skin 1.4

Question 1

Toxic epidermal necrolysis

sx

Answer 1

Fever
Epidermal separation
Over 30% BSA
Sheetlike loss of epidermis

Question 2

Toxic epidermal necrolysis

trmt

Answer 2

Hospital
Treat fluid loss
Burn unit

Question 3

Staphylococcal scalded skin syndrome (SSSS)

Answer 3

Epidermal shedding from s aureus in kids under 5

Question 4

Assoc with lyme disease

Answer 4

Erythema migrans

Question 5

MC arthropod borne disease in US

Answer 5

Erythema migrans

Question 6

Erythema migrans

cause

Answer 6

Borrelia burgdorferi, ixodes tick

Question 7

Erythema migrans

pe

Answer 7

Starts 3-30 days after tick bite
Fever, myalgia, arthralgia, ha, malaise, fatigue
At least 5 cm wide and central punctum where bite was
At sites favored by ticks like waistband

Question 8

Early disseminated days to wks after

Erythema migrans

Answer 8

Skin, CNS, musculoskeletal
HA, stiff neck, fatigue, malaise
Cardiac and neuro sx

Question 9

Persistent months to yrs after

Erythema migrans

Answer 9

Musculoskeletal- joint pain

CNS- encephalopathy, axonal polyneuropathy

Question 10

Erythema migrans

dx

Answer 10

Dx fpr lyme disease
ELISA IgM and IgG Ab- may not come until 2-4 wks after exposure
Must do western blot (test)

Question 11

Must do western blot to dx this

Answer 11

Erythema migrans

Question 12

Erythema migrans

trmt

Answer 12

Remove tick within 24 hrs with forceps only
GOLD std doxycycline
Amoxicillin if allergic

Question 13

Rocky mountain spotted fever

cause

Answer 13

Rickettsia rickettsii transmitted by wood, dog, or lone star tick

Question 14

Rocky mountain spotted fever

PE

Answer 14

Fever, chills, nausea, HA, vomiting, myalgia

Maculopapules on wrists and ankles then spread to trunk

Question 15

Rocky mountain spotted fever

dx

Answer 15

+ fluorescent Ab stain

Question 16

Rocky mountain spotted fever

trmt

Answer 16

Treat fast with doxycycline or chloramphenicol

20% mortality without trmt

Question 17

Cutaneous larva migrans cause

Answer 17

Cat or dog hookworm, parasite, in their poop and humans step on it

Question 18

Cutaneous larva migrans PE

Answer 18

Creeping eruption-in epidermis and superficial dermis

Pink papule

Question 19

Cutaneous larva migrans trmt

Answer 19

None

Goes away on own

Question 20

“Swimmers itch”

“Clamdigger’s itch”

Answer 20

Cercarial dermatitis

Question 21

Cercarial dermatitis cause

Answer 21

Organisms in aquatic settings

We get infected after going in freshwater

Question 22

Cercarial dermatitis pe

Answer 22

Prickling after bug enters
Red macules, urticaria
Everywhere but bathing suit areas

Question 23

Cercarial dermatitis trmt

Answer 23

None

Resolves on own

Question 24

Actinic purpura?

Answer 24

Purple macules on sun exposed areas

Common in old ppl

Question 25

Actinic purpura | pe

Answer 25

Round or oval ecchymosis on hand or forearm

Question 26

Actinic purpura | trmt

Answer 26

none

Question 27

Sarcoidosis ?

Answer 27

Bilateral hilar lymphadenopathy Noncaseating granulomas In aa

Question 28

Sarcoidosis pe

Answer 28

Lupus pernio- purple donut on nose, cheeks, ears | Apple jelly yellow brown color on diascopy

Question 29

Sarcoidosis dx

Answer 29

Angiotensin converting enzyme | Biopsy is diagnostic

Question 30

Sarcoidosis trmt

Answer 30

Hydroxychloroquine

Question 31

Heliotrope rash-

Answer 31

red/purple on eyelid

Question 32

Gottron papules-

Answer 32

purple papules on hand

Question 33

Shawl sign-

Answer 33

red and atrophy on neck and shoulders

Question 34

Dermatomyositis pe

Answer 34

Heliotrope rash- red/purple on eyelid Gottron papules- purple papules on hand Shawl sign- red and atrophy on neck and shoulders Periungual erythema Affects proximal muscles- hard to rise from chair, raise hands above head, climb

Question 35

Dermatomyositis dx

Answer 35

High muscle enzymes like cpk and aldolase | Abnormal muscle biopsy

Question 36

Dermatomyositis trmt

Answer 36

Methotrexate | Azathioprine

Question 37

Scleroderma pe

Answer 37

Raynaud’s → white blue red Sausage digits- painless edema CREST

Question 38

3 stages of Generalized scleroderma

Answer 38

Edematous- edema of face and digits Indurative- skin is hard and restricts mvmts Atrophic- distal finger become small and pointed with ulcers, mask like facies Also affects GI, renal, derm, pulm, myopathic

Question 39

2 forms of Localized scleroderma

Answer 39

Morphea- sharp demarcated plaques | Linear scleroderma- en coup de sabre are linear malformations on face

Question 40

Scleroderma trmt

Answer 40

Raynaud's- nifedipine to open BV | Localized “burns out” over time and softens

Question 41

Granuloma annulare | sx

Answer 41

Asymptomatic

Question 42

Granuloma annulare | PE

Answer 42

Cosmetic concern Shiny papules and annular plaques that are skin colored, red, or purple Pebbled surface

Question 43

Granuloma annulare | dx

Answer 43

Biopsy confirms

Question 44

Granuloma annulare | trmt

Answer 44

Heals on own over months

Question 45

Looks like ringworm but asymptomatic

Answer 45

Granuloma annulare

Question 46

Necrobiosis lipoidica | PE

Answer 46

Plaques ulcerate over yrs and are painful Atrophic with yellow hue, telangiectasia, and defined borders Symmetry on both shins

Question 47

Necrobiosis lipoidica | dx

Answer 47

Glucose intolerance | Biopsy confirms

Question 48

Necrobiosis lipoidica | trmt

Answer 48

Control DM | Topical and intralesional corticosteroids

Question 49

Necrobiosis lipoidica is assoc with this condition

Answer 49

dm

Question 50

Factitious ulcers-

Answer 50

geometric weird shape

Question 51

Pyoderma gangrenosum-

Answer 51

rapidly growing painful ulcer

Question 52

Venous insufficiency-

Answer 52

lower leg edema with brown color