Dermatology Flashcards
If scale is present in - toddler: - extensor: - groin\breast: Then the etiology is probably
- atopy
- autoimmune
- fungal infection
Health care workers are at high risk of developing which dermatological conditions?
Irritant contact dermatitis due to washing
Knowing the race of the patient, what is the specific severe condition that could be associated with it:
- white race
- African American
- melanoma and vitilgo
- discoid lupus
Female cooking and the heat suddnely caused her to flush and develop rash, what is this
Rosacea
Multivitamin can induce rash known as
Erythema multiforme
Lichen planus affects: ……… threrefore must examine mouth.
Mucus membranes
A bad prognosis of rosacea is the presence of:
Conjunctivitis
Name examples of primary lesions:
- <0.5-1cm: papule, macule, pustule, nodules, vesicles
- >0.5-1cm: plaque, tumor, patch, bulla
A raised superficial lesion is:
Papule - plaque
Palpable deep leasion is:
Nodule & tumor
Flat lesion
Macule and patch
Elevated fluid filled lesion
Vesicle and bulla
Shape and distribution of infectious contageosum is:
Papule with punctum
- child: abdomen
- adult: groin due to sexual transmission
Define the following special morphologies (primary lesion):
- wheals:
- Milia:
- Comedones:
- edema under the dermis for urticaria
- Infant acne
- acne (blackhead is open - whitehead is closed)
Urticaria duration:
Only 24-48hours
Describe the following secondary lesions with one word
- scale
- crust
- erosion
- excoriation
- ulcer
- scar
- cyst
- necrosis
- corencyte aggregate
- dryness of serum or exudate
- superficial defect
- deep defect due to scratch
- tissue necrosis, deep defect, poor healing
- healing skin
- filled with lining cells &lined with epithelium
- dead tissue
Pathognomic sign for imptigo
Honey comb crust around mouth
Impetigo is caused by which organism
streptococcus
Most common secondary lesion in patients with atopic dermatitis
Lichenification
Differentiate rosacea from acne
Rosacea has clean appearance
Define atrophy
Drcrease in size and number of cells > depression and thinning of cells
Steroid injection dermatological side effect
Atrophy - hypopigmentation
Define fissure and where do we see it most commonly
Vertical cleavage of skin
In dryness
Differentiate discoid and annular leison;
- discoid: filled with lesion - lupus
- annular: empty center - tinea corporis
Koebner phenomenon is:
Appearance of new skin lesion in area of dermatosis
Name differentials for linear configuration deramtosis
- scabies
- kobenar
- lichen planus
How does patients with 5th disease look like, and what is the most common organism to cause this disease?
Young person with slap cheeks, reticular rash and is caused by b19
What is the common site for herpes simplex vs herpes zooster
simplex: periorifical
Zooster: dermatomal
What is the most common lesions in apocrine areas?
Hiadradnitis supperative
How does secondary syphlis in adults usually appear
Hand and foot dermatological lesion
Hand, foot mouth disease is caused by
Coxakie
If lesion is
Vesicle + burning + dermatomal disterbution.
This is probably is
Shingles (zooster)
How to treat commadones
Retin A topical
How to treat mild acne with papule and pustule
Retin A +benzyl peroxide
Moderate acne + nodule
Moderate acne + pustule
Both topical retina A + benzyl peroxide
Except
- nodule: oral antibiotic
- papule: topical antibiotic
Severe acne with nodule must take
Oral isoteritonion
Routine tests before isotertinoin:
Cbc for agranulocytosis, LFT because metabolized in liver, RFT because of dryness, pregnancy test because teratogenicity, lipid profile because increase LDL
Most common side effects of isoteritoin therapy
Depression, myalgia, dryness “avoid contact lens”
What is rhyinophema?
Swollen nose with sebacous gland hyperplasia and fibrosis (irreversible stage 3 rosacea)
Flushing in rosacea can be triggered by
- Heat and cold
- nicotine, caffeine and alcohol
- spice
- UV light
- hormonal
What are the stages of rosacea
- erythema + talengectasia
- referral: pustule/papule
- referral: rhinopehyma
How to treat rosacea stage 1?
Sun screen
- topical metro
- benzyl peroxide - clindamycin - eryhromycin
What medications are strongly contraindicated in rosacea?
Topical corticosteroid
Describe the typical presentation of pitryalisis roscea:
It starts as (fever or flu) ->
solitary nodule (scale\oval\annular)
known as herald patch ->
it increase in number and becomes macule specifically in the abdomen like a christmas tree
Herald patch is pathognomic for
Pitryalsis rosacea
What is the treatment of choice in pityriasis rosacea?
No treatment (self-limiting) 3-8wk
- antihistamine if itchy
- mild topical steroid if redness
Which patients are at high risk to develop pitryiasis vesicolor
Athletes
How to treat pityriasis versicolor:
- shampoo: ketoconazole [10d + 6w]
- cream: flucoconazole\itraconazole [6w]
When to refer pityriasis versicolor for dermatology
After [6wks] for oral antifungal
What is pityriasis alba
Hypopigmentation. Appears with sun exposure. So limit sun exposure c:
Vitiligo is associated with:
- thyroid disease
- B12 def.
- DM
- MG
- Addisons.
which hyper-pigmented leisons will you recommend for biopsy?
“The characteristics that may concern melanoma”
A: asymmetrical
B: bleeding, ulceration, changing in sensation
C: color changing
D: diameter >6mm
Describe psoriasis:
Patches with erythema + some with silver scales. Might be itchy, occurs in the extensors. Associated with nail changes
If they appear in knee: psoriatic vulgaris
How to differentiate between gutate psoriasis and typical psoriasis?
The appearance:
- psoriasis: erythematous & scaly patches
- Gutate: small rain-drops lesion
The presentation
- Gutate is proceeded by URTI infection “ie; sore throat”
Both: in the back & extensors
Most important complaint associated with atopy is:
Pruritus
Distribution of atopy in adults VS in children?
Adults: flexors and hands
Children: face
Best treatment for atopy is:
Emollients
General management approach for atopy?
1- Avoid triggers 2- emollients 3- topical mild-moderate steroid 4- antibiotic if infections 5- antihistamine if itchy
What are the possible causes behind napkin rash?
- infrequent change
- diarrhea (SE of medics\illness)
- use of wipes instead of water
- change of diapers brand
How to manage diaper rash?
- Education
- barrier (Vasline gel - zinc oxide)
- mild topical steroid for 1w
How to differentiate contact dermatitis from candidiasis in the buttock of the baby?
Sparing of flexure folds
Define Effluvium:
Increased loss of hair >100 hairs\day
How to differentiate in appearance
- tinea capitis
- alopecea areata
- Trichotilomania
- traction alopecia
- [round] Scaly + broken hair shaft but not complete clean baldness + positive fluorescence.
- [oval] affect different parts of body hair + clean baldness
- [Linear] hair of different lengths + stress.
- related to hair style + in temporal\parietal areas.
How to differentiate in management
- tinea capitis
- alopecea areata
- Trichotilomania
- traction alopecia
- Oral Griseofulvin** + topical azoles or shampoo. (6wks)
- intralesional injection w\steroid + minoxidil
- Minoxidil
- Minoxidil.
(Provide education in traction alopecia & alopcia areata)
What are the phases of telogen effluvium?
Only catagen and telogen
Possible causes for telegon effluvium:
- Thyroid disease
- IDA
- Lactating mother
- family androgenic alopecia
- Infection\ ICU admission
- medications
Most effective treatment for androgenetic alopecia
hair transplantation is the most effective.
Can use:
- Minoxidil 2-5%
- finasteride.
