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EOR Family Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is included in the atopic disease triad?

A
  1. Eczema
  2. Allergic rhinitis
  3. Asthma

Usually starts in childhood

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2
Q

Altered immune reaction in genetically susceptible people when exposed to certain triggers - causes an increase in IgE production

A

Atopic dermatitis (Eczema)

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3
Q

Triggers for Atopic dermatitis (Eczema)

A

Heat
Perspiration
Allergens
Contact irritants (wool, nickel, food)

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4
Q

Hallmark of atopic dermatitis (eczema)

A

pruritus!

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5
Q

Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales

A

Atopic dermatitis (eczema)

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6
Q

Atopic dermatitis (eczema) is most commonly found:

A

Flexor Creases

Antecubital fold and popliteal folds

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7
Q

Special characteristic of atopic dermatitis (eczema)

A

Dermatographism - localized development of hives when the skin is stroked

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8
Q

Sharply defined discoid/coin shaped lesions found on the dorsum of the hands, feet, and extensor surfaces (knees, elbows)

A

Nummular Eczema

Atopic dermatitis

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9
Q

Management of atopic dermatitis (eczema)

A
  1. Topical corticosteroids, antihistamines for itching

2. Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus) are alternatives for steroids

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10
Q

Seborrheic dermatitis may be due to a hypersensitivity to:

A

Malassezia furfur

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11
Q

Seborrheic dermatitis is most commonly seen in:

A

Adult men

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12
Q

Seborrheic dermatitis occurs most common in areas of:

A

High sebaceous gland over secretion - scalp, face, eyebrows, body folds

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13
Q

Erythematous plaques with fine white scales seen on infants heads

A

Cradle Cap - Seborrheic Dermatitis

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14
Q

Erythematous plaques with fine white scales seen on the scalp, eyelids, beard/mustache, etc.

A

Seborrheic dermatitis

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15
Q

Management of seborrheic dermatitis

A

Topical: selenium sulfide, sodium sulfacetamide, ketoconazole (shampoo or cream)
Systemic: oral antifungals - itraconazole, fluconazole, ketoconazole, terbinafine

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16
Q

Triggers for dyshidrosis

A

Sweating
Emotional stress
Warm and humid weather
Metals (ex. nickel)

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17
Q

Pruritic “tapioca-like” tense vesicles on the soles, palms, and fingers

A

Dyshidrosis

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18
Q

Management of dyshidrosis

A

Topical steroids - ointment preferred

Cold compresses

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19
Q

Skin thickening in pts with eczema secondary to repetitive rubbing/scratching

A

Lichen simplex chronicus

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20
Q

Scaly, well-demarcated, rough hyperkeratotic plaques with exaggerated skin lines

A

Lichen simplex chronicus

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21
Q

Management of lichen simplex chronicus

A

Avoid scratching!
Topical steroids (high strength)
Antihistamines
Occlusive dressings

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22
Q

Has an increased incidence with Hepatitis C

A

Lichen planus

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23
Q

The 5 P’s of lichen Planus

A

Purple, polygonal, planar, pruritic papules

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24
Q

Lichen planus most commonly seen on:

A

Flexor surfaces, skin, mouth, scalp, genitals, nails and mucous membranes

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25
Q

Koebner’s Phenomenon

A

New lesions at site of trauma

Seen in psoriasis and lichen planus

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26
Q

Fine white lines on the skin lesions or on the oral mucosa - nail dystrophy

A

Wickham Striae

Seen in lichen planus

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27
Q

Management of lichen planus

A

Topical corticosteroids
Antihistamines for pruritus
Rash will usually spontaneously resolve in 8-12 mo

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28
Q

Urticaria and angioedema are _____ mediated and usually occur immediately after offending drug/trigger is taken

A

IgE

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29
Q

Erythema multiforme is a __________ reaction that is usually delayed and cell mediated

A

Morbilliform

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30
Q

Most common type of drug reaction/skin eruption

A

Exanthematous / Morbilliform Rash

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31
Q

Generalized distribution of “bright-red” macules and papules that coalesce to form plaques - typically begins 2-14 days after medication initiation

A

Drug eruption

Exanthematous/Morbilliform Rash

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32
Q

2nd most common type of drug eruption

A

Urticaria

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33
Q

3rd most common type of drug eruption

A

Erythema multiforme

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34
Q

Most common type of drug eruption

A

Exanthematous/morbilliform

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35
Q

Most common offending drugs with urticaria

A

Antibiotics and NSAIDs

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36
Q

Management of drug induced exanthematous/morbilliform rash

A

Oral antihistamines

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37
Q

Management of drug induced urticaria / angioedema

A

Systemic corticosteroids, antihistamines

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38
Q

Management of drug induced erythema multiforme

A

Symptomatic therapy

Topical steroids, oral antihistamines

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39
Q

Associated with Human Herpes Virus 7

A

Pityriasis Rosea

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40
Q

This rash can mimic syphilis, so an RPR should be ordered if the pt is sexually active

A

Pityriasis Rosea

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41
Q

Solitary salmon-colored macule on the trunk, followed by general exanthem 1-2 weeks later

A

Herald Patch

Pityriasis Rosea

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42
Q

Very pruritic salmon-colored papules with collarette scaling along cleavage lines in a christmas tree pattern

A

Pityriasis Rosea

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43
Q

Management for pityriasis rosea

A

None needed
PO antihistamines, topical corticosteroids as needed
Can use UVB phototherapy if severe and started early

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44
Q

Keratin hyperplasia due to T cell activation leads to greater epidermal thickness and increased epidermis turnover

A

Psoriasis

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45
Q

Raised, dark-red plaques/papules seen with thick silver/white scales

A

Psoriasis

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46
Q

Plaque Psoriasis is most common seen on the:

A

Extensor surfaces

Elbows, knees, scalp, nape of neck

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47
Q

25% of plaque psoriasis also have:

A

Nail pitting

Yellow-brown discoloration until the nail (oil spot)

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48
Q

Punctate bleeding with removal of plaque/scale

A

Auspitz sign

Seen with psoriasis and actinic keratosis

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49
Q

Deep, yellow non-infected pustules that evolve into red macules on palms/soles

A

Pustular psoriasis

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50
Q

Erythematous rash that lacks scales, seen in body folds (groin, gluteal fold, axilla)

A

Inverse psoriasis

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51
Q

Inflammatory arthritis that includes joint stiffness > 30 minutes relieved with activity. May also have “sausage digits”

A

Psoriatic arthritis

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52
Q

Radiograph deformity seen with psoriatic arthritis

A

Pencil in cup deformity

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53
Q

Management for psoriasis

A

Topical steroids first line
Moderate-severe: phototherapy
Systemic treatment: Methotrexate

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54
Q

Most common cause of erythema multiforme

A

Secondary to herpes simplex infection

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55
Q

Multiple target-like lesions that spares the mucosa

A

Erythema Multiforme Minor

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56
Q

Multiple target-like lesions that includes mucosal involvement

A

Erythema Multiforme Major

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57
Q

Treatment of erythema multiforme

A

Typically resolves after 2 weeks

Can give topical steroids and antihistamines

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58
Q

Most common medications causing SJS and TEN

A 
Allopurinol
Sulfonamides 
Lamotrigine
NSAIDs
Anticonvulsants
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59
Q

SJS affects _______% of body surface area

A

< 10%

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60
Q

TEN affects _______% of body surface area

A

> 30%

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61
Q

Prodrome of fever, malaise, myalgias followed by lesions on face and trunk. Bullous and vesicle formation begins days after

A

SJS/TEN

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62
Q

Gentle pressure to the skin causes sloughing

A

Nikolsky Sign

Seen in SJS/TEN

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63
Q

Main cause of death with SJS/TEN

A

Sepsis and shock secondary to infection

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64
Q

Treatment for SJS/TEN

A

Admit to hospital, preferably to burn unit

Supportive care is mainstay

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65
Q

Chronic widespread autoimmune blistering skin disease primarily of the ELDERLY

A

Bullous pemphigoid

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66
Q

Bullous pemphigoid will have ________ of Nikolsky sign

A

Absence

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67
Q

Bullous pemphigoid is caused by an ______ autoimmune attack on the epithelial basement membrane

A

Type II HSN

IgG

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68
Q

Management of bullous pemphigoid

A

Systemic corticosteroids
Antihistamines
Azathioprine (immunosuppressant)

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69
Q

4 main pathophysiologic factors for acne vulgaris:

A
  1. Increased sebum production
  2. Clogged sebaceous glands
  3. P. acne overgrowth
  4. Inflammatory response
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70
Q

Small, non inflammatory bumps from clogged pores

A

Comedones

Acne vulgaris

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71
Q

Treatment for mild acne

A

Topical retinoids
Benzoyl peroxide
Topical abx (Clindamycin)
OCPs

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72
Q

Treatment of rmoderate acne

A

Oral abx (Doxy, Minocycline, Erythromycin, Clindamycin)

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73
Q

Treatment of severe (nodular/cystic) acne

A

Isotretinoin

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74
Q

S/E of isotretinoin

A

Highly teratogenic

Hepatitis, increased triglycerides/cholesterol, psych side effects

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75
Q

What must be done before prescribing isotretinoin?

A

Highly teratogenic
Obtain at least 2 pregnancy tests prior to initiation and monthly
Must be on 2 forms of contraception

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76
Q

Symptoms due to increased capillary permeability and increased vasomotor instability with lesion formation

A

Rosacea

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77
Q

Triggers for Rosacea

A 
EtOH
Hot/cold temperature
Hot drinks
Hot baths
Spicy foods
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78
Q

Acne-like rash, erythema, facial flushing, telangiectasia

A

Rosacea

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79
Q

Absence of comedones distinguishes it from acne

A

Rosaceae

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80
Q

Treatment for rosacea

A

Metronidazole first line
Topical abx
Can do oral abx if severe

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81
Q

Lifestyle modifications for rosacea

A

Sunscreen, avoid toners, camphor and triggers

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82
Q

Most commonly seen in fair-skinned elderly with prolonged sun exposure

A

Actinic keratosis

Seborrheic keratosis

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83
Q

Premalignant condition to squamous cell carcinoma

A

Actinic keratosis

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84
Q

Most common premalignant skin condition

A

Actinic keratosis

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85
Q

Dry, rough, scaly “sandpaper” skin lesion or erythematous, hyperkaratotic

A

Actinic keratosis

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86
Q

May present with a projection (horn) on the skin

A

Actinic keratosis

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87
Q

Diagnosis of actinic keratosis

A

Punch or shave biopsy

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88
Q

Management of actinic keratosis

A

Observation, surgical

Topical 5-fluorouracil, imiquimod

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89
Q

Most common benign skin tumor

A

Seborrheic keratosis

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90
Q

Small papule/plaque velvety warty lesions with a greasy/stuck on appearance

A

Seborrheic keratosis

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91
Q

Intense itching, especially in the occipital area, papular urticaria may been seen

A

Lice

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92
Q

White oval-shaped egg capsules at the base of the hair shafts

A

Nits

Lice

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93
Q

Management of lice

A

Permethrin topical drug of choice
Safe in children > 2 y/o
If lice in hair: permethrin shampoo (leave on 10 min)
If pubis/body: permethrin lotion at least 8-10 hours

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94
Q

Second line management of lice and S/E

A

Lindane
Neurotoxic - headaches, seizures
Do not use after showering

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95
Q

Instructions for mom with children with lice

A

Bedding/clothing should be laundered in hot water with detergents and dried in hot drier for 20 minutes.
Toys that cannot be washed should be placed in airtight plastic bags x 14 days

96
Q

Scabies cannot survive off the human body for _____ days

97
Q

Intensely pruritic papules, vesicles and linear burrows

98
Q

Commonly found in the intertriginous zones including web spaces between fingers/toes and scalp

99
Q

Increased intensity of rash at night

100
Q

Diagnosis of scabies

A

Clinical diagnosis

Can scrape burrows with mineral oil to identify mites or eggs under microscopy

101
Q

Treatment of scabies

A

Permethrin topical
Apply topically from neck to soles of feet for 8-14 hours before showering
Repeat application after 1 week is recommended

102
Q

Second line tx for scabies

A

Linedane (cheaper)
Do not use after bath/shower
May cause seizures
Teratogenic, not used in breastfeeding women or children < 2 y/o

103
Q

Instructions for scabies

A

All clothing, bedding, should be placed in plastic bag at least 72 hours then washed and dried using heat

104
Q

Spider bite with local burning and erythema, will have an erythematous margin around the ischemic center, or a “red halo”

A

Brown Recluse spider bites

105
Q

Spider bite after 24-72 hours that will have hemorrhagic bullae that undergoes eschar formation

A

Brown recluse spider bite

106
Q

Management of brown recluse spider bite

A
  1. Local wound care - clean area with soap and water, apply cold packs to bite site
  2. Pain control - NSAIDs, opiates
  3. Dermal necrosis - debridement
107
Q

Spider bite that may cause muscle pain, spasms and rigidity. Muscle pain most commonly affects the extremities, back and abdomen

A

Black widow spider bites

108
Q

Classic appearance is a blanched circular patch with a surrounding red perimeter and central punctum (target lesion)

A

Black widow spider bitet

109
Q

Management of black widow spider bite

A
  1. Wound care and pain control
  2. Opioids +/- muscle relaxants if severe
  3. Antivenom used if not responsive to other medications
110
Q

Major risk factor for basal cell carcinoma

A

Exposure to UV light

111
Q

Pearly papule with a telangiectatic vessel that typically occurs on face

A

Basal cell carcinoma

112
Q

Diagnosis of basal cell carcinoma

A

Shave biopsy

113
Q

Basal cell carcinoma where papule ulcerates

A

Rodent ulcer

114
Q

Treatment of basal cell carcinoma

A

Rarely metastasize

Removal

115
Q

Connective tissue cancer caused by Human Herpes Virus 8

A

Kaposi Sarcoma

116
Q

Cancer most commonly seen in immunosuppressed pts or HIV

A

Kaposi Sarcoma

117
Q

Macular, papular, nodular, plaque like brown/pink/red violaceous lesions

A

Kaposi Sarcoma

118
Q

Management of Kaposi Sarcoma

A

HAART therapy

Radiation therapy for local dz

119
Q

Most dangerous form of skin cancer, as it has high risk for metastasis

120
Q

ABCDE rule of melanomas

A 
Asymmetry
Border irregularity
Color variation
Diameter > 6 mm
Evolving shape, size, or color
121
Q

Diagnosis of melanoma

A

Excisional biopsy with 1-3 mm of the surrounding skin and part of subcutaneous fat

122
Q

Treatment of melanoma

A

Surgical removal

Adjunctive tx with interferon alpha can prolong survival in high risk groups

123
Q

Non-scarring immune-mediated hair loss targeting the anagen hair follicles

A

Alopecia Areata

124
Q

Alopecia areata is commonly associated with other _________ disorders

A

Autoimmune

Thyroid, Addison’s disease

125
Q

Smooth discrete circular patches of complete hair loss that develops over a period of weeks

A

Alopecia Areata

126
Q

Short hairs broken off a few mm from the scalp at the margins of the patches with tapering near the proximal hair shaft

A

Exclamation point hairs

Alopecia Areata

127
Q

Management of alopecia areata

A

Local - intralesional corticosteroids

Extensive - topical corticosteroids

128
Q

Progressive loss of the terminal hairs on the scalp in a characteristic distribution

A

Androgenetic alopecia

129
Q

___________ is the key androgen leading to androgenetic alopecia

A

Dihydrotestosterone

130
Q

Treatment of androgenetic alopecia

A
  1. Minoxidil (best if used early)
  2. Oral Finasteride
    S/E: decreased libido, sexual or ejaculatory dysfunction
131
Q

Nail infection by various fungi, occurs most commonly on the great toes

A

Onychomycosis

132
Q

Management of onychomycosis

A

Itraconazole and terbinafine

However, associated with hepatotoxicity and drug interactions

133
Q

Infection of the nail margin

A

Paronychia

134
Q

Paronychia most commonly occurs after __________

A

Skin trauma

Biting nails, cuticle damage

135
Q

Most common organism in paronychia

A

Staph aureus
GABHS
Candida if slow growing

136
Q

Closed-space infection of the fingertip pulp - progression of a paronychia

137
Q

Management of paronychia

A

Warm soaks
Antibiotics (Cephalexin)
Incision and drainage if needed

138
Q

HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum causing papula formation

A

Condyloma acuminatum

139
Q

Genital warts

A

Condyloma acuminatum

140
Q

Tiny, painless, papules evolve into soft, fleshy, cauliflower-like lesions

A

Condyloma acuminatum

141
Q

Management of condyloma acuminatum

A

Most warts resolve spontaneously within 2 years if immunocompetent
Chemical, salicylic acid, cryotherapy, laser and podophyllin

142
Q

Exanthem with prodrome of high fever for 3-5 days, which resolves before onset of a rose pink, maculopapular blanchable rash on the trunk/back progressing to the face

A

Roseola Infantum

Sixth disease

143
Q

Only childhood exanthem that starts on the trunk

A

Roseola infantum

Sixth disease

144
Q

Management of roseola infantum (sixth disease)

A

Supportive
Anti Inflammatories
Antipyretics (to prevent febrile seizures)

145
Q

Oral exanthem with vesicular lesions with erythematous halos in the oral cavity leading to vesicular, macular or maculopapular lesions on the distal extremities (often includes palms and soles)

A

Hand Foot & Mouth Disease

Coxsackie A Virus

146
Q

Management of hand foot and mouth disease

A

Supportive
Antipyretics
Topical lidocaine

147
Q

Rashes that affect palms/soles

A

HF and M
RMSF
Syphilis (secondary)
Janeway lesions (endocarditis)

148
Q

What causes mumps?

A

Paramyxovirus

149
Q

Low grade fever, myalgias, headache, parotid gland pain and swelling

150
Q

Management of mumps

A

Supportive
Anti-inflammatories
Symptoms usually last 7-10 days

151
Q

Complications of mumps

A

Orchitis in males

Acute pancreatitis in children

152
Q

URI prodrome with high fever and 3 C’s - cough, conjunctivitis, and coryza (stuffy nose)

A

Rubeola (Measles)

153
Q

Small red spots in buccal mucosa with pale blue/white center

A

Koplik Spots

Rubeola (Measles)

154
Q

Morbilliform (maculopapular) brick-red rash on face beginning at hairline, moving to extremities that darkens and coalesces

A

Rubeola (Measles)

155
Q

Rash usually lasts 7 days, fading from top to bottom. Fever often concurrent with rash

A

Rubeola (Measles)

156
Q

Low grade fever, cough, anorexia, lymphadenopathy (posterior, cervical, posterior auricular). Pink, light-red spotted maculopapular rash on face and extremities

A

Rubella (German Measles)

157
Q

3 day rash

A

Rubella (German Measles)

158
Q

Small red macules or petechiae on soft palate

A

Forchheimer Spots

Rubella (German Measles)

159
Q

Compared to rubeola, spreads more rapidly and does not darken or coalesce

A

Rubella (German Measles)

160
Q

Diagnosis of rubella (german measles)

A

Clinical

Rubella-specific IgM antibody via enzyme immunoassay

161
Q

Management of Rubella

A

Anti-inflammatories

Supportive

162
Q

Rubella (german measles) is teratogenic, especially:

A

In the first trimester

Can lead to sensorineural deafness, TTP (blueberry muffin rash), mental retardation, heart defects

163
Q

Erythema infectiosum (fifth disease) is caused by:

A

Parvovirus B19

164
Q

Stuff nose, fever followed by a slapped cheek rash on face with circumoral pallor

A

Erythema infectiosum (fifth disease)

165
Q

Lacy reticular rash on the extremities (especially upper) that spares the palms and soles

A

Erythema infectiosum (fifth disease)

166
Q

Diagnosis for erythema infectiosum (fifth disease)

A

Serologies

167
Q

Management of erythema infectiosum (fifth disease)

A

Supportive

Anti-inflammatories

168
Q

Have to be aware of erythema infectiosum (fifth disease), because it may cause aplastic crisis in pts with:

A

Sickle cell disease OR

G6PD deficiency

169
Q

Clusters of vesicles on an erythematous base, dew drops on a rose petal in different stages (macules, papules, vesicles, pustules, and crusted lesions). Usually pruritic.

A

Varicella (chicken pox)

170
Q

Management of varicella (chicken pox)

A

Symptomatic treatment

171
Q

Molluscum contagiosum is due to:

A

Poxviridae family (benign viral infxn)

172
Q

Single or multiple dome-shaped, flesh-colored to pearly-white, waxy papules with central umbilication

A

Molluscum contagiosum

173
Q

Treatment for molluscum contagiosum

A

No treatment needed in most cases

May do: curettage, cryotherapy, imiquimod, topical retinoids if severe

174
Q

HPV infects keratinized skin, causing excessive proliferation and retention of the stratum corneum - papule formation

A

Verrucae (warts)

175
Q

Firm, hyperkeratotic papules between 1-10 mm with red-brown punctuations. Thrombosed capillaries are pathognomonic

A

Common and plantar warts (verrucae)

176
Q

Numerous, small, discrete, flesh-colored papules measuring 1-5 mm in diameter. Flat

A

Flat warts (verrucae)

177
Q

Management of verrucae (warts)

A

Most resolve spontaneously within 2 years if immunocompetent
May use OTC salicylic acid and plasters
Can do cryotherapy (liquid nitrogen), etc.

178
Q

Most common etiologies of erysipelas/cellulitis

A

Streptococci (GABHS)

Staph aureus

179
Q

Infection of the skin that presents with erythema, edema, warmth and tenderness

A

Cellulitis / Erysipelas

180
Q

______ involves deeper dermis and subcutaneous fat

A

Cellulitis

181
Q

_______ involves only upper dermis

A

Erysipelas

182
Q

Raised with clear line of demarcation between infected and uninfected tissue

A

Erysipelas

183
Q

Treatment for cellulitis

A
  1. elevate area and keep skin hydrated
  2. those with drainage should be treated for MRSA (clindamycin, TMP/SMX or doxy)
  3. Those without drainage should be treated for MSSA (clindamycin, cephalexin, dicloxacillin)
184
Q

Treatment for erysipelas

A

Those with mild infxn can be treated with penicillin, macrolide, cephalexin or clindamycin
Improvement should be noted after 3 days of treatment

185
Q

Highly contagious superficial vesiculopustular skin infection that typically occurs at site of superficial skin trauma

186
Q

Impetigo occurs primarily on exposed surfaces of the:

A

Face and extremities

187
Q

Risk factors for impetigo

A

Warm
Humid conditions
Poor personal hygiene

188
Q

Vesicles, pustules that have a characteristic honey colored crust

A

Nonbullous impetigo

189
Q

Most common causes of impetigo

A

Staph aureus

190
Q

Vesicles form large bullae (rapidly), which rupture and leave thin “varnish-like crusts”, fever and diarrhea also

A

Bullous impetigo

191
Q

Management of impetigo

A
  1. Mupirocin (Bactroban) topical drug of choice TID x 10 days
  2. Wash area gently with soap and water
192
Q

Management of impetigo if extensive disease or systemic symptoms (fever)

A

Systemic abx - cephalexin

Dicloxacillin, clindamycin, ertyrhomycin, azithromycin

193
Q

Velvety hyperpigmented lesions found on neck and axilla that is usually associated with insulin resistance

A

Acanthosis Nigricans

194
Q

Management of acanthosis nigricans

A

Screen for diabetes
Treat underlying cause
Topical retinoids, vitamin D analogs, and hydroquinone can be used for cosmetic purposes

195
Q

Chronic abscess of apocrine sweat glands or sebaceous cysts with tract formation. Red tender inflammatory nodules/abscesses

A

Hidradenitis suppurativa

196
Q

Most common areas of hidradenitis suppurativa

A

Axilla, groin, under breasts or anogenital areas

197
Q

Management of hidradenitis suppurativa

A
  1. Mild: topical clindamycin
  2. Deep, recurrent infxns: punch debridement
  3. Painful abscess - I and D
  4. surgical excision
  5. watch obesity (common cause)
198
Q

Subcutaneous benign tumor of adipose tissue. Soft, symmetric, painless, easily mobile, palpable mass in the subcutaneous tissue

199
Q

Mobile masses of fibrous tissue and keratinous (cottage cheese like) substance

A

Sebaceous cyst

200
Q

Management of sebaceous cyst

A

No tx needed
Abx and I and D if becomes infected
Cosmetic removal

201
Q

Hypermelanosis (hyperpigmentation) of sun exposed areas of the skin

202
Q

Melasma usually seen on:

A

Face and neck

203
Q

Diagnosis of melasma

A

Wood’s Lamp - appearance unchanged under black light

204
Q

Management of melasma

A 
SUNSCREEN
Topical bleachers (hydroquinone, topical retinoids, azelaic acid)
205
Q

Tender abscess with drainage on or near the gluteal cleft near the midline of the coccyx or sacrum with small midline pits

A

Pilonidal disease

206
Q

Management of pilonidal disease

A

I and D

May surgical remove tracts if recurrent

207
Q

Skin intact, superficial, nonblanchable redness that does not dissipate after pressure is relieved

A

Stage I pressure ulcer

208
Q

Epidermal damage extending into dermis. Shallow ulcer that resembles a blister or abrasion

A

Stage II pressure ulcer

209
Q

Full thickness of the skin and may extend into the subcutaneous layer

A

Stage III pressure ulcer

210
Q

Deepest, extends beyond the fascia into the muscle, tendon or bone

A

Stage IV pressure ulcer

211
Q

Purple area of discolored skin

A

Suspected deep tissue injury

212
Q

Ulcer covered with slough or eschar, making depth undetermined

A

Unstageable pressure ulcer

213
Q

Management of pressure ulcers

A
  1. Optimize nutritional status, offer pain control
  2. Wet to dry dressings, hydrogels
  3. May need surgical debridement for stages III and IV
214
Q

Type I HSN (IgE) or complement-mediated edematous reaction of the dermis and/or SQ tissues

215
Q

Mast cells release histamine causing vasodilation of venules and edema of dermis and SQ tissue

216
Q

Blanchable, edematous pink papules, wheals or plaques (oval, linear or irregular)

217
Q

Localized urticaria where the skin is rubbed (urticaria pigmentosa)

A

Darier’s sign

218
Q

Management of urticaria

A

Oral antihistamines treatment of choice

219
Q

Autoimmune destruction of melanocytes leading to skin depigmentation

220
Q

Irregular discrete macules and patches of total depigmentation. Commonly involves the dorsum of the hands, axilla, face, fingers, body folds and genitalia

221
Q

Management of vitiligo

A
  1. Localized: topical corticosteroids

2. Disseminated: systemic phototherapy

222
Q

Superficial hair follicle infection with singular or clusters of small papules or pustules with surrounding erythema

A

Folliculitis

223
Q

Most common organism for folliculitis

A

Staph aureus

224
Q

Treatment for folliculitis

A
  1. Topical Mupirocin, clindamycin, erythromycin
225
Q

Annual, scaling lesions and broken hair shafts. Inflamed plaques with multipel pustules with scarring and alopecia

A 
Tinea capitis (fungal)
Ringworm
226
Q

Treatment for tinea capitis

A

PO griseofulvin

Terbinafine, itraconazole

227
Q

Pruritic, scaly eruption rash between toes

A

Tinea pedis (athlete’s foot)

228
Q

Management for tinea pedis

A

Topical antifungals

PO griseofulvin if uneffective

229
Q

Diffusely red rash on the groin or on the scrotum

A

Tinea cruris (jock itch)

230
Q

Management of tinea cruris

A

Topical antifungal

PO griseofulvin in ineffective

231
Q

Erythematous plaques (circular rash with clear center and defined borders), scaling, cracking and vesicles

A

Tinea corporis

232
Q

Management of tinea corporis

A

Topical antifungal

PO griseofulvin if ineffective

233
Q

Diagnosis of fungal infections

A

KOH smear

Wood’s lamp

234
Q

Overgrowth of the yeast Malassezia furfur

A

Tinea versicolor

235
Q

Diagnosis of tinea versicolor

A

KOH prep from skin scraping - spaghetti and meatball appearance
Wood’s lamp - yellow green fluorescence

236
Q

Management of tinea versicolor

A

Topical antifungals - selenium sulfide, sodium sulfacetamide, zinc pyrithione, azoles
PO itraconazole or fluconazole if widespread

EOR Family Medicine (14 decks)

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