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Dermatology Flashcards

1
Q

terminology primary lesion

A 
flat: macule/ patch: cutaneous color
raise:
1. papule/patch
2. vesicles/bulla- fluid filled
3. pustules
4. wheals- cutaneous elevation caused by dermal edema
dermal lesion
1) nodule/tumor
2) cyst- nodule with expressible material
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2
Q

secondary lesion

A 
scaling-desquamation of stratum corner
crusting-dried exudate
pigmentation changes
exoriations-linear erosions caused by fingernail scratches
scars-thicked fibrotic dermis
 ulcer-lack of epic/some of dermis
atrophy-thinning of epic/dermis
fissue-linear crack through dermis
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3
Q

configuation

A

linear, annular, acuate (semi-circle), grouped, discrete

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4
Q

acral

A

hands, feet buttock

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5
Q

woods light

A

pigmentary changes dermatophytes

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6
Q

scraping

A

fungus-10% KOH exudate hyphae
look for mites eggs feces-scabies
base of vesicle scraped for HSV

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7
Q

hyperkeratosis

A

need keratolytics like salicylic acid, urea, acids

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8
Q

topical corticosteroid SE

A

systemic- only if potent and on damaged skin. adrenal suppression,
local SE- more common- w/in days of tx: arena, hirsutism, folliculitis, striae, hyper/hypopigmentation, atrophy, ecchymoses, telangiectasias, tachyphylaxis

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9
Q

antiinflam agents

A

steroids, tracrolimus ointment (for atopic dermatitis), 1-5% sulfer for acne. tar- eczema, psoriasis

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10
Q

inflammatory D

A

contact dermatitis, atopic dermatitis, seborrheic dermatitis, pityriasis rosea, psoriasis, miliaria rubra (heat rash)

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11
Q

contact dermatitis

A

sensitizing agent cause infm of epidermis and superficial dermis

1) allergic contact dermatitis: direct T cell mediated: initial sensitization then rechallenge, not dose dep- poison ivy/oak, jewelry, cream. see: erythematous papule and vesicles. tx- corticosteroid and avoidance
2) primary irritant contact dermatitis: caustic substance irritate skin, dose dep, no sensitization. ex- diaper dermatitis. erythema papules. tx- clean + no moisturizers, change diaper. low potency corticosteroid

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12
Q

seborrheic dermatitis

A

infant and adolescents. unknown et-maybe hypersensitive to yeast. P: red scales and crusts in area with sebaceous gland= scalp, face, chest, groin. greasy skin lesion
infant- limit to scalp= cradle cap
low potency corticosteroid, ulcer, zine or salicylic acid shampoo, topical anti fungal med

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13
Q

pityriasis rosea

A

uncommon

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14
Q

psoriasis

A

3% in kids. 30% first sign in childhood.
etio: if in kid likely auto dom inheritance caused by immune dysregs –> epi prolif
P: scaling papuls, plaques. scalp, nongreasy, hair loss, ears, elbow,. silvery scale. koebner phenomenon- new lesion dev at trauma sites
nail involvement common= pits, distal thickening, lifting of nail med/ destruction
arthritis uncommon in kids
manage- mod-high pot CS, UV light, bit D, 3% salicylic acid, retinoids, anthralin

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15
Q

miliaria rubra (heat rash)

A

disrupted sweat ducts near upper dermis- occlusion or friction. sweat into skin –> inflm –> more sweat -> more occlusion –> rash
small erythematous pruritic papule or vesicles in rubbed area-inguinal, axilla, chest, neck
tx: no med, avoid occlusive clothes- decr sweating

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16
Q

hypersensitive D

A

urticaria, serous sickness, erythema multiform, toxic epidermal necrolysis

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17
Q

serum sickness

A

~urticaria, systemic sign=fever, arthralgia, = organ injury. cause med meds~ cephalosporin

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18
Q

erythema multiform

A

HS to multi stimuli, drug, viruses etc
EM minor, EM major, steven johnson. all has target lesion= fixed, dull red, oval macule with dusky center containing a papule or vesicle.

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19
Q

toxic epidermal necrolysis

A

drug rxn. widespread epidermal neurosis, sloughing >30% skin loss.. no target lesion. Nikolsky sign- skin peal with lateral pressure. 10-30% mortality bc sepsis, dehyration, electrolyte abn

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20
Q

skin infection

A

fungal, bacterial, viral, ectoparasites

21
Q

fungal

A

etio- child, urban, humid, crowded

category: hair, skin nails
dx: KOH scraping, wood light

22
Q

tinea capitis

A

fungal hair loss cause by trichophyton tonsuring from human-human contact.
P: patchy cair loss -black dot ringworm. scales and pustules, kerio= boggy nodule red, occipital posterior cervical lymphadenopathy
tx- systemic oral antifungal. topical bad.

23
Q

tinea corporis/pedis/cruris

A 
infect body, foot, groin. et: M canis
corporis- ringwarm= oval scaly circal erythematous patches with partial central clearing
pedis- athlete's foot, can have vesicles
cruris- scales and erythema
tx: topical antifungal
24
Q

tinea unguium (onychomyocisis)

A

fungal nail infection. yellow

25
tinea versicolor
pityrosporum oribularea= yeast invade stratum corneum. scaly macule on trunk, proximal arm, face. hypo/perpig. more prominent with sun. dx- circular spore or hyphae on koh. spaghetti and meatball appearance slenium sulfid
26
viral exanthem
skin associated with viral infection. morbilliform- measles like. scarlatiniform- scarlet fever like- papular, vesicular, petechial
27
erythema infectious (fifth disease)
fifth grade= school age. etio: parvovirus B19- respiratory secretion also see aplastic crisis, prolong anemia, fetal hydrous, miscarriage P: begin with URI then 1-2 wk bright red macular rash on cheeks = slapped cheek= not contagious. lacy reticular rash, arthralgia tx: supportive
28
roseola infantum
29
gianotti crosti= papular acrodermatitis
30
varicella
dew drop on rose petal= vesicle on red background. crops of lesions --> crust. fever common. if at risk for complication give acyclovir
31
herpes simplex 1/2
neonatal. 2/3 by 2. gingivostomatitis - most common HSV in infancy alway by 1. on lip, mouth, tongue. pain on swelling, drooling, fever grouped vesicles on erythematous base newborn- scalp contact with mom lesion- sepsis, meningoencephalitis.= emergency herpetic whitlow- oral lesion + finger sucking= finger lesion latent in dorsal ganglia- retrigger by sunlight, fever, stress, trauma dx: tzanck preparation= microscope with direct fluorescent ab or culture base of lesion, pcr if test csf
32
hand-foot-mouth disease and herpangina
coxsackievirus A16. vesicle papule, pustule. if only oral lesion= herpangina. fever. supportive tx
33
warts
HPV. ireg, discrete flesh colored papules, smooth or rough. contagious. condylomata acuminata= multiple in genital spontaneously resolve in 1-2y. liq Nitrogen, recurrence high
34
molluscum contagiosum
poxvirus. fresh colored papule with central umbilication. on haired skin though face, extremity trunk. contagious. HIV associated. self resolve
35
ectoparasites
louse infestation or scabies
36
louse infestation
lice in head/body (pedicures humanus), groin (phthirus pubis). ingest blood. nits- eggs on hair shaft- white oval. body- papule and pustules pubic- nits and black crusted papule or blue macule 1% permethrin shampoo, comb 12hr application of 1% benzene hexachloride lotion
37
scabies
sarcoptes scabiei. pruritic papules or vesicles. itching severe. S shaped burrows. tx- 5% permethrin lotion or 1% lindane. highly contagious
38
pigmentation D
hypopig, neurocutaneous D, nevocellular nevi
39
hypopig
postinflm hypopig, pityriasis alba (atopic dermatitis, cheeks), vitiligo (complete loss of pig in patchy area cause by melanocyte destruction, no tx), oculocutaneous albinism- genetic defect in melanin synthesis (photophobia, nystagmus, blue eyes, white skin/hair)- no tx.
40
Tuberous sclerosis
ash-leaf, angiofirboma= adenoma sebaceum. shagreen patch- orange peel appearance. ungual fibroma. infantile spasm, #1 cuase of neonatal cardiac tumor
41
NF I
cafe au lait. lis nodules (iris hamartoma)
42
Nevocelular nevi
congenital: any color papule or plaque detected btw birth-6mo - all have incr risk of ca. giant nevi (>6cm) = high risk of melanoma= excision + observe other nevi acquired nevi: peak 2-3/11-18. most junctional nevi. risk of ca lower than congenital.
43
hair disorder
alopecia areata, tinea capitis (common cause of hair loss), traumatic alopecia, telogen effluvium
44
alopecia areata
AI injury to follicle. complete hair loss in well remarked scalp areas w/o inflm. sudden with smooth skin. pitting nail in 40%. most regrow in 1y. topical CS or minoxidil speed it up.
45
traumatic alopecia
trichotillomania: perifollicular petechiae and excoriations | traction alopecia: due to friction/ traction of tight hair braids, curlers etc. thinner but few broken hair
46
telogen effluvium
2nd most common alopecia after male pattern baldness. due to acutely stressful event ~ preg. convert hair from growing phase (anagen) to resting phase (telogen) lose>100/d. spontaneous regrow.
47
acne vulgaris
most common skin disease. androgen stimulate sebum production - obstructed = comedones --> inflm bc bacteria- propionibacterium acne. benzoyl peroxide good for both inflm and noninfm (black/white heads). systemic isotretinoin (actuate) good for all. but test for preg bc incr teratogenic
48
atopic dermatitis
eczema. itch that rashes. irritation- scratch- rash | tx: lubricate skin, use anti-inflm in bursts, tx associated skin infection

Peds (21 decks)

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