Skin!

Question 1

what is the most common pathogen for onychomycosis (tinea unguem) ?

Answer 1

dermatophyte fungi (anthropophilic)
trichopyton rubrum

Question 2

what are two ways that fungi invade hair?

Answer 2

ectothrix (surrounding shaft)

endothrix (inside shaft)

Question 3

most common hair fungi

Answer 3

trichophyton rubrum (most common)
microsporum (associated with pets)

Question 4

what type of mould commonly invades nails?

Answer 4

aspergillus

Question 5

what type of fungi (yeast) causes folliculitis ?

Answer 5

malassezia (pityrosporum)

Question 6

what causes hot tub folliculitis?

Answer 6

pseudomonas

Question 7

what causes hot tub folliculitis?

Answer 7

pseudomonas

Question 8

what is candida and what do you see on a microscope?

Answer 8

yeast, pseudohaphea

Question 9

systematic approach to lesions

Answer 9

are they solitary or multiple
if multiple are they localized or generalized
are they melanocytic versus non melanocytic
how long has lesion been present
has the lesion(s) evolved
what has the patient done to it (i.e. applied coconut oil, scratched at it, used anything OTC)

Question 10

what is an auspitz’s sign?

Answer 10

removal of plaque = bleeding = psoriasis

Question 11

what are the 4 types of rosasea?

Answer 11

erythemato telangiectasia
papulo pustular
occular
phymatous (rhinophyma)

Question 12

what cells are involved in psoriasis immune response?

Answer 12

T cells!

Question 13

how fast do epidermal cells evolve in psoriasis? how long is normal?

Answer 13

3-4 days

14-20 days

Question 14

time course for guttate psoriasis?

Answer 14

6-12 mo

Question 15

how common is joint involvement in psoriasis?

Answer 15

5-30%

Question 16

chronic plaque psoriasis is commonly in what regions?

Answer 16

extensor surfaces, scalp, knees, elbows, gluteal cleft

Question 17

tx for psoriasis

Answer 17

emolients 
keratolytic agents
topical corticosteroids 
calciptrial and calcitriol 
coal tar
medicated shampoos

Question 18

types benign nevi, which is most common to become CA

Answer 18

junctional (flat)
dermal/intradermal (dome)
compound (central raised w/ surrounding flat)

junctional

Question 19

red flags for nevi

Answer 19

Asymmetry 
Border irregularity 
color variation 
diameter > 6 mm
evolution (change in size, colour, bleeding)

Question 20

where is AK most commonly found?

Answer 20

hands (dorsal), face, head, neck

Question 21

oral tx for SCC

Answer 21

vitamin B3 (nicotinamide) 500 mg PO BID

Question 22

topical tx for BCC

Answer 22

imiquimod

fluorouracil

Question 23

excisional margins for SCC

Answer 23

3-10 mm

Question 24

excision margins for BCC

Answer 24

3-5 mm

Question 25

excision margins for melanoma

Answer 25

Melanoma insitu: 5 – 10 mm
Melanoma < 1mm: 10 mm
Melanoma 1-2mm: 10 – 20 mm
Melamoma > 2mm: 20 mm

Question 26

f/u for melanoma (multiple)

Answer 26

Q3mo

Question 27

4 major subtypes of melanoma

Answer 27

Superficial spreading melanoma
Nodular melanoma
Lentigo Maligna melanoma
Acral Lentiginous melanoma (Asian and black people more common)

Question 28

SCC lesion

Answer 28

pink to dull red, firm, poorly defined dome-shaped nodule with an adherent yellow-white scale.

Question 29

AK lesion

Answer 29

initial presents as a poorly defined are of redness or telangiectasia
Overtime lesion becomes more defined and develops a thin, adherent, yellowish or transparent scale.

Question 30

BCC lesion

Answer 30

pink, violaceous, or pearly-white, sometimes translucent-appearing papules or nodules
• Many have smooth surface with overlying telangiectasias
• Slow growing: flattens centrally, or may develop raised, rolled border
Frequently Bleed, become erosive and crusted, and ulcerate in the center.

Question 31

melanoma lesion

Answer 31

• FOCAL colour change is MORE specific for melanoma than the color itself
• Slate-grey, black or deep blue indicates melanin pigment deep within the dermis.
• Pink or red indicates inflammation
White indicated regression or scarring.