Skin changes in SBL Flashcards
What is pathognomonic for measles?
Koplik spots on the buccal mucosa
Parvovirus is one of the most common causes of _____ in childhood
myocarditis
What can the symptoms of parvovirus B19 mimic?
They can mimic the symptoms of autoimmune states, such as lupus, systemic sclerosis, antiphospholipid syndrome, or vasculitis
What is the difference between Lyme disease vesicles and shingles vesicles?
Lyme’s does NOT follow dermatomal distributions like shingles
What is a common manifestation of EBV that may occur at any age?
infectious mononucleosis
What is characteristic of stage 1 Lyme disease (early localized infection)
Erythema migrans (bullseye lesion) at the bite site ~1 week after the tick bite
What is characteristic of stage 2 Lyme disease
Weeks to months later
Bacteremia
Secondary skin lesions
What is characteristic of stage 3 Lyme disease
months to years later
Musculoskeletal manifestations
neurologic manifestations (rare)
acrodermatitis chromicum atrophicans (rare)
What develops in most Lyme disease patients?
A concomitant viral-like illness characterized by myalgias, arthralgias, headache, fatigue, and possibly fever
What develops in most Lyme disease patients?
A concomitant viral-like illness characterized by myalgias, arthralgias, headache, fatigue, and possibly fever
What is secondary syphilis characterized by?
rash condyloma lata mucus patches generalized lymphadenopathy fever malaise, anorexia arthralgias and myalgias
What is the hallmark of hand foot and mouth disease?
the development of a vesicular eruption on the palms and soles
Vesicles quickly erode and form yellow to gray, oval or football shaped erosions surrounded by an erythematous halo
What is scarlet fever typically caused by?
Group A strep (pyogenes)
What is the most common cause of tonsillopharyngitis in children and adolescents?
Streptococcus pyogenes
Most distinctive symptom of scarlet fever
strawberry tongue
What is erythema multiforme
A rare cutaneous/mucocutaneous eruption characterized by TARGET LESIONS, predominantly on the face and extremities
What are most cases of erythema multiforme related to?
infections (HSV) and Mycoplasma pneumoniae
Characteristics of the lesions of Varicella (chicken pox)
Progress sequentially from rose-colored macules to papules, vesicles, pustules, and crusts
Lesions in all stages are usually present at the same time
What is gonococcemia caused by?
bacterial infection caused by Neisseria gonorrhoeae, a gram-negative, aerobic coccus-shaped bacterium found in pairs
What is the clinical triad of disseminated gonococcemia?
dermatitis
migratory polyarthritis
tenosynovitis
What are the skin findings of gonococcemia
skin findings consist of small to medium sized macules or most typically, hemorrhagic vesicopastules on an erythematous base located on palms and soles
skin lesions may develop necrotic centers
Disseminated meningococcal infection may present as…
meningitis alone
acute meningococcemia with or without meningitis
chronic meningococcemia
What is a possibility in severe cases of meningococcemia
necrosis of the skin and underlying tissue may necessitate amputation
Acute meningococcemia with disseminated intravascular coagulation may produce what?
purpura fulminans
What is the pentad that characterizes TTP
microangiopathic autoimmune hemolytic anemia thrombocytopenia neurologic symptoms fever renal failure
What is often required to initiate clinical TTP
an additional inflammatory trigger (such as infection, surgery, pancreatitis, or pregnancy)
What are the non-palpable purpura (think “other” like autoimmune)
ITP TTP DIC Other thrombocytopenia or platelet dysfunction Clotting factor defect
What are the palpable purpura (think infectious/inflammatory)
Vasculitis:
- SLE
- Sjogren’s
- Henoch-Scholein’s
- RA
Infection: meningoccemia gonococcenia RMSF Endocarditis
What is the most common form of cutaneous cancer?
basal cell carcinoma of the skin
What are the risk factors of melanoma
history of sunburns blue or green eyes blonde or red hair fair complexion >100 typical nevi, any atypical nevi prior personal or family history of melanoma p16 mutation
How does one screen for melanoma
ABCDE
Asymmetry Border Color Diameter Evolution
Characteristics of a shave biopsy
Most common biopsy technique Less time consuming Good cosmetic result Limited downtime for the patient Limited to processes occurring to the depth of the mid dermis
Characteristics of a punch biopsy
can provide full thickness skin sample
Rapid healing
Limited by the diameter of the punch tool
May not be adequate for processes in the subq tissue due to limitations with depth
Characteristics of an excisional biopsy
Sterile technique required
Advantages include an adequate sample down to the subq tissues
Margins can also be controlled and adjusted as needed
Limitations of excisional biopsy
Increased duration of the procedure
Longer healing time
Greater potential for scarring
Suture removal
What should you do if you suspect melanoma
AVOID BIOPSY
Refer to dermatology or appropriate surgically trained physician
