Dermatology Flashcards
Macule vs Patch
macule <1cm
patch >1cm
Vesicles vs Bullae
0.5cm, less = vesicle, more = bullae
Pustule vs Abscess
pustule less than 1 cm
abscess greater than 1 cm
Phototherapy for Psoariasis
UVB, narrow band
ecthyma
streptococcal, impetigo variant
usually legs and feet with eschar present
Prophylaxis for cellulitis
> 3 episodes/year
Erythrasma
hyperpigmentation of skin folds
Corynebacterium, treat with oral macrolides
Dermatophytosis of non-hair–bearing skin
miconazole, clotrimazole, and ketoconazole
2-4 weeks
Dermatophytosis of hair–bearing skin
terbinafine or itraconazole
pityriasis versicolor
hypopigmented macules on back
short rod-shaped hyphae and round yeast (“spaghetti and meatballs”)
ketoconazole 2% shampoo or selenium sulfide suspension
scabies treatment
permethrin cream, repeat in 7 days
lice treatment
premethrin
Venous Stasis Ulcers
medial aspect of lower legs
can have lipodermatosclerosis
Arterial Ulcers
bony prominences
surrounding erythema, punched out
erythroderma, causes?
steroids, psoriasis
seborrheic dermatitis Rx
selenium or zinc preparations
Psoriasis, systemic therapy indications
> 10% body surface involvement
Rx for dermatitis herpetiform
dapsone
porphyria cutanea tarda
vesicles in sun exposed areas, skin fragility (usually hands)
etoh, hep c, hemochromatosis
lichen planus
pruritic purple polygonal papules likely on flexural surfaces
Aplasia Cutis Congenita
congenital absence of the skin, small, localized, usually scalp
Multiple Spots of Aplasia Cutis in Infant, think…
trisomy 13
Erythema Toxicum Neonatorum
first few days of life (usually not at birth)
small, pink pustules filled with eosinophils
Transient Neonatal Pustular Melanosis
pustules that become scaly, hyperpigmented macules
Neutrophils!
PHACES Syndrome
P - posterior fossa abnormalities/Dandy Walker H - Hemangioma A - arterial anomalies C - cardiac defects, esp Coarc E - eye abnormalities S - sternal defects/supraumbilical raphe
Sturge Weber Syndrome
cerebral vascular malformation causing seizures, ID, glaucoma
+/- associated with facial vascular malformations/port wine stains
Klippel-Trenaunay Snydrome
vascular malformation of extremities
soft tissue and/or limb overgrowth
Types of Contact Dermatitis
Allergic & Irritant
Allergic - Type IV T cell mediated, delayed
Irritant - direct damage to skin
Treatment of Contact Dermatitis
severe - at least 2-3 week taper of steroids
Lichen Simplex Chronicus
caused by repetitive scratching & itching
Xerotic Eczema / Xerotic Dermatitis
lower extremities of older individuals
dried up lesions/looks like a dried creek bed
Transient Acantholytic Dermatosis
pruritic red papules, usually in elderly individuals
cause unknown
Infants w/ large congential melanocytic nevus
melanoma risk 6-8%, highest during the first 5 years of life
Nevus of Ota
common in AA & Asians
unilateral, irregularly speckled bluish-gray discoloration on face, esp peri-ortbital, slcera, etc
Rare malignant transformation to melanoma
Melasma
patchy hyperpigmentation of the skin on the face. It can also be seen on the upper extremities
usually due to pregnancy or OCP
Rx hydroquinone
Polymorphous light eruption
young fair skinned women
tiny red bumps on skin, lasts for weeks
Rosacea versus Lupus
rosacea: includes nasolabial folds
Rosacea: treatment
topical flagyl, topical ivermetin, azelaic acid
Rosacea: treatment of erythema
brimidone, oxymetazoline (alpha 2 agonists)
Hidradenitis Suppurativa treatment
OCPs, spirolactones
antibiotics
adalimulab
Pitted Keratolysis
Rx clinda or BPs
Molluscum Contagious in Adults
- HIV
- STIs
Crowe Sign
small, grouped, freckle-like cauf au lait spots in axilla in groin
NF1
Ichthyosis Vulgaris
AD
fine, white scales on extensor surfaces; hyperlinear palms & soles
improvements in summer & hot climates
X-linked recessive ichthysosis associations
presents in first months of life/birth
increased risk of GU disorders: undescended testes, underdeveloped penis & scrotum
Rule of 9s: Head & Neck
9
Rule of 9s: Arm
9
Rule of 9s: Leg
18
Rule of 9s: Anterior Trunk
18
Rule of 9s: Posterior Trunk
18
Solar Lentigines
“liver spots”
Pyogenic Granulomas
after trauma
common w/ pregnancy, HIV meds, retinoids
Keratoacanthoma
SCC versus benign variant
pink nodule w/ central crater filled middle
surgical excision
Bullous pemphigoid
urticarial and eczematous lesions that progress to tense bullae on an erythematous base
Pemphigus vulgaris
flaccid vesicles that rupture easily and leave erosions
+Nikolsy sign
common in oral + genital regios
Gorlin Syndrome
basal cell nevus syndrome
- basal cell carcinoma in childhood
- associated w/ ovarian cancer
Incontinentia Pigmenti (IP)
X-linked dominant disorder, lethal in males
rash on baby girl –> patterened blistering along lines of Blaschko
Delayed teeth eruptuion
Strabismus
drug reaction occuring at same location with repeat exposure
fixed drug reaction
Pruritis, causes to think about
Uremia
Hodgkin Lymphoma
secondary eczematous eruption after contact dermatitis
ID reaction
occlusion-and-heat-related superficial clear skin vesicles
miliaria (heat rash)
Auspitz Sign
bleeding with removal of scale (psoriasis)
ABC(D)E of melanoma
> 6mm
blue-black skin nodules
nodular melanoma
pregnancy related panniculitis of anterior legs
erythema nodosum
eczema charcterized by vesicles on sides of fingers
dyshidrotic (pompholyx)
Hemolytic Conditions associated with Sweet syndrome
MDS, AML
Imaging for erythema nodosum
CXR!
Red, scaly, polycyclic photosensitive rash
subacute cutaneous LE
Digital Pitting
Raynould/Scleroderma
Pyogenic Granulomas
red, friable
associated with pregnancy, acne & HIV meds
eruptive xanthomas
associated with high triglyceride levels
Xanthelsma classic condition
PBC
Bowen Disease
squamous cell carcinoma in situ
usually large, gradually enlarging plaque with crusting and scaling
Melanoma Treatment
Stage 1/2 - excision
3 - adjuvant such as interforn
4- anti-PD1 (pembrolizumab, nivoluzamab)
ACLE
malar rash or maculopapular
SCLE
photosensitive plaques or psoriasiform scaly plaques
DCLE
red-to-violet, thick plaques
Sweet Syndrome
acute febrile neutrophilic dermatosis
red to violet juicy plaques and papules
Amyloidosis Skin Findings
waxy appearance
pinch purpura - easy bruising with minor pressure
raccoon eyes
macroglossia
Time period for DRESS
2-6 weeks
Acute Generalized Exanthematous Pustulosis
medication (antibiotic) exposure within 1-2 days
fever, erythema, pustules
Sarcoidosis involving face
lupus pernio
