Other Dermatoses Questions Flashcards
What is Acanthosis Nigricans?
Symmetrical hyperpigmented velvety plaques that are possibly caused by factors that stimulate proliferation
What are the risk factors for Acanthosis Nigricans?
-Type 2 diabetes, insulin stimulates skin proliferation
-obesity (skin folds/diabetes)
Can occur in kids and adults (commonly on posterior neck for kids)
What are the common clinical features of Acanthosis Nigricans?
-Commonly found in skin folds (friction may play a role)
-makes skin look “dirty”
-usually asymptomatic/mild pruritis
-symmetric (on both sides)
Clinical diagnosis
What are the treatments for Acanthosis Nigricans?
-treat underlying disease (obesity, diabetes), this will not improve appearance/clear up pigment
-ketalytics/topical retnoids can improve appearance, can be irritating/start low and work up tolerance
**if patient has AN, usually test for diabetes/check plasma insulin level
What is malignancy associated Acanthosis Nigricans?
Uncommon, appears abruptly/widespread
-extremely itchy, plaques often in mouth
-may signal aggressive GI malignancy
-Leser Trelat sign (multiple eruption of SK’s)
-older patients
-other symptoms: ask about dark/tarry stool, night sweats, etc.
What is Hidradenitis suppurativa?
An occlusive and chronic autoimmune disorder caused by dysfunction of apocrine glands (active at puberty)
What are the risk factors for Hidradenitis suppurativa?
Associated with other conditions: inflammatory bowel disease, metabolic syndrome (obesity, hyperlipidemia, prediabetes), or acne
-Most common at 20-40 yrs old
What are the common clinical features of Hidradenitis suppurativa?
-Erythema
-Begins macular in areas like armpit or anogenital and then becomes inflamed (papules and abscesses)
-
What are the treatments for Hidradenitis suppurativa?
What are Lipomas?
What are the risk factors for Lipomas?
What are the common clinical features of Lipomas?
What are the treatments for Lipomas?
What are Epidermal Inclusion Cysts?
What are the risk factors for Epidermal Inclusion Cysts?
What are the common clinical features of Epidermal Inclusion Cysts?
What are the treatments for Epidermal Inclusion Cysts?
What is Melasma?
What are the risk factors for Melasma?
What are the common clinical features of Melasma?
What are the treatments for Melasma?
What is a Pilodinal Cyst?
A cyst which occurs near tailbone/top cleft of buttocks
(hair becomes embedded in skin and causes inflammation/infection, and abscess)
- location will cause irritation, rupture, inflammation
What are the risk factors for a Pilodinal Cyst?
Obesity, sedentary lifestyle, excess body hair, poor hygiene
Most common in young men
What are the common clinical features of a Pilodinal Cyst?
Abscess formation near tailbone will cause erythema, pain, discharge
What are the treatments for a Pilodinal Cyst?
I&D
Culture
Antibiotics (if cellulitis present)
If lesion is recurrent: all affected tissue must be fully surgically removed, or will reoccur
What are Pressure Ulcers?
What are the risk factors for Pressure Ulcers?
What are the common clinical features of Pressure Ulcers?
What are the treatments for Pressure Ulcers?
What is Urticaria?
What are the risk factors for Urticaria?
Infection, foods, medications, skin pressure, heat, cold, stress, pregnancy, sun exposure, chronic medical illness
What are the common clinical features of Urticaria?
Hives, raised dermal edema/erythema (wheals)
very pruritic
each wheal lasts less than 24 hours (may have multiple wheals erupt at different times, so condition can last more than 24 hours)
-blanching (whitish color)
-migratory
-acute <6 weeks, chronic >6 weeks
What are the treatments for Urticaria?
What is Vitiligo?
Areas of depigmentation in skin which occur most likely due to an autoimmune response which hinder the function of melanocytes/pigment production
Woods lamp: UV light can illuminate
What are the risk factors for Vitiligo?
Genetics
Association with other autoimmune disorders (thyroid labs may be ordered)
What are the common clinical features of Vitiligo?
Depigmented macules/patches
-well demarcated
-asymptomatic
-hands/feet/arms/face/hair (perioral and periocular)
-progressive
-non contagious
clinical ddx
What are the treatments for Vitiligo?
No cure
High SPF sunscreen
Systemic phototherapy/lazer for small patches (stimulates melanocytes)
Topical therapy (first line), steroids/immunomodulators for inflammation
Oral steroids for rapidly progressing disease
Surgical skin grafting (only for stable disease)
mental health referral
Depigmentation therpay (permanent loss of pigment)
What classes of steroids are safe to use on the face/folds?
Classes 6 & 7
What classes of steroids can NEVER be used on face/folds?
Classes 1, 2, & 3
What classes of steroids are okay to use on the face/folds if necessary, but should be avoided?
Classes 4 & 5
What are common oral steroids used? Can you stop taking them abruptly?
Prednisone, medrol dose pack
can’t stop these abruptly, must taper off
What is a common effect of prolonged steroid use?
Glaucoma, skin atrophy
