gluteal skin lesions

Question 1

intergluteal plionidal dx

Answer 1

skin or subcutaneous infection near the natal cleft of buttocks.

chronic dx can present as a tender mass or sinus with purulent drainage.

Question 2

risk factors for pilonidal dx

Answer 2

obesity, local trauma, prolonged sitting and family history - stretch the natal cleft that damages the underlying hair follicles and creates an opening (pore or sinus) that becomes infected

Question 3

diagnosis of pilonidal cyst

Answer 3

clinically and no need for imaging or labs studies

Question 4

initial management of pilonidal cyst

Answer 4

I & D but most people will benefit from surgical excision

Question 5

genital warts are called

Answer 5

condylomata acuminata due to HPV

Question 6

skin colored white or gray verrucous filiform papules on the anal or perianal area

Answer 6

not associated with sinus tract condylomata acuminata from HPV

Question 7

Crohn’s dx can cause

Answer 7

fissures and tags and abscesses will need to see other findings

Question 8

chronic painful swollen and inflammed lesions in the intertriginous areas (axilla and inguinal region).

Answer 8

hidradenitis suppurativa

Question 9

severe hidradenitis suppurativa

Answer 9

can see perirectal dx with purulent drainage and sinus tracts similar to pilonidal dx but generally doesn’t affected gluteal cleft area

Question 10

perianal abscess

Answer 10

severe anal and rectal pain and systemic symptoms such as fever and malaise and see perianal erythema with fluctuance

Question 11

what is this?

Answer 11

condylomata acuminata which occurs due to HPV infection with low oncogenetic risk (types 6 and 11)

Will have variable appearance but it is non friable, non tender fungating lesions with no LAD. Lesions can continue to proliferate in size and number and be found throughout the vulva and perianal region.

Question 12

how to diagnose condyloma acuminata?

Answer 12

Clinical diagnosis but biopsy can be done to rule out malignancy if there are atypical features like ulceration or induration or if lesions do not improve with treatment.

Question 13

Management of condyloma acuminata

Answer 13

need to examine urethra, cervix, anal canal to make sure there’s no signs of high risk oncogenic HPV infection (16-18).

Large internal lesions can result in bowel and bladder obstruction.

Treatment of condyloma acuminata is with topical therapy (trichloroacetic acid podophyllotroxin, surgery for only for those who faile conservative management)

Question 14

Difference between condyloma acuminata vs condyloma lata

Answer 14

Condyloma acuminata is from HPV types 6 and 11 and low oncogenetic risk. Has a caudiflower (fungating appearance) and no LAD and non friable or non tender.

Condyloma lata- result of secondary syphilis and see flat pink or grey velvety papules that appear on mucosal surfaces.