- stoney hard nodules on achilles tendon on extendor tendons of finger from high TC

skin 1.3 Flashcards by Morgan C

Dermatofibrosarcoma protuberans pe

Slow growing tumor on shoulders or chest
Continued growth, irregular borders
Common in 20-50 yo

How well did you know this?

Not at all

Perfectly

Dermatofibrosarcoma protuberans

Punch or excisional biopsy

How well did you know this?

Not at all

Perfectly

Dermatofibrosarcoma protuberans

trmt

Excision via MOHS surgery

How well did you know this?

Not at all

Perfectly

Keloid?

Inc fibroblast activity

Common in darker skinned ppl

How well did you know this?

Not at all

Perfectly

Keloid pe

Firm, plaque like papule or nodule that extends beyond trauma borders

How well did you know this?

Not at all

Perfectly

Keloid trmt

1 is intralesional steroids: Kenalog 40

How well did you know this?

Not at all

Perfectly

Dermatofibrosarcoma protuberans ?

Rare
Malignant dermal neoplasm
Don’t metastasize often

How well did you know this?

Not at all

Perfectly

Lipoma ?

Benign tumor of subcutaneous fat

How well did you know this?

Not at all

Perfectly

Lipoma sx

Asymptomatic

How well did you know this?

Not at all

Perfectly

Lipoma pe

Skin colored
Elevation, Rubbery and movable
MC on trunk, neck, extremities

How well did you know this?

Not at all

Perfectly

Lipoma dx

Biopsy if suspicious

Elliptical excision or punch biopsy to get all fat cells

How well did you know this?

Not at all

Perfectly

Lipoma trmt

None

Cosmetic

How well did you know this?

Not at all

Perfectly

Neurofibroma?

Proliferation of neural tissue in dermis

Benign

How well did you know this?

Not at all

Perfectly

Neurofibroma pe

Skin colored papule or nodule

Buttonhole sign

How well did you know this?

Not at all

Perfectly

Dx for NFM1- 2+ of following

6+ café au lait macules
2+ neurofibromas or 1 plexiform neurofibroma
Axillary or groin freckling
Optic nerve glioma
2+ lisch nodules (iris hamartomas)
Osseous lesions
1st degree relative with NFM 1

How well did you know this?

Not at all

Perfectly

Neurofibroma trmt

Excision

How well did you know this?

Not at all

Perfectly

xanthoma ?

Collection of lipids in dermis or tendons

How well did you know this?

Not at all

Perfectly

Tendon xanthomas

stoney hard nodules on achilles tendon on extendor tendons of finger from high TC

How well did you know this?

Not at all

Perfectly

Tuberous xanthomas-

potato like on butt and elbows from high TC or TG

How well did you know this?

Not at all

Perfectly

Eruptive xanthomas-

on extensor surfaces from high TG

How well did you know this?

Not at all

Perfectly

Xanthelasmas

on eyelids from high TC

How well did you know this?

Not at all

Perfectly

Xanthoma trmt

Diet
Statins
Excision

How well did you know this?

Not at all

Perfectly

Kaposi sarcoma

Malignant vasc tumor assoc with HHV8

Inc risk of malignant neurofibrosarcoma if involves mucous membranes

How well did you know this?

Not at all

Perfectly

Kaposi sarcoma

types

Classic- old men eastern europe
Lymphadenopathic- young men in africa
AIDS associated

How well did you know this?

Not at all

Perfectly

Kaposi sarcoma | cause

AIDS, immunosuppression → must test for AIDS

Kaposi sarcoma | pe

Purple macules, papules, dermal plaques, nodules MC on legs in Classic KS Can be anywhere

Drug eruptions | ?

Systemic rash of sudden onset from drug

Drug eruptions | pe

hives Bright red macules or papules Start proximal then go distal

Drug eruptions | trmt

DC drug | May take 1-2 wks to clear

Viral exanthem

Virus spreads through the blood to the skin

Koplik spots-

tiny white papules with red base on buccal mucosa pathognomonic for measles

measles/rubeola

3 C’s: cough, coryza, conjunctivitis Begins on head then goes to extremities Can cause encephalitis

German measles/rubella

Begins on head then goes to extremities

Herpesvirus 6/roseola

Rose red macules | Fever goes away right before rash

Parvovirus B19/erythema infectiosum/ fifth disease

Slapped cheek then spreads to arms and legs and has reticular/lacy look

Enterovirus (echo and coxsackie virus from hand foot and mouth disease)

Vesicles on palms, soles, and mouth | Almost always have fever

Mono

Trmt with ampicillin or amoxicillin triples rash

Most have fever and constitutional sx before they appear

viral xanthems

SLE is mc in

MC women of childbearing age

SLE | sx

Fatigue, fever, arthralgia, weight change, alopecia, raynaud’s (white→ blue → red)

Dx american rheumatism association criteria- need 4+

``` Butterfly (malar) rash Discoid rash Photosensitivity Oral ulcers Arthritis Renal (worse prognosis), neuro, heme, or immunological disorders ANA ```

SLE | dx

ANA Anti ds DNA Anti sm a and b

SLE | trmt

Sunscreen Topical steroids Antimalarial hydroxychloroquine DOC

Cellulitis | cause

Staph, strep, H influenzae

Cellulitis | sx

Ill, febrile

Cellulitis | pe

``` 4 signs of inflammation: Rubor- red Calor- hot Tumor- swelling/edema Dolor- pain ```

Cellulitis | pe

Skin and blood culture

Cellulitis | trmt

Systemic ATB | Facial cellulitis needs IV trmt

Erysipelas

- sharp demarcated borders in strep infection

Abscess and furuncle | ?

Pus filled nodules in dermis | Furuncle- from infected hair follicle; abscess isnt

Abscess and furuncle | cause

S aureus is MC

Abscess and furuncle | sx

Painful, spongy red hard nodules Abscesses are larger and deeper No fever

Abscess and furuncle | dx

Culture

Abscess and furuncle | trmt

Incision and drain is gold std | Antiseptic skin cleansers and topical mupirocin

Hidradenitis suppurativa-

recurrent scarring and draining of nodules in axillae, groin, and under breasts

Erythema nodosum | ?

Inflammation of subcutaneous fat on lower legs

causes Erythema nodosum

Post strep, sarcoidosis, IBD, pregnancy

Erythema nodosum | pe

VERY tender red nodules 1-2 cm wide on lower legs | Self limiting, resolve in 3-6 wks

Erythema nodosum | dx

Throat culture if post strep Anti streptolysin O CXR if sarcoidosis Deep punch biopsy

Erythema nodosum | trmt

Treat cause | NSAIDS for pain

Fixed drug eruption | sx

Red plaques that come in the same spot every time you get exposed to a new med

Fixed drug eruption | causes

MC NSAIDS, sulfonamides, tetracyclines, one more got cut off

Urticaria/wheals | ?

Vascular red blanchable swelling skin that itches | Wheals last 30min-24 hrs

Urticaria/wheals | causes

Acute- resp infections and meds | Chronic- unknown

Urticaria/wheals | pe

Edematous plaques with pale centers and red borders

Urticaria/wheals | dx

LFT to r/o hepatitis | CBC to r/o heme causes

Urticaria/wheals | trmt

Stop meds | Antihistamine fexofenadine

MC event that comes before recurrent erythema multiforme

Herpes simplex infection is

Erythema multiforme | MCC

MCC meds and infections

Erythema multiforme | pe

Itch and burn Red papules and plaques Target lesions with 3 zones of color Usually on palms and soles

Erythema multiforme | dx

Tzanck prep or viral culture for vesicular lesions | Biopsy is diagnostic

Erythema multiforme | trmt

Stop meds | Treat herpes with valacyclovir

Steven johnson syndrome?

Erythema multiforme when mucous memb are involved

Drugs assoc with sjs:

sulfonamides, quinolones, cephalosporins, tetracyclines, phenobarbital, phenytoin, valproic acid, allopurinol

Steven johnson syndrome | pe

Vesicle and bullae | Up to 10% BSA

Steven johnson syndrome | trmt

Hospital Treat fluid loss Burn unit