Derm Flashcards
(119 cards)
1
Q
Macules
A
< 1 cm; circumscribed and flat
2
Q
Patch
A
flat, >1 cm
3
Q
Papules
A
raised, < 1cm
4
Q
nodules
A
papules > 1 cm, in dermis or subcutatneous area
5
Q
Plaques
A
well defined elevated confluence of papules > 1cm
6
Q
Vesicles
A
circumscribed, fluid containing epidermal elevations < 1 cm
7
Q
Bulla
A
vesicle > 1 cm
8
Q
Pustules
A
circumscribed, small elevations with purulent exudate
9
Q
Wheals
A
plateau-like edematous elevations, pink or red
10
Q
Scale
A
dry or greasy flakes of stratum corneum
11
Q
Crust
A
dried serum, blood or pus with debris on skin surface
12
Q
Excoriation
A
shallow, hemorrhagic linear excavation
13
Q
Erosions
A
loss of all or portions of epidermis from physical abrasions, vesicles, or bullae
14
Q
Ulcer
A
rounded or irregular shaped excavations into dermis or deeper
15
Q
Fissure
A
linear deep skin split through epidermis or into dermis
16
Q
lichenification
A
thickened skin with accentuated skin markings
17
Q
atrophy
A
decreased skin thickness
18
Q
Congenital Melanocytic Nevi (CMN)
A
macules, papules or plaque AT BIRTH, +/- hair, lesions grow in proportion to individuals size
19
Q
CMN Risk of malignancy
A
increased size of CMN = increased risk of malignant potential; risk of melanoma
20
Q
Most common pigmented lesion in infants
A
Mongolian spot
21
Q
Mongolian Spot other name
A
Congenital dermal melanocytosis (CDM)
22
Q
Mongolian spot
A
bluish-grey patch with irregular border and normal texture
23
Q
Mongolian spot dx
A
clinical; further work up if FTT or not meeting developmental milestones
24
Q
Mongolian spot prognosis
A
fades by age 2 and disappears by age 10
25
may be mistaken for abuse
CDM (mongolian spot)
26
Nevus sebaceous
hyperplasia of epidermis, sebaceous glands, hair follicles, apocrine glands
27
Nevus sebaceous clinical presentation
usually on scalp or face; waxy solitary, smooth, yellow-orange hairless patch, often oval or linear; more pronounced in adolescence (bumpy, warty or scaly)
28
Goes away with age
Mongolian spot
29
Grows with age
CMN
30
More pronounced in adolescence
Nevus Sebaceous
31
nevus sebaceous dx
some may need histological evaluation; BCC or other malignancy may arise from lesions
32
Nevus sebaceous tx
f/u, refer to derm if concerning changes are observed
33
Malignant potential
CMN, Nevus Sebaceous
34
Aplasia Cutis Congenita (ACC)
absence of skin present at birth
35
ACC presentation
most commonly found midline posterior scalp (may have tuft of hair = neural tube defect), may be associated fluid-filled bulla, well demarcated
36
ACC tx
gentle cleaning and ointment, hypertrophic scar may develop, refer to neuro for surgical repair if large or multiple scalp lesions
37
ACC imaging
done if atypical/large or hair tuft
38
Cafe-au-lait Macultes (CALM)
uniformly pigmented macules/patches; most common in african americans; present at birth OR in early childhood
39
CALM lesions are associated with what conditions
McCune-Albright syndrome or NF1
40
Neurofibromatosis
autosomal dominant (50% new mutations)
41
Sx of NF1
cafe-au-lait, axillary or inguinal freckling, neurofibromas, lisch nodules, optil gliomas, skeletal abnormlaities
42
Kids with NFI need what
yearly ophthalmology exams starting at 1 year
43
Types of vascular anomalies
1. Tumors: neoplasms proliferate and typically require tx to stop growth
2. Malformations: abnormal blood vessels without rapid proliferation (static/slow growing)
44
Vascular Tumors
infantile hemangioma, congenital hemangioma, pyogenic granuloma
45
Vascular malformations
capillary malformations (CM), port-wine stain, nevus simplex
46
Port-Wine Stain (PWS)
cutaneous capillary malformation; present at birth and DOES NOT REGRESS; pink/dark red patch (may darken/thicken)
47
PWS associated with
soft tissue or bony overgrowth, Sturge Weber Syndrome in V1 distribution (congenital glaucoma concerns if patch affects eyelid)
48
Sturge Weber Syndrome
PWS in V1 distribution; concern for congenital glaucoma
49
PWS tx
No tx needed; Pulse dye laser, widespread/extremity overgrowth = refer to vascular specialist
50
Pulse dye laser
tx for PWS; causes intravascular coagulation in abnormal vasculature without damaging surrounding structures (do early before it progresses)
51
Most common benign vascular tumor
Infantile hemangiomas
52
Risk factors for infantile hemangiomas
LBW, female, twin gestation and fair-skin
53
Clinical presentation of infantile hemangiomas
NOT PRESENT AT BIRTH but appear shortly after, can be superficial (bright red and minimally elevated), deep (large with bluish color) or mixed; ulceration is common complication
54
Infantile hemangiomas stages
Proliferative:
1. Early- rapid growth during first 3 months of age (max: 5--7 weeks)
2. Late- less rapid but still ongoing; completed @ 9 mo
Involution: Color darkens and tumors softens, ultimate residual skin changes vary
55
Completed growth of infantile hemangioma
9 mo
56
Max growth period of infantile hemangioma
5-7 weeks of age (grows rapidly first 3 mo)
57
Nevus simplex is also known as...
Salmon Patch
58
Nevus Simplex presentation
faint, TRANSIENT capillary malformation; flat, pink/red patch typically midline of forehead, scalp, upper eyelids, posterior neck and back
59
Most common pediatric vascular lesion
Nevus simplex (salmon patch)
60
NS on nape of neck
stork bite
61
NS on eyelid
angel's kiss
62
Time period for NS
fade within 1-2 years
63
Pyogenic Granuloma
acquired (not born with) lobular vascular tumor; occurs at any age and affects skin prone to traums (hands, fingers, face and mucous membrane); develop rapidly (days to months); FRIABLE, can recur despite treatment
64
Pyogenic granuloma tx
biopsy to confirm dx (surgical excision with primary closure, curettage or shave remove w/ electrodessication, pulsed dye laser); risk of recurrence is high; tx is traumatic (viscious cycle)
65
When to refer hemangiomas to emergent ENT
mandibular hemangioma with stridor or hoarseness; evaluate for airway compromise
66
Diaper dermatitis causes
irritant/contact; seborrheic dermatitis, atopic dermatitis or other underlying skin conditions
67
Diaper derm presentation
episodic with varying severity, persistnec = secondary infection with C. albicans, etc
68
Candidal superinfecton
beefy red plaques (involves skin folds); dx with KOH
69
impetigo
secondary infection of S. aureus or S. pyogenes; fragile pustules and honey crusted erosions
70
Honey crusted erosions
impetigo
71
Bacteria behind impetigo
S. aureus and s. pyogenes
72
Diaper dermatitis therapeutic options
EDUCATE; barrier cream (paste/ointment), low-potency topical steroid if severe or not resolving; breast-milk (anti-inflammatory and anitmicrobial); DON"T USE POWDERS
73
Tx for diaper derm candida infection
Topical antifungal
74
Tx for diaper derm bacterial superinfection (impetigo)
Mupirocin
75
Lice
Pediculus humanus capitis
76
Clinical presentation of lice
asymptomatic; itching if allergic to saliva, cervical LAD, febrile w/ secondary staph infection
77
Dx for Lice
visualize live lice (wet-combing); nits may persist for months and does not indicate active infection
78
Tx for lice
topical pediculicides (pyrethroids, malathion, benzyl alcohol, spinosad)- rinse in sink to avoid skin irritation; wet combing (mechanical removal) w/ conditioner, 15-60 minutes every 3-4 days for several weeks
79
Prophylactic tx for lice
only bedmates
80
Topical pedicullices
pyrethroid, malathion, benzyl alcohol, spinosad
81
Neonatal cephalic pustulosis (Neonatal acne)
not true acnes; inflammation due to Malassezia; self-limited; presents first 2-3 weeks and resolves by 6-12 months
82
Neonatal acne presentation
first 2-3 weeks
83
Neonatal acne resolution
by 6-12 months (usually by 4 months without scarring)
84
Not true acne
neonatal acne
85
Clinical presentation of neonatal acne
inflammed papules/pustules on forehead, nose and cheeks; no comedones
86
Tx for neonatal acne
self-limiting
Mild- cleanse w/ mild soap and water
persistent acne: ketoconazole or hydrocortisone to expedite clearance
87
Infantile Acne
hyperplasia of sebaceous glands; inflammatory papules, comedones, pustules
88
Presentation of infantile acne
3-4 months
89
Resolution of infantile acne
2-3 years
90
Tx for infantile acne
benzoyl peroxide, topical abx, topical retinoids; oral tx only in severe cases
91
"true acne"
infantile acne
92
"the itch that rashes"
atopic dermatitis
93
Atopic dermatitis presentation
infants: cheeks, trunk and extensor surfaces
Adults: neck, flexors, hands and feet
94
Tx for atopic derm
petroleum (vaseline) AAA 2x daily; topical steroids, topical calcineurin inhibitors (elidel, protopic), antihistamines
95
Cradle cap
seborrheic dermatitis
96
yellow, greasy adherent scales on vertex of scalp (may also effect diaper area and axilla)
cradle cap
97
herald patch
pityriasis rosea
98
Pityriasis rosea
benign, viral skin exanthem, mild pruritis, large salmon colored herald patch with colarrette scale followed by smaller lesions; christmas tree patern
99
Vitiligo
acquired skin depigmentation via autoimmune process against melocytes
100
Vitiligo presentation
milk-white macules with homogenous depigmentation and well-defined border, slowly progressive; tx with topical steroids
101
Measles (rubeola)
highly contagious; clinical stages: 1. incubation (2-3 weeks), asymptomatic
2. Prodrome (anorexia, malaise, fever >105
3. Enanthem (koplik spots- bluish white papules (48 hours prior to rahs)
4. exanthem: blanching, maculopapular rash starting on face and spreading head to toe (spares palms and soles)
102
Erythema infectiosum also known as...
Fifth's disease
103
Etiology of Erythema infectiosum
Parvovirus B-19
104
Erythema infectiosum presentation
Stages:
1. Incubation 7-14 days
2. Prodrome: flue like 2-3 days (mild fever, malaise, coryza)
3. Facial rash: slapped cheek
4. Body rash: 2-3 days after face rash/ lacy, pink macular rash of trunk and xtremitites
105
Lacy pink rash
Fifth's disease
106
Slapp Cheek
Fifth's disease
107
Hydrops fetalis
fifth's disease
108
Blueberry muffin
Congenital rubella syndrome (lethal)
109
Roseola Infantum
caused by HHV-6; peak 7-13 months; high fever, resolves, rash appears (blanchable, pink macules), starts on neck /trunk then spreads to face
110
Measles symptoms (prodrome)
3 C's: cough, coryza, conjunctivitis
111
Etiology of hand, foot, mouth
coxsackie A16 virus
112
Etiology of molluscum
Poxvirus
113
Clinical presentation of molluscum
flesh colored, pearly, papules with umbiliciation; not on palms or soles; resolve 6-12 months
114
Verruca Vulgaris etiology
HPV
115
Varicella presentation
Pruritic, lesions at different stages (papule, blister, ulcer) over 4 days and crust over in 6 days
116
Herpes Zoster (shingles)
neuritic pain (throbbing, stabbing, burning), grouped vesicles on erythematous base in dermatomal distribution (unilateral)
117
Etiology of tinea versicolor
Malassezia
118
Etiology of thrush
candida albicans
119
Thrush
mouth pain; creamy-white patches/plaques with underlying erythematous mucosa; thrush will brush
