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MSK 2 > Dermatology - Matthys > Flashcards

Dermatology - Matthys Flashcards

1
Q

Annular, erythematous papules, scaling, eczematous, pruritic in antecubital fossa

What is it?

Often a history of?

Other signs on PE?

Histology

Treatment

A

Atopic dermatitis

Type 1 Hypersensitivity response

Atopy

Allergic shiners, DM lines, allergic salute

Spongiosis, eosinophilia

Moisture, avoidance, anti-pruritics, anti-inflamm

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2
Q

Erythematous, non-scaling, localized w/ sepsis, fever, no muscle involvement, tender and boggy

What is it?

Risk factors?

Initiation?

Treatment?

More mild version on face?

A

Cellulitis

Infection of skin and CT

Stasis dermatitis, lymphedema

Trauma –> Staph/Strep

Cephalosporin, Macrolide, or Clindamycin… + Elevation

Erysipelas

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3
Q

Symmetric erythematous, non-scaling, tender nodules and plaques on anterior LEs.

What is it?

Main differential?

Treatment?

A

Erythema nodosum

Hypersensitivity inflammation of subQ fat (panniculitis)

Sarcoidosis

Anti-inflam, rest, avoidance

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4
Q

Erythematous, scaling w/ silvery plaque, papulosquamous

Histo?

Other findings?

3 subtypes?

A

Psoriasis

Acanthosis, parakeratosis, clubbed rete ridges, no granulosum, tortuous BVs

Nail pitting, Koebner, Auspitz, Woronoff’s ring (after cleared)

Plaque, pustular, guttate

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5
Q

Local radicular pain, then eruption of rash 2-3 days later.

Histo?

Treatment?

A

Herpes zoster - Shingles

Steel gray nuclei, multinucleated giant cells, eosinophilic inclusions

Antivirals, pain control, vaccine

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6
Q

HLA-B13

A

Psoriasis

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7
Q

Rash in the webbing of the fingers and toes

A

Scabies

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8
Q

Branny/flaky, greasy, red-yellow scales on scalp, face, chest. Flaking in hair-baring areas.

Cause?

Common in who?

A

Seborrheic dermatitis

Plasmodium ovale infection

MALES, HIV

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9
Q

DM, warm humid areas chronically have red-brown scaly macules that combine to form erosive collarette-like scale.

How to diagnose?

Cause?

A

Erythrasma

Woods lamp – redness

Coryne. minutissimus infection (Gram + rod)

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10
Q

Middle age patient w/ Hepatitis C. Pruritic papules or plaques.

Things to look for on the rash?

What else to look for? Important why?

Treatment?

A

Lichen planus

Wickham striae (white lines)

Oral lesions –> can lead to SCC

Low dose topical steroids

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11
Q

Woman present at beginning or end of spring/summer. Pruritic rose/pink scaly patches or plaques, with one larger than the rest. Span out in peculiar pattern on thorax.

What is the pattern?

What is the large patch?

Histo?

Treatment?

A

Pityriasis rosea

Christmas tree pattern

Herald patch (1st one)

CD4+ cells and Langerhaan’s cells in the dermis

Light therapy

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12
Q

Moving infection of cornified areas (skin/hair/nails). Positive KOH test.

MUST treat which area?

Cause?

A

Tinea

Nails – can’t kill w/ topicals

Dermatophyte infection – Trichophyton, Microsporum, Epidermophyton

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13
Q

Reddish-orange scaling plaques w/ redness of palms and soles. Glove-type distribution of palms. Follicular keratitis papules. Islands of sparing.

Has features of what?

Treatment?

A

Pityriasis rubra pilaris

Vitamin A deficiency

Retinoids

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14
Q

Pruritic, scaling plaques w/ red-brown shades or hypopigmented shades.

Cause?

Mimics what?

Treatment?

A

CTCL (mycosis fungoides)

HTLV infection

Eczema

Topical steroids, PUVA, nitrogen mustard

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15
Q

Young adult w/ pruritic, scarring, erythematous papules/plaques, scaling, photosensitive rash, worse in sun. On mucosa, palms and soles.

Increased risk of what?

Diagnose w/ what?

Usually does NOT have what?

Treatment?

A

Discoid SLE

SCC

ANA, biopsy

Systemic symptoms

Sunscreen, topical steroids

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16
Q

Purpura - drug reaction?

Argyria - drug reaction?

Phototoxicity - drug reaction?

A

Coumadin

Silver nitrate

Doxycycline

17
Q

Give antibiotics, patient gets worse. What is this?

A

Jarisch-Herxheimer Rxn

18
Q

Most drug eruptions are what hypersensitivity type?

Classic look?

A

Type 4

Expansive erythematous maculopapular rash

19
Q

Erythematous annular plaque, coin-like, with fissures. Worse in winter.

A

Nummulous dermatitis

20
Q

Child under 6, crusty lesion. Asymptomatic flaccid ruptured blister, commonly on face in hot weather, crowded conditions, or immunocompromised patients.

Commonly also have what? Why?

Cause?

Caution?

Treatment?

A

Impetigo

Atopic dermatitis –> causes break in skin barrier –> infection

Staph aureus

Very contagious

Antibiotics

21
Q

Painful erythema in kids. Fever, orange-red macules. Skin peels off. Blisters. Positive nikolsky sign.

Cause?

What causes the blisters?

Cultures?

Treatment?

A

Staph scalded skin syndrome

Staph aureus exotoxin ET1/2

Granulosum desmosome splitting

Negative

Antibiotics, fluids

22
Q

Flaccid bulla on skin w/ erosion in oral mucosa. Positive nikolsky sign. Spreads when press laterally on it.

Associated with?

Cause?

Treatment?

A

Pemphigus vulgaris

Thymoma, Myasthenia gravis

Auto-IgG to desmoglein 3

Prednisone, then Imuran

23
Q

Itching and burning, followed by recurrent vesicles and ulcers. Oral or genital.

Associated w/ what other symptoms?

Treatment?

A

HSV

Encephalitis, seizures, headache

Antivirals

24
Q

Herpes on finger

A

Herpetic Whitlow

25
Q

Grouped vesicles on erythematous base

A

HSV

26
Q

Childhood, dew drops on rose petal vesicles, aphthous ulcers, anywhere BUT distal extremities.

Treatment?

A

Chickenpox (VZV)

Antivirals, antihistamines, VZIg

27
Q

Subacute/acute tense bullae, older patient, NOT in mucosal

Cause?

Can be caused by?

Diagnosis?

Treatment?

A

Bullous pemphigoid

IgG antibodies against hemidesmosomes (BPG 1/2)

UV radiation or drugs

Linear immunofluorescence

Prednisone, other

28
Q

Papules, vesicles, plaques caused by sun exposure. Most common in spring. Skin hardens w/in 30 min of sun exposure.

Common in who?

What is it?

A

Polymorphous light eruption

Native american descent, females

Type 4 hypersensitivity due to UV-A

29
Q

VERY pruritic, grouped, symmetric, burning skin blisters. IgA at tips of dermal papillae. Stomach aches and diarrhea when eating gluten.

Cause?

Genetics?

Treatment?

A

Dermatitis herpetiformes

Gluten-sensitive immune skin disease

HLA-B1, B8, DR8, DRQ

Dapson, gluten-free diet

30
Q

Targetoid, dull/dusky red macules and vesicular papules on palms and soles. Sloughing of skin. Bilateral and symmetrical. Mucosal involvement common. Positive koebner phenomenon.

Causes?

***Associated with?

A

Erythema multiforme

Immune response to drugs (sulfa, phenytoin, PCN, allopurinol), foods, sunlight, contacts

HSV

31
Q

Full thickness skin detachment, fever, tenderness, skin pain, burning. Crinkled surface to skin, positive nikolsky sign, sheets of lost epidermis.

Cause?

Worse in what?

Genetics?

Treatment?

A

TEN

Cell-mediated hypersensitivity to new drugs

SLE, HIV

HLA-B12

IV fluids, burn unit, steroids, IVIg

MSK 2 (20 decks)

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