Skin Flashcards
Slow-growing papule
Pearly rolled borders
Basal cell carcinoma
Rapid growing, volcano-like nodule with central keratotic plug
Keratoacanthoma
Flushing, erythema, telangiectasias, papules/pustules, tissue hyperplasia
Tx?
Rosacea (chronic inflammatory disorder)
Tx with metronidazole! Weird
Brown plaques or nodules with greasy surface and “stuck-on” appearance
Seborrheic keratoses
Can look like melanoma!
Skin-colored papules with indented centers (anywhere except palms and soles)
Mollscum contagiosum (poxvirus)
Papules that become confluent -> vesicles, bullae, crusting
+Neuritic symptoms (pain, itch, burn, allodynia) that could PRECEDE appearance of rash
Herpes zoster
Painful nodules and abscesses in intertriginous areas (axilla)
Hidradenitis suppurativa
Painless blisters, bullae, scarring, hypopigmentation/hyperpigmentation on sun-exposed skin (back of hands, forearms, face). Scarring and calcification like scleroderma.
In patients with HepC
Dx?
Porphyria cutanea tarda
Dx: Elevated plasma or urine porphyrin levels
Tx of acne
Inflammatory acne: topical retinoids and benzoyl peroxide
If moderate: topical antibiotics
If severe or recalcitrant: oral antibiotics and isoretinoin
Where do arterial ulcers happen?
Most distal parts of body (tips of toes)
Hypo or hyperpigmented or mildly red lesions
Often noticed after sun exposure due to tanning of surrounding skin
KOH prep: hyphae and yeast cells in “spaghetti and meatballs” pattern
Tinea vesicolor (pityriasis vesicolor) Fungal infection by Malassezia species
Tx with topical ketoconazole or selenium sulfide
Flat uniformly hyperpigmented skin lesions
Raised, tan colored hamartomas of iris
Clustered freckles in axilla or inguinal
-> Risks for what?
NF1
(=Cafe au lait spots
=Lisch nodules)
-> Neurofibromas = peripheral nerve sheath tumors
Whitish-grey spots on periphery of iris
Down syndrome (Brushfield spots)
Hypopigmented macules
Leathery patch on back of neck?
Risks for what?
=ash leaf spots
=Shagreen patches
Tuberous sclerosis
-> Risk for renal angiomyolipoma, seizures/dev delay, CNS hamartoma, cardiac rhabdomyoma
Port-wine stain
Sturge-Weber (facial angioma)
Leptomeningeal angiomas -> seizures, dev delay
Glaucoma
(W for Weber and Wine)
Sturge Weber vs. tuberous sclerosis?
Both give seizures, developmental delay
Sturge Weber: port wine stain (Weber=Wine). Mostly stuff in head (brain angiomas)
Tuberous sclerosis: ash leaf spots (also -omas elsewhere)
What is the diff between erysipelas and cellulitis? (Bugs, symptomology)
Erysipelas: infection of superficial dermis and lymphatics. Raised, sharply demarcated edges. Rapid onset and early fever. Strep pyogenes
Cellulitis: Infection of deep dermis and subQ fat. Flat edges with poor demarcation. Indolent with later fever. S pyogenes, MSSA, MRSA
Tense bullae on erythematous base
IF shows linear IgG and C3 deposits along basement membrane
Treatment?
Bullous pemphigoid
(IgG ab against hemidesmosome and basement membrane)
Tx: high potency topical glucocorticoid (clobetasol)
Grouped pruritic vesicles on butt and extensor surfaces
Bx: IgA deposits
Dermatitis hepetiformis (autoimmune rxn to gluten)
Tx: dapsone, and eliminate gluten from diet
Vesicular rash with “punched out” erosions and hemorrhagic crusting over eczema area
Organism?
Eczema herpeticum (HSV1)
Firm, hyperpigmented nodule. Fibrous component that causes dimpling in center when area is pinched (“dimple” or “buttonhole” sign)
Dermatofibroma
Dome-shaped, firm, freely movable cyst or nodule with small central punctum. Can be stable or gradually increase in size and can resolve spontaneously. may produce cheesing white discharge
Epidermal inclusion cyst
positive nikolsky sign
SSSS
pemphigus
SJS/TEN
purple flat-topped papules/plaques
puriritic, planar, or polygonal
flexural surfaces
lichen planus
hyperkeratotic papules on sole of foot, can be painful when walking
esp in immunocompromised
warts (HPV)
Treatment for dermatitis hepetifkrmis
Dapsone
Gluten free
Giant cells on Tzank smear
HSV
Things to check on isoretininion
Pregnancy
LFTs
Cholesterol, triglycerides
Tx of pityriasis rosea
Caused by HHV virus
Rash heals in 6-8 weeks with no treatment
Lower lip… SCC or BCC
Squamous
Melanoma types
Superficial spread: most common, legs in women, trunk in men
Nodular: grows vertically, reddish brown nodules, ulcerated
Acral lentiginous: palms, soles, nail beds of Asians and blacks
Lentigo maligna: sun damaged areas of face
Amelanontic: not dark
Leonine facies
Mycosis fungoides= T cell Lymphoma
If systemic = sezary syndrome
Tx with phototherapy
