2/24 6 topics in 60 min Flashcards by Jullet Han

What are some features of Bot Fly Myiasis?

Where is it most prevalent?

How is it transmittted?

What areas does it normally affect?

Central and South America
1-1.5cm soft white larvae with spicules; transmitted via mosquitos
tender red nodule with a central opening (2-3mm) - used as a breathing tube
nodule enlarges and becomes more painful; central necrosis with some bleeding visible
scalp, face, upper body are commonly infested

How well did you know this?

Not at all

Perfectly

What is this diagnosis?

How do you know?

Where is it endemic in?

What causes it? How is it transmitted?

Where does it normally affect?

Bot Fly Myiasis

Central and south America
1-1.5cm soft white larvae with spicules; transmitted via mosquitos
tender red nodule with a central opening, which is used as a breathing tube for the bot fly.
the nodule enlarges and becomes more painful; central necrosis with some bleeding visible
scalp, face, upper body are commonly infested

How well did you know this?

Not at all

Perfectly

What is this diagnosis?

How do you know?

Where is it endemic in?

What causes it? How is it transmitted?

Where does it normally affect?

Bot Fly Myiasis

Central and south America
1-1.5cm soft white larvae with spicules; transmitted via mosquitos
tender red nodule with a central opening, which is used as a breathing tube for the bot fly.
the nodule enlarges and becomes more painful; central necrosis with some bleeding visible
scalp, face, upper body are commonly infested

How well did you know this?

Not at all

Perfectly

What is this diagnosis?

How do you know?

Where is it endemic in?

What causes it? How is it transmitted?

Where does it normally affect?

Bot Fly Myiasis

Central and south America
1-1.5cm soft white larvae with spicules; transmitted via mosquitos
tender red nodule with a central opening, which is used as a breathing tube for the bot fly.
the nodule enlarges and becomes more painful; central necrosis with some bleeding visible
scalp, face, upper body are commonly infested

How well did you know this?

Not at all

Perfectly

GROSS.

What is this diagnosis?

How do you know?

Where is it endemic in?

What causes it? How is it transmitted?

Where does it normally affect?

Lesmaniasis (Leishmania species)

parasite transmitted via sandflies
causes cutaneous, mucocutaneous, systemic disease
many forms present in various parts of the world
lesions start off as a typical athropod bite, develops into a papule that slowly enlarges over months into an asymptomatic ulcerated nodule, with a raised violaceous border

How well did you know this?

Not at all

Perfectly

What is this diagnosis?

How do you know?

Where is it endemic in?

What causes it? How is it transmitted?

Where does it normally affect?

Lesmaniasis (Leishmania species)

parasite transmitted via sandflies
causes cutaneous, mucocutaneous, systemic disease
found in many parts of the world (too many to name..)
lesions start off as a typical athropod bite, develops into a papule that slowly enlarges over months into an asymptomatic ulcerated nodule, with a raised violaceous border

How well did you know this?

Not at all

Perfectly

What are some features of Lesmaniasis?

Where is it most prevalent?

How is it transmittted?

What areas does it normally affect?

prevalent in many areas; named by geographic loc.
parasite transmitted via sandflies
causes cutaneous, mucocutaneous, systemic disease
many parts of the world
lesions start off as a typical athropod bite, develops into a papule that slowly enlarges over months into an asymptomatic ulcerated nodule, with a raised violaceous border

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Lesmaniasis (Leishmania species)

prevalent in many areas; named by geographic loc.
parasite transmitted via sandflies
causes cutaneous, mucocutaneous, systemic disease
lesions start off as a typical athropod bite, develops into a papule that slowly enlarges over months into an asymptomatic ulcerated nodule, with a raised violaceous border

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

How is it transmitted?

How is it treated?

Cutanea Larva Migrans “Creeping Eruption” (Ancyclostomia braziliense hookworm)

transmitted from animal feces through follicles and fissured skin; usually occurs 2-4 weeks after returning from a beach vacation in the Caribbean, south/Central America, sandbox
red to violaceous serpiginous tract, emerges and migrates through the skin, usually on the feet and ankles.
Itching can be intense and lesion can be secondarily infected
trmt: cryotherapy

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

How is it transmitted?

How is it treated?

Cutanea Larva Migrans “Creeping Eruption” (Ancyclostomia braziliense hookworm)

transmitted from animal feces through follicles and fissured skin; usually occurs 2-4 weeks after returning from a beach vacation in the Caribbean, south/Central America, sandbox
red to violaceous serpiginous tract, emerges and migrates through the skin, usually on the feet and ankles.
Itching can be intense and lesion can be secondarily infected
trmt: cryotherapy

How well did you know this?

Not at all

Perfectly

Cutanea Larva Migrans

What are some features of ?

Where is it most prevalent?

How is it transmittted?

What areas does it normally affect?

How do you treat this bad boy?

Cutanea Larva Migrans “Creeping Eruption” (Ancyclostomia braziliense hookworm)

transmitted from animal feces through follicles and fissured skin; usually occurs 2-4 weeks after returning from a beach vacation in the Caribbean, south/Central America, sandbox
red to violaceous serpiginous tract, emerges and migrates through the skin, usually on the feet and ankles.
Itching can be intense and lesion can be secondarily infected
trmt: cryotherapy

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Urticaria (Hives)

pruritic, red-pink, polycyclic wheals (some with central clearing)
lesions can coalesce, migrate, or recur

How well did you know this?

Not at all

Perfectly

What are some features of Urticaria?

What causes it?

How is it diagnosed?

pruritic, red-pink, polycyclic wheals (some with central clearing)
lesions can coalesce, migrate, or recur
lesions are transient, but eruption may persist for weeks
due to histamine release triggered by foods, drugs, or allergens
Dx: no good laboratory test; testing is rarely needed to make the diagnosis

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Urticaria

pruritic, red-pink, polycyclic wheals (some with central clearing)
lesions can coalesce, migrate, or recur

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Urticaria

pruritic, red-pink, polycyclic wheals (some with central clearing)
lesions can coalesce, migrate, or recur

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Urticaria

pruritic, red-pink, polycyclic wheals (some with central clearing)
lesions can coalesce, migrate, or recur

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

When does this usually occur?

What is it caused by?

How do you treat it?

She has a PUPPPy in her belly.. kidding

Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

usually occurs in 3rd trimester
hive lesions/wheals resolve in 24hrs, migrate, or change shape without intervention
commonly causes: ingestants, Inhalants, Injectants, Infections and Internal disease (occult malignancy)

treatment: antihistamines

How well did you know this?

Not at all

Perfectly

What are some features of Pyoderma Gangrenosum?

What causes it?

What disease is it normally associated with?

How is it treated?

Why should the patient NOT undergo debridement?

expanding, necrotizing, inflammatory ulcer (non-infectious) with “undetermined boders”
“Pathergic”– an abnormally /excessive reaction that develops at sites of trauma
Lesions are multiple, usually on on the legs, very painful
associated with inflammatory bowel disease (30%)

Treatment: IVIG and TNF inhibitors (steroids, cyclosporine, infliximab)
***debridement is contraindicated because it may result in injury, resulting in an expansion of the ulcer

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

What causes it?

What disease is it normally associated with?

How is it treated?

Why should the patient NOT undergo debridement?

Pyoderma Gangrenosum

expanding, necrotizing, inflammatory ulcer (non-infectious) with “undetermined boders”
“Pathergic”– an abnormally /excessive reaction that develops at sites of trauma
Lesions are multiple, usually on on the legs, very painful
associated with inflammatory bowel disease (30%)
Treatment: IVIG and TNF inhibitors (steroids, cyclosporine, infliximab)
***debridement is contraindicated because it may result in injury, resulting in an expansion of the ulcer

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

What causes it?

What disease is it normally associated with?

How is it treated?

Why should the patient NOT undergo debridement?

Pyoderma Gangrenosum

expanding, necrotizing, inflammatory ulcer (non-infectious) with “undetermined boders”
“Pathergic”– an abnormally /excessive reaction that develops at sites of trauma
Lesions are multiple, usually on on the legs, very painful
associated with inflammatory bowel disease (30%)
Treatment: IVIG and TNF inhibitors (steroids, cyclosporine, infliximab)
***debridement is contraindicated because it may result in injury, resulting in an expansion of the ulcer

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

What causes it?

What disease is it normally associated with?

How is it treated?

Why should the patient NOT undergo debridement?

Pyoderma Gangrenosum

expanding, necrotizing, inflammatory ulcer (non-infectious) with “undetermined boders”
“Pathergic”– an abnormally /excessive reaction that develops at sites of trauma
Lesions are multiple, usually on on the legs, very painful
associated with inflammatory bowel disease (30%)
Treatment: IVIG and TNF inhibitors (steroids, cyclosporine, infliximab)
***debridement is contraindicated because it may result in injury, resulting in an expansion of the ulcer

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

What causes it?

What disease is it normally associated with?

How is it treated?

Why should the patient NOT undergo debridement?

Pyoderma Gangrenosum

expanding, necrotizing, inflammatory ulcer (non-infectious) with “undetermined boders”
“Pathergic”– an abnormally /excessive reaction that develops at sites of trauma
Lesions are multiple, usually on on the legs, very painful
associated with inflammatory bowel disease (30%)
Treatment: IVIG and TNF inhibitors (steroids, cyclosporine, infliximab)
***debridement is contraindicated because it may result in injury, resulting in an expansion of the ulcer

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Bonus: what is it caused by? and how do you treat it?

Keloid

scar or collagen tumors that extend beyond the areas of trauma; can occur spontaneously
firm, flesh colored nodules that are asymptomatic to tender, variable sizes
increased melanosomes in darker skin types (same number of melanocytes)
treatment - inject it with steroids

How well did you know this?

Not at all

Perfectly

What does this person have?

How do you know?

Bonus: what is it caused by? and how do you treat it?

Keloid

scar or collagen tumors that extend beyond the areas of trauma; can occur spontaneously
firm, flesh colored nodules that are asymptomatic to tender, variable sizes
increased melanosomes in darker skin types (same number of melanocytes)
treatment: inject it with steroids

How well did you know this?

Not at all

Perfectly

What does this person have? How do you know? Bonus: what is it caused by? how do you treat it?

**Keloid** - **scar or collagen tumors** that extend beyond the areas of trauma; can occur spontaneously - **firm**, **flesh colored nodules** that are asymptomatic to tender, **variable sizes** - increased melanosomes in darker skin types (same number of melanocytes) - treatment: inject it with steroids

What does this person have? How do you know (what are some defining features of it?) List one possible DDx and how would you differentiate between the two? What is the treatment?

**Pomade Acne** - **open and closed comedones** form as a result of the **lubricating pomades** that is used to keep hair from becoming dry and brittle - usually at the forehead and temples - ddx: acne vulgaris (in acne vulgaris, the comedones are generally not limited to the forehead) - treatment: avoid the pomade and other greasy comedogenic oils

What disease does this person have? How do you know? What are some features of this disease? Who and where does it normally affect? How is it diagnosed? What are the treatments for it?

**Sarcoidosis** - **waxy, red-brown papule** with an “apple jelly-like” appearance **- peri-nasal**, **peri-orbital** skin folds - seen almost exclusively in **black skin**. - Dx: clinical findings - Bx: non-caseating granulomas, “naked tubercles” - Treatment includes topical and intralesional corticosteroids, systemic antimalarials

What disease does this person have? How do you know? What are some features of this disease? Who and where does it normally affect? How is it diagnosed? What are the treatments for it?

**Sarcoidosis** - **waxy, red-brown papule** with an “apple jelly-like” appearance **- peri-nasal**, **peri-orbital** skin folds - seen almost exclusively in **BLACK skin (if you see black skin on the exam, sarcoidosis should be at the top of your DDX)**. - Dx: clinical findings - Bx: non-caseating granulomas, “naked tubercles” - Treatment includes topical and intralesional corticosteroids, systemic antimalarials

What disease does this person have? How do you know? What are some features of this disease? Who and where does it normally affect? How is it diagnosed? What are the treatments for it?

In what populations is melanoma most prevalent? What areas are usually affect?

* **white skin** * darker skin - melanomas are common at acral and periungual skin, and palmar and plantar surfaces

What does this person have? How do you know? Who does it normally affect?

Basal Cell Carcinoma *(refer to BCC lecture for better pictures/explanations)* * features * see **pearly (shiny)**, somewhat **translucent** lesion * presence of **telangietasias** * **whites skin** or **african americans w. lighter skin tones (UV exposure)** * similar anatomic distribution in both * BCCs in Black, Hispanic and Asian skin is almost always of the **pigmented type**, which makes early diagnosis very difficult because it can be confused with melanoma

What are some features of basal cell carcinoma? In what populations is it most prevalent? What areas are usually affect?

Basal Cell Carcinoma (refer to BCC lecture for better pictures/explanations) * features * **pearly (shiny)**, somewhat **translucent** lesion * presence of **telangietasias** * **whites** or **blacks with lighter skin tones** (UV exposure) * similar anatomic distribution in both * BCCs in Black, Hispanic and Asian skin is almost always of the **pigmented type**, which makes early diagnosis very difficult because it can be confused with melanoma

What does this person have? How do you know? Who does this affect?

Basal Cell Carcinoma *(refer to BCC lecture for better pictures/explanations)* * features * **pearly (shiny)**, somewhat **translucent** lesion * presence of **telangietasias** * **whites** or **blacks with lighter skin tones** (UV exposure) * similar anatomic distribution in both * BCCs in Black, Hispanic and Asian skin is almost always of the **pigmented type**, which makes early diagnosis very difficult because it can be confused with melanoma

What are some features of squamous cell carcinoma? In what populations is it most prevalent? What areas are usually affect?

*(see SCC lecture for better descriptions)* * solitary enlarging nodule with a red indurated base and a central scale or ulceration * most common in **black skin**, in non-sun exposed skin (ie legs); especially acral and periungual skin, and palmar and plantar surfaces

What are some features of Mycosis Fungoides (CTCL)? What areas does it normally affect? What is Sezary syndrome?

**Cutaneous** **T cell lymphoma** * presents in the **skin - thin, pink, scaly patches over the TRUNK** * patch/plaque stages may show annular, round, oval, or arcuate plaques, which can migrate, expand, and ulcerate * evolves through several stages including **mycosis fungoides, patch, plaque and tumor** * late stage: **sezary syndrome**

What does this person have? How do you know? What are some of the features of the disease? What is more progressed form of this disease?

Mycosis Fungoides (Cutaneous T cell lymphoma) * presents in the skin - thin, pink, scaly patches over the TRUNK * patch/plaque stages may show annular, round, oval, or arcuate plaques, which can migrate, expand, and ulcerate * evolves through several stages including mycosis fungoides, patch, plaque and tumor * late stage: Sezary - ENTIRE body is warm, inflamed, exfoliative

What does this person have? How do you know? What are some of the features of the disease? What is more progressed form of this disease?

Characterize this type of drug rash. What is it normally caused by?

Urticarial - **Wheal-like** or **hive-like pink edematous patches and plaques**, which coalesce and migrates; intensely pruritic **- antibodies** are usually the common cause; usually occurs after 2weeks after first dose

Characterize this type of drug rash. What is it normally caused by?

Morbiliform - pink to red, oval shaped macules that begin on the trunk and expand centrifugally to the extremities (often spares the face); “**measle-like” pattern** - usually few days to 2 weeks after starting a drug (**usually antibiotics**)

Characterize this type of rash. What is it usually caused by?

Morbiliform - pink to red, oval shaped macules that begin on the trunk and expand centrifugally to the extremities (often spares the face); **“measle-like” pattern** - usually few days to 2 weeks after starting a drug **(usually antibiotics)**

Characterize this type of rash. What is it usually caused by?

Fixed Drug Eruption - round **red-purple asymptomatic** **patch**, that may eventually erode or desquamate and even blister, but **does not generalize.** - common locations include the **fingers, hands and genitalia**, especially the glans penis - the **eruption occurs in the same location** every time - **aspirin, ibuprofen, tetracyclines and sulfa drugs** are common culprits.

Characterize this type of rash. What is it usually caused by?

Photo-Toxic Drug Eruption (Drug-induced photosensitivity) development of rashes as a result of the **combined effects of a chemical drug and light**; usually in _sun-exposed areas_

Characterize this type of rash. What is it usually caused by?

Photo-Toxic Drug Eruption (Drug-induced photosensitivity) development of rashes as a result of the **combined effects of a chemical drug and light**; usually in _sun-exposed areas_

Characterize this type of rash. What are the 2 major forms and how are they different? What is it caused by?

Erythema Multiforme Minor * “**targetoid**” **macules** on the **palms and soles**; may generalize * minor - limited to **skin** * major - **skin and mucous membrane** involvement * infections (HSV or Mycoplasma pneumonae) * drugs (Sulfa, ß-lactam, phenytoin

Characterize this type of rash. What are the 2 major forms and how are they different? What is it usually caused by?

Erythema Multiforme **Minor** * “**targetoid**” **macules** on the **palms and soles**; may generalize * minor - limited to **skin** * major - **skin and mucous membrane** involvement * infections (HSV or Mycoplasma pneumonae) * drugs (Sulfa, ß-lactam, phenytoin

Characterize this type of rash. What are the 2 major forms and how are they different? What is it caused by?

Erythema Multiforme **Major** * “**targetoid**” **macules** on the **palms and soles**; may generalize * minor - limited to **skin** * major - **skin and mucous membrane** involvement * infections (HSV or Mycoplasma pneumonae) * drugs (Sulfa, ß-lactam, phenytoin

Characterize this type of rash. What are the 2 major forms and how are they different? What is it caused by?

Erythema Multiforme Minor and Major * “**targetoid**” **macules** on the **palms and soles**; may generalize * minor - limited to **skin** * major - **skin and mucous membrane** involvement * infections (HSV or Mycoplasma pneumonae) * drugs (Sulfa, ß-lactam, phenytoin

Characterize this type of rash. What are the 2 major forms and how are they different? What is it usually caused by?

Stevens Johnson Syndrome * more severe form of erythema multiforme - that includes fever, bulla, and necrosis * high mortality rate * erythema multiforme * "**targetoid**” **macules** on the **palms and soles**; may generalize * minor - limited to **skin** * major - **skin and mucous membrane** involvement * infections (HSV or Mycoplasma pneumonae) * drugs (Sulfa, ß-lactam, phenytoin, many others)

Characterize this type of rash. What else does it affect?

**Toxic Epidermal Necroysis** * more severe form of Stevens Johnson, with \>30% of the body surface involved * initially resembles a morbilliform eruption or erythema multiforme like reaction, with mild mucosal involvement but **rapidly** evolves into * **generalized** **erythroderma** * **full-thickness epidermal necrosis and skin sloughing**; with or without significant mucosal involvement * **inflammation of many internal organs**: liver, lungs, gastrointestinal, renal, lymph nodes, joints.

Characterize this type of rash. What else does it affect?

**Toxic Epidermal Necroysis** * more severe form of Stevens Johnson, with \>30% of the body surface involved * initially resembles a morbilliform eruption or erythema multiforme like reaction, with mild mucosal involvement but **rapidly** evolves into * **generalized erythroderma** * full-thickness epidermal **necrosis and skin sloughing**; with or without significant mucosal involvement * **inflammation of internal organs**: liver, lungs, gastrointestinal, renal, lymph nodes, joints.

Characterize this type of rash. What else does it affect?

**Toxic Epidermal Necroysis** * more severe form of Stevens Johnson, with \>30% of the body surface involved * initially resembles a morbilliform eruption or erythema multiforme like reaction, with mild mucosal involvement but rapidly evolves into * generalized erythroderma * full-thickness epidermal necrosis and skin sloughing; with or without significant mucosal involvement * inflammation of many internal organs: liver, lungs, gastrointestinal, renal, lymph nodes, joints.

2/24 6 topics in 60 min Flashcards

(63 cards)