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Flashcards in Derm Deck (75):
1

Condyloma acuminata

are soft, fleshy warts that are caused by the HPV. Cervical dysplasia and carcinoma in situ are likely caused by types 16, 18, 31, 33, and 34

2

erythematous, scaly, nontender nodule on his left lower lip. There are no surrounding telangiectasias. The nodule is firm, ill-defined, and fixed to the underlying tissue

Squamous cell carcinoma

3

If you push on a Hemangiomata if will?

blanch under pressure

4

___________ are precursors to squamous cell carcinoma

Actinic keratoses (AK)

5

difference between tinea capitis and alopecia areata

alopecia areata has round sharply demarcated patches of hair loss. Tinea Capitis is scaly and painful, less demarcated.

6

Secondary syphilis hair findings

moth eaten

7

What type of ulcer is associated with DM?

Neurotropic

8

Name the rule of 9s for burn victims

9(neck/head)9(upper anterior torso)9(lower posterior torso)9(lower anterior torso)9(upper anterior torso)9(each arm)9(anterior leg) 9(posterior leg) 1(genital)

9

bites from what spider can cause bites can lead to necrosis of the skin, destruction of red blood cells, blood clot formation, acute renal failure, coma, and death.

Brown recluse

10

2 most common bugs of cellulitis

strep A and staph A

11

Neonates: cellulitis most common bug

Group B Strep

12

US finding of cellulitis

cobblestone

13

Erysipelas

Superficial bacterial skin infection that involves lymphatics
● Classically on face, common on leg

14

most common bug of Erysipelas

strep progenies, treat for strep. raise border

15

Impetigo bugs

Staph aureus predominantly, also strep pyogenes

16

tx Impetigo

Mupirocin ointment
● Avoid scratching (can self inoculate)
● Oral abx: for more severe cases (dicloxacillin, cephalexin (MSSA), TMP/SMX, clindamycin (MRSA)

17

tx of acne

Tx: topical retinoids, benzoyl peroxide, oral abx (tetracyclines), OCPs (decreased
androgen levels), oral isotretinoin (teratogenic).

18

When on isotretinoin, MUST be on

OCPs simultaneously due to potential teratogenic effects.

19

tx for rosacea

Tx: avoid triggers (hot beverages, Ethanol, sunlight)
○ Hydrocortisone topical
○ Metronidazole topical

20

which one is worse and has oral lesions? Bullous pemphigoid or Pemphigus vulgarism


Pemphigus vulgarismtx

21

low down on Bullous pemphigoid

● Low mortality (“not so bad”)
● Elderly
● Negative Nikolsky sign
● Tense bullae
● Rarely oral lesions
● Treatment: stop offending drug, topical/oral steroids

22

name 3 disorder with positive Nikolsky sign

Pemphigus vulgaris, SSSS, Toxic epidermal necrolysis

23

tx of Pemphigus vulgaris

Treatment: treatment similar to burns, systemic steroids, immunomodulators

24

● High mortality (“bad”)
● Younger
● Positive Nikolsky sign
● Flaccid bullae
● Oral lesions

of Pemphigus vulgaris

25

Desquamation (AKA: skin sloughing) 3 disorders

Erythema multiforme “minor, Stevens-Johnson syndrome,
Toxic epidermal necrolysis.

26

Target lesions, Palms and soles, then moves centrally
● Causes: Herpes simplex and Mycoplasma pneumonia
ONLY ON SKIN

Erythema multiforme “minor

27

tx of Erythema multiforme “minor

acyclovir,

28

Severe immune-complex mediated hypersensitivity
● MUCOUS membranes
● Systemic symptoms

Stevens-Johnson syndrome

29

causes of Stevens-Johnson syndrome


o Antibiotics (PCN, Sulpha)
o Antiepileptics
o NSAIDs

30

Tx of steven johnson syndrome

● Treatment: remove cause, treat similar to burns

31


● Severe form of Stevens-Johnson syndrome
● Histology: dermal-epidermal cleavage
● >30% body surface area ( larger involvement than Steven john sons syndrome)
dermal cleavage (external vs.. internal layers of the skin

Toxic epidermal necrolysis

32

● Treatment of toxic epidermal necrolysis

Burns ICU, supportive, IV immunoglobulin

33

steven johnson of the eye

can go blind must see ophthalmologist (acute care)

34

Lichen simplex chronicus

Firm, thick plaques
● Secondary to pruritis
● Lichenification
● Treatment: topical steroids

35

Pityriasis rosea is from what herpes family

Human herpesvirus 7

36

Symptom progression: 1-Viral prodrome, 2-Herald patch, 3-“Christmas Tree”
● Round, oval salmon-colored maculopapular rash

Pityriasis rosea

37

raised scaly rashes: Papulosquamous diseases

Psoriasis, Pityriasis rosea, Psoriatic arthritis,Lichen planus,
Fixed drug eruption, Dermatophyte (fungal) infection & secondary syphilis

38

Distal IP polyarthritis
● Pitting of finger nails
● Pathology: HLA B27 positive (iritis, sacroiliitis, inflammatory bowel disease)
● Treatment:
o systemic steroids

Psoriatic arthritis

39

Pruritic
o Planar
o Purple
o Polygonal
o Papules (“violaceous papules”)

Lichen planus (this is immune related)
Wrist, ankles, legs and MOUTH (white linear line inside cheek)

40

Actinic keratosis or Seborrheic keratosis can cause CA?

ACTINIC KERATOSIS

41

horrible DIP joints and skin issues (pencil cup)

psoratic arthritis (give strong immunosuppressant drugs)

42

Seborrheic keratosis describe

flat warty brown

43

androgenic alopecia

male patterned baldness

44

Paronychia tx

I & D

45

treatment for lice

Primarily topical
o Permethrin (Elimite®, Nix®)
o Pyrethroids (A200®, RID®)
o Malathion (Ovide®)
o Lindane (Kwell®) ⇒ too toxic ⇒ seizure
● Oral Ivermectin - for severe cases

46

dx scabies

Light microscopy of skin scrapings
● CBC

47

tx for bed bugs

Treatment is supportive
○ Antipyretics, antibiotics if infection
● Eradication with insecticides
● New mattresses, etc

48

Africanized Bees
● “Killer” bees may result in?

May result in:
○ Hemolysis
○ Rhabdomyolysis
○ Acute renal failure

49

localized, Most common, Death rare because usually, pearly, rolled edges

BCC

50

Exanthems think

viral or drug rash

51

Primarily head, neck, and oral
● Actinic keratosis is a precancerous lesion that can precede this
● Clinically: scaling, crusting, telangiectasia, raised nodule or shallow ulcer, firm, slow
growing, may bleed

SCC

52

A:
B:
C:
D: how many mm
E:
of skin cancer

asymmetry
(irregular) borders
(variation in) coloration
diameter >6mm
evolution in lesions

53

Connective tissue tumor, predominantly in HIV and immunosuppressed
● HHV-8 causative
● Usually cutaneous but also in other organs
● Clinically: on skin it is purple-red-blue papules, painless, non-pruritic

Kaposi sarcoma

54

Common viral disease of the skin
● Poxvirus
● Discrete, flesh colored, waxy, dome shaped umbilicated papules

Molluscum contagiosum

55

Molluscum contagiosum tx

self limiting

56

Verrucae (bad HPV numbers)

warts 16,18

57

Vitiligo

Associated with autoimmune endocrine disease destruction of melanocytes

58

what are worse Alkali or acid burns

Alkali more severe than acid

59

urticara is _____ mediated by

IgE

60

stage I-IV pressure ulcers

Stage I: non-blanching erythema
Stage II: necrosis, superficial, partial thickness
Stage III: deep necrosis, crater ulcer with full thickness skin loss
Stage IV: FULL thickness

61

chloasma / Melasma

sun damage

62

Hidradenitis suppurativa

Disease of apocrine sweat glands

63

Tinea Versicolor / Pityriasis versicolor bug

Malassezia furfur

64

Tinea Versicolor tx

selenium sulfide shampoo

65

Dermatophyte tx

Itraconazole – careful with liver dz
o Terbinafine

66

Which of the following is the most common complication associated with Herpes Zoster infection?

Post-herpetic neuralgia

67

Where is Atopic Dermatitis usually found in infants and young children?

Antecubital and popliteal fossa

68

A 7 year old girl is brought to your clinic because for the last 5 days she has had a slight fever, sore throat, and abdominal pain. This morning, however, she developed a rash on her cheeks. Physical exam shows a brightly erythematous rash across both cheeks, and a lacy rash on both arms. Given this patient’s most likely diagnosis, what is the causative organisms?

This patient most likely has Erythema infectiosum, for which the most common causative agent is Parvovirus B19.

69

A 23 year old female with history of anxiety and depression presents to your office because of an itchy rash on her abdomen that she has had for years some evidence of excoriation, but no telangiectasias, or signs of infection. Which of the following is the most likely diagnosis

Lichenified plaques due to chronic scratching, especially in someone with a nervous habit (due to anxiety) leads to lichen simplex chronicus.

70

what is hydoxyzine

Hydroxyzine or another H1 receptor blocking agent is the treatment of choice in Urticaria. Other agents may be added if the patient is still having symptoms (corticosteroids, H2 receptor blockers, doxepin, etc)

71

What is the different between diagnosis of Hansen’s disease instead of vitiligo?

The loss of sensation at the areas of depigmentation should increase your suspicion of leprosy (Hansen’s disease).

72

What is the most common location affected by erysipelas?

the legs

73

A 63 year old man presents complaining of discoloration and scaling on the top of his head. Physical exam reveals a bald male with various erythematous papules and scaly plaques covering the majority of the scalp. Lesions are rough to palpation. Which of the following is the treatment of choice in this condition?

Topical 5-Fluorouracil cream would be the treatment of choice in this patient with Actinic Keratosis. Since his lesions are widespread over the scalp, cryotherapy or excision are unreasonable treatment options at this time.

74

What is the most common location affected by erysipelas?

legs

75

what is potassium hydroxide preparation?

KOH prep