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D2 Flashcards

1
Q

Clinical manifestation of keratoacanthoma?

A

Rapidly growing nodule with ulceration and keratin plug
Often show spontaneous regression and resolution
Common in fair skin individual
Commonly involve UV exposure and trauma site

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2
Q

Clinical significance?

A

may resemble or progress to SSC

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3
Q

managment?

A

Excisional biopsy with complete mass removal

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4
Q

SCC-Ca risk?

A

UV light
Chronic skin ulcer
Scared/inflamed skin
If occur secondary to burn wound called Marjolein ulcer
radiotherapy and osteomyelitis site are also risk

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5
Q

visual assessment of a pigmented lesion for melanoma?

A 
AbCDE(>=1-2 from below)
Asymmetry
Border irregularity
Color variation
Diameter > 6 mm
Evolving appearance over time
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6
Q

other criteria(7 point checklist and Ugley duckling sign)?

A

7PC
>=1 major and >=3 minor criteria
MjC: Change in shape, size, or color
MiC:>7 mm size, local inflammation, crusting/bleeding, and sensory symptom
UDS
One lesion significantly different from other

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7
Q

Most important prognostic factor in melanoma?

A

Breslow depth(Distance from granular layer to the tumor depth point)

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8
Q

Nodular malignant melanoma caracterstich?

A

Grow vertically
nodular lesion on a sun-exposed area
Deeply rpigmented,asymmetric & uniform color
ABCD criteria are not good for assessment
suspect in case of .>1 from the following (Ugley duckling sign, elevation from around tissue, firm palpation, and continuous growth)

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9
Q

Basal cell carcinoma risk factor?

A

Sun/Uv light
fair/light skin
Ionizing radiation
Arsenic poisoning

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10
Q

CM?

A 
Slowly growing
Locally invasive
Rare metastasis
Pink/flesh-colored
Pearly papule
Translucent
Central Telagectasis
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11
Q

Diagnosis?

A

Narrow margin 2-3 mm excisional biopsy

In the cosmetic area Mohs micrographic surgery

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12
Q

Sample taking in melanoma?

A

Excisional biopsy
2-3 mm from normal tissue
Full-thickness
But in the face and another important area, an incisional biopsy can considerd

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13
Q

Risk of Hidradinitis superlativa?

A 
Smoking
Obesity
DM
Family history
Mechanical stress
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14
Q

pathogenesis of Hidradenitis suppurativa?

A

Chronic inflammation of pilosebaceous unit-disable keratinocyte shedding from follicular epithilium

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15
Q

CM?

A

Involve intertriginous /hair area
Solitary, Inflamed, Painful nodule
Chronic relapsing and remitting course
Can become purulent and drain serosangious fluid

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16
Q

Complication?

A

Scaring
Sinus
Comedone

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17
Q

Risk factor for pressure ulcers other than immobilization?

A

Malnutrition
Dementia
Decrease skin perfusion
Decrease sensation

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18
Q

Indication for imaging in diabetic foot ulcers for osteomyelitis suspicion?

A 
Deep wound
> 14-day stay
>2 cm
increase CRP/ESR
associated adjacent ST involvement
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19
Q

Burn wound infection sign?

A 
Sign of sepsis
Progression of wound stage
Loss of graft tissue
Confusion
Decrease urine output
Thrombocytopenia
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20
Q

The pattern of infection etiology?

A

Usually multi bacterial
<5 days: G+Ve–S.Aureus
>5 days: G-Ve –Pseudomonas

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21
Q

What to do?

A

Quantitative wound culture

Biopsy(To determine depth)

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22
Q

managment?

A

Broad-spectrum(carpapenem)+
Vancomycin(MRSA)
Pseudomonas should be covered(Aminoglycoside)
wound care and debridement

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23
Q

more common in?

A

wound >20 %

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24
Q

CM of pyoderma gangrenusum?

A 
Begin with papule and pustule
Rapidly progressive
Painful ulcer  
purulent base
Vioulacious border
Pathergy(precipitation at site of trauma)
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25
Epidemiology of PG?
Common in age 40-60 and in women | Associated with: IBD.Other inflammatory Diseases (like RA) and malignancy
26
Diagnosis?
Is a diagnosis of exclusion | Biopsy: Neutrophilic infiltration
27
Management?
Topical/systemic corticosteroid | Surgical debridement should be avoided(pathergy)
28
CM of squamous carsinoma of skine?
Scaly nodule/plaque +-hyperkeratosis/ulceration Nurologic sign(if PN involvment) SCC in situ:Red,slowley growing patch/plaque. Involve below and lower Lip(At vermilion border)
29
Diagnosis?
Dysplastic/anaplastic keratinocyte with keratin pilare
30
Adverse prognosis sign?
Large size Deep involvemnt Regional LN involvment
31
Basal cell carcinoma fetcher in the biopsy?
Spindele cell surounded by pallaseding basal cell
32
Which skin cancer have ealy nural invasion?
SCC
33
Whay SCC have scaley lesion which blleed and ulcerate with peeling?
Due to high keratinization
34
Epidermal inclusion cyst pathogenesis?
Due to epidemis is loged ito dermis due to trauma, comedons or denovo Form mass filled with keratin and lipid with surounded by Squamous cell.
35
CM(Mass caracter)?
``` Dome shaped freley moving firm nodule/cyst central punctum affect fece,neck and thrunk ```
36
Prognosis ?
Usually reocur But can raptured and form chessy dischrge Inflamed and involve surounding tissue
37
managment?
Observation | Drain if inflamed and form cyst
38
Dermatofibroma CM?
``` Firm Hyperpigmented Usually involve LE Fibrous componenet Central dimpling ```
39
cause of angiosarcoma after brast ca treatment?
Radiation Lymphedema due to LN disection Lead to internal lining of LV/BV proliferation
40
Lesion caracter?
4-8 year after treatment echimotic or purpuritic papular lesion on breast,axilla and UE skin
41
Prognosis?
More agresive than primary angiosarcoma | Surgical resection is curative
42
Melanoma riisk factor?
``` >=2 familiy history Previous history Fair skin prior atypical nevi numerous>100 nevi sever burn history ```
43
Pressure ulcer managment?
Superficial:Moist dressing Deep:Complex dressing and debridement
44
superficial BCC feucher?
redish pach,irritated area which can bleed
45
erythema multiformis pathogenesis?
``` T cell mediated rxn caused by Infection like HSV,M.Pnumonia Drug like sulfonamide Malignancy Collagen vascular disease ```
46
lesion caracter?
``` Involve all area exept genitalia Papular central dusky ring of pale lesion pheripherial erythema Involve mucosa if sever ```
47
managment?
``` resolve by itself Symptomatic therapy(topical CS or antihistamin) ```
48
Porphyria cutanea tarda CM?
``` affect sun exposed area bullea blister scaring and calcification Hypo/Hyperpigmentation Associated abdominal pai and nurophychiatric menifestation ```
49
Risk factor?
``` HIV HCV Exesive alcohol Estrogen Smoking ```
50
Diagnostic testing?
Elevated urine/plasma porphyrine Elevated TA Iron overload
51
Pathogenesis?
Urophyriphirogen decarboxylase deficiency---phyriphirogen accumulate iin skine--photosensetivity rxn
52
managment?
Phelebotomy hydroxychloroquine HCV Tx
53
Skine disease associated with HIV?
Recurent herpes zoster Sudden onset sever psoriasis Dissiminated molluscum contagiousum
54
Psoriasis CM?
``` involve extensor surface,scalp an sacrum plaque erythematous scaly autipitiz sign ```
55
Extra skine menifestation?
``` Psoriatic artheritis Naile change(pitting) Eye inflamation(conjectivitis and uvietus) ```
56
Pricipitating factor?
Trauma(kohebner phenomina) withdrawal of GC drug(antimaleria,endometacine & propranolol) Infection(HIV,streeptococal pharengitis)
57
CM of vitiligo?
Hypopigmented Pach afect Acral, extensor surface and face
58
Clinical course?
In majority progress 10-20 repigmentation associated autoimmune disease(MCC: Hashimoto and graves)
59
Treatment?
Minor: topical GC Major: Oral GC/Topical calcineurin inhibitor and PUVA
60
Pathogenesis?
Autoimmune melanocyte destruction
61
Tinea cruris and candidia interigo D/C in lesion?
CI: Moist and macerated TC: Dry and scaly similar to Tinea corporis
62
TC CM?
spares scrotum caused by trichophyton rubrum moisture and sweating increase the risk
63
Managment?
Mild:Topical azole Resistant: oral azoles keep perineum clean and dry Treat another site Tinea infection
64
nummular eczema CM?
``` Circular scaly fissure pruritic intermittent exudation(yellowish discharge) Mostly affect extremity ```
65
pathogenesis?
Dry skin(poor lipid content)--Chronic inflammation
66
Risk factor for dermatophyte infection?
Environmental factor | Patient factor
67
Environmental factor?
Warm, Humid environment Direct contact with infected fomite, person, and public shower autoinoculation(from another site tinea infection) IC(HIV, DM, and GC therapy)
68
Common drug associated with photosensitivity?
AB:Tetracycline(doxycycline) APS:Chlopromazine,prochlopromazine Diuretics:Furosamide and HCT other:amidadrone,prometazine and piroxicam
69
Pathogenesis?
Drug metabolite reacts with UV---ROS--damage DNA and cell membrane
70
lesion type?
Similar to sunburn(direct DNA damage) but more painful and redder.
71
what about photoallergic rxn?
Due to hypersensitivity RXn to systemic or topical(sunscreen) medication Eczematous lesion
72
Liches planus clinical finding?
``` 5P papular/plaque Pruritic purple/pink polygonal lacy, White network line(Wickham stria)--mucosa flexural area(knee, wrist) ```
73
disease-associated?
HCV | Thiazide and ACE
74
natural history?
Chronic Associated with trauma site(Kobbner phenomena) resolve within 2 year
75
treatment?
Mild: Topical CS Disseminated: systemic GC /phototherapy

dermatology (4 decks)

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