Dermatology Flashcards
(51 cards)
top 4 categories of skin problems
- inflammatory disease
# 2. infection - tumors
- other
7 broad categories of skin disease
- dermatitis
- papulosquamous
- urticaria/erythema
- infection
- follicular
- tumors
- other
Wheels
(indicative of urticaria, NOT the same as urticarial vasculitis)
= pruritic dermal swellings sharply defined w/o surrounding erythema.
*EACH individual lesion lasts less than 24 hrs
Abscess
a furuncle or carbuncle (round, red, tender, may rupture) found on the back or thighs, that is a localized infection caused by Staph. aureus.
Tx: antibiotics, mupirocin, wash hands well w/ soap.
Scalded Skin Syndrome
Diffuse erythema w/ fever, followed by desquamation that travels from the head and shoulders to the trunk; usually in infants.
Caused by Staphylococcal toxins.
Tx: Nafcillin IV (emergency)
Bullous Impetigo
Clusters of vesicles on face, trunk, extremities and perineum that turn to bullae then crust over; in children ages 2-5.
Cause: Group II streptococci
Tx: Mupirocin, Dicloxacillin, or cephalexin
Non-bullous Impetigo
Clusters of vesicles which fill with pus then dry into “honey colored” crusts, mostly on the face.
Cause: streptococci, but may be contaminated w/ staph.
Tx: Mupirocin, Dicloxacillin or cephalexin
Erysipelas
Sharply demarcated erythema and swelling in adults, on the face, ears, or lower legs; acute onset often w/ initiating skin lesion.
* 4 telltale signs: Rubor (red), Calor (hot), Dolor (painful), tumor (swelling); hard to distinguish from cellulitis.
Cause: Group A strep or staph.
Tx: penicillin, cephalosporin or erythromycin
Scarlet Fever (rash)
** 1st 48 hrs: white coated “strawberry tongue,” turns red after 5 days; accompanying small papules on neck that spread. Followed by brawny desquamation.
Cause: group A strep
Tx: penicillin, erythromycin, dicloxacillin
Ecthyma
Deep infection in butt, thighs, or legs usually in tropics; = vesicle or pustule that becomes ulcer, scars.
Cause: Staph or strep pyogenes
Tx: penicillin, erythromycin, cephalosporin.
Ecthyma gangrenosum
red macule –> papule –> hemorrhagic bulla –> necrosis & gangrenous ulcer (w/ greenish tint & pink halo/edge)
* occurs in immunocompromised only*
Cause: pseudomonas
Tx: 3rd generation cephalosporins
haemophilus cellulitis
purple/red swelling of face, in children 6 mo - 3 years old; occurs w/ URI & otitis media usually.
=> “preseptal cellulitis” if affects eyelid (dangerous complication)
Cause: Haemophilus infection
Tx: IV cephalosporins
Rocky Mountain Spotted Fever
pale or red macules appearing 1st on wrists and ankles, then spreading to palms and soles of feet, = vasculitis.
Other Sx: fever, malaise, vomitting; Risk hepatomegaly.
Cause: rickettsia infection from tick bite (esp. in North/South Carolina)
Tx: doxycycline
cutaneous signs of gonococcemia
a few medium-small crusty pustules over red base on extremities, usually last ~4 days.
Other Sx: fever, myalgia, tenosynovitis; acute abdomen
Cause: gonorrhea infection spread to blood
Cutaneous signs of meningococcemia
diffuse petechia or hemorrhagic purpura on face and extremities; usually in children under 2.
Other Sx: sudden onset of fever and severe headache, stiff neck
Cause: Neisseiria meningitidis
Complication: “Waterhouse Fridericksen Syndrome” = massive bleeding into skin and adrenal glands from septicemia.
Onychomycosis
fungal infection of finger or toenails.
a) Distal = yellowish hyperkeratosis, most common (in anyone)
b) Proximal = white discoloration under proximal nail fold, in immunosuppressed (esp. AIDS)
Dx w/ KOH
Athlete’s Foot (tinea pedis)
a) interdigital - damp, flaky & itchy btwn toes
b) vesiculobullous - blisters on heel, insole or ball of foot
c) moccasin - diffuse scaliness across whole sole of foot
Dx w/ KOH, Tx = topical
tinea cruris (jock itch)
= contamination from tinea pedis, ringed expanding erythematous plaque on inner thighs & butt.
spares penis & scrotum
Dx w/ KOH, Tx = topical + treat tinea pedis.
tinea corporis vs. versicolor
Corporis: expanding erythematous & scaly circular plaque; on face, trunk or extremities
Versicolor: brown, pink or hypopigmented scaly patches on trunk;
* “spaghetti & meatballs” appearance under microscope
Candidiasis
a) Intertriginous/Diaper: broad erythematous plaque in moist areas (axilla, submammary, inguinal)
b) Perinychia: thickened, red nailfolds
c) Thrush: in mouth (mucosal surfaces) –> Chronic Mucocutaneous if child w/ T cell deficiency.
Cause: yeast (candida), = opportunistic, esp. immunocompromised but not excusively!
Sebhorreic keratosis
common benign epidermal growth, esp. on face/trunk & age 30+;
= well-marginated pigmented papule or plaque.
Tx: liquid N, curettage or shave excision
actinic keratosis
pre-cancerous epidermal growth,
= rough, scaly, red plaque/papule, esp. on sun-exposed areas.
** 10% convert to squamous cell carcinoma!**
Tx: cryoTx, acid peel, curettage. best = prevention!
warts (verruca vulgaris)
benign epidermal hyperplasia due to HPV infection,
- common, plantar, periungual, mosaic (if transplant/immunosupr.)…
*esp. in school children or ppl w/ risks (athletes, animal exposure)
**spread w/ contact!
Tx: salicylic acid, 3M duct tape, cryotherapy, candida Ag, laser…
molluscum contagiosum
Soft, domed papules from poxvirus infection of epidermal cells;
- esp. in kids (face, trunk, extremities) or genitals in adults
Tx: spontaneously remit, or cryoTx. *hard to Tx in AIDS (persistant)
