Rapid DDx: Derm Flashcards
Comedones
few papules/pustules
mild acne vulgaris
comedones
moderate amount of papules/pustules
moderate acne vulgaris
nodular/cystic lesions > 5 mm seen on face, back, chest or upper arms
severe acne vulgaris
Woman 30-50 yo
hx of etoh, hot drinks, hot baths, hot food, sun exposure
papulopustules
centrofacial erythema, flushing
telangiectasias
skin coursening with burning and stinging
no comedones
rosacea
male pt.
perifollicular papules/pustules
erythema on hair bearing skin
itchy rash
folliculitis
20-40 yo hx of HSV
Hx of sulfa use, beta lactams, phenytoin, phenobarbitol
target lesions with dusky central area on extremities and trunk
red inflammatory zone surrounded by pale ring of edema
erythematous halo on periphery of lesion
NEG Nikolsky
erythema multiforme
Hx new med use
initial fever/URI sxs
widespread flaccid bullae which started on trunk and face
involvement of 1 or more mucous membranes
POS Nikolsky
Extremely pruritic and painful
SJS
Hx autoimmune d/o
smooth, discrete, circular patches of complete hair loss
painless, non-pruritic
onset over period of weeks
nail changes
alopecia areata
Gradual onset hair loss/thinning
non-scarring
began as bitemporal thinning at frontal scalp
aldrogenetic alopecia
opaque, thick, discolored and cracked nail on great toe.
onychomycosis
hx biting nails
rapid development of painful, red, swollen area around nail folds
paronychia (staph areus)
Hx of splinter/cuticle damage
severe, throbbing pain, erythema, swelling, fluctuance to pad of fingertip
felon
visualization of spider at site of skin changes
burning and erythema for 3-4 hours followed by skin blanching
red halo appeared for 24-72 hours followed by hemorrhagic bulla with eschar
fever, chills, N/V
Morbilliform rash
Brown Recluse bite
visualization of spider at site of skin changes
pain at the bite site with muscle pain, spasms, rigidity within 30 minutes-2 hours
central punctum o a blanched circular patch with surrounding red perimeter
black widow bite
Child < 10 yo
erythematous malar rash on sides of face with circumoral pallor
lacy rash developed on upper extremities a few days after face rash appeared.
No rash on palms or soles
erythema infectiosum (Fifths Disease)
Sick contact
started with high fever with cough, stuffy/runny nose, red eye with d/c
small white spots on erythematous base appeared on buccal mucosa
48 hours later morbilliform/maculopapular brick red rash that began at the hairline and spread down the body
Rubeola (measles)
Child < 5 yo, summertime
sudden onset fever, URI, anorexia
painful oral vesicles surrounded by erythema that undergo ulceration
vesicular, macular, papular lesions on distal extremities
not pruritic or painful
hand, foot, and mouth disease
child 3-10 yo, early fall
sudden onset high fever
small papulovesicular lesions on the posterior pharynx that turn to ulcers
anorexia due to pain
malaise, headache, vomiting
herpangina
Hx of wound to extremity
localized macular erythema
not sharply demarcated border
swelling, warmth, tenderness of affected area
no systemic sxs
Cellulitis
intensely erythemetous rash
raised, sharply demarcated border
rash on lower extremity
systemic sxs like fever, chills
erysipelas
Hx cellulitis
red, tender streaks coming from site of cellulitis
lymphadenitis of nodes near site
lymphangitis
erythematous, tender, indurated nodule with fluctuance
may have central plug
no systemic sxs
furuncle/carbuncle
child 2-6 yo
papules, vesicles, pustules with drainage and developing golden crust
occurs on face
regional LAD
nonbullous impetigo
child 2-6 yo
rapidly forming of large bullae and varnish like crust
fever and diarrhea
bullous impetigo
ulcerative lesion that almost appears like a cigarette burn
ecthyma impetigo
immunodeficient patient
patches of alopecia with black dots
tinea capitis
preadolescent patient living in crowded condition
scaly patch with alopecia
tinea capitis
immunocompromised preadolescent patient
inflammatory plaque with pustules on scalp
thick crusting
painful
kerion
adolescent male patient
pruritic, erythematous erosions and scales between third and fourth digital interspaces
tinea pedis
pruritis in intertrigonous region of groin
annular patches/plaques with diffuse erythema
sharply demarcated raised border with satellite vesicles
sparing of scrotum/mucosa
tinea cruris
Hx of contact sports, adolescent male
pruritic oval plaque with central clearing and well-defined, raised borders
spread outwardly
tinea corporis
Obese patient with DM
erythematous, beefy red macerated plaque to inguinal fold
erythematous satellite lesions
pruitic and painful
intertrigo
intense nighttime pruritis with small papules and linear streaks in the web spaces
no involvement of neck or face
scabies
Adult, sexually active male
intense pruritis with red papules on the scrotum
worse at night
scabies
Female, 3-12 yo
pruritis of the scalp
not better or worse at night
dandruff looking flakes on hair
pediculosis
Child
Hx of summer camp
multiple dome-shaped flesh colored waxy looking papules
2-5 mm with central umbilication
molluscum contagiosum
firm, hyperkeratotic papule
1-10mm in size
red/brown dots inside lesion
occurs on hand
common/plantar wart
numerous small but discrete flesh colored papules
1-5mm in diameter, 1-2 mm in height
found on face and shins
flat warts
started as small painless papules on genitals
evolved to soft, fleshy, cauliflower like lesions
condyloma acuminata
