Other Dermatoses Questions

Question 1

What is Acanthosis Nigricans?

Answer 1

Symmetrical hyperpigmented velvety plaques that are possibly caused by factors that stimulate proliferation

Question 2

What are the risk factors for Acanthosis Nigricans?

Answer 2

-Type 2 diabetes, insulin stimulates skin proliferation
-obesity (skin folds/diabetes)
Can occur in kids and adults (commonly on posterior neck for kids)

Question 3

What are the common clinical features of Acanthosis Nigricans?

Answer 3

-Commonly found in skin folds (friction may play a role)
-makes skin look “dirty”
-usually asymptomatic/mild pruritis
-symmetric (on both sides)

Clinical diagnosis

Question 4

What are the treatments for Acanthosis Nigricans?

Answer 4

-treat underlying disease (obesity, diabetes), this will not improve appearance/clear up pigment

-ketalytics/topical retnoids can improve appearance, can be irritating/start low and work up tolerance

**if patient has AN, usually test for diabetes/check plasma insulin level

Question 5

What is malignancy associated Acanthosis Nigricans?

Answer 5

Uncommon, appears abruptly/widespread

-extremely itchy, plaques often in mouth
-may signal aggressive GI malignancy
-Leser Trelat sign (multiple eruption of SK’s)
-older patients
-other symptoms: ask about dark/tarry stool, night sweats, etc.

Question 6

What is Hidradenitis suppurativa?

Answer 6

An occlusive and chronic autoimmune disorder caused by dysfunction of apocrine glands (active at puberty)

Question 7

What are the risk factors for Hidradenitis suppurativa?

Answer 7

Associated with other conditions: inflammatory bowel disease, metabolic syndrome (obesity, hyperlipidemia, prediabetes), or acne

-Most common at 20-40 yrs old

Question 8

What are the common clinical features of Hidradenitis suppurativa?

Answer 8

-Erythema
-Begins macular in areas like armpit or anogenital and then becomes inflamed (papules and abscesses)
-

Question 9

What are the treatments for Hidradenitis suppurativa?

Question 10

What are Lipomas?

Question 11

What are the risk factors for Lipomas?

Question 12

What are the common clinical features of Lipomas?

Question 13

What are the treatments for Lipomas?

Question 14

What are Epidermal Inclusion Cysts?

Question 15

What are the risk factors for Epidermal Inclusion Cysts?

Question 16

What are the common clinical features of Epidermal Inclusion Cysts?

Question 17

What are the treatments for Epidermal Inclusion Cysts?

Question 18

What is Melasma?

Question 19

What are the risk factors for Melasma?

Question 20

What are the common clinical features of Melasma?

Question 21

What are the treatments for Melasma?

Question 22

What is a Pilodinal Cyst?

Answer 22

A cyst which occurs near tailbone/top cleft of buttocks

(hair becomes embedded in skin and causes inflammation/infection, and abscess)

• location will cause irritation, rupture, inflammation

Question 23

What are the risk factors for a Pilodinal Cyst?

Answer 23

Obesity, sedentary lifestyle, excess body hair, poor hygiene

Most common in young men

Question 24

What are the common clinical features of a Pilodinal Cyst?

Answer 24

Abscess formation near tailbone will cause erythema, pain, discharge

Question 25

What are the treatments for a Pilodinal Cyst?

Answer 25

I&D
Culture
Antibiotics (if cellulitis present)
If lesion is recurrent: all affected tissue must be fully surgically removed, or will reoccur

Question 26

What are Pressure Ulcers?

Question 27

What are the risk factors for Pressure Ulcers?

Question 28

What are the common clinical features of Pressure Ulcers?

Question 29

What are the treatments for Pressure Ulcers?

Question 30

What is Urticaria?

Question 31

What are the risk factors for Urticaria?

Answer 31

Infection, foods, medications, skin pressure, heat, cold, stress, pregnancy, sun exposure, chronic medical illness

Question 32

What are the common clinical features of Urticaria?

Answer 32

Hives, raised dermal edema/erythema (wheals)
very pruritic
each wheal lasts less than 24 hours (may have multiple wheals erupt at different times, so condition can last more than 24 hours)
-blanching (whitish color)
-migratory
-acute <6 weeks, chronic >6 weeks

Question 33

What are the treatments for Urticaria?

Question 34

What is Vitiligo?

Answer 34

Areas of depigmentation in skin which occur most likely due to an autoimmune response which hinder the function of melanocytes/pigment production

Woods lamp: UV light can illuminate

Question 35

What are the risk factors for Vitiligo?

Answer 35

Genetics
Association with other autoimmune disorders (thyroid labs may be ordered)

Question 36

What are the common clinical features of Vitiligo?

Answer 36

Depigmented macules/patches
-well demarcated
-asymptomatic
-hands/feet/arms/face/hair (perioral and periocular)
-progressive
-non contagious

clinical ddx

Question 37

What are the treatments for Vitiligo?

Answer 37

No cure

High SPF sunscreen
Systemic phototherapy/lazer for small patches (stimulates melanocytes)
Topical therapy (first line), steroids/immunomodulators for inflammation

Oral steroids for rapidly progressing disease
Surgical skin grafting (only for stable disease)
mental health referral

Depigmentation therpay (permanent loss of pigment)

Question 38

What classes of steroids are safe to use on the face/folds?

Answer 38

Classes 6 & 7

Question 39

What classes of steroids can NEVER be used on face/folds?

Answer 39

Classes 1, 2, & 3

Question 40

What classes of steroids are okay to use on the face/folds if necessary, but should be avoided?

Answer 40

Classes 4 & 5

Question 41

What are common oral steroids used? Can you stop taking them abruptly?

Answer 41

Prednisone, medrol dose pack

can’t stop these abruptly, must taper off

Question 42

What is a common effect of prolonged steroid use?

Answer 42

Glaucoma, skin atrophy