Other derm, hypersensitivity, pigmentation Flashcards
How can you tell the difference between an arterial and venous ulcer?
arterial ulcers = ulcer pulsation reduced but palpable and involve numbing/tingling with pallor, blue/purple discoloration, needs referral
venous ulcers = ache in lower extremities, hyperpigmentation in lower extremities, needs debridement and weight reduction
What is erythema nodosum?
erythema but nodule-like. Most likely painful, red on lower legs, bruise-like, mostly bilateral and associated with fatigue, malaise, and arthralgia. Often, URI symptoms precede this, but can be caused by a lot of things
how do you treat erythema nodosum?
treat underlying disease and symptomatic relief – could be caused by many, many, many things – throat culture, ASO titer, ESR, CXR
What is erythema multiforme?
classic target lesion with center area, red zone, pale ring of edema, and erythematous halo; may be red to cyanotic, purpuric, vesicular, bullae/erosions and preceded by malaise, fever, itching, burning…post-infection
Does erythema multiforme have a nikolsky sign?
no - skin does not come off with rubbing
How do you treat erythema multiforme?
mild = no treatment
moderate = oral corticosteroids like prednisone
HSV induced = acyclovir
What is SJS caused by?
sulfonamides
What are the symptoms of Steven Johnsons Syndrome?
flu-like symptoms with skin tenderness and erythema; flaccid bullae, mucosa, burning, followed by epidermal necrosis and sloughing with raised purpuric target lesions that can resemble a burn and become blisters
What diagnosis question can help you differentiate from SJS?
are there 2 or more mucosa area lesions?
no = not SJS/TEN
What Nikolsky sign does SJS/TEN have?
+ Nikolsky sign
How do you treat SJS/TEN?
SJS: stop drug and supportive treatment
TEN: higher fever: IVIG; oral/iv glucocorticoids, topical steroids, cyclosporine
What is hypersensitivity vasculitis?
asymptomatic, localized areas of cutaneous hemorrhages where palpable blood leaks out of amaged vessels, nodules, urticarial lesions
“Henoch-Schonlein purpura”, often from drugs, infections, or connective tissue disease
What are Henoch Schonlein purpura?
palpable purpura of red spots or bumps changing to dark purple bumps
How do you treat hypersensitivity vasculitis?
stop the drug, elevate legs, compression stockings, colchicine, dapsone
severe involvement = corticosteroids
What is vitiligo?
irregular discrete white macules and patches that slowly progress and enlarge
What is vitiligo associated with?
white hair/premature hair, alopecia, poliosis, SCC
What can help diagnose vitiligo?
wood’s lamp to see focal type (single site), segmented (1 side) or generalized (widespread)
What can help manage vitiligo?
sunscreen/window shades, repigmentation options like topical steroids, calcineurin inhibs, topical psoralens,
Ruxlotinib inhibitor?
What is albinism?
snow white, cream-white skin, hair white, and associated with eye disorders and cancer
What is melasma?
macular hyperpigmentation of “Mask like hypermelanosis”, serrated and irregular geographic borders common cheeks, forehead, nose, upper lip, chin
What can cause melasma?
hormonal changes
What can help diagnose melasma?
wood’s lamp: marked accentuation
What can you use to treat melasma?
topical steroids, azelaic acid, topical retinoids, hydroquinone
moderate: fluocinolone, hydroquinone +tretinoin
What is acanthosis nigricans?
velvety thickening of skin around back of neck, axilla, groin; pruritic; hyperpigmented macules and patches with palpable plaques
What can you treat acanthosis nigricans?
keratolytics or retinoids
