First AID Dermatology

Question 1

Bulla

Answer 1

Fluid filled raised vesicle; diameter > 5mm

Question 2

Excoriation

Answer 2

Traumatic linear lesion characterized by break in the epidermis, raw linear area; often self-induced

Question 3

Macular

Answer 3

Circular discoloration of the skin; diameter <5mm; FLAT

Question 4

Nodule

Answer 4

Hard, raised lesion with spherical contour; diameter >5mm

Question 5

Papule

Answer 5

Hard, raise lesion with spherical contour; diameter <5mm

Question 6

Patch

Answer 6

FLAT lesion similar to macule; diameter >5mm

Question 7

Plaque

Answer 7

Elevated, flat-topped lesion usually >5mm (may be coalescent papules)

Question 8

Pustule

Answer 8

Discrete, pus filled, raised lesion;

Question 9

Scale

Answer 9

Dry, horny, platelike excrescence, usually results from imperfect cornification

Question 10

Vesicle

Answer 10

Fluid-filled raised lesion; diameter <5mm;

Question 11

Allergic contact dermatitis

Answer 11

delayed-type hypersensitivity (type IV); linear lesion that appears after some exposure, traces the line of the irritant (poison ivy, jewelry, cosmetics)

Question 12

Atopic dermatitis (eczema)

Answer 12

type I hypersensitivity; scaly & vesicle –> rupture & crust; on flexor surfaces; often pruritic

Question 13

Nevocellular nevus

Answer 13

benign common mole

Question 14

Psoriasis

Answer 14

over proliferation of keratinocytes; characterized by papules & plaques with silvery scales; usually non-pruritic; 10% of patients have psoriatic arthritis;

Question 15

Rosacea

Answer 15

affects primarily women; begins with facial flushing (EtOH, embarrassment, heat) –> telangiectasias, superficial pustules, central redness;

Question 16

Seborrheic Keratosis

Answer 16

benign epidermal tumor; arises spontaneously; round, flat, coin-like plaque that appears pasted on, tan to dark (melanin in basaloid cells), velvety to glandular surface; elderly/easily treated with excision;

Question 17

Urticaria Treatment

Answer 17

antihistamine & remove causative agent

Question 18

Urticaria

Answer 18

wheal-and-flair reaction, very pruritic; food/insect bite/drugs –> IgE mediated mast cell histamine release; usually last 24 hours –> urticarial vasculitis);

Question 19

Hereditary angioneurotic edema

Answer 19

inherited dificiency in C1 esterase inhibitor –> uncontrolled activation of the early components of complement;

Question 20

Albinism

Answer 20

mutation in tyrosinase; normal melanocyte count but poor melanin production; very little pigment to skin, white hair; Risk factor for skin cancer;

Question 21

Melsama

Answer 21

Hyperpigmentation around the mouth or on the abdomen in response to estrogen; @ risk –> pregnant women & contraceptive takers;

Question 22

Vitiligo

Answer 22

autoimmune destruction of melanocytes; patchy areas of complete depigmentation;

Question 23

Cellulitis

Answer 23

usually by S aureus or S. pyogenes; infection of dermis or SubQ; acute painful erythematous region of skin that progressive;

Question 24

Cellulitis Treatment

Answer 24

antibiotics;

Question 25

Impetigo

Answer 25

superficial infection (S. aureus or S. pyogenes); vesicles & pusturles –> rupture and form honey-colored crust;

Question 26

Impetigo treatment

Answer 26

antibiotics

Question 27

Necrotizing Fascitis

Answer 27

often by anaerobic group A streptococci; infection down to deep fascia; presents with erythematous region, fever –> tissue turns black/gray & crepitus from CO2/methane production; Treatment

Question 28

Necrotizing Fascitis treatment

Answer 28

amputation, shock, death, surgical debridement, IV antibiotics;

Question 29

Staph Scalded Skin Syndrome (SSSS)

Answer 29

exfoliative exotoxin released by S aureus that cleaves desmoglein 1 (cell-cell interactions, dermolysis between stratum spinosum and stratum granulosum; @ Risk newborn & children;

Question 30

Staph Scalded Skin Syndrome (SSSS) Presentation

Answer 30

fever, generalized rash –> sloughing of upper layer dermins;

Question 31

Verrucae

Answer 31

caused by HPV (a DNA virus); epidermal hyperplasia –> cauliflower-like lesion found on children’s hands/foot; Treatment

Question 32

Verrucae treatment

Answer 32

cryotherapy, salicylic acid, cantharidin;

Question 33

Bullous pemphigoid

Answer 33

antibodies targeted against hemidesmosomes (type II hypersensitivity); fluid accumulates below the epidermis; bullae doesn’t rupture when pressed; found throughout body but spares oral mucosa; linear immunofluorescence at the basement membrane;

Question 34

Dermatitis Herpetiformis (rare)

Answer 34

IgA antibodies against gluten cross react w/ reticulin (tethers basement membranes to superficial dermis); very pruritic grouped vesicles that form on the extensor surfaces; Treatment

Question 35

Dermatitis Herpetiformis (rare) treatment

Answer 35

gluten-free diet;

Question 36

Erythema multiforme (self-limited)

Answer 36

T-cell mediated hypersensitivity to drugs/infection –> attack basal cell layers of skin/mucosa –> papules with pale central area;

Question 37

Steven-Johnson Syndrome

Answer 37

febrile erythema multiforme w/ erosion & crusting of oral mucosa, lips, perianal region, urethra w/ bulla formation; Note can be diagnosed w/ less than 10% of body covered, due to drug reaction, high mortality;

Question 38

Toxic epidermal necrolysis

Answer 38

diffuse necrosis, sloughing of cutaneous & mucosal epithelial surfaces–> analogous to extensive burn (w/ 30% of body), poor prognosis;

Question 39

Pemphigus Vulgaris (type II hypersensitivity)

Answer 39

loss of normal intercellular adhesion; mucosoa & skin affected (scalp, face, groin, trunk); superficial vesicles & bullae –> rupture when pressed

Question 40

Acantholysis

Answer 40

dissolution/lysis of intercellular adhesion sites within a squamous epithelial surface (all types of pemphigus)

Question 41

Acantholysis Nigrans

Answer 41

hyperplasia of the stratum spinosum –> velvety light-brown patch under axilla or back of neck; Associated w/ insulin resistance & underlying malignancy;

Question 42

Acantholysis Nigrans Treatment

Answer 42

find underlying cuase, treat malignancy;

Question 43

Lichen planus

Answer 43

pruritic polygonic purple papules on skins and mucosa –> resolve spontaneously in 1-2 years w/ zone of postinflammatory hyperpigmentation (extremities, wrists, elbows, glans penis, oral 70%); “Saw-tooth appearance”

Question 44

“Saw-tooth appearance”

Answer 44

lymphocytic infiltration along dermoepithelial contour