Dermatology Flashcards
Macule
primary skin lesion
Papule
primary skin lesion
Umbilicated
primary skin lesion
Pustule
primary skin lesion
Patch
primary skin lesion
> 1 cm flat nonpalpable area of skin discoloration, larger than macule.
ex: vitiligo
Plaque
Primary skin lesion
> 1 cm raised lesion, same or different color from surrounding skin, can result from a coalescence of papules
ex: psoriasis vulgaris
Bulla
primary skin lesion
> 1 cm fluid filled
ex: 2nd degree burn
Cyst
Primary skin lesion
Raised encapsulated, fluid-filled lesion
Intradermal cyst
Wheal
Primary skin lesion
Circumscribed area of skin edema
Ex: hive
Purpura
Primary skin lesion
Flat red-purple discoloration that does not blanch with pressure
Petechiae when
Excoriation
Secondary skin lesion
Usually linear, raised, often covered with crust
Ex: stretch marks over pruritic lesions
Lichenification
Secondary skin lesion
Skin thickening usually found over pruritic or friction areas
Ex:found over pruritic or friction areas. Callus
Scales
Secondary skin lesion
Raised superficial lesions that flake with ease
Ex: dandruff, psoriasis
Erosion
Loss of epidermis
Ex: open bulla or vesicle
Ulcer
Loss of epidermis and dermis
Fissure
Narrow linear crack into epidermis, exposing dermis
Ex: athletes foot. Plantar section of foot
Linear
In streaks such as the typical photo dermatitis cause by exposure to plant oil (urushiol) contained in poison ivy, poison oak, poison sumac
Clustered
Occurring in a group without patter, such as the lesions seen in an outbreak of herpes simplex type 1 (hsv-1, “cold sore”)
Dermatonal
Limited to boundaries of a single or multiple dermatomes, such as the lesions seen w/zoster (shingles)
Scattered
Generalized over body without a specific pattern or distribution, as seen in a viral exanthem such as rubella or roseola
Confluent or coalescent
Multiple lesions blending together, such as the lesions seen in psoriasis vulgaris
Annular
In a ring, often seen in the characteristic “bull’s eye” lesion seen in Lyme disease
Treatment for psoriasis vulgaris
Medium-potency topical corticosteroid
Treatment for scabies
Permethrin lotion
Treatment for verruca vulgaris
Imiquimod cream
Treatment for tinea pedis
Topical ketoconazole
Treatment for rosacea
Topical metronidazole
What condition is most likely to occur in there antecubital fossa?
Eczema
What condition is most likely to occur in the anterior surface of the knees?
Psoriasis vulgaris
What condition is most likely to occur in sun exposed areas?
Actinic keratosis
What condition is most likely to occur over waistband area?
Scabies
What condition is usually preceded by herald patch on the trunk?
Pityriasis rosea
Where is actinic keratosis skin lesions located?
Predominately on sun expose skin, such as the face neck, back of the hands, forearms, upper chest, upper back, and rim of the external ear.
Size ranges from microscopic to several centimeters in diameter.
Describe actinic keratosis skin lesions
On skin surface, red or brown, scaly, often tender but usually minimally symptomatic.
Occasionally flesh colored, more easily felt by running a finger over the affected area than seen
When is topical treatment appropriate for the treatment of poison ivy?
Optimal for localized acute contact dermatitis
When is systemic treatment appropriate for treatment of poison ivy?
Preferred when >/=20% of total body surface area is affected with severe rash (ie; large number of blisters), or if rash impacts face, genitals, hands and/or rash impacts occupational function.
What types of topical treatment can be used for poison ivy?
Mid or high potency topical corticosteroids, such as triamcinolone (0.1%, Kenalog, Ariscort) or clobestasol (0.05%, Temovate)
For areas of thinner skin (e.g. Fleural surfaces, eyelids, face, anogenital region), lower- potency corticosteroids recommended, such as desonide ointment (Desowen) or consider oral therapy
What type of systemic type of treatment can be used for poison ivy?
Prednisone 0.5 to 1 mg/kg/day for 5-7 days (usually provides relief within 12-24 hours) ; typically significant patient response with this treatment, should be followed by 5-7 additional days with prednisone dose reduced by 50% to minimize risk of recurrence of skin lesion.
Total recommended systemic corticosteroid therapy duration: 10-14 days.
What is the clinical presentation of nonbullous impetigo?
Erythematous macule that rapidly evolve into a vesicle or pustule, ruptures, contents dry, leaving a crested, honey color exudate
What is the clinical presentation of bullous impetigo?
Bulla contains clear, yellow fluid that turns cloudy, dark yellow.
Bulla rupture easily, within 1 to 3 days, leaving a rim of scale around red, moist base, followed by a brown-lacquered or scalded-skin appearance.
What is the clinical presentation of erysipelas?
Infection of the upper dermis, superficial lymphatics, usually includes heat, redness and discomfort in the region.
Clinical presentation of cellulitis?
Infection of the dermis and subcutaneous fat usually includes heat, redness and discomfort in the region.
What is the clinical presentation of cutaneous abscess, furuncle, & carbuncles?
Skin infection involving a hair follicle and surrounding tissue, usually includes heat, redness and discomfort in the region.
Clinical presentation of a brown recluse spider bite:
Red, white, and blue sign.
Central blistering what surrounding gray to purple discoloration at bite site surrounded by a ring of skin surrounded by a large area of redness
Is the treatment of a brown recluse spider bite?
Local debridement, elevation, loose immobilization.
At time of bites, ice to limit venom spread is helpful.
Dapsone often prescribed with scant evidence of effectiveness.
1st° burn classification:
Superficial burns that impact epidermis only, no blisters present
Causes: sunburn, scald, flash flame
Treatment for a 1st° burn
Cold compresses, lotion or ointment, acetaminophen or ibuprofen
Second-degree burn classification
Superficial partial thickness (upper layers of papillary dermis) or Deep partial thickness (deeper layers of dermis, including reticular dermis)
Causes: scalds, flash burns, chemicals
Third-degree burn classification
Full thickness (epithelium, dermis, underlying fat)
Causes: flame, hot surface, hot liquids chemical, electric
How to treat a moderate nonpurelent cellulitis/erysipelas/impetigo?
IV Rx: penicillin or ceftriaxone or cefazolin, or clindamycin
How to treat a mild nonpurelent abscess/carbuncle/furuncle?
Oral Rx: penicillin VK or cephalexin, or dicloxacillin, or clindamycin
How to treat a moderate purulent abscess/carbuncle/furuncle?
I&D , C&S
Empiric RX: TMP/SMX (Bactrim) or doxycycline
Therapy directed by C&S; MRSA=TMP/SMX, MSSA= DICLOXACILLIN OR CEPHALEXIN
Auspitz sign
The appearance of punctuate bleeding spots that occur when psoriasis scales are scrape off
