Skin, hair and nails Flashcards
1
Q
KOH
A
- Fungal infections
- KOH, wait 20-30 min
- Presence of hyphae or spores
2
Q
Gram stain
A
- Bacterial infection
- Gram +/-
- May determine abx
3
Q
Wet mount
A
- BV or trichamonas
- BV = clue cells
- Trich = flagella
4
Q
Woods light
A
- Black light to ID infxn
- Vitiligo, accentuated margins
5
Q
Acetowhitening
A
- Warts
- Acetic acid turns warts white, better on mucosa
6
Q
Shave biopsy
A
- Low suspicition of melanoma
- Using razor blade
7
Q
Punch biopsy
A
Removal of core tissue, sample into deep dermis
8
Q
Excisional biopsy
A
- Large, deep lesions
- Need to remove entire lesion- Melanoma
9
Q
Incisional biopsy
A
- Small portion removed and sent to pathology
10
Q
Liquid nitrogen- Indication
A
Seborrheic and actinitc keratosis, warts
- Lesions where surgery unnecessary/ favorable
11
Q
Liquid nitrogen- Application
A
- Spray in circular pattern,
- Allow to unfreeze and repeat
12
Q
Liquid nitrogen- AE
A
Pigment change, scarring, alopecia, nerve damage
13
Q
Macule
A
Flat,
14
Q
Patch
A
Flat, > 1 cm
15
Q
Papule
A
Raised
16
Q
Plaque
A
Elevated, circumscribed, > 1 cm, can be confluence of papules
17
Q
Vesicle
A
collection of fluid
18
Q
Bulla
A
> 0.5 cm collection of fluid
19
Q
Wheal
A
Itchy, pink swelling,
transient
20
Q
Nodule
A
Circumscribe, palpable lesion
- > 1 cm, demis and epidermis
21
Q
Pustule
A
Circumscribed collection of leukocytes
- Can turn to be furuncle or carbuncle
22
Q
Crust
A
Dried exudate
- Serous, purulent or hemorrhagic
23
Q
Purpura
A
Non-blanching, extraversion of blood vessels
24
Q
Fissure
A
Linear loss of epidermis and dermis
25
Petichiae
Pinpoint purpuric lesion
26
Keloid
Scarring that exceeds size of original injury
27
Scar
CT formation, dermal damage
28
Ulcer
Loss of thickness to dermis
| Does not scar in mucus membranes
29
Atrophy
Thinning of skin, loss of subQ
| Wrinkling and translucency
30
Erosion
Focal loss of epidermis,
| - No scarring, does not penetrate dermis
31
Scale
Excess epidermal cells, abnormal keritization
32
Milia
Small, white yellow cysts, common in infatns
33
Blaschko's lines
Non-random cutaneous distribution pattern of skin lesion or pigment abnormalities arising from embryogenesis and mosaicism
34
Seborrheic keratoses- Eti
- Fair skinned, elderly, prolonged sun exposure
| - Benign
35
Seborrheic keratoses- Sx
- Stuck on appearance
| - Small plaque, velvety tan, flesh clolored
36
Seborrheic keratoses- Tx
Cryo to remove
| - No tx needed, cosmetic removal
37
Atypical nevi- Eti
- People with lots of moles
- Fried egg appearance in sun exposed areas
- Indistinct borders
38
Malignant melanoma- Eti
- UV radiation
- Fair skinned, light hair/ eyes
- Very aggressive, high rate of METS
- Most common skin cancer death
39
Malignant melanoma- Sx
```
Asymmetry
Irregular borders
- Blue to black color
- > 6 mm
- Change in appearance
```
40
Malignant melanoma- Dx/ Tx
- Full thickness excision
| - Skin exams q 6 mo x 5 years, q 3 mo with multiple
41
Seborrheic dermatitis- Eti
- Unclear, high sebaceous glands
- Scalp, face, brows, body folds
- Adult men
- Lifelong recurrence and outbreaks
42
Seborrheic dermatitis- Sx
- Infants- cradle cap
| - Erythematous greasy plaques with fine white scale
43
Seborrheic dermatitis- Tx
Selenium sulfide, ketoconazole
| - topical steroids
44
Dermatofibroma- Sx
- Firm, hyper pigmented nodules
- Dimple when squeezed
- Benign
45
MRSA- Sx, Dx
- Erythema, induration, drainage and abscess, boils
| - Wound culture
46
MRSA- Tx
- Clindamycin
- Doxy or minocycline
- TMP-sulfa
47
Erythrasma- Eti
- Chronic, superficial Corynebacterium minutissimum infxn
- Gram +
- Old, obese, DM
48
Erythrasma- Sx
- Intertriginous areas, web spaces, axilla
- Sharply marginated patch- tan to pink
- Maceration
49
Erythrasma- Dx
Woods lamp- Coral red florescence
50
Erythrasma- Tx
Benzoyl peroxide wash
| - Clinda or erythromycin lotion
51
Scabies- Eti
- Sarcptes scabiei infestation
| - Skin to skin contact, fomites
52
Scabies- Sx
- Intensley pruritic red papules with linear burrows
| - Intertriginous zones, web spaces
53
Scabies- Dx
Skin scraping- mites or eggs
54
Scabies- Tx
- Permetharin (elimite)
- Lidane
- Wash bedding, towels
55
Skin tags
- Pedunculated, fleshy papules
- May indicate insulin resistance
- Elective removal- cryo
56
Herpes simplex- Eti
- Skin to skin contact of lesions
57
Herpes simplex- Sx
Burning, stinging, painful prodrome
| - Recurrent grouped vesicles on erythematous base
58
Herpes simplex- Dx
Tzanck smear
| - Serology, ELISA
59
Herpes simplex- Tx
Acyclovir, valacyclovir or famicyclovir
60
Varicella zoster- Eti
- varicella zoster virus
- Highly contagious
- Immie available
61
Varicella zoster- Sx
- Dew drop on rose petal
- Intensely pruritic, contagious
- Papule -> vesivle -> crust
62
Varicella zoster- Tx
Acyclovir w/in 24 hrs
| - Sx relief
63
Herpes zoster- Eti
- Reactivation of varicella zoster
| - Trauma, stress, immunosuppression
64
Herpes zoster- Sx
Tingling, follows dermatome
| - Vesicles on erythematous base
65
Herpes zoster- Tx
- Zostavax > 60
| - valacyclovir or famciclovir
66
Dyshidrotic eczema- Eti
Sweating, stress, warm weather, metals
67
Dyshidrotic eczema- Sx
- "Tapioca pudding" tense vesicles on palms, soles and lateral digits
- Pruritic, deep seated
68
Dyshidrotic eczema- Tx
- Topical steroid ointment
69
Atopic dermatitis- Eti
- Allergic rhinitis, allergy, asthma
- Childhood, Increased IgE
- Flares in winter, M>W
70
Atopic dermatitis- Sx
- Poorly defined erythematous, edematous blisters, that crust and scale
- Lichenification
- Pruritus- scratch/ itch cycle
- Flexor creases
71
Atopic dermatitis- Tx
Hydration w/ wet dressings, emollients
- Calcinurin (tacrolimus)
- Glucocorticoids
- Anti-histamines
72
Actinic keratosis- Eti
Fair skinned elderly with prolonged sun exposure
| - Pre-malignant condition- SCC
73
Actinic keratosis- Sx
- Sandpaper skin- dry, rough scale
| - Hyperkeratotic skin horns
74
Actinic keratosis- Tx
Obs, cryo surgery
| Topical 5-FU
75
Pityriasis rosea- Eti
Children, you'd women
| - Assoc with viral infections
76
Pityriasis rosea- Sx
- Herald patch and white circular/ collateral scaling in christmas tree distribution
- Pruritic
- Trunk and prox extremeties
77
Pityriasis rosea- Dx/ Tx
None needed, symptoms mgmt of pruritus
78
Sebaceous cyst- Sx
- Non-painful lump with foul smelling, greyish white cheesy exudate
79
Sebaceous cyst- Tx
- Drainage or nothing
| - Recurr unless removal of cyst sac
80
Psoriasis- Eti
- Chronic, multisystem immune inflammatory response
| - Genetic
81
Psoriasis- Sx
Raised erythematous plaques with silver/ white scale
- Extensor surfaces
- Nail pitting or oil spots
- Arthritis- Sausage fingers, pencil in cup deformity
- Auspitz sign- punctate bleeding at with plaque removal
Koebner phenomenon- Lesions at line of trauma
82
Psoriasis- Tx
- Phototx- UVB
- Topical high potency steroids
- Vit D analogs and retinoids
- Methotrexate or immune agents
83
Erysipelas- Eti
- Superficial cellulitis
| - Beta heme strep
84
Erysipelas- Sx
- On cheeks, superficial
- Edematous, spreading, circumscribed erythematous area
- Noticiable advances of margin w/in hours
- Pain, chills, fever and toxicity
85
Erysipelas- Tx
- Elevated bed
- Penicillin VK
- Erythromycin if allergic
86
Cellulitis- eti
- Gram +
87
Cellulitis- Sx
- Pain a lesion site
- Malaise, chills, fever
- Edematous, warm spreading plaque
- lymphangitis and lymphadenopathy
88
Cellulitis- Tx
- IV or parenteral abx
| - Dicloxacillin or cephalexin
89
Contact dermatitis- Eti
Irritant (MC) or allergic rxn
90
Contact dermatitis- Sx
- Erythema, edema and pruritis followed by vesicles and bullae
- Weeping, crusting
- Bizzare patterns
91
Contact dermatitis- Tx
- Corticosteroids- high potency topicals
- systemic if really bad
- Calamine for itch
92
Folliculitis- Eti
- Superficial follicle infxn
- Staph Aureus
- Cluster of papules/ pustules with erythema
93
Folliculitis- Tx
- Mupirocin topical, alcohol with AlCl
| - Dicloxacillin
94
Acne vulgaris- Eti
- Adolescent males
| - Propionbacterium acnes
95
Acne vulgaris- Sx
- Sore comedones, papulopustules, nodules and cysts
96
Acne vulgaris- Tx
- Mild: Topical reninoid, benzoyl peroxide, topical abx, OCPs
- Moderate: + systemic abx- clinda or erythro, spironolactone
- Accutane if severe
97
Rosacea- Eti
- Inflammatory acniform disorder
| - ETOH, heat
98
Rosacea- Sx
Episodic flushing, erythema, telangiectasis on face, red eyes
- No comedones
99
Rosacea- Tx
Topical metronidazole
| PO doxy or tetracycline
100
Furuncle- Eti
S. aureus, necrotizing folliculits
101
Furuncle- Sx
Tender nodule with fluctuant abscess, central plug, surrounding cellulitis
102
Furuncle- Tx
I&D, heat compress
103
Tineas- Eti
Fungal ifxn- microsporum, trichophyton or epidermopyton
104
Tinea capitus- Sx
- Annular, scaling lesion, broken hair shaft
| - Hair loss w/ black dots, erythema
105
Tinea capitus- Tx
Griseofluvin
106
Tinea barbae- Sx
Severe inflammatory papules, pastures around beard hair
107
Tinea barbae- Tx
Griseofluvin
108
Tinea corporis- Sx
- Annular erythematous plaques w/ central clearing
| - Scaling
109
Tinea corporis- Tx
Topical antifungal 1-2 weeks post clearing
110
Tinea cruris
- Jock itch- Scale and inflammation, pruritic
| - Topical antifungal
111
Tinea versicolor
- Fungal infxn
- Velvety tan, pink or brown patches
- No scale
112
Tinea versicolor- Dx
Spagetti and meatballs
113
Tinea versicolor-Tx
Topical selenium sulfide or ketoconazole
114
Tinea unguium/ onchomycosis
- Brittle, yellow, opaque, hypertrophic nail beds
| - Great toe MC
115
Tinea unguium/ onchomycosis- Tx
Grisofulvin, terbenafine or itraconazole
116
Tinea pedis- Sx
- Athlete's foot, trichtophyton
- Itchy, burning scale on feet
- Moccasin foot
117
Tinea pedis- Tx
- Topical azole or turbinafine, aluminum subacetate
118
Candidiasis
- Esophageal- odynophagia
- Vaginal- itching, cottage cheese discharge
- Tx- fluconazole
119
Molluscum contagesousum
- Poxvirus
- Dome shaped papule with umbilicated center
- Self limiting
120
Verrucae
- AKA, warts, HPV
| Tx with cryo, salicylic acid
121
Basal cell- Sx
- Most common skin CA
- Pearly white, dome shaped papule
- Telangiectasia
122
Basal cell- Tx
electrodessication or curettage, cryo, etc
| - METs rare
123
Squamous cell carcinoma- Sx
- Preceeded by actinic keratosis
- Central ulceration
- Red, elevated nodule white scales, crusted lesions
124
SCC- Tx
Excision
125
Lichen planus- Sx
- Flat topped papules, fine white striae,
- Flexoral surfaces
Wickham striae
- Tx: high potency steroids
126
Hidradentitis suppurativa- Sx
Inflammatory nodules on axilla, inguinal area d/t blockage
| - Tx- topical clincamycin
127
Sunburn
- Sharply marginated erythema
- Blistering, heat, no rash
- NSAIDs, aloe, hydration, hospital
128
Dematoheliosis
Repeated sun exposure
- Deep wrinkling, yellow to purple hue
- Atrophy, hypertrophy
129
Drug, chemical photosensitivity
- Extreme itch, eczematous eruption on sun exposed areas
130
Topical phototoxic dermatitis
Drugs + sun
| - Appears like contact dermatitis
131
Phytophotdermatitis
Erythema, edema and vesicles in bizzare streaks
132
Polymorphous light eruption
- Hypersensativity rxn
| - pruritus, paresthesia papulovesicles for 7-10 days
133
Porphyria
- Fragile skin d/t urogen deficieny
- TEnse bullae on normal skin
- Milia on dorsa of hands, feet, scalp
- Pink urine
134
Permethrin
lice and scabies
| - AE: burning, pruritis
135
Crotamiton (eurax)
Scabies only
| - AE: allergic dermatitis
136
Acne oral abx
Moderate to severe acne:
Tetracycline
Minocycline
Erythromycin
