Dermatology Flashcards
Which two rashes spare the inguinal folds?
- Contact dermatitis
- Eczema
Which diaper rashes go into inguinal folds?
- Candida
- Psoriasis
- LCH rash
What does nummular eczema look like?
- Coin shaped eczematous lesions on extensor surface of extremities
- Lesions are uniform without central clearing
- Lesions may ooze, crust, or have scales on them
What is Pityriasis Alba?
The hypopigmented skin after seborrheic dermatitis clears
What is the Auspitz sign?
The bleeding that occurs after a psoriasis scale is removed
What differentiates an LCH rash from eczema?
Petechiae or papules in the rash
What are the clinical findings of lichen sclerosus?
- White and scaly
- Chronic, inflammatory, dry, white
- No thickening or sclerosis
- In genital area
- pruritis
What are the clinical features of lichen stratus?
“Striae are linear.”
- Looks like eczema
- Linear or papular and can follow lines of Blaschko
What are the clinical features of icthyosis vulgaris?
“Icky fishy scales”
- Rash resembles fish scales
- Often seen in atopic dermatitis
What are the clinical features of lamellar icthyosis?
“Don’t lament over the lamellar baby, though they look quite alarming. They are not as sick as the harlequin babies.”
- Thin, transparent film over body
- Missing eyelashes
- Everted eyelids
What are the clinical features of harlequin icthyosis?
- Hard, armor-like, horny covering
- Restricted movement
- Poor prognosis
What is pyoderma gangrenosum?
- Pyoderma is associated with Preexisting diseases
- Deep bluish necrotic and boggy looking ulcers
What is granuloma annulare?
- Chronic skin condition
- Annular lesions
- Slightly pruritic
- No scales
- Tx: steroids
What are the main clinical features of Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)?
- TEN if >30% body surface is involved
- Bullae followed by a hemorrhagic crusting
- Severe blistering -> Nikolsky sign
- Bull’s-eye or target lesion
- At least two mucous membranes involved (usually lips and eyes)
- Rash begins within 2 months of starting implicated medications
What are the main clinical features of erythema multiforme?
- Target lesions start on hands or feet and then progress to trunk
- 0-1 mucous membranes involved
What are the major clinical features of scleroderma?
- Thickened skin with ivory or waxy appearance
- Girls affected more than boys
- Tx: topical lubricants for limited cases, immunosuppression for more severe cases
What is an epidermoid cyst?
- Saclike growth present at birth
- Contain hair and teeth
- Often associated with tufts or sinuses
- Should be removed because they can get infected
How is comedonal acne treated?
- Retinoid
- Benzoyl peroxide, but not to be used at the same time as the retinoid
How is inflammatory acne different from comedonal acne?
Inflammatory acne has a red base
How is inflammatory acne treated?
- Minor cases: localized with small lesions
- Topical antimicrobial: benzoyl peroxide, clindamycin, erythromycin
- Retinoic acid topical
- Severe cases: large, nodular, multiple areas
- Oral antibiotics:
- First line: tetracycline, doxycycline, erythromycin
- Second line: Minocycline
- OCPs
- Isotretinoin
- Oral antibiotics:
What diseases are associated with peg teeth?
Incontinentia pigmenti
Hypohidrotic ectodermal dysplasia
What is the timeline for hemangiomas?
- Proliferation during the first 6 months
- Largest size by 1 year
- Begin to involute around 2 years
- Disappear by 5 to 10 years
What is PHACES Syndrome?
Required: A large hemangioma in the face or neck area plus one of the following:
Posterior fossa malformation (Dandy Walker)
Hemangioma
Arterial cerebrovascular anomaly
Cardiac: esp Coarctation of the aorta
Eye: microphthalmia, strabismus
Sternal defect
What are port wine stains?
- Capillary malformation
- Usually unilateral, segmental, do not cross midline
- Start as pink and flat lesions -> become dark red and purple -> become thick and raised in adulthood
- If on face, can be associated with glaucoma
- Grow in proportion with child
What is Sturge-Weber syndrome?
- Port wine stain in a
- Trigeminal nerve distribution +
- Intracranial vascular malformation +/-
- Glaucoma +/-
- Neurologic deficits (seizure, cognitive deficits)
What is Klippel-Trenaunay Syndrome?
“Cripple-T” = crippling disorder
- AV fistulae
- Hemihypertrophy
- Port Wine stain
What is McCune Albright Syndrome?
3 P’s:
- Pigmentation: cafe-au-lait spots (multiple or >3cm)
- Precocious puberty (and other endocrine problems)
- Polyostotic fibrous dysplasia: bone problems (fractures, cranial deformities)
What are the clinical features of Tuberous Sclerosis?
ASHLEAF A: ashleaf spots (seen with woods lamp), at least 3 on body; autosomal dominant S: shagreen patch H: heart rhabdomyosarcomas L: lung hamartomas E: epilepsy; periventricular or cortical tubers; infantile spasms A: angiolipoma (renal); angiofibroma F: facial angiofibroma
- Need at least 2 of these to make diagnosis
What are the clinical features of neurofibromatosis I?
CAFESPOT
* First degree relative has the disease
C: café au lait spots (6)
- <10 yrs: >5 mm
- >10 yrs: >15 mm
A: axillary freckling
F: fibromas
E: eye - lisch nodules
S: scoliosis/bony abnormalities
P: pseudoarthrosis of tibia; pheochromocytoma
OT: optic tumor (optic nerve glioma)
- Need at least 2 of these to make diagnosis
What are the clinical features of Incontinentia Pigmenti?
- X-linked dominant (all males die)
- 4 stages:
- Inflammatory vesicular phase
- Verrucous phase
- Hyperpigmentation phase (along lines of Blaschko)
- Hyperpigmentation disappears
- Systemic associations:
- Delayed dentition
- Mental retardation
- Paralysis
- Peg teeth
- Seizures
What are the clinical features of hypohidrotic ectodermal dysplasia?
- Related to incontinentia pigmenti, but in boys
- Decreased sweating
- Sparse hair
- Delayed tooth eruption and deformed teeth
What is that organism responsible for a skin infection and a premature baby?
Staph epidermidis
What is the treatment of choice for cellulitis?
Cefazolin
Discreet Zone of erythema/edema/induration = tx with cefaZolin
What are the clinical features of Pityriasis Rosea?
“Pretty Rosea occurs in the winter around Christmas time, when you hark the HERALD and are not exposed to light.”
- HERALD patch: first lesion
- Oval, parallel lesions with thick scales in a Christmas tree pattern
- Tx: light exposure
Which HSV strain usually affects the mouth and which usually causes an STD?
HSV-1: gingivostomatitis
HSV-2: STD
“1 mouth. 2 genitals transmit STDs.”
What are the clinical features of erythema nodosum?
“Shiny nodes on your cudis.”
- Erythematous macules usually on the shins
- No central clearing
- Painful
- Associations:
- CUDIS
- Crohn’s
- UC
- Drugs (OCPs, sulfa drugs)
- Infections (Yersinia, EBV, TB, Fungal)
- Sarcoidosis
- CUDIS
What are the clinical features of erythema migrans?
“Don’t ever LIE to MY GRANny.”
- Caused by borrelia burgdorferi -> Lyme dz
- Red border expands from the tick bite with central clearing -> bull’s eye lesion
- Tx:
- PO doxycycline (if >8yrs) or PCN/amox (if (<8yrs): arthritis, disseminated erythema migrans, palsy, neuropathy
- IV PCN/CTX: carditis, neuritis (encephalitis/meningitis), recurrent arthritis
What is erythema marginatum associated with?
“It is marginal if the marginatum rash will get you diagnosed with rheumatic fever.”
- Usually on trunk and extremities
What are the clinical features of erythema infectiosum?
- Due to parvovirus B 19
- Slapped cheek rash
- Followed by lacy or reticular rash on extremities
What is milia?
“Millions of milia.”
- Whiteheads all over the baby’s face
What is the sebaceous hyperplasia?
- Pinpoint papules on baby’s nose in central face
- Due to maternal androgen exposure
What is erythema toxicum neonatorum?
- Erythematous macules with raised central lesions
- Seen at age 0-2 days, disappears by 7 days
- EOSINOPHILS
- Early, Erythematous, Eosinophils
What is transient neonatal pustular melanosis?
- African American babies
- Present at birth and resolves within a few days
- Leaves hyperpigmented macules
- PMNs
At what age do you see neonatal acne?
Months 1-4
What causes infantile acne?
Androgenic stimulation
Describe the clinical appearance of alopecia areata.
- Round, well circumscribed areas of alopecia
- Hairs at the periphery are short and resemble an ❗️
What are the clinical features of zinc deficiency?
- Scaly and extremely erythematous dermatitis in perioral and perianal area
- Alopecia
- Poor taste
What mineral deficiencies do strict vegetarians and vegans have?
"FUZZY CAB ... FeZi CaB12" Fe: Iron Zi: Zinc Ca: Calcium B12: vitamin B12
What is acrodermatitis enteropathica?
- Autosomal recessive
- Zinc transport defect
What is telogen effluvium?
- Acute hair shedding that occurs diffusely
- Hair has keratin bulb on the root end because it was too young to shed
- Due to psychological or medical stressors
What causes black dot alopecia?
Tinea capitis
What is the cause of incomplete hair loss with hair of differing length?
Trichotillomania
What causes a hair collar sign?
- Aplasia cutis congenita
- Hairless area with a collar of dense hair at the edges
- Associated with underlying spinal dysraphism an underlying skull defects
