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PANCE REVIEW > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Erythema Nodosum presentation and common causes

A

Presents as a sore stinging nodules on the shins, MC caused by strep infections or sarcoidosis

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2
Q

“Stuck on” lesion with greasy appearance

A

Seborrheic keratosis

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3
Q

Alopecia Areata vs Androgenic Alopecia

A

Alopecia Areata: immune-mediated hair loss coming on in PATCHES with “exclamation point hairs”; often other immune comorbidities and nail manifestations ; steroids are treatment

Androgenic ALopecia: progressive loss of the terminal hairs, hiring THINNING; due to low DHT levels ; treat with Minodixil or finasteride

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4
Q

What is the atopic triad?

A
  1. atopic dermatitis (eczema)
  2. asthma
  3. allergic rhinitis
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5
Q

Clinical manifestations of atopic dermatitis (eczema)

A
  • Pruritus
  • red, blistery lesions in FLEXOR surfaces, scaling
  • dermatographism
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6
Q

What is dermatographism ?

A

localized hives when the skin is stroked

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7
Q

What is Nummular eczema?

A

sharply defined COIN SHAPED lesions on dorsum and extensor surfaces

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8
Q

Treatment for atopic dermatitis

A

Avoid triggers, topical steroids and antihistamines

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9
Q

Dyshidrosis (aka pompholyx)

A

Puritic “tapioca-like” tense vesicles on the soles, palms, fingers in response to water such as sweat, humid weather, or nikel

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10
Q

What is lichen simplex chronic?

A

Skin lichenification due to chronic itching in eczema patients

Treat with topical steroids

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11
Q

Clinical manifestations of Lichen Planus

A

-5 P’s: Purple, polygonal, planar, puritic, papillose with WICKHAM STRIAE (white lines) found on flexor surfaces, skin, mouth, scalp, genitals

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12
Q

Pathophis of lichen planus

A

idiopathic cell- mediated immune response with a high incidence in Hep C.

-Treat with topical steroids

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13
Q

What is Koebner’s phenomenon and what is it seen in?

A

New lesions at sites of trauma seen in lichen planus and psoriasis

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14
Q

What is psoriasis?

A

Chronic mulisystem inflammatory immune disorder that results in keratin hyperplasia

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15
Q

Clinical manifestations of plaque soriasis

A
  • Rasied red lesions with thick silver scaling
  • MC on EXTENSOR surfaces
  • nail pitting and auspitz sign
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16
Q

What is Auspitz sign?

A

punctate bleeding with removal of plaques in psoriasis

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17
Q

Psoriasis management

A

Mild: topical steroids

Severe: Phototherapy, methotrexate

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18
Q

Other types of psoriasis (not including plaque)

A
  • Pustular: deep yellow pustules evolving into red merciless on palms/soles
  • Guttate: small discrete red lesions with fine scales
  • Inverse: no scaling
  • Erythrodermic: generalized rash over most of the skin (worst type)
  • Psoriatic arthritis: pencil in cup deformity
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19
Q

Pityriasis (tinea) versicolor Hallmarks

A
  • Overgrowth of yeast Malassezia furor
  • Hyper/hypo-pigmented round merciless with fine scaling, grows in patches , this part of skin fails to tan
  • KOH prep shows hyphae & spores “spaghetti & meatball”
  • Woods lamp exam

-Treat with topical antifungals

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20
Q

Topical antifungals

A

Selenium sulfide

Sodiom sulfacetamide

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21
Q

What is seborrheic dermatitis?

A

hypersensitivity to malassezia furfur yeast that occurs in areas of high sebaceous gland functioning

  • Presents as cradle cap in infants and DANDRUFF in adults
  • Treat with topical antifungals
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22
Q

5 types of hypersensitivity reactions

A

Type 1: Ig-E mediated, acuate urticaria and angioedema

Type 2: cytotoxic antibody mediated causing cell lysis

Type 3: immune antibody-antigen complex

Type 4: Delayed, cell mediated (erythema multiforme, morbiliform rash)

Type 4: non-immunologic

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23
Q

What is the MC presenting rash in a drug eruption?

A

Exanthematous/Morbiliform Rash: generalized bright red macules and papillose that coalesce to form plaques.

-typically 2-14 days after drug taken

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24
Q

Different presentations of cutaneous drug eruptions

A
  1. Morbiliform rash (MC)
  2. Urticarial (2nd MC) (type 1)
  3. Erythema multiform (type 4)
25
Q

Drugs that MC cause erythema multiform reaction

A
  • sulfa
  • penicillians
  • phenobarbitol
  • dilantin
26
Q

Pathophysiology of urticaria

A

mast cells release histamine causing vasodilation and edema of dermis

27
Q

Outside of medications, what illnesses are associated with erythema multiforme?

A

HSV (MC)

mycoplasma

S. pneumo

28
Q

What is the difference between erythema multiforme minor and major

A

MINOR: target lesions with no mucosal membrane involvement

MAJOR: target lesions with involvement of at least 1 mucus membrane, but there is no epidermal detachment (that would be SJS)

29
Q

Steven-Johnson Syndrome

A

MC after drug reaction that develops less than 10% BSA sloughing with epidermal detachment (Nikolsky sign), at least 1 mucus membrane involved

30
Q

Toxic Epidermal Necrolysis

A

MC after drug reaction that develops over 30% BSA sloughing with skin necrosis and epidermal detachment (+ nikolsky sign) ; at least 1 muscus membrane involved

31
Q

What is the pathophysiology behind acne vulgarism?

A
  1. increased sebum production due to increased androgen activity
  2. Clogged sebaceous glands
  3. P. Acne overgrowth
  4. Inflammatory response
32
Q

3 clinical manifestations of acne vulgaris

A
  1. Comedones
    - open=blackhead, partial block
    - closed=whitehead, complete
  2. Inflammatory: pustules surrounded by inflammation
  3. Nodular or cystic acne:heals with scarring
33
Q

Management of Mild Acne

A
  • topical retinoids
  • benzoyl peroxide (decreased P. acne)
  • OCP (decrease androgens)
34
Q

Management of moderate acne

A
  • mild treatment PLUS oral antibiotics

- Doxycycline, Minocycline

35
Q

Management of severe acne

A

-all other treatments plus

Isotretinoins

-these increase Trigs, psych effects, teratogenic

36
Q

What is the pathophysiology of Rosacea?

A

Persistant vasomotor instability of unclear etiology

37
Q

Roasacea treatment

A

Metronidazole

38
Q

What is actinic keratosis?

A

MC premalignant skin condition

-leads to squamous cell carcinoma

39
Q

Hallmarks of actinic keratosis

A

-scaly hyper pigmented sandpaper lesions in sun exposed areas

40
Q

What is seborrheic keratosis?

A

MC benign skin tumor

41
Q

Clinical manifestations of seborrheic keratosis

A

small papule with a velvety warty lesion

“greasy stuck on appearance”

42
Q

What lesions will whiten with acetic acid application?

A

HPV

43
Q

Condyloma Acuminata

A

genital warts

HPV 6,11

Painless papule that evolve into soft fleshy cauliflower-like lesions

44
Q

Vitiligo

A

Autoimmune destruction of melanocytes resulting in skin depigmentation

45
Q

What is Kaposi Sarcoma?

A
  • Connective tissue cancer found in immunocompromised patients
  • Caused by Human herpesvirus 8
  • Violet red/brown plaque like lesions
  • HAART therapy is treatment
46
Q

3 types of impetigo

A
  1. Nonbullous: vesicles & pustules, honey colored crust; Staph MC. GABHS 2nd
  2. Bullous: vesicles form large bullae, Staph MC
  3. Ecthyma: ulcerative, GABHS
47
Q

Impetigo management

A
  • Mupirocin (Bactroban) cream

- If severe you can use antibiotics such as Cqphalexin or clindamycin

48
Q

Treatment of folliculitis

A

Topical mupirocin

49
Q

Layers of the skin impacted by cellulitis

A

dermis and subcutaneous tissue

**not well demarcated!

50
Q

MC causative organisms of cellulitis

A

S. Aureus MC

-GABHS (strep pyogenes)

51
Q

Erysipelas

A
  • Caused by GABHS
  • WELL DEMARCATED, often on the face
  • Treat with PCN
52
Q

Lymphangitis

A

spread of cellulitis through the lymph vessels leaving streaking

53
Q

Medical management of cellulitis

A

Cephalexin; dicloxacillan

54
Q

What antibiotic should be used in a cat bite

A

Augmentin

Doxy if pen allergic

55
Q

Clinical manifestations of scabies

A
  • intensely pruritic lesions with linear burrows often in the web spaces
  • papules on scrotum, glans or penile shaft, body folds are pathopneumonic for scabies
56
Q

Scabies treatment

A

Permethrin topical cream

-ivermectin if extensive

57
Q

What is pediculosis

A

Lice

58
Q

What are the white oval shaped egg capsules at the base of hair shafts in those infected with lice called?

A

Nits

59
Q

What is the treatment for lice?

A

Permethrin

PANCE REVIEW (15 decks)

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