Miscellaneous Skin Conditions

Question 1

Hereditary skin condition where cell turnover is reduced to 4 days instead of 27 leading to increase in number of cells produced without normal cell keratinization

Answer 1

psoriasis

Question 2

psoriasis plaques that form at the site of a skin injury 1-2 weeks later

Answer 2

Koebner’s phenomenon

Question 3

Improves psoriasis

Answer 3

sun exposure

Question 4

Pinpoint bleeding under the scale that results from removal

Answer 4

Auspitz sign

Question 5

Patient presents with salmon pink papules/plaques that are sharply marginated w/silvery-white scaling

Answer 5

psoriasis

Question 6

Most common type of psoriasis. Is well defined, symmetrical, appears on knees, scalp, elbows, lower back

Answer 6

plaque

Question 7

Type of psoriasis commonly found in axilla, groin, naval, submammary region, palms, scalp, soles. NO SCALES and more common in overweight persons

Answer 7

inverse

Question 8

Type of psoriasis that occurs in young adults and children. Multiple small teardrop shaped erythematous papules. Scattered diffusely on the proximal extremities and trunk

Answer 8

guttate

Question 9

Most generalized and least common type of psoriasis with erythema and scaling from head-toe. High risk of systemic infection and electrolyte imbalance

Answer 9

erythrodermic

Question 10

Severe form of psoriasis w/life threatening complications. Acute onset with sheets of superficial pustules with erosions. Associated w/fever, diarrhea, leukocytosis, hypocalcemia

Answer 10

pustular

Question 11

The most common precipitating factors for erythrodermic or pustular psoriasis

Answer 11

acute withdrawal of systemic corticosteroids

Question 12

Useful in all cases of psoriasis. Hydrates stratum corneum and decreases water evaporation. Softens scales

Answer 12

emollients- eucerin, lubriderm, moisturel applied while skin is still damp

Question 13

first line agents for mild/limited plaque psoriasis.

Answer 13

topical steroids

Question 14

Used as add-on therapy with topical steroids for treating psoriasis. Enhances effects of UVB therapy

Answer 14

coal tar

Question 15

VItamin D analog used in mild to moderate plaque psoriasis as an immune modulator. Side effects include hypercalcemia and hypercalciuria when topical doses exceed 100g/wk

Answer 15

Calcipotriol (Dovonex)

Question 16

Less effective than Calcipotriene but much fewer side effects including fewer changes in systemic calcium metabolism

Answer 16

Calcitriol (Rocaltrol)

Question 17

Areas you cannot use calcipotriol (Dovonex) due to irritation

Answer 17

face and groin

Question 18

Systemic therapies only indicated for severe or incapacitating psoriasis or with topical treatment failure

Answer 18

PUVA, methotrexate, retinoid, cyclosporine

Question 19

What do the following have in common: Beta-blockers, NSAIDs, lithium, ACEI, digoxin?

Answer 19

drugs that may exacerbate psoriasis

Question 20

Immune mediated skin eruption of well-circumscribed wheals on an erythematous base. IgE mediated

Answer 20

Urticaria (hives)

Question 21

Hypersensitivity reaction involving the deep layers of the skin. Swelling of the lips, eyelids, palms, soles, genitalia

Answer 21

angioedema

Question 22

Patient presents with edematous, erythematous, well circumscribed blanching wheals with serpiginous borders

Answer 22

urticaria

Question 23

Substances that may aggravate urticaria and angioedema

Answer 23

ASA, NSAIDs, ETOH, ACEI

Question 24

Initial treatment for urticaria and angioedema

Answer 24

H1 blockers (diphenhydramine, fexofenadine)

Question 25

Treatment for urticaria and angioedema refractory to H1 blockers

Answer 25

H2 blockers (Ranitidine)

Question 26

reserved after a trial of maximal doses of antihistamines for urticaria and angioedema

Answer 26

steroids

Question 27

for severe attacks (anaphylaxis like reactions) of urticaria and angioedema

Answer 27

subQ epi

Question 28

What conditions should you consider investigating for patient who presents with urticaria and angioedema?

Answer 28

thyroid and H.pylori

Question 29

formation of antibodies to melanocytes. Often occurs in the context of other autoimmune conditions such as pernicious anemia and Hashiomoto’s thyroiditis

Answer 29

vitaligo

Question 30

Treatment that can help with repigmentation of vitaligo

Answer 30

topical steroids, tacrolimus, psoralens, UVA/UVB

Question 31

potentially fatal disease of the mucous. Intraepidermal blistering secondary to an autoimmune process

Answer 31

pemphigus

Question 32

Lesions characteristic of pemphigus that begin in oropharynx and spread to scalp, face, chest, axillae, groin

Answer 32

flaccid bullae that are tender and painful

Question 33

Required for diagnosis of pemphigus or bullous pemphigoid

Answer 33

biopsy

Question 34

Treatment for pemphigus

Answer 34

hospitalization, systemic corticosteroids, immunosuppressives

Question 35

skin finding in which the top layers of the skin slip away from the lower layers when slightly rubbed. associated with pemphigus and TEN

Answer 35

Nikolsky sign

Question 36

Chronic, subepidermal blistering autoimmune disease. May possibly be triggered by a drug reaction or infection. Almost exclusively in the elderly population

Answer 36

bullous phemphigoid

Question 37

Describe the lesions of bullous pemphigoid

Answer 37

tense and fluid filled blisters associated with urticarial plaques

Question 38

1st line treatment for bullous pemphigoid

Answer 38

topical high dose or oral steroids

Question 39

Most common cutaneous cyst. Derived from epidermis or epithelium of hair follicle. Becomes filled with keratin and lipid-rich debris

Answer 39

epidermoid cyst

Question 40

Very common, button-like dermal nodule | Lesion may be tender and is benign

Answer 40

dermatofibroma

Question 41

Benign subcutaneous tumors. Soft, rounded, and movable against the overlying skin.

Answer 41

lipoma

Question 42

What is the difference between epidermal and subcutaneous masses?

Answer 42

epidermal feel fixed whereas subcutaneous are generally mobile