Skin Under Attack Questions

Question 1

The skin biopsy is from someone who has? What does the histologic examination show?

Answer 1

Molluscipox Virus; it reveals intracytoplasmic inclusions within keratinocytes a.k.a. Henderson-Paterson bodies

Question 2

This patient most likely has? What is the most affected site? What organism causes it? What is the characteristic feature?

Answer 2

Impetigo; face; Staph aureus and Strep pyrogenes; Honey-colored crust

Question 3

This patient most likely has? Describe the disease.

Answer 3

Folliculitis; superficial infection of hair follicles with pus accumulation in the epidermis

Question 4

What’s wrong with this BABEH!? What’s it caused by? What demographic is it in? Describe what’s going on here. What is Tx?

Answer 4

An exotoxin; Staphlococcal Scalded Skin Syndrome, caused by an infection with exotoxin producing S. Aureus (loss of cell-cell adhesion due to cleaving of desmoglobin 1); primarily in infants and children (adults with renal dz/ICP’s); Diffuse generalized erythema and superficial desquamation with flexural accentuation; Treat with Abx (beta-lactamase resistant) and supportive care

Question 5

This lesion is caused by? What is the lesion called? What causes the most cases of this?

Answer 5

HPV 6; Genital Warts (condylomata acuminata; 90% caused by HPV 6 and 11

Question 6

What is wrong here?

Answer 6

Pt has Tinea Unguium; a fungal infection of nail plate or bed with nail bed deformity (onchodystrophy) and thickening (hyperkeratosis) and discoloration

Question 7

What is this? What is it characterized by?

Answer 7

The kid has herpes… (but why is he so happy?); HSV1 present as painful, grouped vesicles on an erythematous base

Question 8

What’s this guys problem? What is it due to? What are risks? When are lesions no longer contagious?

Answer 8

He has Shingles (Herpes Zoster - VZV); Due to reactivation of latent VZV in any dorsal root ganglion (single dermatome affected) the produces a painful prodrome with dermatological vesicular eruption; risks are old age and ICPs; Contagious until crusted

Question 9

What is this?

Answer 9

Basal Cell Carcinoma (note the telangiectasis)

Question 10

What does this patient have? What is it caused by? What does infection produce?

Answer 10

Molluscum Contagiousum; Caused by a DNA poxvirus of the Molluscipox genus; Produces smooth, dome-shaped, umbilicated papules

Question 11

What vaccine protects against both anogenital warts and cervical cancer? What is the vaccine composed of?

Answer 11

Quadrivalent Vaccine = Gardasil; Composed of L1 VLP from HPV 6, 11, 16, and 18

Question 12

What is the Bivalent VLP vaccine (Cervarix) composed of?

Answer 12

HPV 16 and 18 VLP

Question 13

What’s this?

Answer 13

Herpes

Question 14

What’s this?

Answer 14

Furuncle

Question 15

What’s this?

Answer 15

Abscess

Question 16

What is this? What was it caused by?

Answer 16

Hot tub folliculitis; Pseudomonas

Question 17

What’s this?

Answer 17

Tinea Versicolor

Question 18

Describe this; What was it stained with?

Answer 18

“Spaghetti and Meatball” appearance of a scraping of Tinea Versicolor when stained with KOH

Question 19

What’s this?

Answer 19

Warts…

Question 20

What is this? What causes it?

Answer 20

It is the Koebner Phenomenon; It is caused by autoinnoculation by scrating, in this case he said it was a wart but there are many other causes

Question 21

What’s this?

Answer 21

Jock itch (Totally unneccesary but included for completeness)