Skin under attack

Question 1

Dx?

Answer 1

Molluscum contagiosum

Question 2

The causative agent of this lesion replicates in:

Answer 2

Nucleus

(Shingles - VZV - herpesviruses are DNA viruses which replicate in the nucleus)

Question 3

Causative agent?

Answer 3

HPV2

Question 4

Most likely causative agent?

Answer 4

Trichophytan tonsurans

Question 5

Test to definitively diagnose the agent of this infection?

Answer 5

Tzank smear

(Herpetic whitlow - look for multinucleated acanthotic keratinocytes)

Question 6

Two names for this lesion?

Answer 6

Tinea faceis, Ringworm

Question 7

Causative agent?

Answer 7

Poxvirus

Question 8

HPV serotype?

Answer 8

HPV1

(Palmoplantar warts)

Question 9

HPV serotype?

Answer 9

HPV 2,4

Question 10

Most likely causative agent?

Answer 10

Malassezia

(Tinea versicolor - notice hypopigmentation in round patches)

Question 11

Dx?

Answer 11

Herpetic whitlow

Question 12

HPV serotype?

Answer 12

HPV 3,10

(Flat warts)

Question 13

Unlike this lesion which generally spares the penis and scrotum, ___, ___, and ___ usually will involve the penis and scrotum.

Answer 13

Scabies

Genital herpes

Genital warts

Question 14

Dx?

Answer 14

Tinea pedis

Question 15

Most likely causative agent?

Answer 15

Strep

(Erlysipelas)

Question 16

How does the primary infection with this virus differ from the primary infection with the causative agent of herpes labialis?

Answer 16

HSV2 (genitalis) initial infx = severe, vesicles, fever, lethargy

HSV1 (labialis) initial infx = usually asymptomatic

Question 17

Dx?

Answer 17

Molluscum

Question 18

Dx?

Answer 18

Tinea corporis

Question 19

Dx?

Answer 19

Herpes

(Tzank smear showing multinculeated acanthotic keratinocytes)

Question 20

Most likely bugs?

Answer 20

Staph aureus, strep pyogenes

Question 21

What time of year is this infection most common?

Answer 21

Late winter - early spring

Question 22

Where does this patient most likely live?

Answer 22

Tropical areas

(Tinea versicolor caused by Malasezzia)

Question 23

Dx?

Answer 23

Oral candidiasis

Question 24

Dx?

Answer 24

Tinea capitis

Question 25

Two bugs that may be causing this?

Answer 25

Strep pyogenes or staph auerus

(Folliculitis)

Question 26

The causative agent of this lesion most likely lives in which skin layer?

Answer 26

Stratum corneum

(Tinea corporis - most superficial fungal infections caused by dermatophytes which eat keratin)

Question 27

Dx?

Answer 27

Tinea cruris

Question 28

Dx?

Answer 28

Tinea facia

Question 29

Dx?

Answer 29

Tinea pedis

Question 30

How to tell if this is a furuncle or folliculitis?

Answer 30

Furuncle - infx of hair follicle down to subcutis

Folliculitis - superficial infection of hair follicle

Question 31

Dx?

Answer 31

Tinea versicolor

Question 32

Why might this patient have developed this infection?

Answer 32

Taking Abx

(Vaginal candidiasis)

Question 33

Two vaccines used for this virus?

Answer 33

Zostavax, varivax

Question 34

Two possible diagnoses?

Answer 34

TSS, Kawasaki disease

Question 35

What infection would this patient have had before this one?

Answer 35

Chickenpox

(Shingles)

Question 36

In which demographic is this disease common?

Answer 36

Elderly

(Erysipelas)

Question 37

Dx?

Answer 37

Folliculitis

Question 38

Dx?

Answer 38

Furuncle

Question 39

Dx?

Answer 39

Impetigo

Question 40

Characteristic presentation?

Answer 40

Pain out of proportion to clinical findings

Question 41

Pathogenesis?

Answer 41

S. auerus antigen against desmoglein

Question 42

This lesion most likely occured following?

Answer 42

Surgery or deep abscess