Dermatology I highlights Flashcards
List the 8 characteristics of skin lesions you need to memorize (hint: there’s a mnemonic)
CLAMPS TN
1) Color
2) Location/distribution (extent, pattern)
3) Arrangement (grouped vs disseminated & confluence (yes or no)
4) Margination (well- or ill-defined)
5) Palpation (consistency, temperature, mobility, tenderness, depth)
6) Shape
7) Type (ie, papule, macule, pustule)
8) Number: single vs multiple (# of lesions)
1) What is a macule patch?
2) What is a plaque patch?
1) A macule > 1cm diameter = patch
2) Flat or barely elevated plaque = patch
True or false: wheals are always elevated
True
Define urticaria
Multiple wheals/rash = urticaria “hives, whelps”
True or false: you cannot cut off keloids, you can only inject them with steroids (which have the risk of atrophy)
True
List 6 papulo-squamous diseases (papules and plaques)
1) Dermatitis
2) Eczema
3) Drug eruptions
4) Lichen planus
5) Pityriasis rosea
6) Psoriasis
Differentiate between acute and chronic eczema/ dermatitis
1) Acute: pruritis, erythema, vesiculation
2) Chronic: pruritis, xerosis, lichenification
1) Does dyshidrotic eczema come back?
2) Describe its vesicles
1) Yes; recurrent
2) Deep-seated pruritic, clear “tapioca-like”
What is a major aspect of lichen simplex chronicus treatment?
D/c scratching
What are the 2 kinds of contact dermatitis?
Irritant and allergic
What is a key element of contact dermatitis?
Well-demarcated [erythema and edema]
1) Where is stasis dermatitis usually found?
2) What is a key aspect of Tx?
1) Lower legs and ankles
2) Compression stockings
True or false: stasis dermatitis is cellulitis
FALSE
Atopic dermatitis:
1) Does it relapse?
2) What is a primary characteristic?
3) Who is it frequent in?
1) Yes
2) Itch-scratch cycle
3) Frequent /w personal or FHx AD, allergic rhinitis, & asthma
What can be called “The itch that rashes”?
Atopic dermatitis
When should you give PO steroids to pts with atopic dermatitis?
PO steroids only for severe intractable cases
1) When is seborrheic dermatitis worse?
2) Name 2 groups it’s common in
1) Worse in fall/winter (dry environment and stress)
2) HIV, Parkinson’s
1) What is a primary characteristic of cradle cap (seborrheic dermatitis on head)
2) Describe how seborrheic dermatitis looks like on rest of the body
3) Tx?
1) yellow greasy
2) Red, greasy, yellowish scales, sebacous glands
3) Mild topical steroids
Who is perioral dermatitis most common in?
Females 20-45
What condition spares vermillion border?
Perioral Dermatitis
‘Dusky red to violaceous’ describes what lesions?
Fixed drug eruptions
Name 2 drugs that can cause fixed drug eruptions
NSAIDs and oral contraceptives
What are the 4 Ps of lichen planus?
Papule, purple, polygonal, pruritic (and flat topped)
Is lichen planus usually on flexors or extensors?
Flexors
Pityriasis rosea:
1) What is its first Sx?
2) What happens next?
1) Primary (“herald”) patch
2) “Christmas tree” pattern (lines of cleavage) on back
Describe a herald patch
Salmon-red plaque with fine collarette peripheral scale
What can be described as silver “scales” on a plaque? (Hint: when scraped, they reveal pinpoint bleeding)
Psoriasis
Pityriasis rosea:
1) When does it resolve?
2) What is its probable etiology?
1) Spontaneously in 6-12 weeks
2) Reactivation HSV-7 & HSV-6
What can occur after a strep (guttate) infection?
Psoriasis
If a lesion is described as drop-like what may it be?
Guttate psoriasis
What is an important Tx for plaque psoriasis?
Topical steroids
What condition is characterized by target-shaped lesions and herpes simplex virus?
Erythema multiforme
1) What is the most common cause of erythema multiforme?
2) List a common PE Finding
1) Herpes simplex virus (HSV)
2) Target lesions on oral& genitals and/ or palms& soles
What is the easiest way to differentiate between erythema multiforme major and minor?
Major always has mucosal involvement, minor does not
True or false: erythema multiforme can be found on palms and soles
True
When should PO steroids be used for erythema multiforme?
For disabling oral lesions
1) Are SJS and TEN acute or chronic? Explain
2) What is their primary characteristic?
1) Acute, life-threatening mucocutaneous reaction
2) Necrosis and detachment of epidermis
1) What is affected 90% of the time in SJS and TEN?
2) Where are these rarely present?
1) Mucous membranes affected
2) Palms/soles
What is a condition that can be drug-induced by anti-seizure meds?
SJS/ TEN
What condition is characterized by painful skin sloughing off, conjunctival burning, and painful mouth lesions?
SJS/ TEN
True or false: SJS/ TEN typically have symmetric lesions
True
1) What is the main Tx for SJS/ TEN?
2) What is a controversial Tx?
1) Admit to ICU or burn center, d/c offending agent/drug
2) Systemic glucocorticoids (contraindicated late in disease course)
1) What does Bullous pemphigoid (vesiculobullous disease) often start with?
2) Who does it often occur in?
3) How would you describe the bullae?
1) Urticarial eruption.
2) Elderly patients (60-80yrs)
3) Tense
1) What kind of condition is pemphigus (vesiculobullous disease)?
2) Who does it often occur in?
3) What is a key characteristic of the vesicles/ bullae?
1) Autoimmune disease
2) Adults 40-60
3) Easily rupture
Which has vesicles/ bullae that are tense, pemphigus or bullous pemphigoid?
Bullous pemphigoid
What must be present to Dx acne vulgaris?
Comedones
1) What causes acne?
2) Name a medication that can contribute to acne
1) Propionibacterium acnes (P. acnes)
2) Steroids
What are the 2 types of comedones? Describe each
1) Open= blackheads
2) Closed – white heads
List 2 treatments for mild acne vulgaris
1) Topical antibiotics
2) Benzoyl peroxide
1) What acne vulgaris Tx cannot be used during pregnancy?
2) What works best?
1) Topical retinoids
2) Combination therapy
PO Isotretinoin is used for acne vulgaris when? What is the brand name?
When it’s severe; Accutane
What is extremely teratogenic?
PO Isotretinoin
What can PO Isotretinoin not be used with? Why?
Tetracycline; can cause pseudotumor cerebri
PO Isotretinoin can cause what levels to be elevated?
1) Elevated triglycerides
2) Mild to moderate elevations of transaminases
What is characterized by “flushing & blushing” and telangiectasias?
Rosacea
List what can cause rosacea flare ups
Hot liquids, spicy foods, alcohol/wine, aged cheese, exposure to sun & heat, stress
Rhinophyma is found in the late stage of what?
Rosacea
Where is folliculitis found?
Hair bearing skin
1) What is the most common etiology of folliculitis?
2) What else can cause it?
1) Staph aureus
2) Pseudomonas aeruginosa (hot tub)
What medication can bleach stuff?
Benzoyl peroxide
List 4 characteristics of the lesions associated with Hidradenitis suppurativa
1) Double comedones
2) Abscesses
3) Sinus tracts
4) “Bridge” scars
True or false: Erythema multiforme always occurs on the palms and soles
False
