Patient viewing wrap up

Question 1

5 risks for skin CA

Answer 1

1. skin type
2. sun exposure
3. Fam Hx
4. immunosupresion
5. tanning beds

Question 2

3 key dermatitis mgmt points

Answer 2

1. Tx inflam
2. moisture
3. prevent/tx infection

Question 3

6 systemic diseases with psoriasis

Answer 3

Psoriatic arthritis – up to 30% of patients
Lymphoma (e.g. Hodgkin’s, CTCL etc)
Depression
IBD
Uveitis 
Metabolic Syndrome

Question 4

5 biopsy complications

Answer 4

infection
dehiscence
recurrence
bleeding 
pain

Question 5

sun exposure diffs for BCC and SCC

Answer 5

BCC - intermittetn and intense

SCC - cumulative

Question 6

5 types of non-scarring alopecia

Answer 6

Telogen effluvium – increased shedding of otherwise normal hairs in response to stress such as surgery, pregnancy, malnutrition, etc.
Androgenetic – male-pattern and female-pattern hair loss
Alopecia areata – autoimmune process
Anagen effluvium – classically caused by chemotherapy
Trichotillomania – self-induced plucking or breakage of hair

Question 7

potential triggers of telogen effluvium

Answer 7

Post-surgery
Post partum
After severe illness (especially febrile)
Severe nutritional deficiency (extreme dieting, malnutrition)
Severe psychological trauma (rare)
Chronic illness can lead to chronic telogen effluvium

Question 8

5 signs of scarring alopecia

Answer 8

burning,
pain +/- itching 
erythema
perifollicular scale
atrophy, loss of follicular ostia

Question 9

2 types of pruritus

Answer 9

skin disease

systemic

Question 10

systemic causes of pruritus

Answer 10

Kidney disease
Liver disease (especially obstructive/cholestatic liver disease)
Medications (ASA, morphine, other opiates)
Thyroid disease (both hyper and hypothyroidism)
Malignancy especially lymphoma
Polycythemia vera
Infections: HIV, Hepatitis B and C, intestinal parasitism
Connective tissue disease
Neuropathic itch (point out that this is usually not generalized), which can be caused by nerve compression, posthepetic
Skin dryness or xerosis

Question 11

4 clues to venous ulcer

Answer 11

location
underlying stasis changes/lipdermatosclerosis
edema
varicosities

Question 12

Tx of stasis

Answer 12

Most important treatment is COMPRESSION
Leg elevation
Topical steroids
Wound care

Question 13

signs of dermatomyositis

Answer 13

• Poikiloderma with “shawl sign” on the V of chest/upper back
• Heliotrope sign: violaceous eruption around the eyes
• Gottron’s papules: lichenoid lesions over the knuckles
• Nail fold changes: cuticle dystrophy, nail fold telangiectasias etc.
• Mechanics hands
• Holster sign: rash to hips
• Calcinosis cutis
• Non scarring alopecia

Question 14

MDSOAPBRAIN for lupus

Answer 14

*Malar rash
*Discoid rash
Serositis (pleuritis or pericarditis)
Arthritis (non erosive, > or equal to 2 peripheral joints)
*Oral or nasopharyngeal ulcers
*Photosensitivity
Hematologic disorder including:
Renal dysfunction
ANA positivity
Immunological studies with positivity in 1 or more of:
* Anti-DsDNA (correlates with disease activitity) OR
Anti-Smith OR
Anti-cardiolipin antibodies, lupus anticoagulant or false positive VDRL
Neurological disease