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Dermatology > All pictures together for ID > Flashcards

All pictures together for ID Flashcards

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1
Q

What disease is this

A

Cellulitis
Caused by Group A strep
Treat with Diclox 500mg (bacterial) PO
Systemic symptoms

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2
Q

What disease is this

A

Erysipelas
Caused by Strep A pyrogens
Treat with Amoxicillin 300mg PO
IF Staph, treat with azithro or IV abx
Systemic symptoms

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3
Q

What disease is this

A

Impetigo- Bullous- honey colored crust
weakness, fever, diarrhea in young kids. Warm temperatures cause it
Treat with Mupirocin (Ointment)
Bullous caused by strep

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4
Q

What disease is this

A

Impetigo- non bullous- Honey colored crust, caused by staph
Treat with Muprocin

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5
Q

What disease is this

A

Follliculitis
Staph aureus most common cause from shaving, etc
Pseudomonas aerginosa (hot tub folliculitis) common
TENDER and ITCHY, NO systemic Sx

Treatment:
Treat with Mupirocin (IF staph), if Pseudomonas, treat with Ciprofloxacin PO

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6
Q

What disease is this

A

Condyloma acuminatum
HPV- genital warts
100 types of HPV

Diagnosis: Viral culture to confirm and PCR

Treat with Topical imiquimod or Liquid nitrogen therapy

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7
Q

What disease is this

A

HSV type 1
Single or grouped vesicular lesions

Labs: Cell culture, tzanck smear, antibody detection, PCR

Treatment: Acyclovir, Valcyclovir (IV acyclovir needed for encephalitis)

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8
Q

What disease is this

A

HSV type 2
Papules>vesicles> pustules, may have fever, headache, malaise
Fluid filled vesicles, shallow

Diagnosis:
Cell culture, Tzanck smear, antibody detection, PCR

Treatment: Acyclovir, valcyclovir (IV acyclovir if encephalitis)

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9
Q

What disease is this

A

Molluscum contagiosum
Asymptomatic, firm, umbilicated, pearly papules
painful
MolluscUM=UMbillicated

Diagnosis:
Viral culture
Histologic culture shows Henderson-paterson bodies

Treatment:
Self resolving in 6-9 months, curettage to remove infectious central core
Topical cantharidin

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10
Q

What disease is this

A

Varicella-zoster (Chickenpox)
Caused by stress, radiation, contact, infection
VERY sick, widespread vesicles, cough

Diagnosis: Viral culture, PCR, Tzanck smear

Treatment: Acyclovir PO, Valacyclovir
Gabapentin for pain

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11
Q

What disease is this

A

Vericella Zoster (Shingles)
Can be dormant in spine for years after chickenpox infection
VERY painful, acute pain along dermatome, Hutchison’s Sign: Vesicle tip of side of nose (Trigeminal nerve- EMERGENCY)
Ramsay Hunt- Facial nerve palsey

Diagnosis: Viral Culture, PCR, Tzanck smear

Treatment:
Acyclovir, Valacyclovir, Gabapentin for Pain
NO oral steroids Work

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12
Q

What disease is this

A

Viral Exanthem, 5th disease (Erythema infectiosum)
Red facial rash with lacy, pink, macular rash on torso and extremities
Usually young kids, caused by PARVOVIRUS 19
Spread by Respiratory transmission

Clinical presentation:
Can cause Aplastic crisis, Arthritis in adults

LABS:
Clinical findings, IgM antibodies for Parvovirus, CBC, Culture
Treatment:
Antipyretics, analgesics, hydration

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13
Q

What disease is this

A

Coxsackievirus A16 infection (Hand foot and mouth disease)
Painful oral ulcers, low grade fever, grey-red vesicles, Erosion, 1 week recovery

Labs:
Clinical diagnosis, Viral culture for IgA (Coxsackievirus) CBC

Treatment:
Magic Mouthwash, hydration

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14
Q

What disease is this

A

Measles
Koplik’s Spots(FIRST before rash)- Grey-White papules on buccal mucosae
3 C’s: Cough, Coryza, Conjunctavitis
Erythmatous rash that goes from head to toes

Diagnosis:
PCR, Measle’s Virus IgM antibodies, CBC

Treatment: Vitamin A, Magic Mouthwash, Hydration

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15
Q

What disease is this

A

Tinea Capitis (fungus)
Trichophyton tonsurans causes 90% of cases
Spread from person to person
Ranges from mild puritis to Kerions, alopecia, scales, posterior cervical lymphadenopathy

Diagnosis:
KOH, Wood’s Lamp (can be -), Lab Culture

Treatment: Griseofulvin PO for 4-6 weeks.
CMP for Liver Fx before giving Antifungals
Ketoconazole shampoo

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16
Q

What disease is this

A

Tinea Corporis (ringworm)
Infection of trunk and limbs
Trichophyton rubrum
Bulls eye center, red scaly papule, annular plaque, demarcated border

Diagnosis: KOH exam (Branched septate hyphae, spores)
Cultures from border of lesion
DTM cultures- 2 weeks
Skin Biopsy (PAS- periodic acid schiff- hyphae in skin)

Treatment:
Terbinafine, miconazole

Oral antifungals

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17
Q

What disease is this

A

Tinea Cruris
Jock Itch
Annular, hyperpigmented patches or plaques, sharpley demarcated, raised border
Diagnosis: Fungal cultures
Treatment: Topical antifungals (first-line), Avoid Tight-fitting clothing

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18
Q

What disease is this

A

Tinea Pedis
Interdigital toe web infections
Superficial fungal infection
Itching and scaling of feet, moccasin style pattern

Diagnosis:
KOH (branched septate hyphae, segmented hyphae)
DTM( Fungal fulture)
PAS (Hyphae)
Biopsy (confirm Dx)

Treatment: Terbinafine (topical)

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19
Q

What disease is this

A

Tinea Unguium (onychomycosis) (yeast infection)
Candida albicans
Most commonly on big toe

Diagnosis: KOH
Cultures
Biopsy

Treatment: Fluconazole

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20
Q

What disease is this

A

Tinea Versicolor
Yeast infection
Surfer’s spots
Spaghetti and meatballs
White scaley powder on skin

Diagnosis:
Wood lamp- Green-yellow flourescence
KOH shows spaghetti and meatballs
Cultures
Treatment:
Ketoconazole lotion, or pigmentation resolves with sun exposure

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21
Q

What Disease is this

A

Candidiasis
Yeast infection
Diaper rash, budding leash, satellite lesions
Angular cheilitis
Plaques with scalling, purietic

Diagnosis:
KOH shows budding yeast

Traetment: Nystatin, ketoconazole

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22
Q

What Disease is this

A

Candidiasis
Yeast infection
Diaper rash, budding leash, satellite lesions
Angular cheilitis
Plaques with scalling, purietic

Diagnosis:
KOH shows budding yeast

Traetment: Nystatin, ketoconazole

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23
Q

What Disease is this

A

Photosensitivity reaction
Exogenous photodermatoses- reaction by photosensitizer
Can be drug induced (NSAIDS, hydrochlorathiazide, antifungals)

LABS:
CBC, ANA (if its autoimmune), Urine test for polyphyrins

Treatment: Sun protection, treat underlying disorder

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24
Q

What Disease is this

A

Acne Vulgaris
Papules and pustules, comedones on forehead

Diagnosis: History and clinical findings

Treatment:
Benzoyl peroxide, retanoids- Trentanoin

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25
What Disease is this
Acne Vulgaris Moderate with comedones, papules and pustules Treatment: Benzoyl peroxide, doxycycline, YAZ (estrogen and peresterone)
26
What Disease is this
Acne Vulgaris Severe (Nodular and cystic acne) Treatment: Oral contraceptives (YAZ), Isotrentin (For severe)
27
What Disease is this
Rosacea Chronic inflammatory disorder Vasomotor instability Triggers: Alcohol, hot or cold weather, hot drinks, hot baths, sun exposure Treatment: Avoid Triggers Topical Antibiotics Oral antibiotics (tetracycline if BAD)
28
What Disease is this
Phymatous roscea Rhinophyma with nodules Treatment: Oral antibiotics (tetracycline) Topical antibiotics (Clindamycin)
29
What Disease is this
erythematotelangiectatic rosacea Chronic inflammatory disorder Vasomotor instability Triggers: Alcohol, hot or cold weather, hot drinks, hot baths, sun exposure Treatment: Avoid Triggers Topical Antibiotics Oral antibiotics (tetracycline if BAD)
30
What Disease is this?
Perioral Dermatitis Not on lips Rash and acne like Diagnosis: history and clinical findings, skin biopsy in atypical cases Treatment: Topical calcineurin inhibitors, Cyclosporin gel Give Doxycycline daily for 6 weeks orally
31
What Disease is this?
Hidradenitis suppurativa Chronic inflammatory skin condiiton from hair follicle obstruction Tombstone and rope like scarring Diagnosis: Recurrent abscesses and lesions, typical distribution and presence, Diffuse connections Treatment: Weight loss, topical medications, loose fitting clothing, Retinoids
32
What Disease is this?
Dishydrotic eczema Recurrent puritic rash on hands and palms Triggers: Sweating, emotional stress, humid weather Sudden onset of the development of puritic vesicles Labs: KOH Patch testing to ensure no allergy Treatment: Wet dressings (Burrow solution) to dry dressings Alternate steroids (medium-High with wet dressings) Resolves on own, but leaves BROWN spots
33
What Disease is this?
Atopic Dermatitis Pruretic inflammation of dermis via epidermal barrier Dry skin, plaques ATOPIC triad: Allergy, Atopic Dermatitis, Allergic Rhinitis Diagnosis: IgE increased Swab and culture CBC Treatment: Avoid triggers Diphenhydramine Aquaphor Topical Steroids Dicloxacillin (oral)
34
What Disease is this?
Contact Dermatitis Scales, plaques, Exposure to irratant Burning and itching after exposure Linear lesions Labs: CBC, Culture/Swab, Scraping to rule out anything else Treatment: Remove Irratant Topical Steroids Cool compresses/oatmeal baths Oral staroids if SEVERE
35
What Disease is this
Seborrheic keratosis Common, Benigh, epidermal lesions Around 50 years of age Labs: Shave or punch biopsy Treatment: Cryosurgery Cautery and curettage
36
Sign of Leser-Trelat is associated with what disorder
internal malignancy Sudden apperance of SKs
37
What is this
Dysplastic nevi
38
What is this
Spitz Nevi
39
What is this
Lipoma Very common, non cancerous tumor made of fat cells Slow growing, symptomless
40
What is this
Lipomas and epithelial inclusion cysts
41
What is this
Pilinodal disease
42
What is this
Cherry angioma
43
What is this
Spider Angioma
44
What is this
Actinic keratosis Diagnosis: Based on clinical findings and biopsy results Treatment: Follow up with skin exam (complete skin exam) Single lesions- treated with cryotherapy Multiple lesions- Treated with 5-flouracil to decrease lesions, imiquimod
45
What disease is this
Squamous cell carcinoma Diagnosis: Excisional or Punch biopsy Treatment: Surgical Excision, MOHS surgery
46
What disease is this
Squamous cell carcinoma Diagnosis: Excisional or Punch biopsy Treatment: Surgical Excision, MOHS surgery
47
What disease is this
Keratoacanthoma
48
What is this
Melanoma Diagnosis: Excisional biopsy Treatment: Excision of the lesion with margins MOHS surgery Keytruda (immunotherapy)
49
What is this
Melanoma
50
How do you measure thickness of the tumor
Breslow score
51
What is this
Kaposi's sarcoma Associated with HIV Diagnosis: Biopsy: angiogenesis, inflammation, and proliferation (whorls of spindle-shaped cells with leukocytic infiltration and neovascularization), and immunohistologic staining. Treatment: HIV-associated KS: antiretroviral therapy. Intralesional chemo (vinblastine) Extensive disease: radiation If biopsy is +, must get HIV test. Radiation therapy, excision, cryotherapy, laser ablation, intralesional, topical therapy, chemotherapy.
52
What is this
Mycosis Fungioides Also called cutaneous T cell Lymphoma Localized or generalized erythematous scaly patches or plaques, on trunk Severe pruritus w/ follicular involvement and hair loss Local or diffuse lymph node enlargement Plaques >5cm Diagnostics: Skin biopsy CBC w Sezary count Treatment: Stage 1-2: Radiation Topical chemotherapy
53
What is this disease, and describe diagnosis/treatment
Nummular eczema/dermatitis Diagnosis: History and clinical Biopsy/culture to rule out KOH to rule out fungus Treatment: Hydrated petrolium/aquaphor, topical steroids
54
What is this disease, and describe diagnosis/treatment
Lichen Simplex chronicus Skin thickening from chronic skin scratching Thick and scaly, well demarcated Dx: KOH, History and clinical, culture to rule out something else Treatment: Stop rubbing and scratching, occlusive dressings at night over high potency topical steroids or low potency on face
55
What is this disease, and describe diagnosis/treatment
Stasis dermatitis Edema and hyperpigmentation Labs: History and clinical findings, Viral to rule out other cause, KOH to rule out fungus Treatment Elevation and compression, Cool water dressings for inflammation, oral antihistamines for puritis
56
What is this disease, and describe diagnosis/treatment
Seborrheic dermatitis Inflammatory papulosquamous disease Sebaceous glands make hypersensativity reaction Pink, red patches with areas with sebaceous glands (or scalp itching, dandruff) Cradle cap Yellow, greasy adherance scales Treatment: Dandruff shampoos (selenium sulfide or zinc pyrithione) 1% hydrocortisone decreases itching and redness Topical antifungals (ketoconazole)-- mild to moderate
57
What is this disease, and describe diagnosis/treatment
Alopecia areata Nonscarring immune mediated hair loss Diagnosis: Clinical diagnosis, biopsy can be performed when diagnosis is uncertain. Punch biopsy- definitive, peritubular lymphocytic inflammatory infiltraties sourrounding follicles Treatment: Intralesional corticosteroids (topical corticosteroids) JAK inhibitors (Bactrin)
58
What is this disease, and describe diagnosis/treatment
Onchomycosis Labs: KOH and fungal culture PCR PAS (periodic acid schiff test) Check LFTs before perscribing antifungals Treatment: Management if KOH or PAS are positive Systemic antifungals- oral terbinafine, fluconazole
59
What is this disease, and describe diagnosis/treatment
Paronychia Acute infection of the nail folds Staph infection Labs: Bacterial culture to determine cause CBC to make sure not systemic Treatment: Warm water with antiseptic soaks, Bactrin and mupirocin Moderate: Oral abx MRSA risk: TMP-SMX I&D for treatment if severe
60
What is this disease, and describe diagnosis/treatment
SLE- can look like anything (Butterfly rash, maculopapular, annular polycyclic lesions, ring-shaped) Labs: DIF- positive for lupus CBC, ANA (autoimmune antibody) CRP RFTs Treatment: Topical steroid Antimalarials (Hydrochloroquine, methotrexate Refer to rheum
61
What is this disease, and describe diagnosis/treatment
Dermatomyositis, Autoimmune, attacks skin, muscles, joints, lungs Photodistributed on face Sholder weakness, joint weakness, systemic symptoms of muscle weakness Labs: CBC, CMP, Skin biopsy (Shows increased mucosin), muscle biopsy Possible malignancy before or after diagnosis PSA, PAP to rule out malignancy Treatment: Systemic steroids, Methotrexate, JAK inhibitors, IvIG Refer to rheum
62
What is this disease, and describe diagnosis/treatment
Vasculitis- Caused by medication, infection, environment, malignancy. Elderly women May Itch or burn, or have no symptoms Jaw Claudication, vision changes LABS: CMP, CBC, UA (blood) DIF skin biopsy Treatment: Resolves over 1 week with RICE and NSAIDS, dapsone
63
What is this disease, and describe diagnosis/treatment
Acanthosis Nigricans Linked to insulin resistance (obesity, PCOS, diabetes) Brown, velvety patches and plaques on axilla, groin, back of neck Puritis common LABS: Biopsy, Fasting glucose, HgA1C Treatment: Manage underlying disease Retinoids (trentonin)
64
What is this disease, and describe diagnosis/treatment
Xanthelasma caused by high cholesterol, age, bad diet, Yellow deposits around eyes LABS: Increased cholestorol Treamtent: Lipid control, cosmetic removal, recurrence is common
65
What is this disease, and describe diagnosis/treatment
Dermatitis herpitiformis Autoimmune (gluten sensitive, celiac) Intense puritis papules, vesicles, on extensor surfaces LABS: Blood test, biopsy Treatment: Stop gluten ingestion
66
A patient has Spider angiomas, talengiectasia on palms, Terry's nails, and porphyria. What condition is this likely to be?
Liver disease and the associated symptoms
67
What dermatologic symptoms are associated with liver disease
Terry's nails, porphyria (sores on hands), spider angiomas and telangiectasia on palms
68
What dermatologic symptoms are associated with lung disease
Sarcoidosis (granulomatous disease) Lupus pernio (large blue/red and dusky purple nodules, plaque-like lesions on nose, cheeks, ears, fingers, toes. Purple-red or borwn plaques, or circular lesions Thickening of old scars (sarcoidosis) Erythema nodosum (Bumps on shins, plaques of red-purple or brown, thickened, circular skin lesions) LABS: Biopsy shows granuloma on organs and lungs Treatment: Biopsy of skin, corticosteroids, Methotrexate, tetracycline
69
What is this disease, and describe diagnosis/treatment
Lung disease/ granulomatous disease Also has erythema nordosum Etiology: 20-40, black women and men, maculopapular eruptions, subcutaneous nodules, sarcoid plaques and papules LABS: Biopsy shows granuloma on organs and lungs Treatment: Tetracycline, NSAIDS, self limited NO DOSE No cause Oral contraceptives/ Pregnancy Drugs (Sulfa, NSAIDs) Other infections (strep, TB, histoplasmosis) Sarcoidosis Enteropathies (IBD– Crohns’s, Ulcerative colitis) ^ or NODOSUM
70
What is this disease, and describe diagnosis/treatment
RMSF (Rocky moutnain spotted fever) Tick borne (Rickettsia rickettsii (attached for 24 hours) Spring/Summer, North/South America Rash: Ankles, limbs, and trunk rash, Start as macules, then become papules, petechiae, and ecchymotic Labs: Antibody test (Serology) Indirect flourescence Ab test 10-14 days after Treatment: Doxycycline, Chloramphenicol
71
What is this disease, and describe diagnosis/treatment
Chancroid STI Caused by Haemophilius ducreyi PAINFUL LABS: Swab for everything (syphillis) PCR test Treatment: Azithromycin, cipro
72
What is this disease, and describe diagnosis/treatment
Lyme disease Deer tick (Borrelia burgdorfi) Fever, Malaise, aches Erythema migrans skin lesion Targetoid lesion (LARGE, takes up all of trunk) Labs: Antibody test (Serology) Indirect flourescence Ab test 10-14 days after Treatment: Doxycycline, chloramphenicol
73
What is this disease, and describe diagnosis/treatment
Chancre lesion Caused by syphilis infection PAINLESS BUT comes back over time (1-10 years) and causes damage to brain, nerves, eyes, heart Labs: PCR test Treatment: Benzathine penicillin G
74
What is this disease, and describe diagnosis/treatment
Granuloma Inguinale caused by Klebsiella granulomatis STI PAINLESS Bad smelling LABS: Examine fluid from sore STI swab Viral culture Treatment: Oral antibiotics 3 weeks or more, TMP-SMX, Azithromycin, IM or IV abx
75
What is this disease, and describe diagnosis/treatment
Lymphogranuloma venerum STI caused by chlamydia trachomatis Symptoms begin 3 days after infection SYSTEMIC symptoms ( fever, lymph nodes swollen, skin broken down, forms sinus tract) LABS: Blood test NAATS (nucleic acid amplicication) from sores Treatment ABX 3 weeks, Doxycycline, Erythromycin, Tetracycline
76
What is this disease, and describe diagnosis/treatment
Psoriasis Inflammatory papulosquamous disease Abnormal T cells that are joined in skin, nails, joints, can be above ears or near hair Silvery-white plaques that bleed when removed (Auspitz sign) Nail pitting (90%) Strep bacteria associated with guttate psoriasis 30% of psoriasis patients develop psoriatic arthritis Labs: History and clinical findings, Punch biopsy if warrented to show acanthosis ( thickening of skin) Treatment: Topical (TAR) Phototherapy (UVB light) Systemic: Methotrexate, cyclosporin steroids over thick plaques with occlusion
77
What phenomenon is this
Koebner phenomenon Injury or irritation to skin induces psoriasis
78
What is this disease, and describe diagnosis/treatment
Lichen sclerosis Acute or chronic inflammatory mucocutaneous, papulosquamous dermatitis (skin, nails, mucous membranes) Biopsy shows atrophic, hypopigmented skin that is thinned White patches, fine cigarette paper Labs: Biopsy (shows hypopigmented skin that is thinned) Treatment: High potency steroids (Clobestasol) Increases chance of SCC Can be mistaken for abuse in children because of itching
79
What is this disease, and describe diagnosis/treatment
Purigo nodularis Puritic chronic dermatitis (result of scratch-itch cycle) LABS: Biopsy- shows increased nerve fibers in dermis, neural hyperplasia Treatment: High potency steroids with occlusion Azathioprine, Gabapentin for pain
80
What is this disease, and describe diagnosis/treatment
Purigo nodularis Puritic chronic dermatitis (result of scratch-itch cycle) LABS: Biopsy- shows increased nerve fibers in dermis, neural hyperplasia Treatment: High potency steroids with occlusion Azathioprine, Gabapentin for pain
81
What is this disease, and describe diagnosis/treatment
Purigo nodularis Puritic chronic dermatitis (result of scratch-itch cycle) LABS: Biopsy- shows increased nerve fibers in dermis, neural hyperplasia Treatment: High potency steroids with occlusion Azathioprine, Gabapentin for pain
82
What is this disease, and describe diagnosis/treatment
Pityriasis rosea Pink, oval plaques, with scales Onset related to URI within 1 month Herald patch- FIRST- Largest- Appears first on trunk, christmas tree pattern LABS: History and clinical findings, rule out syphillis Treatment: Self-limited, Topical steroids if purietic
83
What is this disease, and describe diagnosis/treatment
Lichen Planus Inflammatory papular squamous disorder Middle age adults ITCHY lesions, planar, purple, plaques, Wikhams striae (white lines with magnificatoin) Treatment: Antihistamines for itching, Topical steroids Systemic retinoids (spironalactone)
84
What is this disease, and describe diagnosis/treatment
Urticaria (HIVES) Allergy to drugs (penicillin, ASA, radiographic dye), Foods Anaphylaxis in minutes (IgE) Swelling of lips, trouble breathing LABS:CBC- High eosinophils RAST testing Treatment: Antihistamines, H1 blockers (loratidine), H2 blockers (ranitidine) Steroids (oral)
85
What is this
Angioedema
86
What is this
Angioedema
87
What is this disease, and describe diagnosis/treatment
Vitiligo Autosomal recessive Type A- symmetric pattern Type B- Segmental (one area of the body) LABS: Wood's lamp (hypopigmentation, bright blue/white light) Biopsy: Abscence of melanocytes and pigment Check TSH, CBC, CMP Treatment: Mild to low potency topical steroids Calcineurin inhibitors (tacrolimus)
88
What is this disease, and describe diagnosis/treatment
Post inflammatory hyperpigmentation Acne can cause it after inflammation or lazer treatments Risk factor: darker skin types, areas resolving erythema multiforme Treatment: SPF, Hydroquinone (bleaching agent) Azelaic acid
89
What is this disease, and describe diagnosis/treatment
Brown pigmentation on face, macular, brown, hyperpigmentation caused by sun exposure, oral contraceptives, pregnancy Treatment: Fades after pregnancy, hydroquinone or azelaic acid (skin lighteners)
90
What is this
Merkel Cell carcinoma Diagnosis: Excisional biopsy Treatment: Surgery Lymph node drainage Excision of leson and sourrounding lymph nodes Spreads VERY quickly, so biopsy LNs
91
What is this
Mycosis Fungoides (T cell lymphoma) Diagnosis: Skin biopsy, CBC shows eosinophilia and malignant T cells Treatment: UV radiation, chemotherapy (topical)
92
What disease is this
Drug eruption Single or multiple round, demarcated, red plaques with GREY center Itches and burns Systemic fever and rash, hives Diagnosis: Ask about history/drugs currently on Usually spares face Treatment: Stop medications, antihistamines, cooling lotions
93
What is this disease
Urticaria **Wheeles SUPER itchy ASA, PCN, BP meds, Radiographic dye causes Type 1 Reaction-- Anaphylaxis (IgE mediated) Diagnosis: CBC- high eosinophils RAST testing Treatment: Antihistamines, cooling lotions
94
What disease is this
Seborrheic Keratoses Diagnosis: Sign of lesser trelalt- apperance of many of them at the same time Biopsy if ANY question about melanoma Treatment: Benign, no treatment needed. But, cryotherapy if desired for visual apperance
95
What Disorder is this
Vitiligo Diagnosis: Wood's lamp (depigmented, bright white and blue apperance) Biopsy: absence of melanocytes Treatment: Low potency topical corticosteroids Tacrolimus (calcineurin)
96
What disease is this?
Linchen Planus 6 P's Planus Puiruitic Planar Plaques Purple Polygonal Diagnosis: history and clinical findings (ideopathic, inflammatory condition) Treatment: Antihistamines for itching, steroids for local disease
97
What disease is this? Diagnosis and treatment?
Erythroderma/ Exfoliation Inflammatory disease 30% idiopathic >90% of body erythema Can occur because of psoriasis Males>females Diagnosis: DIF/Biopsy- autoimmune CBC Treatment: LIFE THREATENING Maintain fluid and temperature, wet to dry dressing, antibiotics, treat underlying disease, antihistamines IVs if loss of fluids Keep warm (loss of body temp due to widespread erythema)
98
What is this? Diagnosis? Treatment?
DRESS syndrome Clinical triad: High fever, extensive skin rash, organ involvement Develops over many days and weeks Have Fever Mibiliform rash Erythroderma or exfoliative Facial swelling Diagnosis: CBC, LFTs WBC, LFTs, Fever, Skin rash Lymphatenopathy usually Eosinophilia Hepatomegaly (FEEL LIVER ON PE) Treatment: Stop medication, supportive care, corticosteroids, antibiotics. IvIG 8% mortality rate
99
What is this? Diagnosis Labs? Treatment?
Erythema Multiforme Target lesions HSV Commonly caused by URI, mycoplasma pneumona Dusty center of lesion Diagnosis: Biopsy or direct IF studies Negative Niklosky's sign (no epidermal detatchment) Often febrile Palms, soles, arms, legs Treatment: Remove offending drugs Topical steroids, oral antihistamines, analgesics, skin care
100
What disease is this?
Erythema Multiforme TARGETOID on palms and soles HSV causes it
101
What is the most common reaction in a patient who has HSV?
Erythema multiforme
102
If you suspect a patient has erythema multiforme that is caused by Herpes, what test do you run to see if they have had it recently?
Run a Titer test for HSV
103
What disease is this? What labs do you order? Treatment?
SJS/TEN Also in mouth and mucosae surfaces Diagnosis: Blood culture and blister Biopsy (shows full tissue necrosis) CBC, CMP Treatment: Supportive therapy, airway management Treat like severe burns (pain control, withdrawal medications, electrolytes)
104
What disease is this? What labs diagnose it? Treatment?
SJS/TEN Also in mouth and mucosae surfaces Diagnosis: Blood culture and blister Biopsy (shows full tissue necrosis) CBC, CMP Treatment: Supportive therapy, airway management Treat like severe burns (pain control, withdrawal medications, electrolytes)
105
Erythroderma is caused by which diseases
HIV, Eczema, Psoriasis
106
The most common virus that causes erythema multiforme is
HSV
107
Most common cause of SJS in kids
Infection
108
Lesions in SJS and EM are described as
Targetoid
109
What disease is this? What labs do you order to diagnose it? Treatment?
Bullous pemphigoid ITCHY, TENSE Blisters Caused by sulfa drugs, penacillin, or IgG caused Erythema or purietic papules that form plaques, on skin folds and flexural areas Plaques turn dark red after 1-3 weeks, vesicles and bullae appear rapidly Bullae are tense and rupture in around 1 week Labs: DIF+, IIF+, Skin biopsy shows subepidermal bullae with infiltration of eosinophils Treatment: Oral/topical steroids, immunosuppressive drugs, minocycline
110
Itchy tense blisters vs flaccid, painful blisters
Itchy and tense= bullous pemphigoid Flaccid and Painful= pemphigus vulgaris
111
What disease is this? What labs do you order to diagnose it? Treatment?
Pemphigus vulgaris IgG autoimmune disorder Flaccid, easily ruptured, erosions, mucosal involvement, head, upper trunk, +Niolsky's sign Armpits are involved Diagnosis: Skin biopsy shows Intraepidermal bulla +DIF, +IIF Treatment: Eroded areas covered with petrolatum and dressings Fatal if untreated-- send to burn unit or ICU Rituximab to treat, IVIG
112
What is the deepest skin structure involved in a superficial burn
Epidermis first degree burn
113
What is the deepest skin structure involved in a superficial partial thickness
upper dermis 2nd degree
114
What is the deepest skin structure involved in a deep partial thickness burn
lower dermis 2nd degree
115
What is the deepest skin structure involved in a full thickness burn
3rd degree subcutaneous structures
116
What classification of burn is this
first degree, superficial, epidermis involvement
117
What classification of burn is this
Epidermis and superficial dermis Blistered Very painful Minimal scarring
118
What classification of burn is this
Deep partial thickness burn Epidermis and deep dermis Blistered dermis is pale or white Scarring No pain, 3 weeks -2 months to heal May need surgery or graft
119
What classification of burn is this
Partial/full thickness Treat with sterile, clean gauze, pain control (opioids), burn center for sure
120
What procedure is done in full thickness burns to increase blood flow
escherotomy (cut skin so it doesn't restrict blood flow)
121
Most common causes of chemical burns
Cement Concrete Lime-fertilizer TAR (roofing and asphalt) Brush off dry chemicals Irrigate with water use proper PE

Dermatology (6 decks)

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