Other Dermatoses Flashcards
How does acanthosis nigricans present?
- symmetrical
- hyperpigmented
- velvety, plaques
Where does acanthosis nigricans typically present?
- skin folds
- i.e. posterior neck, axilla, under the breast, and groin
What are the symptoms of acanthosis nigricans?
- usually asymptomatic
- mild pruritis possible
What causes acanthosis nigricans?
- ? factors that stimulate epidermal proliferation, i.e. insulin
- ? friction and sweat
What is the treatment for acanthosis nigricans?
- treat underlying dz (weight loss, DM dz)
- will not disappear, just prevent progression
How is appearance improved in acanthosis nigricans?
- keratolytics
- topical retinoids
What is malignancy associated acanthosis nigricans?
- acanthosis nigricans associated with GI malignancy
- underlying tumor is usually aggressive
What is hidradenitis suppurativa?
- disorder of the terminal follicular epithelium in the apocrine gland bearing skin
Who does hidradenitis suppurativa affect?
- females > males with family hx
How does hidradenitis suppurativa present?
- erythema to painful papules/nodules to abscess formation to discharge to scarring
- patient presents with scarring resulting in dermal contractures
- open comedones
- recurrence
How is the hidradenitis suppurativia diagnosed?
- clinical features
- typical lesion with progression, distribution, and reccurence
What is the treatment for hidradenitis suppurativa?
- no cure
- surgical excision of glands
- abx
- intra-lesion steroid
- pain management
What is a lipoma?
- benign subcutaneous fatty tumor
- discrete rubbery mass, 2-10cm
What are lipomas composed of?
- fat cells
What is the treatment for lipomas?
- none
- surgical excision
What is an epidermal inclusion cyst?
- proliferation of epidermal cells within a circumscribed space in the dermis
How does an epidermal inclusion cyst start?
- pimple or ingrown hair
How does epidermal inclusion cyst present?
- asymptomatic
- may become inflamed
- cheesy, foul smelling contents when ruptured
Describe the appearance of epidermal inclusion cyst
- flesh colored
- firm
- round
- nodule
- size varies
What is the treatment for epidermal inclusion cyst?
- none necessary
- excision must get entire lining
What is a melasma?
- hypermelanosis of sun exposed skin
What is the patient population for melasma?
- females, hormonal influence
- OCP and pregnancy
What causes melasma?
- sun exposure
What are the symptoms of melasma?
- asymptomatic
- cosmetic concern
What is a common distribution of melasma?
- mustache
What is the treatment for melasma?
- difficult
- sun avoidance
- high SPF
- avoid hormonal rx
- hydroquinone
- topical retinoid
What is vitiligo?
- acquired pigmentary disorder of skin and mucous membranes
- melanocyte destruction
How does vitiligo present?
- depigmented macules or patches
- well demarcated
- usually asymptomatic
- progressive
Where does vitiligo present?
- hands, arms, feet, and face
- perioral and periocular
What is the issue with treatment of vitiligo?
- more distal lesions harder to tread
What is the cause of vitiligo?
- idopathic
- ? autoimmune
- ? genetic
- ? inherent defect in melanocytes
How is vitiligo diagnosed?
- clinically, visual
- biopsy
What is the common association with vitiligo?
- thyroid disorders
- check thyroid labs
What is the treatment for vitiligo?
- no cure
- difficult to treat
- no standard tx
- high SPF
- systemic phototherapy
- excimer laser
- topical therapy
- depigmentation therapy
- surgical
- mental health referal
What is urticaria?
- fancy word for hives
What is the most common derm presentation to the ED?
- urticaria
Describe urticaria
- raised
- well circumscribed lesion of erythema and edema
- aka wheal
- very pruritic
Why does urticaria occur?
- release of histamine
- other vasoactive substances in the dermis
What is the treatment for urticaria?
- ED for signs of lifethreatening rxn
- antihistamines
- no systemic steroids
- biologic
- remove offender
- epipen + ED
pilondial cyst
- cyst near tailbone at the top of the cleft of the buttocks
How does a pilondial cyst start?
- hair punctures skin and becomes embedded (ingrown hair like EIC)
What are the symptoms of a pilondial cyst?
- abscess
- erythema
- pain
- discharge
What is the treatment for pilondial cyst?
- I&D
- abx
- gen surg ref for surgical excision
What type of reaction is urticaria?
- type I hypersensitivity
