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Dermatology Flashcards

1
Q

Diagnosis of bullous pemphigoid

A

Biopsy both lesional skin for histology + perilesional normal skin for direct immunofluorescence

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2
Q

Pityriasis (tinea) versicolor presentation

A
  • young adult + asymptomatic + oval to round hyper or hypogpigmented macules
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3
Q

Treatment of pityriasis versicolor

A

Topical antiseborrheic shampoos or lotions (selenium sulfide or ketoconazole)

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4
Q

Tinea diagnosis

A

KOH prep using scale showing fungal hyphae

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5
Q

Tinea infection presentation

A

Annular + peripheral scale + central clearing

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6
Q

Eczematous dermatitis treatment (specific treatment)

A
  • topical glucocorticoids

- mild cleansers, emollients (petrolatum)

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7
Q

eczema location

A

antecubital and popliteal fossa

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8
Q

diagnosis of urticarial vasculitis

A

Skin biopsy

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9
Q

Presentation of urticarial vasculitis

A

Short duration urticarial wheels that resolve + painful + leave bruise-like changes

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10
Q

Diagnosis of allergic contact dermatitis

A

Epicutaneous patch testing

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11
Q

Treatment of striae and atrophy from topical steroids

A

Stop topical steroids

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12
Q

Chickenpox (varicella) presentation

A

Pruritic papules and vesicles on umbilicate center that appear in crops and then crust over

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13
Q

What is melanonychia?

A

Brown longitudinal pigmentation of nail plate

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14
Q

What is paronychia?

A

Loss of cuticles, tender, edematous nail folds involving multiple fingers

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15
Q

Definition of moderate to severe psoriasis

A

30% or more body surface area involvement

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16
Q

Treatment of moderate to severe psoriasis

A

Systemic agents (MTX, TNF inhibitors – etanercept, adalimumab, infliximab)

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17
Q

Other indications for systemic therapy with psoriasis

A
  • psoriatic arthritis, pustular psoriasis, or groin/scalp involvement
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18
Q

Treatment of pruritic urticarial papules and plaques of pregnancy (PUPPP)

A

Topical steroids

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19
Q

Treatment of intrahepatic cholestasis of pregnancy

A

ursodeoxycholic acid

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20
Q

What is miliaria + presentation

A
  • “heat rash”
  • multiple discrete red papules due to the occlusion of sweat ducts
  • often due to sweat gland occlusion from patient being immobilized (after surgery)
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21
Q

Candida clinical features

A

Intertriginous areas

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22
Q

Treatment of severe nodulocystic acne

A

Oral isotretinoin

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23
Q

What is amyopathic dermatomyositis?

A

skin findings characteristic of dermatomyositis but without clinical or laboratory evidence of muscle disease

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24
Q

Characteristic findings of dermatomyositis

A

Heliotrope sign, shawl sign, gottron papules

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25
Q

Mixed connective tissue disease clinical features

A

Features of SLE + systemic sclerosis + polymyositis

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26
Q

Strongest prognostic indicator in Stevens-Johnson syndrome/toxic epidermal necrosis (TEN

A

Body surface area

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27
Q

Bullous pemphigoid clinical features

A

Elderly person + trunk and upper legs + intact/nonruptured blisters

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28
Q

Treatment of impetigo

A

IF mild –> mupirocin ointment

More severe –> oral abx (dicloxacillin, erythromycin)

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29
Q

Impetigo clinical features

A

Honey-colored crust + common in kids

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30
Q

Rheumatoid vasculitis clinical features

A

Elderly male smoker + long-standing RA history +

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31
Q

Presentation of actinic purpura

A

Age and sun damage-related capillary fragility + bleeding under atrophic skin

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32
Q

Presentation of subacute cutaneous lupus erythematous (SCLE)

A

Photodistributed + worsens with sun exposure + erythematous annular scaly patches

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33
Q

Common causes of drug induced SLE

A 
HCTZ
ACEinhibitors
NSAIDs
PPIs
Terbinafine
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34
Q

Management of recurrent cellulitis

A

Source control (treat intertrigo and maceration between toe spaces + treat edema + eczema + venous insufficiency)

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35
Q

Cellulitis presentation

A

Well-demarcated + warm + tender

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36
Q

Management of recurrent actinic keratosis

A

Biopsy to rule out neoplasm (can’t completely cut it out because histology is necessary to guide treatment)

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37
Q

Presentation of actinic keratoses

A

Red scaly papules and plaques that occur in sun-exposed areas in old people

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38
Q

Treatment of actinic keratoses

A

IF single –> Cryotherapy

IF grouped –> 5-Fu or imiquimod

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39
Q

Standard treatment of basal cell carcinoma

A

Typically wide local excision

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40
Q

Basal cell carcinoma clinical features

A

Asymptomatic + translucent/pearly + sun-exposed areas + telangiectasis

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41
Q

Keratoacanthoma presentation

A

(look at picture)

  • rapidly growing pink nodule with crusted core and central crater (volcaniform)
  • rapidly grow, then slowly involute, eventually resolving completely
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42
Q

Squamous cell carcinoma presentation

A

(see picture)

- pink hyperkeratotic papule or nodule

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43
Q

SCC compared with basal cell

A

SCC’s have scale and do not have translucent, pearly appearance

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44
Q

What is lupus pernio

A

Sarcoidosis of the nose and central face

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45
Q

Presentation of lupus pernio

A

Violaceous subcutaneous plaques or nodules

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46
Q

Management of basal cell tumor on the face or genitals

A

Mohs surgery (also used for large or recurrent tumors, tumors with aggressive features)

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47
Q

Erythema multiforme clinical features

A

Target lesions + mucous membrane involvement + often triggered by drug or infection (mycoplasma or HSV)

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48
Q

Disseminated gonorrhea presentation

A

Vesiculopustular or hemorrhagic macular skin lesions + polyarthralgia

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49
Q

Actinic purpura is

A

age-related bruising due to capillary fragility and bleeding under atrophic skin

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50
Q

clinical features of stasis dermatitis

A

Edema + erythema + scaling + pruritus + more often bilateral

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51
Q

treatment of stasis dermatitis

A

Start with compression stockings and leg elevation

Can also use topical steroids and emollients

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52
Q

stasis dermatitis vs. cellulitis

A

Cellulitis = tender, not pruritic, hot to the touch, less scaling than stasis dermatitis

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53
Q

Psoriasis clinical features

A

Well-demarcated + erythematous plaques with silvery scale + nail changes

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54
Q

Treatment of epidermal inclusion cyst

A

Excision (NOT I&D, only I&D if they rupture)

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55
Q

Term for hair loss with pregnancy + why it happens

A

Telogen effluvium

- triggered by physically traumatic event (surgery, parturition)

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56
Q

seborrheic dermatitis clinical features

A

Erythematous patches w/ greasy scale + located on scalp, nasolabial folds and chest

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57
Q

Seborrheic dermatitis associations

A 
HIV
Neurologic conditions (Parkinson disease)
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58
Q

Derm conditions associated with chronic hep C

A

Porphyria cutanea tarda

Lichen planus

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59
Q

Transient acantholytic dermatosis clinical features

A

Red pruritic papules on the chest, flanks, and back + due to dry skin, heat, and heavy sweating

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60
Q

Allergic contact dermatitis clinical features

A

Pruritic eruption of patches and plaques + vesicular

61
Q

Lichen planus presentation

A

Pruritic, purple, polygonal papules that coalesce into plaques

62
Q

Melanotic macule clinical feaures

A

Small, well-circumscribed, brown-to-black macule + often on lower lip but can be on any mucosal surface

63
Q

Precursor to squamous cell carcinoma

A

Actinic cheilitis

64
Q

Actinic cheilitis clinical features

A

Chronic red-to-tan scaly patches + typically lower lip

65
Q

localized scleroderma clinical features

A

isolated sclerotic circumscribed plaques

66
Q

lentigo maligna clinical features

A

Subtype of melanoma that arises on head and neck of old people + indolent

67
Q

Most aggressive form of malignant melanoma

A

Nodular melanoma

68
Q

Treatment of mild inflammatory acne in pregnant woman

A

Topical erythromycin + topical benzoyl peroxide

69
Q

Describe morbilliform drug rash

A
  • Most common form of cutaneous adverse drug reactions
  • Erythematous papules coalescing into plaques = often pruritus + no systemic symptoms + peripheral eosinophilia + delayed (several weeks after)
70
Q

Treatment of morbilliform rash

A

Antihistamines + topical steroids

71
Q

DRESS clinical features

A

Delayed (2-6 weeks) + eosinophilia + skin pain/facial edema + …

72
Q

Viral exanthem vs. morbilliform rash

A
  • Viral exanthem occurs immediately after infection, morbilliform rash is delayed several weeks after medication
73
Q

Treatment for vitiligo

A

Topical steroids or immunomodulators

74
Q

Chancroid presentation

A

Painful ulcerations + inguinal lymphadenopathy

75
Q

Pyoderma gangrenosum clinical features

A

Painful, exudative ulcer + purulent base + ragged, edematous, violaceous border

76
Q

Pyoderma gangrenosum primary association

A

IBD

77
Q

Pyoderma gangrenosum treatment

A

Topical or oral steroids or immunosuppressive agents (azathioprine, cyclosporine, infliximab)

78
Q

Calciphylaxis presentation

A

Painful subcutaneous nodules or plaques + overlying red-brown discoloration + superimposed purpuric patches, often with central necrosis

79
Q

Phototherapy used for psoriasis

A

Narrowband (ultraviolet B) therapy (not absorbed by DNA)

80
Q

Presentation of cutaneous-only PAN

A

Tender, subcutaneous nodules from vascular inflammation + livedo reticularis

81
Q

Systemic PAN clinical features

A

GI bleeds + HTN + preceding chronic viral hepatitis

82
Q

What is leukocytoclastic vasculitis?

A
  • A finding, not a diagnosis

- palpable purpura secondary to another condition (SLE, RA, medications)

83
Q

Erythema nodosum associations

A
  • lymphoma, sarcoidosis, TB, fungal infections (coccidioidomycosis), strep, hormones (OCP, pregnancy), IBD, NOT SLE
84
Q

Erythema nodosum

A

CLINICAL – acute onset of tender nodules on bilateral shins typically in a young woman. Biopsy not necessary.

85
Q

Pitted keratolysis clinical features

A

Bacterial infection of feet leading to waxy/scaly plaques + thickening of plantar skin + punctate erosions in the plaques that may coalesce to form broader erosions and odor

86
Q

Erythrasma clinical features

A

Bacterial infection of intertriginous areas (axilla) – skin has wrinkled, cigarette paper texture

87
Q

Management of venous stasis ulcers

A

Compression therapy

88
Q

Most common leg ulcers

A

Venous stasis ulcers

89
Q

Location of venous stasis ulcers

A

Distal lower leg + often medial aspect of the ankle

90
Q

Venous stasis ulcers clinical features

A

Surrounding venous stasis (irregular border + surrounding hyperpigmentation) + pts often have varicose veins and peripheral edema

91
Q

Why is cilostazol given in PAD?

A

Increase peripheral blood flow for the treatment of intermittent claudication

92
Q

Term for diffuse erythema following steroids + why this occurs

A

erythroderma (steroids precipitate erythroderma in patients with underlying psoriasis)

93
Q

DRESS presentation + timing

A
  • weeks after receiving medication

- rash + facial edema + peripheral eosinophilia + LAD

94
Q

Presentation of dermatophyte infection

A

Erythematous annular patches + surface scaling + pruritic + (doesn’t necessarily have central clearing?)

95
Q

Tzanck preparation used for

A

Herpes infection

96
Q

HSV description

A

Grouped vesicles on an erythematous base

97
Q

Wood lamp used for

A

Vitiligo (to evaluate hypo and depigmentation lesions)

98
Q

Calciphylaxis lesions

A
  • intensely painful, black necrotic tissue, may form hard eschar in ESRD patients
  • typically in thighs and lower abdomen
  • calcium-phos product greater than 60 typically
99
Q

Nephrogenic systemic fibrosis clinical features

A
  • yellowish, thickened papules and nodules with skin tightening and sclerosis in ESRD patients on HD exposed to gadolinium-containing contrast dyes
100
Q

Management of an abscess

A
  • IF no systemic signs of infection – I&D

- IF systemic signs of infection – I&D + abx

101
Q

Clinical features of inverse psoriasis

A

Red plaques with variable amounts of scale in the axillae, intergluteal cleft ,and perineum

102
Q

Treatment of dermatitis herpetiformis

A

dapsone (and check for G6PD deficiency)

103
Q

Common cause of ulceration superimposed on venous stasis

A

Contact dermatitis from topical abx (neomycin, bacitracin)

104
Q

Treatment of hand dermatitis

A
  • FIRST LINE: topical emollients (petrolatum) + minimize hand washing
    SECOND LINE: topical steroid
105
Q

Hand dermatitis etiology + clinical features

A
  • type of irritant dermatitis
  • frequent water exposure from over hand washing, AICD, atopic dermatitis
  • scaling, fissured skin on palm or dorsal hand
106
Q

Treatment of comedonal acne

A

Topical retinoid

107
Q

Presentation of comedonal cacne

A
  • open and closed comedones + no inflammatory papules or pustules
108
Q

Management of severe nodulocystic acne with scarring when other therapies have failed

A

Isotretinoin

109
Q

When topical antibiotics are used for acne

A
  • pustules and inflammatory papules are present
110
Q

Treatment of postscabetic pruritus

A
  • (itching can persist for several weeks after scabies treatment)
  • antihistamins + topical steroids
111
Q

Other triggers for erythema nodosum

A
  • hormones, OCPs, hormone replacement therapy, pregnancy
112
Q

Lipodermatosclerosis clinical features

A

woody indurated tissue in patient with chronic venous stasis

113
Q

Arterial ulcer management

A

Surgical revascularization

114
Q

arterial ulcer locations

A
  • most commonly tips of and between digits

- also at sites of increased pressure (lateral malleolus, metatarsal heads, sites of previous trauma)

115
Q

Porphyria cutanea tarda clinical features

A

see photo online
- fragile skin + easily ruptured vesicles in sun-exposed areas (hands primarily + these then rupture, forming erosions, dyspigmentation and scarring

116
Q

Workup of patient diagnosed with PCT

A

evaluate for liver disease (hep C and hemochromatosis)

117
Q

Bullous pemphigoid clinical features

A
  • pruritic red plaques that then develop into large bullae + typically on trunk
118
Q

Preferred initial treatment of pyoderma gangrenosum

A

Prednisone

119
Q

Treatment of severe allergic contact eruptions from poison ivy

A

Prolonged systemic glucocorticoids

120
Q

Treatment of tinea pedis

A 
topical antifungals (any of the azoles or terbinafine)
*can't use topical nystatin
121
Q

DRESS features + timing

A
  • rash (morbilliform)
  • prominent facial edema
  • lymphadenopathy
  • fever, hypotension
  • 2-6 weeks after initiation of drug
122
Q

DRESS treatment

A
  • cessation of drug

- systemic steroids with a long taper

123
Q

Typical cause of pruritus in the absence of skin findings

A
  • medications
124
Q

Meds that can cause pruritus in the absence of skin findings

A
  • hctz, calcium channel blockers, opiates, NSAIDS
125
Q

Management of basal cell carcinoma

A

IF low risk + on trunk and extremities –> electrodessication and curettage
IF high risk OR cosmetically sensitive locations –> mohs surgery

126
Q

Alopecia areata clinical features

A

+ acute onset hairloss + smooth, hairless patches of skin (most commonly on scalp)
+ commonly in patients with other autoimmune disorders

127
Q

Treatment of alopecia areata

A

High potency topical steroids

128
Q

Skin manifestations of amyloidosis

A
  • generalized, waxy appearance
  • ecchymoses with minor pressure
  • ecchymoses around the eyes (racoon eyes)
  • yellow waxy papules and plaques perioribitally
129
Q

Description of heliotrope rash in dermatomyositis

A
  • purple or lilac erythema of the eyelids accompanied by edema
130
Q

eruptive xanthomas clinical features

A
  • yellow papules with surrounding erythema
131
Q

Association of eruptive xanthomas

A

pathognomic of hypertriglyceridemia

132
Q

lipid deposits around eyes associated with

A

hypercholesterolemia

133
Q

Dermatofibroma clinical features

A
  • see picture online

- benign firm brown or reddish papules + size of pencil eraser + dimple when pressure applied

134
Q

Pyogenic granuloma clinical features

A
  • similar to cherry hemangiomas (but more firable and tend to bleed)
135
Q

Neurofibromatosis type 1 features

A

neurofibromas + cafe-au-lait macules + lisch nodules (pigmented hamartomas of the iris)

136
Q

Pretibial myxedema clinical features

A
  • firm nodules and plaques with “peau d’orange” appearance on pretibial area
137
Q

pretibial myxedema association

A

hyperthyroidism

138
Q

Etiology of pityriasis versicolor

A

fungal infection

139
Q

What does morbilliform mean?

A
  • Rash that looks like measles (red macules + may be confluent in some places)
140
Q

AK description

A
  • red, rough, scaling patches
  • hx of a lot of sunburns
  • can be multiple
  • forehead, face, legs, arms
141
Q

treatment of AKs

A

5-Flourouracil cream

142
Q

Management of lacerations

A
  • IF penetrating the subcutaneous tissue OR overlying a joint – suture closed
  • check tetanus vaccine status
143
Q

clinical features of body lice

A
  • homeless patient
  • itchy
  • arms, legs, and trunks
  • linear excorations
144
Q

lichen planus clinical features

A
  • Lichen planus commonly presents as intensely pruritic, pink-to-purple, flat-topped papules or plaques; Wickham striae, a reticulated network of fine, white lines, can be seen on the surface.
145
Q

Acute pustular psoriasis clinical features

A
  • diffuse erythematous rash
  • following steroids
  • painful
  • patches and plaques, with pustules
146
Q

Sweet syndrome clinical features

A
  • fever + arthralgia + myalgia + arthritis + often preceding respiratory or GI illness
147
Q

Management of onychomycosis

A

Nail clipping for fungal culture (50% of nail dystrophies are caused by conditions other than fungal infection. infection with yeasts and nondermatophyte molds are becoming more common)

148
Q

brachioradial pruritus clinical features

A
  • deep, crawling, tingling sensation of forearms, shoulders, upper back + no visible skin findings

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