Derm Flashcards by Michael May

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

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How do you reduce roseacea sx?

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

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Treatment of roseacea?

topical metronidazole, systemic abx for maintenance (tetracycline)

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Roseacea

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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

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Keratoacanthoma

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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

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What group does tinea versicolor affect?

Adolescents and young adults

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What contributes to tinea versicolor?

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

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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

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Tinea Versicolor

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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)

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Sebhorric Dermatitis treatment

Sunlight, dandruff shampoo, topical ketoconazole, topical steroids

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Seborrheic Dermatitis

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Delayed type IV hypersensitivity reaction?

Contact Dermatitis

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

allergic contact dermatitis

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contact dermatitis treatment

Topcial corticosteroids or oral steroids

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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.

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Pityriasis Rosea

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Erythema Nodosum

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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.

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Erythema Multiform

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

Erythema Multiform

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Erythema multiform is caused by what?

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

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SJS vs TEN

\<10% = SJS \>30% = TEN

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

SJS

Tx of SJS

IVIG. steroids don't cut it

SJS and Nikolsky +

TEN (Toxic Epidermal Necrosis)

Tx of TEN

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

SJS

TEN

Half of all SJS and TEN cases are due to?

Medications

Pruritic, Polygonal, Purple, flat topped Papules

Lichen Planus tx with steroids

Lichen Planus

Subepthelial blisters. Dont rupture easily. Auto immune

Bullous Pemphigoid

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

How do you treat pemphigus vulgaris?

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

HPV 6 and 11

Chondyloma Acumulata

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

Molluscum Contagiosum

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

Molluscum Contagiosum

Superficial Fungi that infect cutaneous epithelium, nails, and hair

Dermatophytes

Name the 3 dermatophytes

Trichophyton, Microsporum, and Epidermophyton

Examples of dermatophyte infections? and treatments?

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

Dermatophyte (ring worm)

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

Scabies

Scabies tx?

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

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

Scabies

Scabies Dx

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

Scabies

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

Actinic Keratosis

MC skin cancer

Basal Cell

Pearly, smooth papule with rolled edges and surface telangiectasias

Basal Cell

Squamous Cell

Crusting, ulcerated nodule or erosion

Squamous Cell

Numerous atypical moles with indistinct borders and variations in color.

Dysplastic Nevus Syndrome

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

100%

Dysplastic Nevus Syndrome

Most important indicator of prognosis with melanoma?

depth of invasion

Can melanoma lesions itch and bleed?

yes

How do you diagnose melanoma?

excisional biopsy. Disect lymph nodes if they are involved

Melanoma

Decubitus Ulcer

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

Psoriasis

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

Psoriasis

How do you treat psoriasis?

Topical: Steroids, Calcipotriene and Calcitrol (vit D derivatives) Oral: Systemic - immune modulating (methotrexate etc),

Psoriasis

AD - Hereditary, not malignant. Stuck on skin.

Seborrheic Keratosis

chronic depigmenting condition

Vitiligo

What is vitiligo associated with?

DM, hypothyroidism, pernicious anemia, and Addison

Vitiligo

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)

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

Angiodedema

How do you treat angioedema?

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

Chondyloma Accumulata - HPV 6 and 11

Pemphigus Vulgaris

Derm Flashcards

(83 cards)