Dermatology Flashcards
[Derm/Neonate]
Neonatal acne vs infantile acne
First 2-4 weeks of life
No comedones
No treatment
Neonatal acne
[Derm/Neonate]
Neonatal acne vs infantile acne
At 2-4 months of life
Androgenic effects on the sebaceous glands
Comedones
Topical retinoids, benzoyl peroxide (can leave scar)
Infantile ance
[Derm/Vascular]
Diagnosis?
Fixed, reticulated, pink-violaceous vascular patches (not changed with warming)
50% associated with lib hypo/hyperplasia
Ophthalmologic abnormalities
Cutis Marmorata Telangiectatica Congenita
[Derm/pigmented]
Diagnosis?
Management in pediatrics and adult?
A hamartoma of sebaceous glands
Nevus Sebaceous
- Management:
in children - monitoring
in adult - elective excision (malignancy potential)
[Derm/pigmented]
Diagnosis?
Nevus Spilus
(Speckled lentiginous nevus)
[Derm/pigmented]
Diagnosis?
Large melanocytic nevi in the back, scalp, neck
Melanocytes within meninges or CNS
Neurocutaneous melanosis
(Congenital melanocytic nevi with CNS involvement)
[Derm/pigmented]
Diagnosis?
Blue-gray macules and patches on the face
Does not resolve with time
10% develop glaucoma
Periodic ophthalmologic/skin exams
Nevus of Ota
(Nevus of Ito, on shoulder, upper extremity, neck)
[Derm/Genetic/Ichthyoses]
Diagnosis?
Treatment?
Condition associated with X-linked?
prominent scales on the extensor surfaces of the legs and hyperlinear palms
Ichthyosis vulgaris
- Treatment:
Emollient containing an α-hydroxy acid (eg, ammonium lactate) - X-linked:
Cryptorchidism, increased risk for testicular cancer
[Derm/Genetic/Ichthyoses]
Diagnosis?
Its two types?
Autosomal recessive congenital ichthyosis (ARCI)
- Types: both are spectrum
Lamellar ichthyosis (large, dark patelike scaling)
Congenital ichthyosiform erythroderma (smaller, fine scales)
[Derm/Genetic/Pigmentation]
Diagnosis?
Cause?
Associated condition?
Oculocutaneous albinism
- Cause:
tyrosinase deficiency - Associated with:
Eye problem - photophobia, nystagmus, poor visual acuity
Increased risk of skin cancer
[Derm/Genetic/Pigmentation]
Diagnosis?
X-linked (dominant, male lethal)
Neuroectoderm dysplasia - skin, hair, teeth, CNS, eyes
Teeth: Delayed eruption of the teeth
Eye: Strabisumus
CNS: seizures, intellectual disability
Management with emollients, topical steroids
Incontinentia Pigmenti
[Derm/Genetic]
Diagnosis?
Simplex: deep layer, basal keratinocytes
Junctional: basement membrane proteins
Dystrophic: below the basement membrane, type 7 collagen
Epidermolysis bullosa
[Derm/Genetic/Ectoderm]
Diagnosis?
X-linked recessive
Face: saddle nose, frontal bossing, everted lips
Hair: sparce
Teeth: missing or peg-shaped teeth
Sweat: absent sweating, high risk for hyperthermia
Hypohidrotic ectodermal dysplasia
[Derm/Genetic/Ectoderm]
Diagnosis?
Hair, nail dysplasia
Progressive hyperkeratosis of the palms and soles
Normal sweating
Hidrotic Ectodermal Dysplasia
(Clouston syndrome)
[Derm/Pigmentation]
Indication for excision/biopsy in acquired melanocytic nevi (4)
- become painful or pruritic
- ulcerate
- change in size, color, shape
- prone to trauma
[Derm/Pigmentation]
Diagnosis?
Malignancy?
Often in male
Cutaneous hamartoma
Often with hypertrichosis
Becker Nevus
- No malignancy potential
[Derm/Pigmentation]
Diagnosis?
Common in childhood
Hypopigmented to skin-colored papuls
In Blaschkoid distribution (embryonic ectodermal lines of migration)
No treatment needed
Lichen Striatus
[Derm/Pigmentation]
Diagnosis?
Treatment?
Pain and pruritis
Often in female
Anywhere but often in vulva, perinium, glands penis
Lichen Sclerosus
- Treatment:
Topical corticosteroid
[Derm/Atopy]
Diagnosis?
Associated disease?
Hypopigmented pathes with fine scale
Usually cheeks and extensor extremities
Treatment with reassurance, emollients and topical steroids
Pityriasis alba
- Associated with:
atopic dermatitis
[Derm/Atopy]
Diagnosis?
Associated disease?
Redness, cracking of the weight-bearing part of the soles
Interdigital webs are not affected
Juvenile plantar dermatosis
- Associated with:
atopic dermatitis
[Derm/Atopy]
Diagnosis?
Small, firm multilocular vesicles on the palms, soles, fingers
Dyshidrotic eczema
[Derm/Acne]
Diangosis?
Treatment?
Acne-like papules, erythema, telangiectases
Flushing reactions to stimuli
May accompany conjunctivitis, blepharitis, iritis, keratitis
Perioral dermatitis
(Acne Rosacea in children)
- Treatment:
Topical sulfacetamide, metronidazole
Oral tetracyclines
[Derm/Hair]
Diagnosis?
~3 months after severe stress (surgery, withdrawal of hormone therapy, medications (BB, amphetamines, ACEi, OCP)
Many hair pulled out from tugging test
Hair follicle under microscopy: cornified, depigmented, club-shaped bulb without attached root sheath
Telogen Effluvium
[Derm/Pigmentation]
Diagnosis?
Brown to black plaques
Neck, face, trunk
Unknown etiology, benign phenomenon
Wiped off with alcohol swab
Treat with rubbing alcohol
Terra Firma-Forme Dermatosis
[Derm/Inflammatory]
Diagnosis?
Treatment?
Small, scaly papules
Asymptomatic or sometimes pruritic
Preceded by strep pharyngitis or perianal strep
Discoloration under the nail, pitting nail
Guttate psoriasis
(childhood psoriasis)
- Treatment:
topical steroid, topical vitamin D analog (calcipotriene)
[Derm/Infection]
Diagnosis?
Cause?
Brown to pink, well-defined patches
Axillae, groin, toe webs
Flouresces bright red with a Wood lamp
Treat with topical erythromycin/clindamycin
Erythrasma
- Cause:
Corynebacterium minutissimum
[Derm/Infection/Fungal]
Diagnosis?
Autoeczematization of the tinea or seborrheic dermatitis
Pruritic, maculopapular eruption
Distant sites of the infected area
Treatment: continue antifungal, add topical steroid
Dermatophytid (Id) reaction
[Derm/Infection/Fungal]
Diagnosis?
Scaly macules, patches
Hypopigmented, pink/brown
KOH with spaghetti and meatballs
Treat with topical azole
Tinea vesicolor
(Pityriasis vesicolor)
[Derm/Infection]
Diagnosis?
Treatment?
Children with diffuse eruption with papules, vesicles the face, palms, soles
Adolescent, pruritic papules in the interdigital web, volar wrists
Household member with itchiness
Scabies
(Sarcoptes scabiei)
- Treatment:
5% permethrin overnight
repeat in a week
[Derm/Blistering]
Diagnosis?
Mechanism?
Hyperpigmentation and tense vesicles
In sun-exposed areas
Heal with milia formation
Increased iron, hematocrit, urinary copoporphyrins and uroporphyrins
Porphyria Cutanea Tarda
- Mechanism:
Build up of phototoxic porphyrins in the skin
[Derm/Round]
Diagnosis?
Asymptomatic
Pink, annular plagues without scales
Distal extremities
Self-limiting
Granuloma Annulare
[Derm/infection]
Diagnosis?
Christmas-tree appearance
HHV 6 or 7 infection
Pityriasis Rosea
[Derm/Inflammatory]
Diagnosis?
Associated condition?
Painful ulceration
Usually in anterior tibial surface
Rapidly become necrotic, cribriform scarring
Pyoderma Gangreosum
Inflammatory Bowel Disease (Crohn’s disease)
[Derm/Drug]
Diagnosis?
Frequently associated conditions?
Mild pruritis
Target lesions symmetric distribution, palms and soles
Self-limited hypersensitivity
Erythema multiforme
HSV infection
[Derm/Inflammatory]
Diagnosis?
After viral illness
Erythematous papules, macules in the extremities, sparing trunk
Might persist for a few weeks to months
Papular acrodermatitis of childhood
(Gianotti-Crosti syndrome)
[Derm/Inflammatory]
Diagnosis?
Treatment?
Rash resembles varicella but persists
Mildly pruritic, burning, papules and vesicles with hemorrhagic crusts
Hypopigmentation, hyperpigmentation after rash
Relapsing and remitting course
Pityriasis Linchenoides et Valioriformis Acuta
(PLEVA)
- Treatment:
Long term erythromycin or tetracyclines 6-8 weeks
