Dermatology Flashcards
1
Q
Macule
A
Circumscribed change, no elevation/depression, <1cm
2
Q
Papule
A
solid elevated lesion <1.5cm
3
Q
Plaque
A
Solid elevated lesion >1.5cm
4
Q
Nodule
A
Solid lesion <2cm
5
Q
Vesicle
A
Circumscribed elevated lesion <1cm with fluid
6
Q
Pustule
A
contains pus
7
Q
Purpura
A
Non-blanching erythema due to blood in subQ tissue
8
Q
Lichenification
A
Thickened skin
9
Q
Patch
A
Macule > 1cm
10
Q
Bulla
A
vesicle larger than 1cm
11
Q
Tumor
A
Large nodule
12
Q
What is a portwine stain? (5)
A
- Purple/red macules that occur unilaterally and tend to be large/on the face/occiput/neck
- Present at birth and persists through life with darkening/thickening
- Cong malformations with dilated capillaries that will grow with child
- Tx = cosmetic, refer to derm
- Sturge weber!
13
Q
What is a salmon patch or nevus flammeus? (2)
A
- Light pink macule most often found on the nape of the neck, eyelids or glabella, caused by a vascular malformation
- TX - will fade with time, usually by 5-6 years
14
Q
What is pityriasis rosea and what is the management? (3)
A
- benign, self-limiting eruption in a Christmas tree pattern
- s/s = highly pruritic, begins with herald patch that turns into mac/pap rash in 5-10 days, made worse by heat and bathing can last 3-4 mo
- Tx = controlled sunlight
15
Q
What is the clinical course of seborrhea dermatitis?
4; definition, infants, adolescents, tx
A
- Dermatitis secondary to overproduction of sebum
- Infants = erythematous, flaky, greasy, scales usually on the scalp, cradle cap
- adolescent = mild flakes/scales on scalp/forehead/nasal bridge
- Tx - oil to loosen flakes prior to washing, selenium sulfide, tar or salicylic acid shampoo, steroids may be needed if severe
16
Q
What is tinea capitis and what is the management?
5; definition, most common, s/s, DX, TX
A
- Dermatophyte (ringworm) infection of the hair/scalp
- Most common between 3-9 years/person-person transmission
- s/s = red/skin colored scaly papules on the scalp, brittle hair, patchy alopecia, pruritis, can turn into a kerion (boggy inflammatory mass)
- Dx = woods light = yellow/green, KOH exam
- TX = griseofulvin 15-20mg/kg/day x 6-8 weeks, Lamisil 2-6mg/kg/day x2-4 wks, selenium sulfide shampoo to prevent spread, must recheck, keep child out of school x 1 week
17
Q
Telogen Effluvium
A
- Generalized acute hair loss, reactive and caused by illness, pregnancy, stress, diet, endocrine disorders
18
Q
Anagen Effluvium
A
- sudden loss, ie. chemo
19
Q
Alopecia areata
A
- auto-immune, discrete patches of hair loss, exclamation point hairs, tests thyroid
20
Q
What is the clinical course of atopic derm?
4
A
- Most common derm disorder, associated with asthma/allergies
- s/s pap squamous red eruption with scales, pap, plaques, pruritic, dry
- INFANTS = extensor surfaces, trunk, face scalp; diaper area is spared, no lichenification (seruos d/c and crusts; intense itching)
- early to mid childhood = flexural (antecubital and popliteal areas); late/middle childhood, skin creases, hand (wrists, fingers) dermatitis, associated with secondary infections
* Lichenification, stretch marks
21
Q
What is the clinical course of acne and what is the management? (4; definition, mild tx, mod tx, severe tx)
A
- Abnormal keratination, increased sebum production, P. Acnes, lysosomal enzymes lead to pustular lesions, affects infants and adolescents
- Mild acne tx = topical antibiotic (clindamycin/erythromycin), benzoyl peroxide, topical retinoids (retin A, adapalene, Tazavo)
- Mod acne tx = topical and oral antibiotic, contraceptives
- Severe acne tx = Retin A, Accutane
22
Q
What is pediculosis and what is the management? (4; definition, s/s, tx, incubation)
A
- Lice of the head (capitus), body (corporis), and genitals (pubic) transmitted from person to person through direct and indirect contact
- s/s itch, dandruff-like substance, in the hair, nits can be seen head, excoriated macules/papules can be present (body), bluish macules (pubis)
- TX = pyrethrins/permethrin, Lindane as an alternative (can cause seizure), ovide (malathion is flammable), home hygiene, eliminate lice
- Incubation: 6-10 days; may take 4-6 weeks to develop pruritis
* Lice can only live off humans for 24h
* Nits/eggs are visible on woods lamp
23
Q
What is the cause of scabies and what is the management? (4; definition, s/s, DX, TX)
A
- Caused by sarcoptes scabiei, a mite that burrows into the skin, highly contagious, spread through contact/linen/clothes
- s/s intense itching, linear/S shaped burrows especially on finger webs and skin folds, can lead to encrusted papules
- DX = microscopic exam of skin scraping
- TX = permethrin cream (Elimite), repeat tx in 1-2 weeks, antihistamine, tx family members, home hygiene
24
Q
What is impetigo? (4; definition, non-bulla, bulla, s/s)
A
- Superficial bacteria infection of the skin caused by staph or strep, often from trauma/insect bite
- Nonbullous = vesicles that rupture into moist/honey comb colored lesions
- bullous = large, flaccid blisters that rupture leaving a coating/scale
- Can have fever diarrhea
25
What is the management of impetigo?
1. topical antibiotic (mupirocen, polymyxin B), altabax (Retapamulin) if mild oral antibiotic (cephalexin, dicloxacillin, erythromycin) can return within 24 hours of tx started
26
What is staph scalded skin syndrome (definition, s/s, tx)`
1. Blistering skin disease from epidermolytic toxin producing staph
2. s/s= abrupt onset of fever, malaise, tender erythematous skin, + Nikolsky sign=peeling of the skin with light rubbing, crusty sign; skin around mouth nose
TX = admitted for IV, avoid steroids, minimal handling
27
Describe molluscum contagiosum (define, s/s, tx)
1. Poxvirus spread through contact and autoinoculation
2. s/s: multiple flesh toned/pink, umbilicated papules on the face/trunk/extremities
3. TX: watchful waiting, tretinoin/differinor cryotherapy
28
What is the clinical course of allergic contact dermatitis? (define, common causes, s/s, tx)
1. Type 4 (Tcell mediated) reaction, lesions develop 48-72 hours post exposure, common allergens include = nickel/neomycin/poison ivy or sumac
2. s/s vesicular/eczematous eruption with linear papules (Koebner)
3. TX = avoid allergens, systematic steroids, topical steroids
29
Describe the clinical course of diaper dermatitis
| define, s/s, tx
1. Caused by friction/irritation due to urinary wetness
2. s/s only in diaper area, erythematous, eroded, or ulcerated in severe cases
3. TX - Keep area dry/clean, limit diaper use, treat associated candidiasis with nystatin/lotrimin
30
What are warts? (1)
1. Viral infection with HPV, transmitted by direct/indirect contact
31
define Verruca Vulgaris
common wart, affects digits and periungual region
32
define Verruca plantaris
plantar wart, self- limited
33
define Verrucal plana
flat warts
34
How are warts tx? (5)
```
Cantharidin
Salicylic acid
Cryotherapy
Surgical laser ablation
Duct tape
```
35
Vitiligo
Acquired autoimmune condition involving patches of depigmentarion on skin surfaces and in mount and genitalia
Segmented: unilateral, involving 2 dermatomes
Generalized: often bilateral, involving more than 2 dermatomes
May be associated with DM, Addison’s, thyroiditis
36
Open comedone
blackhead
37
Closed comedone
whitehead
38
Acne Treatment (Mild, Mod, Severe)
Mild: topical bezoyl peroxide (b.p.)
Moderate: topical tretinoin or b.p.
Severe: topical tretinoin or oral antibiotics (tetracycline)
*If unresponsive --> oral isotretinoin (teratogen, all females must go on OCP)
Monitor q4-6 weeks then less frequently
39
Folliculitis
superficial involvement of upper hair follicle
40
Furuncle/boil
Deeper involvement of hair follicle and dermal appendages
~usually staph or streptococci
~face, scalp, neck, buttocks, and other areas
41
How to tx Folliculitis/furuncle/boil (3)
1. Staph: dicloxacillin or cephalexin
2. Strep: PCN or cephalosporin (erythro if PCN allergy)
3. MRSA: Bactrim or Clinda
42
Drug Eruptions (4 common agents and manifestation)
1. PCN
2. Sulfates
3. Dilantin
4. Barbiturations
Manifestation: pruritus with erythematous morbilliorm rash beginning on trunk and progressing to extremities
43
Associated atopic dermatitis findings (3)
1. Atopic plexus: extra groove in lower eyelid called Dennies lines; Morgan fold, crease across upper bulb of nose
2. Keratosis pillars: follicular papules on extensor surfaces of arms, anterior thighs, and lateral aspects of cheeks
3. Nocturnal melanin levels are lower and may be associated with sleep disturbances
