Exam 2 - Common dermatologic presentations

Question 1

What is psoriasis?

Answer 1

Common inflammatory multi-system disease that predominantly affects the skin and joints

Question 2

What anatomical location is psoriasis more likely to present?

Answer 2

Elbows and knees - bilateral over extensor surfaces

Question 3

Is psoriasis itchy?

Answer 3

No

Question 4

If a patient has psoriasis and pitting of the nails, what should the provider be concerned about?

Answer 4

Psoriatic arthritis

Question 5

What is guttate psoriasis?

Answer 5

Smaller, tear drop lesions that can be all over the body

• About 1-10 mm in size
• Scale more fine than plaque psoriasis

Question 6

What is erythrodermic psoriasis?

Answer 6

Severe form of psoriasis - generalized redness on almost entire body surface

Question 7

What are possible causes/triggers of psoriasis?

Answer 7

• Stress
• Acute illness

Question 8

Psoriasis management in primary care

Answer 8

• Topical steroids
• Referrals to derm if lesions are large or joints are involved

Question 9

What is onychomycosis?

Answer 9

Fungal infection of fingernails and toenails caused by dermatophytes

• Thickened, brittle, discolored nail bed

Question 10

Onychomycosis risk factors

Answer 10

• Tinea pedis (athlete’s foot)
• Hyperhydrosis (excessive sweating)
• Repeated trauma to foot
• Diabetics
• Tight fitting, occlusive shoes

Question 11

Diagnostic studies for onychomycosis

Answer 11

• KOH wet mount
• Fungal culture

Question 12

Onychomycosis treatment

Answer 12

• Topical antifungals (every day for 48 weeks due to low success rate)
• Systemic antifungals
  
  • Terbinafine is hepatotoxic

Question 13

True/false: if a patient has a lesion on the scalp, topical treatment is preferred

Answer 13

False - oral treatment is preferred for scalp lesions

Question 14

What treatments would be available for patients with non purulent cellulitis?

Answer 14

• PCN B
• Cephalexin
• Clindamycin

If concerned about MRSA: clindamycin, doxycycline