Derm Flashcards by E D

Papules and paulopustules. OPen and closed comedones.

Acne vulgaris

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Acne pathogenesis

Microcomedone

Comedone

Inflammatory papule/pustule

Nodule

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What must be present to Dx acne?

Comedones.

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Facial flushing, telangiectases, central face edema, burning, stinging; spares periorbital areas

Erythematotelangiectatic rosacea (ETR)

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Central face erythema with papules/pustules; edema of skin; less often burning, stinging; flushing less severe; spares periorbital areas

Papulopustular rosacea (PPR)

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Patulous follicular orifices, thickened skin, nodularities; and in men, phyma - rubbery thickening of skin nose, chin, forehead, eyelids, or ears

Phymatous rosacea

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Initial presentation in ~20%; more often occur after an above type; most often blepharitis; also conjunctivitis, iritis, scleritis, hypopyon, keratitis

Ocular rosacea

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Possible rosacea triggers

Hot or cold temperature, exercise, cosmetics

sunlight, spicy food, topical irritants

wind, alcohol, menopausal flushing

hot drinks, emotions, medications

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Rosacea stage 1

Persistent erythema with telangiectases

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Rosacea stage 2

Persistent erythema, telangiectases, papules, tiny pustules

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Rosacea stage 3

Persistent deep erythema, dense telangiectases, papules, pustules, nodules, rarely persistent “solid” edema of central face

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Chronic diseas of unknonw etiology. Very tender, red, inflamed nodules/abscesses. May contain double comedones.

Distributed to axilla, breast, groin.

Hidradenitis Suppurativa

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May occur minutes afte exposure. lesions range from erythema to vesiculation to necrosis.

Irritant contact dermatitis

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Delayed, cell-mediated hypersensitivity rxn

Allergic contact dermatitis

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Poorly defined erythematous patches with or without scales. Found on flexor surfaces. Usually begins in infancy.

Atopic dermatitis

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Solid plaque of lichenification, arising from a confluence of small papules. Excoriations are often present.

Lichen simplex chronicus

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Sudden onset of many deep-seeded, pruritic, clear, tapioca-like vesicles

Dyshidrosis

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Management for dyshidrosis

Burow wet dressings

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Chronic, pruritic, inflammatory dematitis in the form of coin-shpaed plaques composed of grouped small papules and vesicles on an erythematous base

Nummular eczema

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Common, chronic dermatitis characterized by redness and scaling and occuring where sebaceous glands are active

Seborrheic dermatitis

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T-cell mediated papulosquamous disease

Psoriasis

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Common areas for psoriasis breakouts

Extensor surfaces

sacrogluteal region

scalp

palms/soles

*Often bilateral and symmetric

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Three most common psoriasis subtypes

Chronic stable plaque psoriasis

Guttate psoriasis

Palmoplantar pustular psoriasis

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What do you call psoriasis that presents on the groin or genitals?

Inverse psoriasis

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What test should you perform if you suspect guttate psoriasis?

Throat culture (looking for strep)

Raindrop psoriasis

Guttate

Middle to older aged patient with history of mild chronic stable plaque psoriasis who gets a nasty URI and has sudden guttate flare. Prognosis?

Good prognosis for return to baseline after treatment with antibiotics

Young adult without prior history of psoriasis gets nasty URI and has sudden guttate flare Prognosis?

Guttate lesions often slow to improve with slow shift into chronic plaque psoriasis.

Velvity thickening anf hyperpigmentation related to heredity, obesity, endocrine disorders, drug administration, and maligancy

Acanthos Nigricans

Bullous automimmune disease usually seen in the elderly.

Bullous pemphigoid

Often the first location for bullous pemphigoid to appear

Lower legs

Oval, slightly raised plaques. Salmon-colored and often begins with a Heald patch

Pityriasis Rosea

This lesions is a: purple polygonal pruritic planar papule

Lichen planus

Comon rxn pattern of blood vessels in the dermis with secondary epidermal changes. Most cases related to HSV infection.

Erythema multiforme

Necrotic epidermis and sloughing covering \<10% BSA

Stevens-Johnson Syndrome

Epidermal necrosis and sloughing \>30% BSA

Toxic epidermal Necrolysis

Located in derma-epidermal junction Macules or may be slightly raised

Junctional nevus

Located in papillary dermis Raised lesions

Compound nevus

Epithelial lining of a hair follicle Assymptomatic May grow to max 3 cm Central pore Usually face, neck, upper trunk

Epidermoid cyst

Benign subcutaneous tumor- between skin and underlying muscle layer

Lipoma

Most common benign epithelial tumors. Warty plaque with a "stuck on" appearance

Seborrheic keratosis

What do you call the light brown lesion that typically surrounds a seborrheic keratosis?

Solar lentigo

Single/multiple dry rough areas on sun exposed parts of body May develop into Squamous Cell CA

Actinic Keratosis

Which of the following is precancerous? Solar lentigo Actinic keratosis

Actinic keratosis

sharply demarkated, scaling, or hyperkeratotic, macule or papule, or plaque. Pink or red. May have small erosions. Capable of metastasis.

Squamous cell carcinoma

Pearly nodule with telangiectasis. Caused by sun damage. This is the most common CA in the humans.

Basal cell carcinoma

Sometime present as Red firm nodules Sometimes scaly with a crust Sometimes they bleed Often appear like a sore that does not heal What is it?

Squamous cell carcinoma

Slightly raised pink patch, scaling Develops from keratinocytes of the skin and mucosal membranes Slow growing, develops into squamous cell carcinoma

Bowen's disease

This variant of SCC is a rapidly growing nodule with a central crater

Keratocanthoma

Name the four types of melanoma

Superficial spreading - Most common type Nodular Lentigo maligna Acral Lentiginous Melanoma

Precursors to melanoma

Dysplastic nevi Congenitalnevomelanocytic nevus

A-asymmetric B-border (irregular) C-color (viariegated) D-Diameter (\>6mm) E-evolution (this grows fast)

Superficical spreading melanoma

Uniformly flat macule with geographic shape

Lentigo maligna melanoma

Acral lentiginous melanoma

Totally white macules that enlarge and can affect all of the skin. Associated with autoimmune and/or endocrine disorders

Vitiligo

Macular hyperpigmentation, usually of the face. Often associated with pregnancy.

Melasma

Sharply defined, edematous wheals. Can be erytheamtous or blanched with an erythematous border. Can be localized or general.

Uritcaria

Butterfly rash Diffuse or patchy alopecia ulcers or necrotic lesions on oral mucosa

Systemic lupus erythematosus

Raynaud phenomenon Non-pitting edema of hands and feet Sclerodactyly Periorbital edema followed by fibrosis and loss of normal face lines Cutaneous calcification

Scleroderma

Subcutaneous inflammatory, bright red to bluish nodules that follow a course of involved arteries. Become confluent to create painful SubQ plaques.

Polyarteritis nodosa

Develop over bone prominences as a result of external compression, shearing, and friction.

Pressure ulcers

Nonblanching erythema of intact skin

Stage 1 pressure ulcer

Necrosis, superficial or partial thickness.

Stage 2 pressure ulcer

Deep necrosis, crateriform ulceration with full thickness skin loss.

Stage three pressure ulcer

Full thickness necrosis with involvement of of supporting structures like muscle or bone.

Stage four pressure ulcer

Multifocal systemic tumor or endothelial cell origin. Ecchymotic-like macules. Can evolve into pathces/papule/plaques/nodules/tumors that are violaceous, red, pink ,or tan.

Kaposi sarcoma

This can mimic virtually all the morphologic expressions in dermatology.

Drug eruptions

Cutaneous eruption that mimics a measle-like viral exanthem

Exanthematous drug rxn

Dermatophytic infection of the feet

Tinea pedis

Tinea manuum

Large, scaling, well demarcated, dull red/tan/brown plaques. Associated with tinea pedis, and tinea unguium.

Tinea cruris

Small to large scaling, sharply marginated plaques with or without pustules or vesicles, usually at the margins. Annular configuration.

Tinea corporis

Most common agent of tinea corporis

T. rubrum

Large, round, hyperkeratotic plaque of alopecia. Can last for weeks to months.

Tinea capitis

Confluent, beefy red psutules on erythematous base. Satelite lesions

Cutaneous candidiasis

Three types of cutaneous candidiasis

Intertrigio Ocluded skin Diaper dermatitis

White-to-creamy plaques on oral mucosa. Caused by C. albicans

Oral candidiasis

Intertrigio at the angles of the lips Erythema, slight erosion Sometimes white colonies

Angular cheilitis

Sharply demarcated macules. Light brown lesions on light-skin, hypopigmented on dark skin. Caused by Malassezia furfur

Pityriasis Versicolor

Pearly white or skin-colored papules or nodules. Round or oval and umbillicated. Occur in children and sexually active adults

Molluscum contagiosum

Course and prognosis of molluscum contagiosum

In healthy people, MC resolves spontaneously w/o scarring but may take up to 2 years. In immunocompromised patients MC can progress desite aggressive treatment. Can become disfiguring.

Firm, hyperkeratotic, vegitative papules. Caused by HPV.

Verruca valgaris

Flat wart

Verruca plana

Plantar wart

Verruca plantaris

Generalized cutaneous eruption associated with a primary systemic infection

Infectious exanthems

Course, prognosis, and management of infectious exanthems

Usually self-resolves in ~10 days. Tx is supportive

This infectious agent typically presents with grouped vesicles arising on an erythematous base on keratinized skin or mucous membranes

Herpes simplex virus

Wear gloves so you don't get a...

Herpetic whitlow

Vesicular lesions evident in successive crops. Papule or wheals quickly evolve into dewdrop vesicles. Vesicles quickly become umbilicated, evolve into papules and crust.

Varicella

Okay, you had chicken pox. Mom sent you to school so your friends would get chicken pox too. Now you have a painful herpetiform lesion following a dermatomal pattern and your cursing the bed sheet that hurts to drape over yourself. You have...

Herpes zoster.

Get the permethrin 1%.

Pediculosis capitis

Check the seams of your clothes. I think you have...

Pediculosis corporis

I don't want to be the one to have to tell you this, but you've got...

Pediculosis pubis.

Gray or skin-colored ridges, linear or wavy. Common in between your fingers. All because you shared a sleeping bag on that camping trip.

Scabies! You've got scabies!

Okay, so you've got scabies. No one's here to judge you. Let me give you an Rx for...

Permetherin 5%

This common STD is most commonly associated with HPV 6 and 11

Condyloma acuminatum

No apparent inflammation to the skin Non-scarring, hair follicle intact

Alopecia areata

Chronic dermatitis of proximal nail fold and and matrix. Loss of cuticle. Separation of nail plate from proximal nail fold.

Paronychia

Onychomycosis aka Tinea unguium

Small vesicles or erosions with honey-colored crusts. S. aureas.

Impetigo

Bacterial skin infection involving the upper dermis that characteristically extends into the superficial cutaneous lymphatics. It is a tender, intensely erythematous, indurated plaque with a sharply demarcated border. It has a well-defined margin.

Erysipelas

Progressive local necrosis Associated w/ fever, headache, malaise, arthralgia & N/V Initial bite may be painless but pain typically ↑ over the next 2-8 hrs and may become severe

Brown recluse

Generalized muscular pain/spasms & rigidity Target lesion +/- diaphoresis at affected site (20% of patients)

Black widow bite

Derm Flashcards

(103 cards)