PANCE Prep- Derm Flashcards
What do the following describe?
- Macule
- Papule
- Plaque
- Vesicle
- Bulla
- Wheal
- Pustule
- Petechaie
- Nodule
- Patch
- Macule: flat nonpalpable <10mm
- Papule: solid, raised <5mm
- Plaque: raised, flat-topped lesion >10mm
- Vesicle: circumscribed, elevated fluid-filled <5mm
- Bulla: circumscribed, elevated fluid-filled >5mm
- Wheal: transient, elevated lesion (local edema)
- Pustule: pus-filled vesicle or bulla
- Petechaie: small punctate hemorhages that DONT blanch
- Nodule: solid, raised >5mm
- Patch: flat, nonpalpable >10mm
Clinical Manifestation:
- Smooth discrete circular patches of complete hair loss that develops over a period of weeks
- Exclamation point hairs- short hairs broken off a few mm from the scalp at the margins of the patches with tapering near the proximal hair shaft
- Nail pitting or fissuring
Alopecia areata *commonly associated w/ other autoimmune disorders (thyroid, Addison’s disease, etc) *non-scarring immune mediated hair loss targeting the anagen hair follicles
Management of alopecia areata
if Local: inralesional corticosteroids
if extensive: topical corticosteroids
*may be observed if mild
**Relapse is common
Clinical Manifestations:
Varying degrees of hair thinning and nonscarring hair loss MC affecting the temporal scalp, midfront scalp or vertex area of scalp
Androgenetic alopecia
Management of androgenetic alopecia
- Minoxidil
- Oral Finasteride (5-alpha- reductase inhibitor) –> androgen inhibitor which inhibits the conversion of testosterone to DHT
SE of finesteride
5-alpha-reductase inhibitor (androgen inhibitors)
- Decreased libido or sexual function
- ED
Diagnose

Androgenetic Alopecia
Diagnose

Alopecia Areata
What is the atopic triad? and its pathophysiology
- Eczema
- Allergic rhinitis
- Asthma
**Starts in childhood
Type 1 Hypersensitivity, IgE mediated: Altered immune reaction in genetically susceptible people when exposed to certain tiggers–> T cell mediated immune activation and increase IgE production
Clinical Manifestations:
- Prurtic, erythematous, ill defined blisters/papules/plaques –> later dries, crusts over and scales
- +/- dermatographism (localized development of hives when the skin is stroked)
Atopic dermatits aka eczema
Where is Eczema most commonly found
flexor creases (antecubital and popliteal folds)
-Starts on face in infancy and then spreads to extremities w/ age
Treatment/plan for atopic dermatitis (eczema)
- topical corticosteroids for 14 days (steroid before moisturizer)
- antihistamines for itching (diphenhydrame, hydroxyzine)
- Daily skin hydration w/ emollients: Eucerin or Aquaphor
- Short baths a few times a week
- Educate: Avoid irritants (soaps, detergents, freq. baths, perspiratoin, heat), Chronic condition
- If infected: oral cephalexin or topical mupirocin x 7 days
Diagnose

Atopic Dermatitis (Eczema)
Clinical Manifestations:
Sharply defined discoid/coin-shaped* lesion especially on the dorsum of the hands, feet, and extensor surfaces (knees, elbows)
Nummular eczema
Diagnose:

Nummular Eczema
*sharply defined discoid/coin-shaped lesions on dorsum of hands, feet, and extensor surfaces (knees, elbows)
Treatment/Plan for contact dermatitis
- Avoid irritants
- Topical Corticosteroid
Describe and diagnose

Contact dermatitis (diaper rash) with possible candidiasis satellite lesions
erythematous macular rash along the skin folds where the diaper rubs, with possible annular satellite lesions
Treatment/Plan for diaper rash
- Frequent diaper changes
- hydrocortisone 1% cream or a diaper rash ointment such as Desitin or A & D.
- Candida diaper rash (satillite lesions)- Nystatin cream for 7 days
Clinical Manifestations:
- Pruritic “tapioca-like” tense VESCILES* on the soles, palms and fingers (lateral digits)
- Triggers: sweating, emotional stress, warm and humid weather, metals (nickel)
Dyshidrosis (dyshidrotic eczema) (Pompholyx)
Describe/Diagnose and treat

Dyshidrosis (dyshidrotic eczema)- tense VESICLES
- Topical steroids (med-high) ointment preferred
- cold compresses
Clinical Manifestations:
Scaly, well-demarcated, rough hyperkeratotic plaques w/ exaggerated skin lines*
Lichen Simplex Chronicus (neurodermatitis)
- skin thickening in pts w/ eczema
- secondary to repetitive rubbing/scratching- itch/scratch cycle
Describe/Diagnose and Treat

Lichen Simplex Chronicus (neurodermatitis)- scaly, well-demarcated rough hyperkeratotic plaques w/ exaggerated skin lines
- topical steroids (high strength)
- Educate: Avoid scratching the lesions (can use antihistamines)
What are the 5 P’s of Lichen Planus
- Purple
- Polygonal
- Planar
- Pruritic
. Papules w/ fine scales and irregular borders
Describe the clinical manifestations of lichen planus
- 5 P’s: purple, polygonal, planar, pruritic papules w/ fine scales and irregular borders
- MC on flexor surfaces of extremities, SKIN, MOUTH, SCALP, GENITALS, NAILS, and mucous membranes
- +/- Koebner’s phenomenon: new lesions at sites of trauma
- Wickham Striae***- fibe white lines on the skin lesions or on the oral mucosa, nail dystrophy





