Integumentary

Question 1

eczema

Answer 1

acute: erythematous, pruritic, weeping vesicles
subacute: erythema and scaling
chronic: think, lichenified, pruritic plaques

Question 2

Furuncle (Boil)

Answer 2

deep seated infection of the pilosebaceous unit, usually by S. aureus
Acute onset of tender red nodule with pus center.
adjacent lesions can form a coalescent purulent mass or carbuncle forms

Question 3

Tinea

Answer 3

Noncandidal fungal infection
Lesions vary in appearance. 
Microscopic examination of skin scraping with KOH shows hyphae. 
Tinea corporis: nonhairy parts. round active margins with central clearing- annular shape
Tinea cruris: groin and inner thigh
Tinea capitis: scalp
Tinea pedia: feet
Tinea unguium: nails

Question 4

Pityriasis rosea

Answer 4

Not contagious.
Sudden onset of primary (herald) oval/ round plaque.
Eruption 1-3 weeks later, may be itching.
Lesions: pale, erythematous, flat papules and plaques with fine scaling. On the trunk and extremities.
Trunk lesion: parallel alignment.

Question 5

Psoriasis

Answer 5

well circumscribed, dry, silvery, scaling papules and plaque
30% has psoriatic arthritis
May have pitting nail, oncholysis, subungual thickening

Question 6

Rosacea

Answer 6

Telangiectasis, erythema, papules, and pustules on forehead, cheeks, nose.
no iting, may have stining pain.
Tissue hypertrophy of the nose (rhinophyma)

Question 7

Herpes Zoster (Shingles)

Answer 7

pain, ithing, burning red swollen plaques/ vescicles
Does not cross midline.
After eruption, may have postherpetic neuralgia.

Question 8

Herpes Simplex

Answer 8

Type 1: oral
Type 2: genital
group vesicles with erythematous base and then erode,, forming a crust

Question 9

Lyme disease

Answer 9

Early localized infection: single erythema migrans skin lesion, with central clearing
Early disseminated infection: multiple lesions, neurologic symptoms such as facial palsy, meningitis, encephalitis, or carditis symptoms with lightheadedness, palpitations, dyspnea, chest pain, syncope
Late: arthritis or dermatitis

Question 10

Acanthosis Nigricans

Answer 10

By insulin resistance and hyperinsulinism

Malignant form: tumor products with insulin-like activity or transforming growth factor alpha

Question 11

Basal Cell Carcinoma

Answer 11

various clinical forms: nodular, pigmented, cystic, sclerosing, superficial
most frequently on exposed parts
Persistent sore/ lesion, may be itching
Shiny nodule that is pearly or translucent

Question 12

Squamous Cell carcinoma

Answer 12

most common in sun exposed area, esp rim of ear and lower lip
wartlike growth, may have crusting and bleeding
scaly red patch

Question 13

Malignant Melanoma

Answer 13

ABCDE

extension of pigment backward onto the proximal nail fold

Question 14

Kaposi Sarcoma

Answer 14

soft purple painless lesion

Question 15

Alopecia Areata

Answer 15

Sudden rapid hair loss

Question 16

Scarring Alopecia

Answer 16

replacement of hair follicles with scar tissue

Question 17

Traction Alopecia

Answer 17

Result of prolonged tightly pulled hairstyles

Question 18

Paronychia

Answer 18

Inflammation of the paronychium
acute: trauma/ manipulation
chronic: repeated moisture exposure
redness, swelling and tenderness. With purulent drainage accumulates under cuticle

Question 19

Onychomycosis

Answer 19

fungus growth

No pitting

Question 20

Subungual Hematoma

Answer 20

trauma causing immediate bleeding and pain to nail

Hematoma remains until nail grow out/ decompression

Question 21

Oncholysis

Answer 21

loosening of the nail plate that begins at the distal groove

r/t long nails, psoriasis, hyperthyrodism

Question 22

Koilonychia

Answer 22

Spoon nails- central depression with lateral elevation

r/t iron deficiency, syphilis, hypothyrodism

Question 23

Beau Lines

Answer 23

Transverse depression at the bases of the lunulae

temporary r/t systemic disorders

Question 24

White Banding (Terry nails)

Answer 24

whitening of proximal half to 3/4 of nailbed

r/t cirrhosis, CHF, DM2, aging

Question 25

Polymorphic Eruption of Pregnancy

Answer 25

Erythematous urticaria like papules and plaques starting on abdomen, spreading to thighs, buttocks and arms after a few day
Intense pruritic

Question 26

seborrheic dermatitis

Answer 26

scalp: scaling, adherent, thick, yellow and crusted (cradle cap)
other areas: erythematous, scaling, and fissure

Question 27

Miliaria Rubra

Answer 27

Prickly Heat (heat rash)

Question 28

Impetigo

Answer 28

usually by stap/ strep
lesion: itching and burning, typically on the face
macule-> vesicle/ bulla
lesion crusts with honey color from vesicle/ bulla rupture
May have regional lymphadenopathy

Question 29

Chicken pox

Answer 29

direct contact/ droplet/ airbrone
Incubation: 2-3 weeks
Communicability: 1-2 days before rash until lesions crusted over
rash starts on scalp, then moves to extremities
Multiple complications

Question 30

Measles (Rubeola）

Answer 30

invasion of respiratory epithelium
droplet/ airbrone precaution
Includes thymus, spleen, lymph nodes, liver, skin, conjunctiva, lung
Red blotchy rash first on face then to trunk and extremities with fever, conjunctivitis, stuffy nose and cough
koplik spots (white macular lesions on buccal mucosa)
Confluent patches

Question 31

German Measles

Answer 31

droplets precaution, most contagious when rash is erupting
fever, stuffy nose, sore throat, cough-> macular rash on face and trunk-> papular
Forchheimer spots: reddish spots on the soft palate during the prodrome/ first day of rash

Question 32

Trichotillomania

Answer 32

Hair pulling

Question 33

Actinic Keratosis

Answer 33

atypical squamous cells usually r/t sun exposure. Superficial.
Can progress to squamous cell carcinoma over time
raised, gritty, erythematous lesion with irregular rough surface