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Flashcards in 2/24 Red Scaly Rashes Deck (31)
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1
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Psoriasis

genetic predisposition and environmental triggers, and associated with inflammatory diseases of other organs, including psoriatic arthritis, MI, HTN, hyperlipidemia and obesity.

Pink to red. Inflamed, well-demarcated plaques, with thick white scale “silvery” on extensor surfaces (sometimes on umbilicus, gluteal cleft, scalp)

Variants

  • Guttate or “raindrop-like” eruption,
  • Palmar Plantar Pustulosis
  • Erythrodermic
  • Pustular
  • Acrodermatitis (Continua of Hallopeau)

Unique Features: Inverse Nail pitting/nail dystrophies

2
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Psoriasis

genetic predisposition and environmental triggers, and associated with inflammatory diseases of other organs, including psoriatic arthritis, MI, HTN, hyperlipidemia and obesity.

Pink to red. Inflamed, well-demarcated plaques, with thick white scale “silvery” on extensor surfaces (sometimes on umbilicus, gluteal cleft, scalp)

Variants

  • Guttate or “raindrop-like” eruption,
  • Palmar Plantar Pustulosis
  • Erythrodermic
  • Pustular
  • Acrodermatitis (Continua of Hallopeau)

Unique Features: Inverse Nail pitting/nail dystrophies

3
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Pityriasis Rosea

papulosquamous disease related to a viral illness (HHV 6 and 7)

pink to salmon oval shaped patches with thin trailing central scales

sparsely scattered over the central trunk, rarely on the face

“Herald Patch” at onset

4
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Pityriasis Rosea

papulosquamous disease related to a viral illness (HHV 6 and 7)

pink to salmon oval shaped patches with thin trailing central scales

sparsely scattered over the central trunk, rarely on the face

“Herald Patch” at onset

5
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Syphilis

multi-organ infection caused by Treponema pallidum

1˚ chancre in genital mucosa
2˚ generalized round pink scaly patches, asymptomatic non-descript.

Evolves through 1˚, 2˚ and 3˚ stages; can be transmtited congenitally

6
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Syphilis

multi-organ infection caused by Treponema pallidum

1˚ chancre in genital mucosa
generalized round pink scaly patches, asymptomatic non-descript.

Evolves through 1˚, 2˚ and 3˚ stages; can be transmtited congenitally

7
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Lichen Planus

  • inflammatory papulosquamous disease of the skin, hair and nails
  • violaceous papules with lacy white lines and mild scale

Other Key features

  • Wickham’s striae (white lines within papules and plaques)
  • Linear confluent papules, development in areas of injury (Koebner phenomenon)
  • Erosions within mucosa
  • Pterygium (scar) formation of nails

Variants

  • Hypertrophic lichen planus, Genital involvement
  • Oral erosive lichen planus
  • Nail dystrophy,
  • Lichen planopilaris (hair follicle scarring process)
8
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Lichen Planus

  • inflammatory papulosquamous disease of the skin, hair and nails
  • violaceous papules with lacy white lines and mild scale

Other Key features

  • Wickham’s striae (white lines within papules and plaques)
  • Linear confluent papules, development in areas of injury (Koebner phenomenon)
  • Erosions within mucosa
  • Pterygium (scar) formation of nails

Variants

  • Hypertrophic lichen planus, Genital involvement
  • Oral erosive lichen planus
  • Nail dystrophy,
  • Lichen planopilaris (hair follicle scarring process)
9
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Lichen Planus

  • inflammatory papulosquamous disease of the skin, hair and nails
  • violaceous papules with lacy white lines and mild scale

Other Key features

  • Wickham’s striae (white lines within papules and plaques)
  • Linear confluent papules, development in areas of injury (Koebner phenomenon)
  • Erosions within mucosa
  • Pterygium (scar) formation of nails

Variants

  • Hypertrophic lichen planus, Genital involvement
  • Oral erosive lichen planus
  • Nail dystrophy,
  • Lichen planopilaris (hair follicle scarring process)
10
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What are some key features of it?

A

Tinea / Dermatophytosis

  • infection of the skin, hair and nails, with multiple species of fungi
  • Pink annular patches with an inflamed border and central clearing with trailing scale

KOH positive

Many variants, based on location; Capitis (head)

  • Faciei
  • Corporis
  • Manum (hand)
  • Crurus
  • Unguium
  • Pedis
11
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What are some key features of it?

A

Tinea / Dermatophytosis

  • infection of the skin, hair and nails, with multiple species of fungi
  • Pink annular patches with an inflamed border and central clearing with trailing scale

KOH positive

Many variants, based on location; Capitis (head)

  • Faciei
  • Corporis
  • Manum (hand)
  • Crurus
  • Unguium
  • Pedis
12
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What are some key features of it?

A

Tinea / Dermatophytosis

  • infection of the skin, hair and nails, with multiple species of fungi
  • Pink annular patches with an inflamed border and central clearing with trailing scale

KOH positive

Many variants, based on location; Capitis (head)

  • Faciei
  • Corporis
  • Manum (hand)
  • Crurus
  • Unguium
  • Pedis
13
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Granuloma Annulare

  • infiltrative granulomatous disease, unknown cause
  • Asymptomatic annular patches, central clearing, lacks scales
  • dorsal feet and hands, but can generalize

Features: KOH negative

14
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Granuloma Annulare

  • infiltrative granulomatous disease, unknown cause
  • Asymptomatic annular patches, central clearing, lacks scales
  • dorsal feet and hands, but can generalize

Features: KOH negative

15
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Granuloma Annulare

  • infiltrative granulomatous disease, unknown cause
  • Asymptomatic annular patches, central clearing, lacks scales
  • dorsal feet and hands, but can generalize

Features: KOH negative

16
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

How is it diagnosed?

A

Mycosis Fungoides (CTCL)

  • malignant infiltrative disease of the skin
  • red to violaceous patches, linear to oval and annular, with mild elevation and scale

Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.

Various stages:

  • plaques
  • nodules
  • ulcerative lesions,
  • erythrodermic systemic variant (Sézary’s Syndrome)
17
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

How is it diagnosed?

A

Mycosis Fungoides (CTCL)

  • malignant infiltrative disease of the skin
  • red to violaceous patches, linear to oval and annular, with mild elevation and scale

Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.

Various stages:

  • plaques
  • nodules
  • ulcerative lesions,
  • erythrodermic systemic variant (Sézary’s Syndrome)
18
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

How is it diagnosed?

A

Mycosis Fungoides (CTCL) - Sezary CTCL

  • malignant infiltrative disease of the skin
  • red to violaceous patches, linear to oval and annular, with mild elevation and scale

Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.

Various stages:

  • plaques
  • nodules
  • ulcerative lesions,
  • erythrodermic systemic variant (Sézary’s Syndrome)
19
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Tinea Versicolor

superficial dermatophyte (fungal) infection caused by Malassezia furfur

Pink to orange to hyperpigmented oval and annular patches on the central chest and back, with thin, superficial KOH positive scale.

Color variation from light, pink, yellow-orange, and brown; depends on the pigmentation and sunlight exposure of the host

Usually in the “oily” areas of the upper chest and mid back

20
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Tinea Versicolor

superficial dermatophyte (fungal) infection caused by Malassezia furfur

Pink to orange to hyperpigmented oval and annular patches on the central chest and back, with thin, superficial KOH positive scale.

Color variation from light, pink, yellow-orange, and brown; depends on the pigmentation and sunlight exposure of the host

Usually in the “oily” areas of the upper chest and mid back

21
Q

What does this person have?

What stage is it in particular?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Cutaneous Lupus - ACUTE

Immunologic and inflammatory skin disease, may be related to systemic lupus

Acute: Inflamed tender red skin, malar area of face and sun-exposed skin

Subacute: Annular and arcuate patches, may coalesce, upper chest and back

Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar

22
Q

What does this person have?

What stage is it in particular?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Cutaneous Lupus - SUBACUTE

Immunologic and inflammatory skin disease, may be related to systemic lupus

Acute: Inflamed tender red skin, malar area of face and sun-exposed skin

Subacute: Annular and arcuate patches, may coalesce, upper chest and back

Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar

23
Q

What does this person have?

What stage is it in particular?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Cutaneous Lupus - CHRONIC

Immunologic and inflammatory skin disease, may be related to systemic lupus

Acute: Inflamed tender red skin, malar area of face and sun-exposed skin

Subacute: Annular and arcuate patches, may coalesce, upper chest and back

Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar

24
Q

What does this person have?

How do you know?

A

drug interactions to medications

Urticarial: small to large wheals which migrate form arcuate shapes and coalesce

25
Q

What does this person have?

How do you know?

A

Drug rash

Morbilliform: measle-like distribution of pink to red round patches

26
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

A

Erythema Multiforme

temporal relationship with medication administration

Red to pink “targetoid” macules on the palms and soles (specific, not always diagnostic)

Major variant: skin + mucosal erosions; can progress to internal organs

Minor: skin only

27
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What does it mean if this person had multiple ECM lesions?

A

Erythema Chronica Migrans

infection with Borrelia burgdorferi

Bright red, blanchable, expanding macule to patch, with some central clearing and central blue hue

warm to touch, but usually asymptomatic

Multiple ECM lesions, which implies long-standing and/or systemic infection

28
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What is it usually coinfected with?

A

Eczema

common inflammatory process; may be

  • *- familial** (atopic dermatitis),
  • contact (poison ivy) - LINEAR distribution
  • irritant
  • *Pink, pruritic, scaly patches and thin plaques**
  • *poorly demarcated**, diffusely spread and characteristically on the flexor surfaces.

Variants

  • Atopic Dermatitis
  • Eczematous Dermatitis
  • Contact Dermatitis
  • Irritant Dermatitis
  • Dyshidrotic

Frequency co-infected with Staph aureus

29
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What is it usually coinfected with?

A

Scabies

infection and infestation with Sarcoptes scabiei var. hominis mites

Pink pruritic papules, some scale and linear vesicles and burrows, often in the skin folds especially the finger web spaces.

Key features

  • Close contacts are almost always infected
  • Genital infection may be sexually transmitted in adults
  • Fails to respond to oral steroids

Variants

Nodular
Crusted (Norwegian)
Genital
2˚ infection with S. aureus involvement of the palms and soles in infants

30
Q

What does this person have?

How do you know?

What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)

What is it usually coinfected with?

A

Scabies

infection and infestation with Sarcoptes scabiei var. hominis mites

Pink pruritic papules, some scale and linear vesicles and burrows, often in the skin folds especially the finger web spaces.

Key features

  • Close contacts are almost always infected
  • Genital infection may be sexually transmitted in adults
  • Fails to respond to oral steroids

Variants

Nodular
Crusted (Norwegian)
Genital
2˚ infection with S. aureus involvement of the palms and soles in infants

31
Q

testing

A

testing