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Clin Med > eczematous eruptions > Flashcards

eczematous eruptions Flashcards

0
Q

Macule

A

Flat
<1 cm

Well circumscribed
Freckles, flat moles, measles

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1
Q

Layers of skin

A

Stratum basale
Stratum spinosa - losing nuc
Stratum granulosum - no nuc “granulated layer”
Cornified layer

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2
Q

Papule

A

Elevated
Firm
<1cm

Circumscribed
Raised moles, warts

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3
Q

Patch

A

Flat
Nonpalpable
>1cm

Vitiligo, port wine stains, cafe au lait

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4
Q

Plaque

A

Elevated, flat top
Firm
Rough
>1 cm

Psoriasis

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5
Q

Wheal

A

Elevated
Irreg shape of edema

Varied size
Allergic rxn, bug bites

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6
Q

Nodule

A

Elevated
Firm
Deeper than papule
1-2 cm

Circumscribed
Lipomas, erythema nodosum

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7
Q

Tumor

A

Elevated, solid
>2cm

Benign rumors, neoplasms, lipomas

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8
Q

Vesicle

A

Elevated,
Filled with serous fluid
<1cm

Varicella

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9
Q

Bulla

A

Vesicles >1cm

Blister, 2nd degree burn

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10
Q

Pustule

A

Elevated
Filled with purulent fluid (pus)

Impetigo

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11
Q

Cyst

A

Encapsulated in dermis
Filled with liquid

Elevated
Circumscribed
Acne, epidermoid cyst

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12
Q

Scale

A

Flaky skin

Thick or thin
Dry or oily
Irregular
Seborrhea capitis (dandruff)

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13
Q

Lichenification

A

Chronic
Rough thickened skin from itching/scratching
CHRONIC DERMATITIS

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14
Q

Keloid

A

Over scarring

Elevated
Firm
Irregular

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15
Q

Excoriation

A

Scratch

Loss of epidermis
Hollowed out line
Crusted area

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16
Q

Fissure

A

Linear crack in skin

Tinea pedis (athlete’s foot)

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17
Q

Erosion

A

Loss of epidermis
Depressed
Watery discharge

Follows rupture of bullus

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18
Q

Ulcer

A

Loss of epidermis and dermis
Concave

Statis ulcer

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19
Q

Telangiectasia

A

Dilates superficial blood vessel

Tel.angi.ectasia

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20
Q

Milia

A

Small, white papules filled with keratin

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21
Q

Annular lesions

A

Ring shaped lesions

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22
Q

Herpetiform

A

grouped lesions

23
Q

Pruritus

A

Itchiness

24
Q

**Atopic Dermatitis Presentation

A

Acute - erythematous papules, excoriation, pruritic

Subacute - excoriated, scaling papules

Chronic - thickened, lichenification, hyper-/hypopigementation

Babies-extensor, adults-flex folds

25
Q

Atopic dermatitis risk factors

A

First degree relative has condition
Microbes (S aureus, Candida, Trichophyton dermatophytes
Stress
Food allergy

Allergens
Irritant contact
Term IDMs (not preterm IDMs)
Obesity

26
Q

Atopic dermatitis eval

A

Neg skin test to r/o (pos skin test don’t tell much)
RAST (radioallergosorbent test) - good predictor
S aureus cultured from skin

27
Q

** Atopic dermatitis treatment

A 
Stress reduction
Lower temp and raise humidity
Moisturize:
**OINTMENT>cream>lotion>solution
Corticosteroid (least potent effective)
Antibiotics when infected
28
Q

Seborrheic dermatitis presentation

A 
Oily flaky skin over erythematic patches
Dandruff
Varied pruritis
< 6month old, after puberty
Generally no underlying disorder
29
Q

Seborrheic dermatitis treatment

A

Low potency glucocorticoid
Plus anti fungal (for inflammation)
Anti dandruff shampoo – leave in for 3-5 min

30
Q

Lichen simplex chronicus

A

Circumscribed lichenified plaque
From chronic scratch
Treatment: break cycle of itching
High potency topical glucocorticoids; occlusion

31
Q

Nummular (discoid) eczema

A

Coin like legions
Crusted and scaly (begin as edematous papules)
Mainly men
Treatment same as atopic dermatitis

32
Q

Xerotic/ asteototic eczema

A

Winter itch
Caused by dry air, often from use of HV/AC
Treatment- topical moisturizers
Made worse by overbathing and harsh soaps

Dry skin, fine cracks and scales

33
Q

Irritant contact dermatitis

A

Thin skin areas or where irritant touches skin
Most common from chronic hand washing (chronic low grade dermatitis)
Varies from erythema to edema vesicles and ulcers
Eg Hunan hand syndrome (chili burns)
Treatment- avoid irritant

34
Q

Type I Immunological Rxn

A

IgE Mediated

release antihistamines : angioedema, urticaria, bronchospasm, analphylaxis

35
Q

Type II Immunological Rxn

A

Cytotoxic
IgM and IgG recognize drug bound to cell and cell is destroyed
hemolytic anemia and thrombocytopenia

36
Q

Type III Immunological Rxn

A

Immune Complex
soluble IgG or IgM complexes
Complexes deposit in BV walls -> complement cascade -> serum sickness

37
Q

Type IV Immunological Rxn

A

T-cell mediated/delayed hypersensitivity

topical admin activates T-cells -> contact dermatitis

38
Q

Allergic Contact Dermatitis Presentation

A

Erythema
Vesiculation
Server Pruritus

39
Q

Allergic Contact Dermatitic Causes

A

Plants (poison ivy) - urushiol adheres to skin, linear eruption pattern because where touches skin
Nickel - sites of direct contact
Latex [gloves] - many possible allergens esp proteins in latex; common in spina bifida, shunts, kids with atopy; 24-48 hrs after exposure; patch tests
Hair dye and Henna - p-Phenylenediamine (PPD)
Textiles - wash and wear chemicals
Preservatives - cosmetics and topical meds
Fragrances
Drugs - corticosteroids, neomycin, benzocaine
Photoallergy - UV light

40
Q

Dishydrosis/Dishydrotic Eczema presentation

A

pruritic vesicular eruption (“pompholyx”) on thick skin areas
burning pain or itchiness before it occurs

pruritis of hands/feet with sudden onset of vesicles (may be in waves)

41
Q

Dishydrosis associated conditions

A 
hyperhidrosis
atopic dermatitis
contact dermatitis
stress
distnat fungal infection

genetics
UV A light

42
Q

Dishydrosis treatment

A

conld compress
high dose topical corticosteroid
botulism toxin A

immunosuppressants
low Ni or Co diets

43
Q

Stasis Dermatitis/Ulceration presentation

A

lower extremities
secondary to venous incompetence and chrona edema
Early: mild erythema (scaling & pruritus) on medial aspect of ankle
Chronic: brawny edema, eventually develops ulcer
assoc. with DVT, vein removal, varicose veins

44
Q

stasis dermatitis treatments

A

leg elevation
compression stockings
emollients/mid potency topical glucocorticoids
control the edema (like with diuretics)

45
Q

Diaper Rash

A

caused by wetness, friction, and presence of urine, feces, and microoriganisms
esp fecal proteases and lipases
pH elevated - increase activity of ^ and upset normal microbiota
Kawasaki’s = rare form

46
Q

Diaper Rash: Miliaria

A

obstruction of eccrine sweat glands

erythema and vesicles; can develop into pustules

47
Q

Diaper Rash: Intertrigo

A

meceration and chafing of skin b/c wet skin has higher coef of friction and is more fragile

48
Q

Diaper Rash: Contact Dermatitis

A

urine + feces + higher pH = activated fecal lipases, ureases, & proteases that irritate skin and make more permeable to other irritants

49
Q

Diaper Rash: Candidal diaper dermatitis

A

Candida albicans infects compromised skin
often associated with thrush
worsened by antibiotics, esp amoxicillin

50
Q

Diaper Rash: Bacterial diaper dermatitis

A

Bullous impetigo or folliculitis
most often staphylococcus or streptococcus

skin compromised by higher pH, secondary infection by fecal microorganisms

51
Q

Diaper Rash: seborrheic diaper dermatitis

A

associated with other signs of seborrhea (cradle cap/dandruff)

52
Q

Diaper rash: atopic eczema

A

spares diaper area - hydration/occlusion

53
Q

Diaper rash: granuloma gluteal infantum

A

rare

inflamm. response to irritation, candidiasis, or fluorinated corticosteroids

54
Q

Diaper rash treatment

A

airing diaper area
changing diaper type (cloth or super absorbent gels)
barrier ointments
antibacterials if infected

*look out for abuse (dunking baby bum in hot tub)

Clin Med (4 decks)

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