Flashcards in Dermatology Deck (28):
Acute hypersensitivty reaction. Symmetrical, typically on extensor portions of extremities, palms and soles. Commonly caused by infection, mycoplama, HSV. Starts with target lesion. Can have mild oral mucosal involvement.
Steven Johnson Syndrome
Involves 10-30% of body surface area. Hypersensitivity to medication, infection or malignancy. Thick walled vesicles with cleavage of bullae beneath the basement membrane. full thickness epidermal detachment with T cell infiltrate. Nicholsky sign present. conjunctival involvement can progress to involve the cornea. Constitutional symptoms are prominant. Questionable if IVIG is helpful. Steroids are contraindicated.
Toxic Epidermal Necrolysis
30-100% body involvement. Hypersensitivity to medication, infection or malignancy. Thick walled vesicles with cleavage of bullae beneath the basement membrane. Underlying damage to sweat ducts. Nicholsky sign present. conjunctival involvement can progress to involve the cornea. Constitutional symptoms are prominant. Questionable if IVIG is helpful. Steroids are contraindicated.
Transient Neonatal Pustular melanosis
common neonatal rash seen predominantly in black infants. It is characterized by superficial vesicles that rupture, leaving a collarette of scale, and develop a hyperpigmented macule. It may persist for a few months. The condition is benign and requires no treatment. Smears of the lesion reveal numerous PMNs and debris.
Erythema Toxicum, what kind of cells are in it?
seen in the newborn period and may be found in up to 50% of neonates. The condition is benign and self-limited as well and typically 1-2 mm white-to yellow papules or pustules on an erythematous base will be observed. The cause is unknown, but smears reveal large collections of eosinophils.
lesions are superficial inclusion cysts that contain laminated keratinized material. They are typically found on the face and gingivae. They will resolve spontaneously.
Alopecia areata is characterized by hair loss in round or oval patches on the scalp. The skin within the plaques of hair loss is normal. Alopecia areata occurs in 1% of the population; 60% of patients are less than 20 years old. It is associated with atopy and autoimmune diseases. The course of alopecia areata is unpredictable, but may resolve spontaneously in 6 to 12 months. Occasionally, high potency topical steroid preparations are prescribed.
a dermatophyte infection of the scalp caused by Trichophyton tonsurans or Microsporum canis. The lesion starts as a small papule at the base of the hair follicle, spreading into a circular plaque (often known as ringworm). The infected hairs break off and create a pattern known as "black-dot ringworm" where the patches of alopecia have small hairs broken off at the hair follicle. Occasionally, patients have a severe inflammatory response, causing development of a large, boggy mass known as a kerion. Treatment is with oral antifungal agents, such as griseofulvin.
Roseola infantum (also called exanthem subitum) is caused by Human Herpesvirus-6 and occurs almost exclusively during infancy. There is usually no prodromal period. The illness begins with high temperatures (averaging 103 F) for 3 to 5 days; the fever typically resolves rather abruptly. The rash appears within 12 to 24 hours of the fever resolution. The rash of roseola is rose-colored and begins as discrete, small, slightly raised pink lesions on the trunk and spreads to the neck, face and proximal extremities. The rash is not pruritic and no vesicles or pustules develop. The lesions may become confluent. Roseola is self-limited and the treatment is supportive only (i.e. antipyretics during the febrile phase).
Rubella differs from roseola in that it has a distinct prodromal period, with prominent occipital and postauricular lymphadenopathy, and the low-grade fever is coincident with the rash.
Measles (rubeola) is caused by a paramyxovirus and is manifested by cough, coryza, conjunctivitis, and Koplik's spots. The rash associated with measles is generalized, maculopapular, and erythematous, and occurs at the height of the fever
Lack of sweat glands, conical teeth, mid face hypoplasia
How do you make a bleach bath?
1/2C bleach in a bathtub per full tub. Can use twice a week to decrease staph colonization
What is gianotti-crosti syndrome associated with?
HEp B bc stimulates immune complex formation
X linked Dominant disorder - lethal in males, only in females. Mother with recurrent miscarriages can be a tip-off. 4 stages of skin manifestation 1.) lines of Blashko blister 2.) verrucous papules 2-6weeks of life 3.) hyperpigmented swirls 3-6mos 4.) hypopigment replaces hyper
apparent within first 2-4 weeks. No comedones, 2/2 malassezia furfur? Resolves spontaneously within 1-2 months
Appears at 2-4 months caused by androgenous stimulation of the sebaceous glands. There are open and closed comedones. Resolves over 6-12 months. Rarely from excess androgens, like CAH. Ok to treat with topical benzoyl peroxide or antibiotics
Medical name for angels kiss on glabella
nevus simplex, resolves by a few months of life
Medical name for storkbite (posterior hairline)
nevus flameus (port wine stain) does not go away. If in V1, need eval, if V2 can still get optho concerns
Klippel Trenaunay syndrome
vascular malformation of an extremity associated with soft tissue overgrowth. Limb overgrowth is progressive.
Medical name for mongolian spot
Congenital dermal melanocytosis
What must you check for in x linked recessive ichthyosis
at risk for undescended testes, underdeveloped penis and scrotum
basal cell nevus syndrome, dysmorphic facies, develop basal cell CA in childhood, can have jaw cysts that become malignant, can have other malignancies including medulloblastoma
exclamation point hairs
should be referred for surgery. Especially midline lesions can be associated with CNS deformities
treatment of ichythosis
Urea cream is one of the most effective products to treat ichthyosis
what does nevus of ota put you at risk for?
Affected patients are at risk of melanoma and glaucoma.