Derm Flashcards Preview

STEP 2 CK > Derm > Flashcards

Flashcards in Derm Deck (83):
1

erythema, telangiectasias, papules, and pustules with redness, affecting face. Can involve increased vascularity in the eye. Rhinophyma in men (thickened and greasy skin on the nose).

Roseacea

2

How do you reduce roseacea sx?

avoid alcohol, hot beverages, extreme temperatures, and emotional stressors

3

Treatment of roseacea?

topical metronidazole, systemic abx for maintenance (tetracycline)

4

Q image thumb

Roseacea

5

Epithelial tumors that look like Squamous Cell Carcinoma.  They grow very very quickly.  Dome with central crater containing keratinous material grows over the course of several weeks

Keratoacathoma:  Tx: observation.  Will likely regress spontaneously

6

Q image thumb

Keratoacanthoma

7

Well demarcated lesions that are either hyper or hypopigmented and range in color from vrown to tan to white.  Mostly on the trunk.  From several species of malazie group. Part of normal skin flora.

Tinea Versicolor

8

What group does tinea versicolor affect?

Adolescents and young adults

9

What contributes to tinea versicolor?

Hot/humid weather, excessive sweating, and skin oils help it transform from normal skin to this.

10

How do you diagnose and treat tinea versicolor?

Dx: KOH prep (spaghetti and meatballs appearance) hyphae and yeast balls

Tx:  Oral or topical antifungals. Selenium sulfide lotion can help

11

Q image thumb

Tinea Versicolor

12

chronic, idiopathic inflammatory skin disorder in infants and adults.  Seen in oily skin. Seen on scalp, hairline, behind ears, and skin folds.  Scaly patches with moderate erythema. Can be mild and look like dandruff, or severe and be yellow oily flakes 

Sevorrheic Dermatitis (cradle cap)

13

Sebhorric Dermatitis treatment

Sunlight, dandruff shampoo, topical ketoconazole, topical steroids

14

Q image thumb

Seborrheic Dermatitis

15

Delayed type IV hypersensitivity reaction?

Contact Dermatitis

16

skin is sensitized  1 to 2 weeks after first exposure.  Will develop rash subsequently after the next exposure.

allergic contact dermatitis

17

contact dermatitis treatment

Topcial corticosteroids or oral steroids

18

Papulosquamous eruption - Initially "Herald Patches", taht resemble a ring worm (lots of oval/ round patches appear).  Then a rash with multiple ovals appears.  "Christmas Tree Appearance"

Pityriasis Rosea.  commonly remits after 6-8 weeks with no treatment.

19

Q image thumb

Pityriasis Rosea

20

Q image thumb

Erythema Nodosum

21

Painful, red, subcutaneous, elevated nodules on the front of the tibia. Self limited and resolves in a few weeks.

Erythema Nodosum.  Caused by a lot of stuff so get a thorough workup - (strep, sarcoid, TB, syphilis, etc.)  and treat the underlying condition.

22

Q image thumb

Erythema Multiform

23

erythematous macules/papules that resemble target lesions.  Can become bullous. Prurtic and painful. 

Erythema Multiform

24

Erythema multiform is caused by what?

Drugs (pcn, or sulfa (MC)) or idiopathic, or HSV

25

SJS vs TEN

  <10% = SJS     >30% = TEN

26

Involves the mucus membranes. Sloughs off respiratory epithelium and may lead to respiratory failure.  Nikolsky -  But very very bad. 

SJS

27

Tx of SJS

IVIG.  steroids don't cut it

28

SJS and Nikolsky +

TEN (Toxic Epidermal Necrosis)

29

Tx of TEN

IVIG, don't try steroid.  They don't work.

30

Q image thumb

SJS

31

Q image thumb

TEN

32

Half of all SJS and TEN cases are due to?

Medications

33

Pruritic, Polygonal, Purple, flat topped Papules

Lichen Planus tx with steroids

34

Q image thumb

Lichen Planus

35

Subepthelial blisters.  Dont rupture easily. Auto immune

Bullous Pemphigoid

36

Q image thumb

Bullous Pemphigoid

37

AI blistering condition with loss of normal adhesion between cells  (acantholysis). Starts in mouth.  Blisters can rupture and are painful.  Fatal if untreated

Pemphigus Vulgaris

38

Pemphigus Vulgaris

39

How do you treat pemphigus vulgaris?

Steroids, and make sure there's no cancer like non hodgkin lymphoma or CLL

40

HPV 6 and 11

Chondyloma Acumulata

41

Caused by pox virus and seen in sexually active young adults and in some kids

Molluscum Contagiosum (highly contagious).  Extensive lesions seen if HIV positive

42

Q image thumb

Molluscum Contagiosum

43

Small papules with central umbilication and relatively asymptomatic. Kids or sexually active young adults.  Consider HIV infection.

Molluscum Contagiosum

44

Molluscum Contagiosum

45

Superficial Fungi that infect cutaneous epithelium, nails, and hair

Dermatophytes

46

Name the 3 dermatophytes

Trichophyton, Microsporum, and Epidermophyton

47

Examples of dermatophyte infections? and treatments?

Tinea corporis, Tinea capitis, Tinea unguium (nails), Tinea Pedis, Tinea cruris.  Topical antifungals (use oral for capitis)

48

Q image thumb

Dermatophyte (ring worm)

49

Human skin mite. Mites lay eggs in skin and then you develop type IV hypersensitivy to them

Scabies

50

Scabies tx?

Permethrin cream (everywhere head to toe), Lindane (gama benze lotion, don't give to kids), Treat everyone (Scorch the Earth!)

51

Severe pururtis, linear marks with dark dot at one end, excoritaitons from scratching, and eczematous plaques, crusted papules.  May develop secondary bacterial infection.

Scabies

52

Scabies Dx

characteristic linear marks/ burrows, examine scraping under microscope for mites, ova, or scybala

53

Q image thumb

Scabies

54

Small, rough, scaly lesions due to prolonged and repeated sun exposure.  May be horn like. Precursur to SCC

Actinic Keratosis

55

Q image thumb

Actinic Keratosis

56

MC skin cancer

Basal Cell

57

Pearly, smooth papule with rolled edges and surface telangiectasias

Basal Cell

58

Q image thumb

Basal Cell

59

Q image thumb

Squamous Cell

60

Crusting, ulcerated nodule or erosion

Squamous Cell 

61

Numerous atypical moles with indistinct borders and variations in color.  

Dysplastic Nevus Syndrome

62

If dsyplastic nevus syndrome and family history of melanoma, what's the risk for melanoma?

100%

63

Q image thumb

Dysplastic Nevus Syndrome

64

Most important indicator of prognosis with melanoma?

depth of invasion

65

Can melanoma lesions itch and bleed?

yes

66

How do you diagnose melanoma?

excisional biopsy.  Disect lymph nodes if they are involved

67

Q image thumb

Melanoma

68

Q image thumb

Decubitus Ulcer

69

abnormal proliferation of skin cells. Trauma to skin can cause exacerbations.  Associated with psoriatic arthritis

Psoriasis

70

Well demarcated, erythematous papules or plaques that are covered by a thick silvery scaling on extensor surfaces of body

Psoriasis

71

How do you treat psoriasis?

Topical: Steroids, Calcipotriene and Calcitrol (vit D derivatives)

Oral: Systemic - immune modulating (methotrexate etc), 

72

Q image thumb

Psoriasis

73

AD - Hereditary, not malignant.  Stuck on skin.

Seborrheic Keratosis

74

Q image thumb

Seborrheic Keratosis

75

chronic depigmenting condition

Vitiligo

76

What is vitiligo associated with?

DM, hypothyroidism, pernicious anemia, and Addison

77

Q image thumb

Vitiligo

78

caused by release of mediators from mast cells.  Increase in vascular permeability. Will see edematous wheals (hives) that dissapear within hours.  They blanch under pressure.

Urticaria (hives)

79

Caused by ACE inhibitors.  Affects eyelids, lips, tongue, genetalia, hands, or feet.  Localized edema causing puffy look. Can be life threatening if obstructs airway.  

Angioedema

80

Q image thumb

Angiodedema

81

How do you treat angioedema?

Give eopinephrine for laryngeal edeam or bronchospasm and stop offending agent.

82

Q image thumb

Chondyloma Accumulata  -  HPV 6 and 11

83

Q image thumb

Pemphigus Vulgaris