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Dermatology Flashcards

(61 cards)

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1
Q

Flat discolored lesion

A

Less than 1 cm = macule
Greater than 1 cm = patch

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2
Q

Palpable raised lesion

A

Less than 1 cm = papule
Greater than 1 cm = plaque

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3
Q

Lesion with significant depth

A

Less than 1 cm = nodule
Greater than 1 cm = tumor

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4
Q

Fluid containing lesion

A

Greater than 1 cm = cyst

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5
Q

Elevated lesion containing serous fluid

A

Less than 1 cm = vesiscle
Greater than 1 cm = bullae

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6
Q

What causes Rocky Mountain spotted fever?

A

Rickettsia rickettsii tick bite

Sudden onset fever, headache, rash, myalgia, GI complaints

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7
Q

Common phototoxic drugs

A

NSAIDs, quinolones, tetracyclines, amiodarone, phenothiazine

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8
Q

Dermatomyositis lesions

A

Violaceous periorbital HELOPTROPE RASH with edema
Erythema of neck and upper trunk SHAWL SIGN
Violaceous papules over knucles GOTTRON PAPULES

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9
Q

Treatment for tinea versicolor (overgrowth of M furfur)

A

Selenium sulfide lotion
Oral ketoconazole

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10
Q

Define vitiligo

A

Autoimmune reaction against melanocytes associated with other autoimmune diseases such as pernicious anemia, Hashimoto’s thyroiditis or diabetes type 1

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11
Q

Itchy red macules and papules on the face spreading to the neck, trunk and extremities within 24 hours ± red rash on soft palate

A

Rubella

Post auricular lymph nodes
Resp spread
Careful in pregnant ladies

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12
Q

Small white spots on oral mucosa with erythematous macules and papules of face spreading cephalocaudally

A

Measles

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13
Q

Pink macules and papules on trunk spreading to neck and proximal extremities with surrounding white halos

A

Roseola

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14
Q

Skin changes in liver disease

A

Gynecomastia, jaundice, caput medua, loss of body hair, palmar erythema, peripheral edema, purpura, spider angioma

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15
Q

Skin changes in renal failure

A

Photodistributed or diffuse hyperpigmentation including palms and soles, pallor, yellow tinge

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16
Q

Skin changes in diabetes

A

Acanthosis nigricans, foot ulcers, itching, light brown slightly indented scaly patches (diabetic dermopathy), yellow skin and nails

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17
Q

Skin changes in Cushing syndrome

A

Acanthosis nigricans, acne, buffalo hump, hirsutism, telangiectasia, atrophic skin, striae

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18
Q

Skin changes in neurofibromatosis

A

Cafe au lair spots, freckles, neurofibromas

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19
Q

Skin changes in hyperlipidemia

A

Xanthomas

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20
Q

Finger clubbing should make you think of

A

CVD
Lung disease
GI disorders
Chronic methemoglobinemia

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21
Q

Hollow or spoon shaped nails should make you think of

A

Iron deficiency
Malnutrition
Diabetes
Old age

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22
Q

Transverse white lines/leukonychia should make you think of

A

Hypoalbuminemia
Chemotherapeutic agents
Poisons

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23
Q

Black spots on nails should make you consider

A

Hematoma or melanoma

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24
Q

Splinter hemorrhages of nails should make you think of

A

Trauma
Bacterial endocarditis
Blood dyscrasia

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25
Blue green nails should make you think of
Pseudomonas or drug induced causes (azidothymidine AZT)
26
Painful grouped vesicles on erythematous base located on distal finger
Herpetic whitlow Self limiting May consider antiviral therapy
27
MCC noncicatricial (without scarring) alopecia
Androgenic alopecia
28
Skin changes in liver disease
Gynecomastia, jaundice, caput medusa, loss of body hair, palmar erythema, peripheral edema, purpura, spider angiomas
29
Skin changes in renal failure
Photodistributed or diffuse hyperpigmentation including palms and soles, pallor, yellow tinge
30
Skin changes in diabetes
Acanthosis nigricans, foot ulcers, pruritis, light brown slightly indented scaly patches, yellow skin and nails
31
What is pyoderma gangrenosum and what conditions is it associated with?
Inflammatory skin condition that is characterized by large ulcers usually on the lower body Associated with ulcerative colitis, Crohn's, rheumatoid arthritis
32
Skin changes in neurofibromatosis
Cafe au lait macules, freckles, multiple cutaneous neurofibromas (neoplasm of peripheral Schwann cells that presents as soft nodule in the dermis of the skin)
33
Skin changes in porphyria
Blisters, photosensitivity, hypertrichosis, pigmentation, skin fragility ## Footnote Porphyrias are a group of rare, inherited or (less commonly) acquired metabolic disorders in which defective enzymes impair the biosynthesis of heme in the liver and/or bone marrow.
34
Treatment for onychocryptosis | aka ingrown nails
Barrier placement between nail plate and fold Excision of the portion of the nail plate pressing on the fold Maybe antibiotics
35
What is fingernail clubbing associated with?
CVD, lung disease, GI disorders, chronic methemoglobinemia
36
What are spoon shaped nails associated with?
Iron deficiency, malnutrition, diabetes, old age
37
What are white lines on nails associated with?
Hypoalbuminemia, chemotherapy, poisons
38
What are nail splinter hemorrhages associated with?
Trauma (MCC) Bacterial endocarditis, blood dyscrasias
39
What are black nails associated with?
Hematoma, melanoma | Always biopsy when melanoma is suspected
40
Where does herpetic whitlow normally present?
Erythematous base located on the distal finger
41
What are red painful lesions around the nail fold called and what are they commonly caused by?
Paronychia Causes: MCC S. aureus if acute, if in someone who does "wet" work then think C. albicans ## Footnote Rx: Topical glucocorticoids, minimize irritants and water exposure, give topical antibacterial/antifungal as needed
42
What tests should you do in abnormal hair loss?
1st: CBC, ferritin, TSH, microscopic exam and fungal culture (if suspected) 2nd: Scalp biopsy, ANA, androgens
43
What is depigmentation of the hair shaft caused by?
Protein or copper deficiency
44
How do you treat itching from PBC?
Bile acid binding resin (cholestyramine or colestipol), opioid antagonists (naloxone)
45
What endocrine disorders can present with itching?
Thyrotoxicosis, hypothyroid, diabetes
46
What type of cancer can be associated with itching?
Gastric carcinoid because of histamine flush
47
What drugs are associated with Steven Johnson syndrome?
Carbamazepine, phenytoin, allopurinol, lamotrigine, NSAIDs, sulfa Rx: Identification of culprit drug, supportive care on burn unit or ICU, ophthalmology consult | Life threaning because of multisystem involvement ## Footnote Acute life threatening mucocutaneous disorders with extensive necrosis and detachment of the epidermis
48
What is the treatment for shingles?
Often supportive Treat if severe or disseminated Give oral antiviral **if initiated within 72 hours** to reduce pain, viral shedding and healing time | TOPICAL antiviral is of no benefit ## Footnote Clusters of erythematous papules and vesicles commonly following pain in a unilateral dermatomal distribution
49
What tests are done for the diagnosis of herpes simplex?
Tzanck smear - look for multinucleated epithelial cells Viral culture Viral PCR Antibody testing of fluid from base of vesicle | HSV 1 = oral HSV 2 = genital sometimes oral
50
What is a common initial presentation of pemphigus vulgaris?
Mouth ulcers Look for pts with painful skin or oral mucosa lesions Itching is uncommon | Serious autoimmune blistering diease affecting pts 50-60 yo
51
How do you differentiate pemphigus vulgaris from bullous pemphigoid?
PV usually starts in the oral mucosa and move across the face and scalp, BP will start at the extremitites towards the flexural surfaces and trunk PV middle aged (POSITIVE nikolsky), BP elderly (NO nikolsky) PV autoAB against desmoglein vs BP autoAB against hemidesmisomes | Autoimmune bullous skin disease affecting middle aged or elderly ## Footnote PV may require hospital admission, BP can generally be treated with topical and/or oral steroids or methotrexate, azathioprine
52
What is the classic finding of dermatofibroma?
Dimple sign | Common button like nodule presenting on extremities
53
Clinical features of malignant melanoma
Asymmetry Border irregularities Color variation Diameter > 6 mm Evolution
54
Hypertrophic scar vs keloid
Hypertrophic scars are **confined** to the original injury site vs keloids which **extended beyond** the original injury site
55
How does BCC present? | Basal cell carcinoma
Pearly papule or nodule with peripheral telangiectasias | Lots of other presentations possible but this is MC?
56
What should CDKN2A mutation make you suspect?
Malignant melanoma
57
Side effects of isotretinoin
Tertaogen, depression, suicidal ideation | Warn patients
58
Rosacea vs acne
Acne has comedones where as acne does
59
How to treat psoriasis?
Skin: Medium - high potency corticosteroid cream or ointment Calcipotriol ointment Tar Anthralin Tazarotene gel or cream Intralesional triamcinolone Phototherapy Methotrexate, acitretin, cyclosporine Scalp: Tar shampoo Topical corticosteroid lotion, solution, foam Calcipotriol solution Tazarotene gel Face: Low potency corticosteroid cream or ointment Tacrolimnus ointment | Auspitz sign: scale removal = appearance of minute droplets of blood ## Footnote Chronic, recurrent inflammatory skin condition with abnormal epidermal differentiation and hyperproliferation
60
Lichen planus pnemonic
Acute or chronic inflammatory disorder affecting the skin, mucous membranes, and nails Plantar Purple Pruritic Polygonal Papules Mainly seen on inner wrists, torso, extremities Sometimes present as white reticulated lesions of mucosal surfaces (lips and buccal mucosa) | ASSOCIATED WTIH HEPATITIS C **SOMETIMES** - SCREEN PTS ## Footnote Tx: Difficult. Try corticosteroid creams. Maybe systemic agents if bad.
61
Eczema vs psoriasis
Eczema: ill defined, itchy, microvesicles, lichenification Psoriasis: well defined, silvery, symmetric, salmon red

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