Miscellaneous Skin Disorders Flashcards
Nevus
Hyperplasia of melanocytes
If it has a hair it is usually not cancer
If it is positive for one of he melanoma ABCDE then get a bx
The bx is a shave bx or wide excisional (if you think it’s melanoma)
Vitiligo
AI against melanocytes (make sure these patients wear sunscreen bc they lack natural protection)
Sharp demarcations
Usually face, arms, genitals
Dx - first thing is Woods lamp (it’s positive). Then confirm with a bx (no melanocytes)
Tx - none. Maybe look for RA or SLE (ANA, CCP)
Topical or systemic psoralens and exposure to sunlight or PUVA may be helpful.
Ash leaf
Cutaneous symptom of tuberous sclerosis
Patient has single hypopigmented spot anywhere that is wood’s lamp positive.
Tx - CT to look for tubers
Albinism
Def in tyrosinase
Patient is pale from birth. Whole body is hypopigmented. Fair skin and hair and eyes
No odor. No mental retardation.
Dx - clinical
Tx - None. Sunburn easily. High risk for SCC and melanoma
TSS and SSSS
Different severities of the same event: reaction to a toxin in the surface of staph
SSSS looks like TEN, including Nikolsky sign. TSS has the same skin involvement as well as life-threatening multiorgan involvement like hypotension, renal dysfunction (high BUN and Cr), liver dysfunction, CNS involvement (delirium)
Both treated with supportive care and the antistaph meds
In the absence of a penicillin allergy and with a sensitive organism, oxacillin or nafcillin are most effective.
Cefazolin is interchangeable to treat staph.
ABx do not reverse the disease, but they kill the organism producing the toxin
