer
Cold compresses
Topical steroids

53
Q

Characteristics of erysipelas

A

Well-demarcated, raised, superficial
Lymphatic involvement
Redness and pain
Fevers and chills

54
Q

What is the most common cause of erysipelas?

A

Group A strep: strep pyogenes

55
Q

Treatment of mild erysipelas

A

Penicillin G

56
Q

What is erythema multiforme?

A

Acute, self-limited
Type IV hypersensitivity reaction
Associated with HSV (MC), medications (sulfa drugs) and triggers

57
Q

Skin lesions associated with erythema multiforme

A

Extremities (hands, feet, mucosa)
Target-like rash
Raised, blacking, lack of itchiness

58
Q

What causes erythema infectiosum? (Fifth disease)

A

Parvovirus B19

59
Q

Characteristics of erythema infectiosum

A

Slapped cheek rash on face
Lacy reticular rash on extremities that spares palms and soles
Resolves in 2-3 weeks

60
Q

Treatment of erythema infectiosum

A

Supportive
Anti inflammatories

61
Q

What causes hand foot and mouth disease

A

Coxsackievirus type A

62
Q

Characteristics of hand-foot-and mouth disease

A

Sores in mouth, rash on hands, feet, mouth, and buttocks
Usually clears on own in 10 days

63
Q

Treatment of hand-foot-and mouth disease

A

Supportive, anti-inflammatory

64
Q

Characteristics of measles

A

4 C’s: cough, coryza, conjunctivitis, and ccephalocaudal spread
Morbilliform - maculopapular, brick red rash on face
Begins at hairline then progresses to palms and soles last
Lasts 7 days
Koplik spots (small red spots on buccal mucosa with blue0white-pale center) precede rash by 24-48 hours

65
Q

Characteristics of rubella (German measles)

A

“3 day rash” pink light red spotted maculopapular rash
First on face
Spreads to trunk and extremities
Generalized in 24 hours and lasts 3 days
Posterior cervical and posterior auricular lymphadenopathy
Does not darken or coalesce

66
Q

How is rubella related to pregnancy

A

Congenital syndrome
Deafness
TTP
Mental retardation

67
Q

What causes roseola

A

Herpesvirus 6 or 7

68
Q

Characteristics of roseola

A

Starts on trunk and spreads to face
High fever for 3-5 days, then rose pink maculopapular blanchable rash on trunk/back and face

69
Q

Characteristics of folliculitis

A

Papules and pustules
Erythematous, painful but may burn

70
Q

Common cause of folliculitis

A

S. Aureus
Pseudomonas in hot tubs

71
Q

Treatment of folliculitis

A

Mupirocin ointment and topical benzoyl peroxide

If more extensive: dicloxacillin and cephalexin

If MRSA: bactrim, clindamycin, or doxycycline

72
Q

What is hidradenitis suppurativa?

A

Chronic follicular occlusive disease
Recurrent inflammatory nodules, abscesses, sinus tracts, and complex scar formation

73
Q

Characteristics of hidradenitis suppurativa

A

Pea to marble sized nodules under skin that can be painful and enlarge and drain pus
Armpits, groin, and buttocks (where skin rubs together)

74
Q

Treatment of hidradenitis suppurativa

A

Intralesional triamcinolone
Oral and topical abx
Hygiene
Warm soaks
Sometimes surgery

75
Q

Characteristics of impetigo

A

Red sores around nose and mouth
Sores rupture and ooze forming yellow brown crust
“Honey colored” and wheeping

76
Q

Most common cause of impetigo

A

S. Aureus

77
Q

Treatment of impetigo

A

Mupirocin
Dicloxacillin
Cephalexin

78
Q

Complication of impetigo

A

Poststreptococcal glomerulonephritis

79
Q

Characteristics of kaposi sarcoma

A

Lesions in skin, lymph nodes, internal organs, and mucous membranes lining mouth, nose, and throat
Purple, red, or brown skin blotches common sign
Tumors may develop in other areas of the body

80
Q

What is kaposi sarcoma associated with

A

Human herpesvirus 8 and is AIDS-defining cancer

81
Q

Treatment of kaposi sarcoma

A

Radiation or chemotherapy
Rarely, surgery

82
Q

Characteristics of lice

A

Pruritic scalp, body, or groin
Nits: small white specs on hair shaft

83
Q

Diagnosis of lice

A

Observation of lice and nits

Nits = ovoid, grayish-white eggs

84
Q

Treatment of lice

A

Launder fomites such as sheets in hot water (>131 F or 55 C)
Permethrin topical with wet combing
Capitis: shampoo towel-dried hair and wash after 10 mins then repeat in 9 days
pubis/body lice: entire body then washed off after 8-12 hours —> screen for STIs and abstain from sexual contact
Eyelash: ophthalmic grade petroleum jelly BID x 10 days
Lindane = older treatment that can’t be used on infants, children, and elderly due to neurotoxicity
Children can return to school after first application
Resistant cases: oral ivermectin
Treat all family members

85
Q

What is lichen planus

A

Chronic papulosquamous inflammatory dermatosis of unknown etiology, possibly autoimmune

86
Q

Appearance of lichen planus

A

Purplish
Itchy
Flat topped
Lacy white patches sometimes with painful sores on mucous membranes

5 Ps: purple, papule, polygonal, pruritis, planar

87
Q

What is wickham striae?

A

Whitish lines visible in the papules of lichen planus and other dermatoses

88
Q

Treatment of lichen planus

A

Topical steroids

89
Q

What is lichen simplex chronicus

A

Chronic dermatitis due to chronic repeated rubbing or scratching of skin
Skin thickened with accentuated lines

90
Q

Characteristics of lichen simplex chronicus

A

Thick, leathery, brownish skin

91
Q

Treatment of lichen simplex chronicus

A

Break itch scratch cycle with anti-histamines and occlusive dressing

92
Q

What is a lipoma?

A

Fatty tumor that is generally slow growing and usually harmless

93
Q

Characteristics of lipoma/epithelial inclusion cyst?

A

Just under skin and move easily when pressure applied
Common in neck, shoulder, back, abdomen, arms, and thighs
If fast growing: suspect another diagnosis

94
Q

Treatment of lipoma/epithelial epidermal cyst

A

Generally not necessary
If bothersome, painful, or growing surgical excision or liposuction

95
Q

What is an epidermal inclusion cyst?

A

Epidermis cyst due to implantation of epidermal elements in the dermis

96
Q

Presentation of epidermal inclusion cysts

A

Solitary, soft, well defined
Mucin-filled lesions
Painless
Smooth surface and small opening called puncture
Benign

97
Q

Treatment of epidermal inclusion cyst

A

Close observation
Surgical management if necessary

98
Q

What is a melanoma

A

Pigmented lesion with irregular border, irregular surface, or irregular coloration
Melanocytes become cancerous

99
Q

Characteristics of melanoma

A

New, unusual growth
Change in existing mole
Asymmetrical, unevenly pigmented with nodule and irregular border
Asymmetry
Border irregular
Color variability
Diameter increasing or >6
Evolving (change in size, shape, or color)

100
Q

What is prognosis of melanoma most strongly associated with?

A

Depth of invasion

Family Medicine EOR (15 decks)

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