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Internal Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Layers of epidermis (calfiorniams like getting sun burns)

A 
Corneum
Lucidum
Granulosum
Spinosum
Basale
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2
Q

Langerhan cells

A

Immune surveillance

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3
Q

Merkel cells

A

Touch sensation in epidermis

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4
Q

Sebaceous gland

A

Produces sebum into hair follicle, found everywhere except palms and soles

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5
Q

Apocrine glands

A

Empties into hair follicles, found in axillae and perineum

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6
Q

Eccrine sweat gland

A

All over body, timportant in temperature regulation.

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7
Q

Macule

A

Flat,

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8
Q

Patch

A

Flat, >1cm

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9
Q

Papule

A

Elevated, palpable,

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10
Q

Plaque

A

Elevated, palpable, >1cm

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11
Q

Nodule

A

Deep, palpable,

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12
Q

Tumour

A

Deep, palpable, >1cm

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13
Q

Vesicle

A

Fluid filled,

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14
Q

Bulla

A

Fluid filled, >1cm

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15
Q

Cyst

A

Epithelial lined collection containing fluid.

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16
Q

Pustule

A

Elevated lesion containing purulent fluid

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17
Q

Erosion

A

Disruption of epidermis only. Heals without scarring

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18
Q

Ulcer

A

Disruption of epidermis, dermis. Heals with scarring.

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19
Q

Indurated

A

Hard or firm lesion

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20
Q

Wheal

A

papule/plaque that is blanchable and transient

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21
Q

Crust

A

Dried fluid

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22
Q

Scale

A

Excess keratin

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23
Q

Lichenfication

A

Thickening of skin

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24
Q

Fissure

A

Linear slit-cleavage

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25
Q

Excoriation

A

Scratch mark

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26
Q

Xerosis

A

Dryness f skin, conjunctiva or mucous membranes

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27
Q

Atrophy

A

Thinning or depression of skin, histological decrease.

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28
Q

Comedones

A

Collection of sebum and keratin (black and white heads)

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29
Q

Purpura

A

Extravasation of blood into dermis

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30
Q

Petechia

A

Pinpoint purpura

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31
Q

Ecchymoses

A

Larger flat purpura >1cm

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32
Q

Telangiectasia

A

Dilated superficial blood vessels, blanchable.

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33
Q

Acral

A

Hand and feet distribution

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34
Q

Annular

A

Ring shaped pattern

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35
Q

Follicular

A

Involving follicles

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36
Q

Guttate

A

Lesions following a “drop-like” pattern

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37
Q

Koebner phenomen

A

Appearence of lesions in areas of trauma

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38
Q

Koebner phenomen

A

Appearence of lesions in areas of trauma

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39
Q

Reticular

A

Lesions following a net-like pattern

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40
Q

Satellite

A

Lesions outside of primary lesion

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41
Q

Serpiginous

A

lesions follow a snake-like pattern

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42
Q

Target lesion

A

Concentric ring lesion

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43
Q

Epidermal cyst

A

Epidermal cells displaced into dermis, filled with keratin and lipid-rich debris. Central punctum present

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44
Q

Pilar cyst

A

Thick walled cyst lined with statified epithelium. Appearing under scalp, lack central punctum

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45
Q

Dermoid cyst

A

Most commonly found at lateral third of eyebrow or midline under nose.

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46
Q

Ganglion cyst

A

Rubbery and translucent. Originates from joint or tendon sheath.

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47
Q

Milium

A

Small superficial subepidermal papules occuring on face

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48
Q

Dermatofibroma

A

Button-like, firm dermal papule/nodule due to benign tumour from fibroblast proliferation in dermis.

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49
Q

Skin tags

A

Benign outgrowth of skin.

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50
Q

Seborrheic keratosis

A

Well-demarcated waxy papule with “stuck on” appearence. Common benign epithelial tumour

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51
Q

Actinic keratosis

A

Ill-defined, scaly erythematous pauples or plaques on background of sun-damaged skin. Gritty sensation.
Rx: liquid nitrogen, 5-flurouracil cream

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52
Q

Keratoacanthoma

A

Rapidly growing, dome shaped with keratin filled crater. Epitherlial neoplasm, often sponatneously regress within a year.
Rx: excision (same as SCC)

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53
Q

Corns

A

Firm papule with central, transulcent cone-shaped hard keratin core. Localised hyperkeratosis induced by pressure on hands and feet.

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54
Q

Keloid

A

Firm, shiny skin-coloured/red-blue papules that arise from cutaneous injury. Extends beyond margins of original injury.
Rx: intralesion steroids, cryotherapy, silicone compression

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55
Q

Ephelides

A

Freckles, in sun-exposed skin.

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56
Q

Solar lentigo

A

Liver spot, in sun-exposed skin. Benign melanocytic proliferation in dermalepidermal junction. Elderly people

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57
Q

Mongolian spot

A

Congenital, fades in childhood usually

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58
Q

Becker’s nevus

A

Hairy, brown macule patch, onset often in teens.

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59
Q

Nevomelanocytic nevi

A

Common mole

Junctional - macular, arise at dermal-epidermal junction
Compound - papular, invades papillary dermis
Dermal - skin coloured papule, completely migrated into dermis

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60
Q

Melasma

A

Dark skin discolouration on sun-exposed areas of face. Common in pregnancy, OCP, HRT users.

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61
Q

Hemangiomas

A

Vascular tumour of benign proliferation of thick-walled vessels. Soft, compressible, blanches, “bag of worms”.
Appears shortly after birth.

62
Q

Spider angiomas

A

Telangectasia, associated with hyperestrogenic state (liver disease, pregnancy, OCP)

63
Q

Cherry angioma

A

Bright red dome shaped papule, benign vascular neoplasm.

64
Q

Pyogenic granuloma

A

Red dome shaped nodule which is friable. Rapidly developing hemangioma with erosion of epidermis.

65
Q

Nevus flammeus

A

Port wine stain present at birth that follows dermatomal distribution. Congenital vascular malformation of dermal capillaries.

66
Q

Nevus simplex

A

Salmon patch, pink irregular patches due to congenital dilation of dermal capillaries. Regresses spontaneously

67
Q

Acne vulgaris

A

Common acne with comedonal pattern. Common inflammatory pilosebaceous disease.
Rx: erythomycin, clindamycin, isotretinoin, cyproterone (Diane-35)

68
Q

Rosacea

A

Chronic acneiform inflammatory skin disease. Flushing, burning sensation, ruddy checks with dome shaped papules. May be exacerbated by heat, cold, wind, stress, sun, alcohol, caffine.

69
Q

Atopic dermatitis

A

Subacute or chronic eczema with pruritus, mainly in flexor surfaces.
Rx: fatty cream, aqueous cream, topical steroids, topical calcineurin inhibitors

70
Q

Contact dermatitis

A

Cutaneous inflammation caused by external agent. Erythema, pruritus, papulovesicles (allergic), burning (irritant)

71
Q

Dyshidrotic dermatitis

A

Papulovesicular dermatits of hands and feet that coalesce into plaques, followed by fissuring.
Rx: topical steroids

72
Q

Nummular dermatitis

A

Annular, coin-shaped, prutitic, erythematous plaques.

73
Q

Seborrheic dermatitis

A

Greasy, erythematous, scaling. Cause cradle cap in infants.

Rx: olive oil, shampoo

74
Q

Stasis dermatitis

A

Persistent inflammation of lower legs with erythema, xerosis, scaling and brownish pigmentation. Associated with venous insufficiency.

75
Q

Lichen simplex chronicus

A

Chronic dermatitis from continued rubbing/scratching of skin/lichenfication.
Rx: antihistamines, topical steroids

76
Q

Lichen planus

A

Acute or chronic inflammation of mucous membranes or skin characterised by violaceous papules on flexor surfaces. Purple, pruritic, polygonal, peripheral, papules, penis (lacy white reticular network over mucous membranes).
Rx: topical steroids, phototherapy, immunosuppressives

77
Q

Pityriasis rosea

A

Acute, self-limiting eruption. Red oval plaques with central scale, “Christmas tree”, “herald” patch initially

78
Q

Psoriasis

A

Chronic and recurrent disease, well-circumscribed erythematous plaques with silvery scales on extensor surfaces, bleeds when scale removed.
Rx: steroids, vitamin D analogues, retinoids, coal, saliclicylic acid. Phototherapy, methotrexate, cyclosporin for systemic treatment

79
Q

Bullous pemphigoid

A

Chronic autoimmune bullous eruptions. Tense, pruritic, subepidermal bullae on flexor aspects. IgG production against dermal-epidermal BM.
Rx: prednisone, methotrexate

80
Q

Dermatitis herpetiformis

A

Grouped papules/vesicles/urticarial wheals on erythematous base on extensor surfaces. Pruritus, burning, stinging. Associated with coeliacs, thyroid disease. IgA antibody.
Rx: gluten free diet, dapsone for pruritus.

81
Q

Pemphigus vulgaris

A

Autoimmune blistering, flaccid non-pruritic epidermal bullae, secondary erosions. IgG against epidermal layer.
Rx: prednisone, plasmapheresis

82
Q

Drug hypersensitivity syndrome

A

Fever followed by symmetrical bright red exanthematous eruption (may have internal organ involvement). Occurs 10 days after first drug exposure.
Most common: sulfonamides, anticonvulsants

83
Q

Erythema multiforme

A

Macules/papules with central vesicle in bull’s eye pattern. Lesions appears within 3 days and last 2 wks.
Rx: symptomatic treatment

84
Q

Erythema multiforme

A

Macules/papules with central vesicle in bull’s eye pattern. Lesions appears within 3 days and last 2 wks. Associated with HSV, mycoplasma pneumonia, orf virus.
Rx: symptomatic treatment

85
Q

Toxic epidermal necrosis

A

Severe blistering and mucous membrane involvement, diffuse erythema and then necrosis, high fever. Frequently drug related. Rx: 30% mortalitiy, admit to hospital.

86
Q

Toxic epidermal necrosis

A

Severe blistering and mucous membrane involvement, diffuse erythema and then necrosis, high fever. Frequently drug related. Rx: 30% mortalitiy, admit to hospital.

87
Q

Exanthematous eruptions

A

Morbilliform rash commonly caused by antibiotics.

88
Q

Fixed drug eruptions

A

Sharply demarcated erythematous oval patches on skin. Reoccurs on the same location upon subsequent exposure.

89
Q

Ichthyosis vulgaris

A

Generalised hyperkeratosis leading to dry skin

90
Q

Neurofibromatosis Type 1

A 
AD disorder with abnormal proliferation of neural crest elements.
Cafe au lait spot
Axillary or inguinal freckling
Lisch nodules
Optic gliomas
Neurofibromas
91
Q

Vitiligo

A

Primary depigmentation caused by melanocyte destruction. Associated with other auttoimmune disease.

92
Q

Impetigo vulgaris

A

Acute infection with honey crusted lesions.
GAS, S aureus or both.
Rx: topical antiseptics and antibiotics.

93
Q

Bullous impetigo

A

Thin walled bullae containing yellow/turbid fluid. S. aureus.
Rx: topical antibiotics

94
Q

Erysipelas

A

GAS infection involving upper dermis. Confluent, erythematous, well demarcated plaques that are very painful.
Rx: penicillin, cefazolin

95
Q

Cellulitis

A

Infection (GAS, S aureus, H influenza) involves lower dermis/subcutaneous fat. unilateral erythematous flat lesion, tender.
Rx: cloxacillin, cefazolin, erythromycin

96
Q

Superficial folliculitis

A

Superficial infection of hair follicles. Staph, pseudomonas occasionally.
Rx: antiseptics, topical antibacterial

97
Q

Furuncles

A

Boils which are red, tender inflammatory nodules. Involves subcutaneous tissue around hair follicle. S. aureus.
Rx: drainage, topical/systemic abx

98
Q

Carbuncles

A

Deep-seated abcess formed by multiple coalescing boils. S. aureus. Rx: drainage and abx

99
Q

Tinea capitis

A

Round scaly patches of alopecia on scalp.

Rx: terbinafine for 4-6wks

100
Q

Tinea corporis

A

Ring worm, pruritic scaly round plaque with erythematous margin.
Rx: topical clotrimazole, miconazole

101
Q

Tinea cruris

A

Jock itch, scaly patch with well-defined curved border.

Rx: topical clotrimazole, miconazole.

102
Q

Tinea pedis

A

Athlete’s foot, pruritic scaling/maceration of web spaces.

Rx: topical clotrimazole, miconazole.

103
Q

Tinea unguium

A

Onchomycosis, crumbling dystrophic nails with yellowish opaque subungal hyperkeratotic debris.
Rx: terbafine 6wk hands, 12 weeks toes

104
Q

Scabies

A 
Intense pruritus (nocturnal), linear burrows, urticarial crusted papules.
Rx: permethrin cream, antihistamine, change all linens
105
Q

Lice

A

Intense pruritic red excoriations, morbilliform rash, nits on hairs.
Rx: permethrin shampoo

106
Q

Bed bugs

A

Burning wheals turning to firm papules.

Rx: symptomatic

107
Q

Herpes simplex

A

Herpetiform vesicles on erythematous base. May have fever, regional lymphadenopathy, or secondary reactivation. HSV-1 cold sores. HSV-2 sexually transmitted, extremely tender ulcers.
Rx: acyclovir 200mg PO 5x for 10/7

108
Q

Herpes zoster

A

Unilateral dermatomal eruption with vesicles, bullae, pustules.
Rx: analgesics (NSAIDs, amitryptiline), valacyclovir for immunocompromised, gabapentin for post-herpetic neurelgia

109
Q

Molluscum contagiosum

A

Dome shaped umbilicated pearly papules caused by DNA pox virus.

110
Q

Verruca

A

Warts, caused by HPV virus.

Rx: salicylic acid, silver nitrate, occlusive, liquid nitrogen.

111
Q

Candiasis

A

Paronychia: painful red swellings of periungal skin.
Intertrigo: erythematous patches in folds with satillite pustules.
Rx: topical or oral miconazole, ketoconazole

112
Q

Syphilis

A

Primary: painless chancre.
Secondary: macules/papules flat topped and scaling, condyloma lata, mucous patches.
VDRL testing.
Rx: penicillin IM

113
Q

Gonococcemia

A

Disseminated infection with hemorrhagic, tender pustules. Associated fever, arthritis, urethritis, proctitis, pharyngitis, tenosynovitis.
Rx: ceftriaxone

114
Q

Leukoplakia

A

Premalignant white plaques with sharply demarcated borders. Associated with smoking and alcohol.

115
Q

Basal cell carcinoma

A

Rolled edges, surface telagiectasia.

116
Q

Malignant melanoma

A

Lentigo - flat brown staining
Superficial spreading melanoma - irregular, indurated, enlarging plaque
Nodular melanoma - uniformly ulcerated and sharply delinated plaque
Acrolentiginous melanoma - palmar, plantar, subungal skin

117
Q

Squamous cell carcinoma

A

Indurated erythematous nodule with surface scale

118
Q

Non-scarring alopecia

A

Male pattern balding.

Rx: minoxidil, finasteride, spironolactone for women

119
Q

Trichotillomania

A

Compulsive hair pulling

120
Q

Alopecia areata

A

Autoimmune patches of complete hair loss, fine stippling on nails. Occurs in episodes and precipitated by stress. Associated with other autoimmune disease.

121
Q

Scarring alopecia

A

Irreversible loss of hair follicles with fibrosis. Causes: radiation, burns, fungal, TB leprosy, lichen planus, DLE

122
Q

Nail clubbing

A

Loss of nail fold angle.

Associated with: cyanotic heart disease, bacterial endocarditis, pulmonary disorders, GI disorders

123
Q

Koilonychia

A

Spoon shaped nails.

Associated with: iron deficiency, malnutrition, diabetes

124
Q

Onycholysis

A

Separation of nail plate from nail bed.

Associated with: psoriasis, dermatophytes, thyroid disease

125
Q

Onychogryphosis

A

Hypertrophy of nail plate and subungal hyperkeratosis.

Associated with: poor circulation, chronic inflammation, tinea

126
Q

Onychohemia

A

Subungal hematoma.

Associated with: trauma

127
Q

Onychomycosis

A

Fungal infection of nail. Associated with: HIV, DM, PVD

128
Q

Onychocryptosis

A

Ingrown toe nail. Associated with tight fitting shoes, excessive clipping

129
Q

Nail pitting

A

Associated with: psorasis, alopecia areata, eczema

130
Q

Transverse ridging of nails

A

Beau’s line. Associated with: eczema, chronic paronychia, trauma

131
Q

Transverse white lines of nails

A

Associated with: poisons, hypoalbuminea (Muherke’s lines)

132
Q

Behcet’s disease

A

Painful apthous ulcers in oral cavity, erythema nodosum

133
Q

Buerger’s disease

A

Superficial migratory thrombophlebitis, pallor, gangrene

134
Q

Dermatomyositis

A

Helitrope, Grotton’s papules, periungal erythema

135
Q

Polyarteritis nodosa

A

Subcutaneous nodules, stellate purpura, livedo reticularis, splinter hemorrhages

136
Q

Rheumatic fever

A

Petechia, urticaria, erythema nodosum, rheumatic nodules

137
Q

Scleroderma

A

Raynaud’s, nonpitting edema, cutaneous calcification

138
Q

Systemic lupus erythematous

A

Malar erythema, discoid rash, hemorrhagic bullae, photosensitivity

139
Q

Crohn’s disease

A

Pyoderma gangrenosum, erythema nodosum, granuloma annulare

140
Q

Addison’s disease

A

Hyperpigementation, especially mucosa, scars and folds

141
Q

Cushing’s syndrome

A

Moon facies, purple striae, acne, hirutism, atrophic skin with telangiectasia

142
Q

Diabetes mellitus

A

Infections, pruritus, acanthosis nigracans, granuloma annulare

143
Q

Hyperthyroidism

A

Sweaty, nail atrophy, toxic alopecia, pretibial myxedema, oncholysis

144
Q

Hypothyroidism

A

Dry skin, coarse hair, brittle nails, myxedema

145
Q

Adenocarcinoma

  • GI
  • Cervix/anus/rectum
A
  • Peutz-Jeghers (oral mucosa pigmantation), acanthothsis nigrans
  • Paget’s disease (eroding scaling plaques of perineum)
146
Q

Carcinoma

  • Breast
  • GI
  • Thyroid
  • Breast/lung/GU/ovary
A
  • Paget’s disease of breast
  • Palmoplantar keratoderma (thick skin palm/soles)
  • Sipple’s syndrome (multiple mucosal neuromas)
  • Dermatomyositis
147
Q

Lymphoma

  • Hodgkin’s
  • ALL
A
  • Ataxia telangiectasia (on pinna, bulbar conjunctiva)

- Ichthyosis (generalised scaling)

148
Q

Multiple myeloma

A

Amyloidosis (large smooth tongue with waxy papules on eyelids, nasolabial folds, lips, facial petechiae)

149
Q

Liver disease

A

Pruritus, hyperpigmentation, spider nevi, palmar erythema, white nails, porphyria cutanea tarda, xanthomas, jaundice

150
Q

Renal disease

A

Pruritus, pigmentation, perforating dermatosis, calciphylaxis

151
Q

Erythema nodosum

A

Acute or chronic inflammation of subcutaneous fat, round, red, tender nodules on extensor surfaces.
Drugs associated are OCP and sulfonamides.

Internal Medicine (12 decks)

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