Dermatology

Question 1

allergic contact dermatitis

Answer 1

T cell mediated response
Cause: poison ivy, oak, sumac, nickel
Tx: steroids and avoidance of allergen

Question 2

seborrheic dermatitis

Answer 2

hypersensitivity to saprophytic yeast
Sx: red scales and crusts in areas with sebaceous glands (scalp, face, chest groin)
Tx: steroids, zinc, sulfur, or salicylic acid shampoo, antifungal

Question 3

pityriasis rosea

Answer 3

5 years +
Sx: papulosquamous disorder beginning with solitary scaly erythematous lesion (herald patch)
- christmas tree distribution on trunk
Tx: antihistamines, UV light

Question 4

psoriasis

Answer 4

childhood onset auto dom
Sx: scaling papules and plaques on scalp, ears, elbows, kinees, groin –> silvery scale
- koebner phenom new lesions at site of skin trauma
- nail involvement common
- arthritis uncommon in childhood
Tx: steroids UV light vit D, salicylic acid

Question 5

erythema multiforme minor

Answer 5

HSV
Sx: symmetric target lesions, acral distribution
- can involve mouth
- fever, arthralgias, myalgias
Tx: supportive care, good recovery

Question 6

erythema multiforme major

Answer 6

m pneumonia, drugs
Sx; symmetric target lesions acral and truncal distribution
- two mucosal surfaces involved
- fever, arthralgias, myalgias
Tx: supportive care, erythro, azithro, stop drug, good recovery

Question 7

stevens johnson syndrome

Answer 7

drugs
Sx: atypical asymmetric target lesions blisters and necrosis
- two mucosal surfaces involved
- high fever, cough, malaise, HA, arthralgias
Tx: supportive care, stop drug, steroids, IVIG, burn unit, morbidity and mortality

Question 8

erythema infectiosum

Answer 8

5th disease
Cause: parvovirus B19
- can cause aplastic criss, anemia, fetal hydrops or miscarriage in pregnant women
Sx: slapped cheek rash, URI first 1-2 weeks
- lacy reticular rash on trunk and extremities
- arthralgias
Tx: supportive

Question 9

roseola

Answer 9

Cause: HHV 6 and 7 younger than 2
Sx: 3-5 days of high fever, pink papular eruption on trunk
Tx: supportive

Question 10

hand foot mouth and herpangina

Answer 10

coxsackie types A16, A2, A5, A10
Sx: vesicles papules or pustules on palms, soles, fingertips and shallow ulcers on soft palate or tongue
Tx: supportive

Question 11

tuberous sclerosis

Answer 11

auto dom
Sx: ash leaf spots, angiofibromas, shagreen patch (orange peel appearance), ungual fibromas,
- sz, calcifications, cortical or subependymal tubers,
- renal cysts, cardiac rhabdymyomas (NUMBER ONE CAUSE OF NEONATAL CARDIAC TUMORS) retinal astrocytoma or hamnartoma, mental retardation

Question 12

neurofibromatosis I

Answer 12

auto dom
Sx: cafe au lait spots, axillary/inguinal freckling, plexiform neurofibroma or skin neurofibromas,
- optic glioma, calcifications, neurofibromas
- lisch nodules, osseous lesions, scoliosis, HTN, learning problems