Misc Derm Disorders Flashcards
Cherry Angioma
How does this benign lesion form?
abnormal mature capillary proliferation
Cherry Angioma
most commonly seen in who?
middle aged and older adults
Cherry Angioma
Clinical Presentation
- cherry red to purple papules
- flat topped or dome shaped
- seen most commonly on trunk
- friable (bleed profusely when traumatized)
Cherry Angioma
Dx & Tx
- clinical dx
- tx is observation
Cherry Angioma
what would you do if the pt wanted removal for cosmetic reasons?
2 things
- electrocauterization
- laser therapy
Pyogenic Granuloma
most common in who?
young children and adults
Pyogenic Granuloma
seen after what?
- hormone changes (pregnancy)
- initation of new meds
Pyogenic Granuloma
benign vascular ____ of the skin or mucous membranes
tumor
Pyogenic Granuloma
clinical presentation
- solitary
- glistening
- bright red
- friable
- rapidly grows
- nodule or papule
Pyogenic Granuloma
dx & tx
- biopsy
- excision w/ wound closure or curettage followed by electrocautery
Kaposi Sarcoma
vascular cancer associated with which virus?
not asking which population it usually is seen in…
herpes virus 8
Kaposi Sarcoma
most commonly seen in who?
HIV pts (immunosuppressed)
Kaposi Sarcoma
where is it usually seen on the body?
- lower extremities
- face
- oral mucosa
- genitalia
Kaposi Sarcoma
clinical manifestations
- painless
- non-puruitic
- pink/brown/erythemtous/violaceous
- macules, plaques, or nodules
Kaposi Sarcoma
dx and tx
- biopsy
- refer to oncology
- initiate ART
Stasis Dermatitis
inflammatory skin changes associated with?
chronic venous insufficiency
Stasis Dermatitis
clinical presentation
- erythematous/brown/violaceous hyperpigmented
- patches or plaques
- eczematous features (scales, pruritis, weeping erosions, crusting)
- leg edema, increased leg circumference, variscosities
Stasis Dermatitis
what is maintained despite leg edema?
pulse
Stasis Dermatitis
tx
- overall: undelrying venous insufficiency
- acute lesions: topical corticosteroids
- severe/refractory: oral prednisone
Stasis Dermatitis
general meausres for tx
- leg elevation
- compressions socks
- exercise
- gentle cleansing
Decubitus Ulcer
results from what?
vertical pressure
Decubitus Ulcer
risk factors
- elderly
- immobile
- incontinence
Decubitus Ulcer
commonly seen on what body areas?
bony prominences
Decubitus Ulcer
what does pressure in the ulcer impair for the rest of the area?
- nutrient and O2 delivery
- waste remove
Decubitus Ulcer
what does mositure cause?
skin maceration
Decubitus Ulcer
manifestation of stage 1
- superficial
- non-blanchable
- erythematous macule
Decubitus Ulcer
tx of stage 1
- preventive measures
- wound protection
Decubitus Ulcer
manifestation of stage 2
- epidermal damage extending into dermis
- resembles bulla or abrasion
Decubitus Ulcer
tx for stage 2
- maintain moist wound environment via hydrocolloids or hydrogels
Decubitus Ulcer
manifestations of stage 3
- full thickness loss of skin
- may extend into subQ layer
Decubitus Ulcer
manifestations of stage 4
- deepest of the 4 stages
- extends beyond the fascia & into the muscle/tendon/bone
Decubitus Ulcer
tx for stage 3 & 4 wounds
- wound cleansing
- moist wound environment
- debridement of necrotic tissue
- tx of wound infection as needed
Pyoderma Gangrene
auto-inflammatory process mediated by what?
neutrophils into the dermis
Pyoderma Gangrene
triggered by what?
- trauma
- surgical debridement
- attempts to graft an area
Pyoderma Gangrene
associated with what conditions?
5
- IBD
- Rheumatoid arthritis
- malignancies
- hematologic conditions
- arthritis
Pyoderma Gangrene
often misdiagnosed as what?
spider bite
bedridement
Pyoderma Gangrene
clinical maifestations
4 components
- small pustules that break down & rapidly expand to form an ulcer w/ a violaceous border
- satellite ulcerations
- anywhere on body
- painful
Pyoderma Gangrene
how urgent is this?
emergent!
Pyoderma Gangrene
Topical tx
2
- superpotent steroids
- tacrolimus
Pyoderma Gangrene
systemic tx
6 options
- steroids
- cyclosporine
- tacrolimus
- cellcept
- thalidomide
- TNF-inhibitors
Drug Eruptions
how to get the rxn to stop?
stop the med!
Drug Eruptions
what type of rxn are these most often?
hypersensitivity
Drug Eruptions
triggers
5
- antigen from foods
- insect bites
- environmental
- exercise induced
- infections
Drug Eruptions
Class 1 mechanism
IgE-mediated
Drug Eruptions
class 2 mechanism
cytotoxic, antibody mediated
Drug Eruptions
class 3 mechanism
immune antibody-antigen complex
Drug Eruptions
class 4 mechanism
delayed (cell mediated)
Drug Eruptions
non-immunologic mechanism
genetic incapability to detoxify drugs
Drug Eruptions
when does a morbilliform drug eruption occur?
- 5 to 14 d after initiation of new med
Drug Eruptions
what type of rxn causes a morbilliform drug eruption?
type 4 hypersensitivity
Drug Eruptions
which meds commonly cause morbilliform drug eruption?
5
- PCN
- sulfas
- NSAIDs
- allopurinol
- anti-convulsants
Drug Eruptions
clinical presentation
4
- erythematous macules or small papules after initiation of med
- generalized distribution
- coalesce to form plaques
- mild systemic sx
Drug Eruptions
tx
- stop offending med
- oral antihistamines
- short course corticosteroids PO, PRN
Vitiligo
chronic, depigmenting disorder of the skin where which cell types are lost?
melanocytes
Vitiligo
appears in who? when?
- all races
- all genders
- most commonly appears 20-25 y/o
Vitiligo
associated with what other disease states?
general statement, not specific diseasess
autoimmune
Vitiligo
clinical manifestations
- complete loss of pigment in macules or patches of the skin
- chalky/milky white coloration
- can be pruritic
- convex borders
Vitiligo
typically found in what areas of the skin?
- sun exposed
- areas prone to repetitive trauma
Vitiligo
tx
- topical potent corticosteroids
