Dermatology Flashcards
1
Q
What is acanthosis nigricans?
A
a skin condition characterized by dark, velvety patches in body folds and creases
- typically occurs in people who are obese and is associated with insulin resistance, PCOS, and diabetes
- more rarely, it can be a warning sign of a cancerous tumor particularly gastric adenocarcinoma
2
Q
What is the tx of acanthosis nigricans?
A
treating underlying conditions, such as obesity or tumor, may restore the skin
3
Q
What is acne vulgaris?
A
characterized by areas of open comedones (blackheads) incomplete blockage, closed comedones (whiteheads) complete blockage, papules, pustules, nodules or cysts, may result in scarring
-I - comedonal: comedones (+/- small amounts of papules and pustules)
-II - papular: moderate number of lesions, little scarring
III - Pustular: lesions > 25, moderate scarring
IV - nodulocystic: severe scarring
4
Q
How is acne differentiate?
A
by the presence of comedones
-open comedones (blackheads) incomplete blockage, closed comedones (whiteheads) complete blockage
5
Q
What is the tx of acne vulgaris?
A
- most acne - topical retinoids
- cystic acne - tetracyclines, then oral retinoids - isotretinoin (causes dry lips, liver damage, increased triglycerides/cholesterol, pregnancy category X, must obtain 2 pregnancy test prior to starting it and monthly while on it
6
Q
What is actinic keratosis?
A
flesh-colored, pink or yellow-brown lesions with a rough sandpaper feel
- occurs on sun-exposed surfaces and is a precursor to squamous cell carcinoma
- it is mot common on the face, lips, ears, back of hands, forearms, scalp, and neck
- the rough, scaly skin patch enlarges slowly and usually causes no signs or symptoms
7
Q
What is the tx of actinic keratosis?
A
because it can become cancerous, it’s usually removed as a precaution
-treat with observation (many resolve on their own), cryosurgery, 5 FU cream, electrodeiccartion or Imiquimod
8
Q
What is alopecia?
A
sudden hair loss that starts with one or more circular bald patches that may overlap - oval shaped well-demarcated hair loss 90% of alopecia cases are due to the following disorders
- alopecia is preceded by a psychologically or physically stressful event 6-16 weeks prior to onset of hair loss
- growing hairs convert rapidly to resting hair
9
Q
What is tinea capitis?
A
hair loss secondary to fungal infection of the scalp
10
Q
What is alopecia areata?
A
oval-shaped well-demarcated hair loss, autoimmune - attack against hair follicles, onset usually prior to 30 years of age; men and women are equally affected, well-documented genetic predisposition
11
Q
What is traction alopecia?
A
caused by pulling force being applied to the hair (tight hairstyles)
12
Q
What is telogen effluvium?
A
scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (the resting phase of the hair follicle)
13
Q
What is androgenic alopecia?
A
typical male pattern baldness
14
Q
What is basal cell carcinoma?
A
a type of cancer that begins in the basal cells
- basal cells produce new skin cells as old ones die
- limiting sun exposure can help prevent these cells from becoming cancerous
- typically appears as a white waxy or a brown scaly patch, raised pearly and rolled borders, telangiectasis, a central ulcer on sun-exposed areas, such as the face and neck
15
Q
What is the tx for basal cell carcinoma?
A
prescription creams fluorouracil (FU) and imiquimod, photodynamic therapy (PDT) and surgical excision with clear margins
16
Q
What is bullous pemphigoid?
A
a rare, chronic acquired autoimmune sub-epidermal blistering skin disorder caused by linear disposition of autoantibodies (IgG) against hemidesmosomes in the epidermal-dermal junction
17
Q
What are the characteristics of bullous pemphigoid?
A
- bullous pemphigoid is less severe than pemphigus vulgaris, does not affect mucous membranes and has a negative Nikolsky sign
- large bullae and crusts located on axillae, thighs, groin, abdomen, more tense, less fragile and deeper than pemphigus vulgaris
18
Q
How is the dx of bullous pemphigoid made?
A
by skin biopsy with direct immunofluorescence exam shows deposition of IgG and C3 basement membrane
19
Q
What is the tx of bullous pemphigoid?
A
systemic corticosteroids
20
Q
What is cellulitis?
A
acute bacterial skin and skin structure infection of the dermis and subcutaneous tissue; characterized by pain, erythema, warmth, and swelling
- margins are flat and not well demarcated
- caused by staphylococcus and streptococcus in adults
- H. influenzae or strep pneumonia in children
21
Q
What is the tx for cellulitis?
A
treat mild cellulitis (MSSA) with cephalexin or dicoxacillin
- treat methicillin-resistant staphylococcus aureus infection (MRSA) with
- trimethoprim-sulfamethoxazole (TMP-SMZ) 1 DS tab PO BID
- clindamycin 300-450 mg PO
- doxycycline 100 mg PO BID
- intravenous vancomycin or linezolid
22
Q
What is condyloma acuminatum?
A
(also known as genital warts or anogenital warts) refers to an epidermal manifestation attributed to the epidermotrophic human papillomavirus (HPV)
- flesh-colored, cauliflower appearance genital warts caused by HPV types 6 and 11
- the HPV quadrivalent vaccine (Gardasil) protects against 6 and 11 and the 2 most cancer-promotion types, 16 and 18, treated with imiquimod (Aldara), podofilox, cryotherapy, surgery, or TCA
23
Q
What is contact dermatitis?
A
well-demarcated erythema, erosions, vesicles
- allergic: nickel, poison ivy, etc. type 4 hypersensitivity
- irritant (diaper rash): clearers, solvents, detergents, urine, feces
24
Q
What is the tx of contact dermatitis?
A
avoid offending agent, Burrow’s solution (aluminum acetate), topical steroids, zinc oxide (diaper rash)
25
What is atopic dermatitis?
pruritic, eczematous lesions, xerosis (dry skin) , and lichenification (thickening of the skin and an increase in skin markings)
- most common on flexor creases (ex. antecubital and popliteal folds)
- IgE, type 1 hypersensitivity
- infant - face and scalp
- adolescent - flexural surfaces
26
What is nummular eczema?
coin-shaped/disc-shaped
27
What is seborrheic dermatitis?
(cradle cap)
- erythematous, yellowish greasy scales, crusted lesions
- infants - scalp (cradle cap)
- adults/adolescents - body folds
- treatment: ketoconazole shampoo
28
What is perioral dermatitis?
young women, Papulopustular, plaques, and scales around the mouth
29
What is the tx for perioral dermatitis?
topical metronidazole, avoid steroids
30
What is a drug eruption?
an adverse cutaneous reaction in response to the administration of a drug
- skin reactions are the most common adverse drug reactions
- severity can range from mild eruptions that resolve after the removal of inciting agent to severe skin damage with multi organ involvement
31
What is dyshidrosis?
characterized by a pruritic vesicular eruption comprised of clear, deep-seated vesicles without erythema erupting on the lateral aspects of fingers, the central palm, and plantar surfaces
- the eruption has been described as resembling tapioca pudding
- the onset may be acute, recurrent, or chronic
32
What is the tx of dyshirdrosis?
petroleum jelly, moisturizer, cold compresses, and topical steroids
33
What is erysipelas?
a distinct form of cellulitis notable for acute, well-demarcated, raised superficial bacterial skin infection with lymphatic involvement almost always caused by streptococcus pyrogens
34
What are the symptoms of erysipelas?
redness and pain at the affected site, fevers, and chills
35
What is the tx of erysipelas?
mild disease can be treated with penicillin G
36
What is erythema multiforme?
an acute, self-limited and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction associated with certain infections - most commonly herpes simplex virus (HSV), medications (sulfa drugs), and other various triggers
37
What are the characteristics of erythema multiforme?
- skin lesions predominantly involving the extremities (hands, feet, and mucosa)
- target-like shape, raised, blanching and lack of itchiness help characterize this rash
- erythema multiforme is divided into major and minor forms and is now regarded as distinct from Stevens-Johnson syndrome and Toxic Epidermal Necrolysis
- infections are probably associated with at least 90% of cases of erythema multiforme - most commonly HSV
38
What is erythema infectiosum (fifth disease)?
- parvovirus B19 - "slapped cheek" rash on face - lacy reticular rash on extremities, spares palms and soles
- resolves in 2-3 weeks
- treatment is supportive, anti-inflammatoires
39
What are the characteristics of hand-foot-and-mouth disease?
- children <10 years old caused by coxsackievirus type A virus producing sores in the mouth and a rash on the hands, feet, mouth, and buttocks
- the virus usually clears up on its own within 10 days
- treatment is supportive, anti-inflammatories
40
What are the characteristics of measles (rubeola)?
- the 4 C's - cough, coryza, conjunctivitis, and cephalocaudal spread
- morbilliform - maculopapular, brick red rash on face beginning at hairline then progressing to palms and soles last - rash lasts 7 days
- Koplik spots (small red spots on buccal mucosa with blue-white pale center) precedes rash by 24-48 hours
- treatment is supportive - anti-inflammatories, isolate for 1 week after onset of rash
41
What are the characteristics of Rubella (German measles)?
- "3-day rash" pink light red-spotted maculopapular rash first appears on the face, spreads caudally to the trunk and extremities and becomes generalized within 24 hours (lasts 3 days)
- cephalocaudal spread of maculopapular rash, lymphadenopathy (posterior cervical, posterior auricular)
- although the distribution of the rubella is similar to that of rubeola, the spread is much more rapid, and the rash does not darken or coalesce
- teratogenic in 1'st trimester - congenital syndrome - deafness, cataracts, TTP, mental retardation
42
What are the characteristics of roseola (sixth disease)?
Herpesvirus 6 or 7, only childhood exanthema that starts on the trunk and spreads to the face
-high fever 3-5 days then rose pink maculopapular blanch able rash on trunk/back and face
43
What is folliculitis?
infection of one or more hair follicles (packers form which hair grows) characterized by papules and pustules
- the lesions are erythematous papules or pustules, they are usually not painful but may burn
- commonly caused by S. aureus but can be caused by other organisms, Pseudomonas folliculitis is seen in hot tub users
44
What is the tx of folliculitis?
- mupirocin ointment and topical benzoyl peroxide cream are first-line
- in more extensive cases, oral antibiotics may be necessary - dicloxacillin and cephalexin, if methicillin - resistant S. aureus is suspected, patients should be treated with trimethoprim/sulfamethoxazole, clindamycin or doxycycline
45
What is hidradenitis suppurative?
chronic follicular occlusive disease manifested as recurrent inflammatory nodules, abscesses, sinus tracts, and complex scar formation
- pea-to marble sized nodules under the skin that can be painful and tend to enlarge and drain pus
- they usually occur where skin rubs together, such as in the armpits, groin, and buttocks
46
What is the tx of hidradenitis suppurative?
intralesional triamcinolone is 1'st line treatment
| -oral and topical antibiotics, hygiene, warm soaks, and sometimes surgery can help manage symptoms
47
What is impetigo?
a highly contagious skin infection that causes red sores on the face
- the main symptom is red sores that form around the nose and mouth
- the sores rupture, ooze for a few days, then form a yellow-brown crust
- "honey-colored" and weeping
- most commonly caused by S. aureus
48
What is the tx of impetigo?
- topical mupirocin, dicloxacillin, cephalexin for more severe illness
- complications: post streptococcal glomerulonephritis
49
What is Kaposi sarcoma?
causes lesions to grow in the skin, lymph nodes, internal organs, and mucous membranes lining the mouth, nose and throat
- it is associated with human herpesvirus 8 and is an AIDS-defining cancer
- purple, red or brown skin blotches are a common sign
- tumors also may develop in other areas of the body
50
What is the tx of Kaposi sarcoma?
may include radiation or chemotherapy
| -rarely, surgery may be needed
51
What are lice?
pruritic scalp, body or groin
- nits are observed as small white specs on the hair shaft
- body (corporis); pubic (pubis)
52
What is the tx for lice?
launder potential formites such as sheets in hot water (>131 F or 55 C)
-permethrin topical is the drug of choice: capitis: shampoo to towel-dried hair and wash after 10 minutes; pubis: permethrin lotion x 8 hours
53
What is lichen planus?
a chronic papulosquamous inflammatory dermatosis of unknown etiology, probably autoimmune in origin
54
What are the characteristics of lichen planus?
- appears as purplish, itchy, flat-topped bumps
- on mucous membranes, such as in the mouth, it forms lacy white patches, sometimes with painful sores
- clinically characterized by 5Ps purple, papule, polygonal, pruritus, planar
- wichham striae: which lines visible in the papules of lichen planus and other dermatoses
55
What is the tx for lichen planus?
topical steroids
56
What is lichen simplex chronicus?
is chronic dermatitis resulting from chronic, repeated rubbing or scratching of the skin
- skin becomes thickened with accentuated lines ("lichenification")
- the contrast scratching caused thick, leathery, brownish skin
- a long-term manifestations of scratching atopic dermatitis
57
What is the tx of lichen simplex chronicus?
break the itch-scratch cycle (anti-histamines, occlusive dressing)
58
What is a lipoma?
benign fatty tumors, generally slow-growing, and usually harmless
- lipomas are just under the skin and move easily when pressure is applied
- they commonly occur in the neck, shoulders, back, abdomen, arms and thighs
- if the presenting lesion is fast-growing, suspect another diagnosis
59
What is the tx of a lipoma?
generally isn't necessary, but if the lipoma is bothersome, painful or growing, surgical excision or or liposuction may be needed
60
What is an epidermal inclusion cyst?
refers specifically to an epidermoid cyst that is the result of the implantation of epidermal elements in the dermis
- most of the cysts appear at solitary, soft, well defined, mucin-filled lesions
- characteristically, they have a smooth surface and a small opening to the surface of the skin, known as a puncture
- epidermoid cysts are benign lesions; however, very rare cases of various associated malignancies have been reported
61
What is the tx of a epidermal inclusion cyst?
close observation of the tumor in asymptomatic cases and surgical management, if necessary
62
What is melanoma?
usually a pigmented lesion with an irregular bored, irregular surface, or irregular coloration
-occurs when the pigment-producing cells that give color to the skin (melanocytes) become cancerous
63
What are the characteristics of melanoma?
- symptoms might include a new, unusual growth or a change in an existing mole
- can occur anywhere on the body
- asymmetrical, unevenly pigmented patch/plaque with a nodule and an irregular border
64
What are the ABCDE of melanoma?
```
Asymmetry
Border is irregular
Color variability (blue, red, white)
Diameter (increasing or >6 mm)
Elevation (raised)
-prognosis of melanoma is most strongly associated with the depth of the lesion, based on the Clark Classification system of Microstaging
```
65
What is the Clark Classification System of Microstaging for melanoma?
- Level 1: confined to the epidermis (in situ)
- Level 2: invasion into the papillary dermis
- Level 3: penetration to the papillary-reticular interface
- Level 4: invasion into the reticular dermis
- Level 5: penetration into the subcutaneous fat
66
What is the tx for a melanoma?
may involve Mohs surgery, radiation, medications, or in some cases chemotherapy
67
What is Melasma?
can be due to increase in estrogen during pregnancy or from sun exposure
68
What are the characteristics of Melasma?
- hyperpigmentation of the sun-exposed areas of the face (cheeks, forehead, nose and chin)
- appear dark, irregular, well-demarcated macule/patches
- also known as chloasma = "mask of pregnancy"
- in women, melismas often fades on its own after pregnancy or after an affected women goes off birth control
69
What is the tx for melasma?
treat with sunscreen and topical hydroquinone (bleaching agent)
70
What is molluscum contagiosum?
caused by the poxvirus, pearly papules with central umbillication
71
What is the tx of molluscum contagiosum?
the bumps usually disappear on their own
| -may be removed with curettage, cryotherapy, or acid or exfoliative peel-tretinoin, imiquimod (alder)
72
What is nummular eczema?
also known as nummular dermatitis or discoid eczema, is a chronic condition that causes coin-shaped rashes or sores to appear on the skin
- it may occur after an injury
- these spots are often itchy and well-defined
- the condition may results in one patch or multiple patches of coin-shaped lesions
73
What is the tx of nummular eczema?
high or ultra-high potency topical corticosteroids are first-line therapy for nummular eczema
-for patients with recalcitrant disease, a short course of systemic corticosteroids is an alternative treatment
74
What is onychomycosis?
a nail fungus causing thickened, brittle, crumbly, or ragged nails
- the main symptoms are change in the appearance of nails
- rarely, the condition causes the pain or a slightly foul odor
- a typical workup includes a fungal culture plus a test that yields faster results, such as a (KOH) preparation or periodic acid-Schiff (PAS) stain
75
What is the tx of onychomycosis?
terbinafine x 6 weeks for fingernails and 12 weeks for toenails
-LFT monitoring is necessary for most oral anti fungal regimens
76
What is a paronychia?
superficial inflammation of the lateral and posterior folds of skin surrounding the fingernail or toenail
-caused by candida if chronic and staph aureus if acute
77
What is the tx for paronychia?
- without abscess formation - topical antibiotics and warm water of antiseptic soaks (eg, chlorhexidine, providone-iodine) multiple times per day is usually effective
- empiric oral antibiotic therapy may be needed in more severe cases: an anti staphylococcal agent such as dicloxacillin (250 mg four times daily) or cephalexin (500 mg three to four times daily) is appropriate first-line therapy
- paronychia with abscess - incision, and drainage
- tetanus booster if indicated
78
What is pilonidal disease?
an abnormal skin growth located at the tailbone that contains hair and skin
- will usually present as a teenager with pain, discomfort, and swelling above the anus or near the tailbone that comes and goes
- often includes drainage of pus or blood
79
What is the tx of pilonidal disease?
involves drainage and surgical removal of the cyst - look for sinus tract
80
What is Pityriasis rosea?
typically occurs in childbirth and young adults
- characterized by an initial herald patch, followed by the development of a diffuse papulosquamous rash
- easier to identify when the general eruption appears with smaller secondary lesions that follow Langer's lines (cleavage lines) in a Christmas tree-like pattern
- herald patch: large oval plaque with central clearing and scaly border, 1st sign
- pruritic erythematous plaque with central scale in Christmas tree pattern on the trunk
81
What is the tx of Pityriasis rosea?
self-limiting: topical or systemic steroids and antihistamines are often used to relieve itching
-asymptomatic lesions do not require treatment
82
What is a pressure ulcers?
injury to the skin and underlying tissue resulting from prolonged pressure on the skin over a bony prominence
- sacrum and hip most often affected
- prevent by repositioning every 2 hours
83
What are the stages of pressure ulcers?
- Stage 1: erythema of localized area, usually non-blanching over the bony surface
- Stage 2: partial loss of dermal layer, resulting in pink ulceration
- Stage 3: full dermal loss often exposing subcutaneous tissue and fat
- Stage 4: full-thickness ulceration exposing bone, tendon, or muscle, osteomyelitis may be present
84
What is the wound management by the stage of the ulcer?
- Stage 1: aggressive preventive measures, thin-film dressing for protection
- Stage 2: occlusive dressing to maintain healing, transparent films, hydrocolloids
- Stage 3-4: debridement of necrotic tissue, exudative ulcers will benefit from absorptive dressings such as calcium alginates, foams, hydrofibers, dry ulcers require occlusive dressings to maintain moisture, including hydrocolloids, and hydrogels
85
What is psoriasis?
an immune-mediated disease that causes raised, red, scaly patches to appear on the skin
86
What are characteristics of psoriasis?
- typically affects the extensor surfaces of the elbows, knees, or scalp, though it can appear on any location on any location
- the classic clinical appearance is a well-demarcated, erythematous plaque with silvery scaling
- patients may also present with no rash and only join symptoms - pain in both hands and nail changes such as pitting and onycholysis
- Auspitz sign (bleeds when the scale is picked). Koebner's phenomenon (minor trauma causes new lesion)
- Psoriasis Vulgaris: most common, noted on extensor surfaces
- Guttate psoriasis: children, after URI, small lesions
- Inverse psoriasis: intertriginous areas
- pustular psoriaisis: contains pustules
87
What is the tx for psoriasis?
topical steroids
88
What is rosacea?
women aged 30-50, facial erythema, telangiectasis, papules, may cause rhinopehyma
- triggers include heat, alcohol, spicy foods, treat with topical metronidazole
- differentiate from acne by lack of comedones (blackheads)
89
What is scabies?
pruritic papules, s-shaped or linear burrows on the skin
- often located in web spaces of hands, wrists, waist with severe itching (worse at night)
- diagnose with microscopic observation of mite, egg or feces after skin scrape
90
How do you treat scabies?
- treat with topical permethrin 5%
- all clothing bedding, towels washed and dried using heat
- have no contact with body for at least 72 hours
- oral ivermectin for adults and children weighing at least 33 pounds who can swallow pills (OK for nursing women, but avoid in pregnancy)
91
What is seborrheic keratosis?
most common benign skin tumor seen in fair-skinned elderly patients with prolonged sun exposure
-brown, black, or tan growth with waxy, "stuck on" appearance, commonly referred to as barnacles of old age
92
What is the tx of seborrheic keratosis?
not premalignant and needs no treatment unless the lesions are irritated, itchy, or cosmetically bothersome
-lesions may be removed with little or no scarring by cryotherapy (which can cause hypo pigmentation) or by electrodesiccation and curettage after local injection of lidocaine
93
What are the characteristics of a brown recluse bite?
- brown violin on the abdomen
- necrotic wound - local tissue reaction causes local burning at the site for 3-4 hours - blanched area (due to vasoconstriction) - central necrosis erythematous margin around an ischemic center "red halo" - 24/7 hours after hemorrhagic bullae that undergoes Eschar formation - necrosis
94
What are the characteristic of black widow bit?
- red hourglass on the abdomen
- neurologic manifestations - may not see much at bite site: toxic reaction: nausea, vomiting, HA, fever, syncope, and convulsions
95
What is the tx for brown spider bites?
wound care, local symptomatic measures and sometimes delayed excision
96
What is the tx for black widow spider bites?
includes wound care, local symptomatic measures, sometimes parenteral opioids, benzodiazepines
-treat with anti-venom available for elderly and kids
97
What is Stevens-Johnson syndrome?
a rare, serious hypersensitivity complex that affects the skin and the mucous membranes
-usually a reaction to a medication or an infection commonly caused by anticonvulsants and sulfa drugs
98
What are the characteristics of Stevens-Johnson syndrome?
- SJS is 3-10% of the body
- begins with a prodrome of flu-like symptoms, followed by a painful red or purplish rash that spread and blisters
- layers of skin peel away in sheets (+) Nikolsky's sign (pushing blister causes further separation from dermis)
- SJS is milder form of toxic epidermal necrolysis (TEN) with less than 10% of body surface area detachment
- biopsy - shows nectotic epithelium
99
What is the tx of Stevens-Johnson syndrome?
treat the underlying cause and supportive (burn unit)
100
What are tinea infections?
a highly contagious, fungal infection of the skin or scalp
| -KOH - long, branching fungal hyphae with septations
101
What is tinea barbae?
papules pustules, around hair follicles
102
What is tinea pedis?
athlete's foot: pruritic scaly eruptions between toes
- trichophyton rubrum is the most common dermatophyte causing athlete's foot
- mgmt: topical antifungals
103
What is tinea cruris?
"jock itch" diffusely red rash in the groin or on the scroum
104
What is tinea capitis?
most common fungal infection in pediatric population
- occurs mainly in prepubescent children (between 3 and 7 years
- asymptomatic carriers are common and contribute to spread
105
What is tinea corporis?
(ringworm): usually seen in younger children or in young adolescents with close physical contact with others (i.e. wrestlers)
106
What is tinea versicolor?
caused by Malassezia furor, a yeast found on the skin of humans
-lesions consist of hypo or hyper pigmented macule that do not tan
107
What is tinea versicolor?
is caused by Malassezia furfur, a yeast found on the skin of humans
- lesions consist of hypo or hyper pigmented macule that do not tan
- it is classified as an "other" superficial mycoses since it not caused by dermatophytes
- seen in adolescents and young adults
- scaling, oval patches that are either hypo or hyper pigmented
- distributed on the upper trunk, neck, and proximal arms and in areas where there is a high amount of sebum and free fatting acids, which the organism requires, occasionally on the face
108
What is the tx of tinea versicolor?
selenium sulfide 2.5% applied to the affected skin for 10 minutes, wash off thoroughly, apply daily for 7-10 days, monthly applications may help prevent recurrences
109
What is toxic epidermal necrolysis?
a rare, life-threatening skin condition that is usually caused by a reaction to drugs
110
What are the characteristics of toxic epidermal necrolysis?
- TEN is >30% of body
- very similar to Steven-Johnson syndrome - the difference is the age of the individuals (in toxic epidermal necrolysis older patients vs SJS younger patient) and percentage of the body affected (in TEN >30% of body surface area affected vs. SJS <10% of body surface area affected
111
What is urticaria?
(hives) is a skin rash triggered by a reaction to certain foods, medications, stress, or other irritants
- symptoms include blanch able, pruritic, raised, red, or skin-colored papules, wheels, or plaques on the skin's surface
- (+) Darier's sign: localize urticaria appearing where the skin is rubbed (histamine release)
- angioedema: painless, deeper form of urticaria affecting the lips, tongue, eyelids hand and genital
112
What is the tx of urticaria?
usually go away without treatment, but antihistamine medications are often helpful in improving symptoms
- if anaphylaxis given epinephrine: 0/3-0.5 mg; use 1:1,000 dilation for IM route and 1:10,000 for IV route
- peds: epinephrine 0.01 mg/kg SC/IV
113
What are warts caused by?
by Human papillomavirus (HPV),
| -most resolve over 2 years
114
What are verruca vulgaris?
common warts
| -skin-colored papillomatous papules
115
What are verruca plana?
flat warts
| -hands, face, arms, legs
116
What are verrucae plantaris?
plantar warts
- bottom of the foot
- rough surface
- dark spot (thromboses capillaries)
117
What are condyloma acuminatum?
venereal warts
| -flesh-colored, cauliflower appearance genital warts caused by HPV types 6 and 11
118
What is epidermodysplasia verruciformis?
a rare, lifelong hereditary disorder characterized by chronic infection with HPV
119
What is the tx of verrucae (warts)?
most resolve without treatment over 2 years
- cryotherapy with liquid nitrogen may be applied with a cotton swab or with a cryotherapy gun (cryogen)
- self-administered topical therapy such as salicylic acid
120
What is vitiligo?
caused by autoimmune destruction of melanocytes causing these pigment - producing cells to die or stop functioning
121
What are the characteristics of vitiligo?
- loss of skin color can affect any part of the body, including the mouth, hair, and eyes
- it may be more noticeable in people with darker skin
- wood's light examination reveals a "milk-white" fluorescence over the lesion
122
What is the tx of vitiligo?
sunscreen, cover-up, corticosteroids, tacrolimus (an immunosuppressive drug) and vitamin D
-treatment may improve the appearance of the skin but doesn't cure the disease
