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Dermatology Flashcards

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1
Q

What rare condition can acanthosis Nigricans be a warning sign of?

A

Gastric adenocarcinoma

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2
Q

What characterizes acne vulgaris?

A

Open comedones (black heads)
Closed comedones (white heads)
Papules
Pustules
Nodules
Cysts

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3
Q

What are the grades of acne vulgaris?

A

Grade 1: mild acne (comedones) —> open comedones or blackheads
Grade 2: moderate acne —> greater numbers with occasional papules and pustules
Grade 3: severe acne —> large numbers and pronounced inflammation. Risk of scarring high
Grade 4: cystic acne —> large angry blemishes on face and jawline, can also affect neck arms, shoulders, and back

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4
Q

Closed comedones have ______ blockage

A

Complete

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5
Q

Treatment of acne vulgaris

A

Topical retinoids
Cystic acne: tetracyclines then oral retinoids (isotretinoin)

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6
Q

Side effects of isotretinoin?

A

Dry lips
Liver damage
Increased triglycerides/cholesterol, pregnancy category X

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7
Q

What must you obtain with isotretinoin use?

A

Pregnancy test

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8
Q

Description of actinic keratosis?

A

Flesh colored, pink or yellow-brown
sand paper feel
Occurs on sun-exposed surfaces

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9
Q

What is actinic keratosis a precursor to?

A

Squamous cell carcinoma`=

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10
Q

Treatment of actinic keratosis

A

Observation
Cryosurgery
5-FU cream
Electrodessication
Imiquimod

Usually removed as precaution

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11
Q

Tinea capitis

A

Hair loss due to fungal infection of the scalp

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12
Q

What is alopecia areata?

A

Oval-shaped, well-demarcated hair loss
Usually autoimmune attack against hair follicles
Onset prior to 30 yo

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13
Q

What is traction alopecia?

A

Hair loss due to pulling force to hair

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14
Q

What is telegenic effluvium?

A

Thinning or shedding of hair from early entry of hair into telegenic phase
Preceded by psychological or physically stressful event 6-16 weeks prior to hair loss
Growing hairs convert to resting

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15
Q

Appearance of basal cell carcinoma

A

White waxy lump or brown scaly patch
Raised pearly and rolled borders
Telangiectasias
Central ulcer on sun-exposed areas, such as face and neck

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16
Q

Treatment of basal cell carcinoma

A

Fluorouracil
Imiquimod
Photodynamic therapy
Surgical excision with clear margins

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17
Q

What is bulbous pemphigoid?

A

Rare
Chronic acquired autoimmune subdermal blistering skin disorder
Caused by linear deposition of autoantibodies against hemidesmosomes in epidermal-dermal junction

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18
Q

How does bulbous pemphigoid compare to pemphigus vulgaris?

A

Does not affect mucous membranes
Negative nikolsky sign
More tense, less fragile, and deeper than pemphigus vulgaris

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19
Q

Characteristics of bullous pemphigoid

A

Large bullae and crusts
Located on axillae, thighs, groin, and abdomen

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20
Q

How is bullous pemphigoid diagnosed?

A

Skin biopsy with direct immunofluorescence exam showing deposition of IgG and C3 basement membrane

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21
Q

Treatment of bullous pemphigoid

A

Corticosteroids

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22
Q

What is cellulitis

A

Acute bacterial skin infection of dermis and subcutaneous tissue

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23
Q

Characteristics of cellulitis

A

Pain
Erythema
Warmth
Swelling
Margins flat and no well demarcated

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24
Q

Causes of cellulitis in adults

A

Staphylococcus
Streptococcus

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25
Causes of cellulitis in children
H. Influenza Strep pneumoniae
26
Treatment of cellulitis
Mild with MSSA: cephalexin or dicloxacillin MRSA Bactrim Clindamycin Doxycycline IV vancomycin or linezolid
27
Characteristics of condyloma acuminatum
Soft Skin colored Fleshy
28
What types of HPV causes >90% of genital warts
6 and 11
29
What types of HPV are associated with cervical cancer?
16 18 31 33 35
30
What subtypes of HPV does the gardasil 9 vaccine protect against?
6, 11, 16, 18, 31, 33, 45, 52, 58
31
The CDC recommends gardasil-9 starting at what age
11 (can be started at 9)
32
When do patients need to get only a 2 dose series for HPV?
9-14 years of age
33
How is condyloma acuminatum diagnosed?
Clinical evaluation Colposcopy Anoscopy
34
Treatment of condyloma acuminatum
Imiquimod Podofilox Cryotherapy Surgery TCA
35
Characteristics of contact dermatitis
Well-demarcated erythema Erosions Vesicles
36
What can cause allergic dermatitis?
Type 4 hypersensitivity Nickel Poison ivy
37
What can cause irritant contact dermatitis
Cleaners Solvents Detergents Urine Feces
38
Treatment of contact dermatitis
Avoid offending agent Burrow’s solution Topical steroids Zinc oxide
39
Characteristics of atopic dermatitis
Pruritic Eczematous lesions Lichenification Common on flexor creases Infant-face and scalp Adolescent- flexural surfaces
40
What causes atopic dermatitis
IgE type 1 hypersensitivity
41
Treatment of atopic dermatitis
Topical corticosteroids and emollients Topical calcineurin inhibitor
42
What is nummular eczema?
Coin-shaped/disc-shaped
43
Treatment of nummular eczema
High or ultra-high potency topical corticosteroids
44
Characteristics of seborrheic dermatitis
Erythematous Yellowish greasy scales Crusted lesions Infants: scalp (cradle cap) Adults/adolescents: face, chest, scalp
45
Treatment of seborrheic dermatitis
Ketoconazole shampoo
46
Presentation of perioral dermatitis
Young women Papulopustular Plaques Scales around mouth
47
Treatment of perioral dermatitis
Topical metronidazole Avoid steroids
48
What is a drug eruptions
Cutaneous reaction to administration of drug usually within last 6 weeks Range from mild eruption that resolve when agent removed to severe skin damage with organ involvement
49
Diagnosis of drug eruptions
Clinical
50
Treatment of drug eruptions
Monitor for cardiovascular collapse (anaphylaxis) DRESS (drug rash with eosinophilia and systemic symptoms) SJS/TEN (extensive bullous reaction/generalized erythroderma) Withdraw offending agent If anaphylaxis or widespread urticaria —> epinephrine .2-.5 mg and prednisone to prevent recurrence Antihistamines
51
Characteristics of dyshidrosis
Pruritic vesicular eruption Clear, deep seated vesicles without erythema On lateral aspects of fingers, central palm, and plantar surfaces Resembles tapioca pudding
52
Treatment of dyshidrosis
Petroleum jelly Moisturizer Cold compresses Topical steroids
53
Characteristics of erysipelas
Well-demarcated, raised, superficial Lymphatic involvement Redness and pain Fevers and chills
54
What is the most common cause of erysipelas?
Group A strep: strep pyogenes
55
Treatment of mild erysipelas
Penicillin G
56
What is erythema multiforme?
Acute, self-limited Type IV hypersensitivity reaction Associated with HSV (MC), medications (sulfa drugs) and triggers
57
Skin lesions associated with erythema multiforme
Extremities (hands, feet, mucosa) Target-like rash Raised, blacking, lack of itchiness
58
What causes erythema infectiosum? (Fifth disease)
Parvovirus B19
59
Characteristics of erythema infectiosum
Slapped cheek rash on face Lacy reticular rash on extremities that spares palms and soles Resolves in 2-3 weeks
60
Treatment of erythema infectiosum
Supportive Anti inflammatories
61
What causes hand foot and mouth disease
Coxsackievirus type A
62
Characteristics of hand-foot-and mouth disease
Sores in mouth, rash on hands, feet, mouth, and buttocks Usually clears on own in 10 days
63
Treatment of hand-foot-and mouth disease
Supportive, anti-inflammatory
64
Characteristics of measles
4 C’s: cough, coryza, conjunctivitis, and ccephalocaudal spread Morbilliform - maculopapular, brick red rash on face Begins at hairline then progresses to palms and soles last Lasts 7 days Koplik spots (small red spots on buccal mucosa with blue0white-pale center) precede rash by 24-48 hours
65
Characteristics of rubella (German measles)
“3 day rash” pink light red spotted maculopapular rash First on face Spreads to trunk and extremities Generalized in 24 hours and lasts 3 days Posterior cervical and posterior auricular lymphadenopathy Does not darken or coalesce
66
How is rubella related to pregnancy
Congenital syndrome Deafness TTP Mental retardation
67
What causes roseola
Herpesvirus 6 or 7
68
Characteristics of roseola
Starts on trunk and spreads to face High fever for 3-5 days, then rose pink maculopapular blanchable rash on trunk/back and face
69
Characteristics of folliculitis
Papules and pustules Erythematous, painful but may burn
70
Common cause of folliculitis
S. Aureus Pseudomonas in hot tubs
71
Treatment of folliculitis
Mupirocin ointment and topical benzoyl peroxide If more extensive: dicloxacillin and cephalexin If MRSA: bactrim, clindamycin, or doxycycline
72
What is hidradenitis suppurativa?
Chronic follicular occlusive disease Recurrent inflammatory nodules, abscesses, sinus tracts, and complex scar formation
73
Characteristics of hidradenitis suppurativa
Pea to marble sized nodules under skin that can be painful and enlarge and drain pus Armpits, groin, and buttocks (where skin rubs together)
74
Treatment of hidradenitis suppurativa
Intralesional triamcinolone Oral and topical abx Hygiene Warm soaks Sometimes surgery
75
Characteristics of impetigo
Red sores around nose and mouth Sores rupture and ooze forming yellow brown crust “Honey colored” and wheeping
76
Most common cause of impetigo
S. Aureus
77
Treatment of impetigo
Mupirocin Dicloxacillin Cephalexin
78
Complication of impetigo
Poststreptococcal glomerulonephritis
79
Characteristics of kaposi sarcoma
Lesions in skin, lymph nodes, internal organs, and mucous membranes lining mouth, nose, and throat Purple, red, or brown skin blotches common sign Tumors may develop in other areas of the body
80
What is kaposi sarcoma associated with
Human herpesvirus 8 and is AIDS-defining cancer
81
Treatment of kaposi sarcoma
Radiation or chemotherapy Rarely, surgery
82
Characteristics of lice
Pruritic scalp, body, or groin Nits: small white specs on hair shaft
83
Diagnosis of lice
Observation of lice and nits Nits = ovoid, grayish-white eggs
84
Treatment of lice
Launder fomites such as sheets in hot water (>131 F or 55 C) Permethrin topical with wet combing Capitis: shampoo towel-dried hair and wash after 10 mins then repeat in 9 days pubis/body lice: entire body then washed off after 8-12 hours —> screen for STIs and abstain from sexual contact Eyelash: ophthalmic grade petroleum jelly BID x 10 days Lindane = older treatment that can’t be used on infants, children, and elderly due to neurotoxicity Children can return to school after first application Resistant cases: oral ivermectin Treat all family members
85
What is lichen planus
Chronic papulosquamous inflammatory dermatosis of unknown etiology, possibly autoimmune
86
Appearance of lichen planus
Purplish Itchy Flat topped Lacy white patches sometimes with painful sores on mucous membranes 5 Ps: purple, papule, polygonal, pruritis, planar
87
What is wickham striae?
Whitish lines visible in the papules of lichen planus and other dermatoses
88
Treatment of lichen planus
Topical steroids
89
What is lichen simplex chronicus
Chronic dermatitis due to chronic repeated rubbing or scratching of skin Skin thickened with accentuated lines
90
Characteristics of lichen simplex chronicus
Thick, leathery, brownish skin
91
Treatment of lichen simplex chronicus
Break itch scratch cycle with anti-histamines and occlusive dressing
92
What is a lipoma?
Fatty tumor that is generally slow growing and usually harmless
93
Characteristics of lipoma/epithelial inclusion cyst?
Just under skin and move easily when pressure applied Common in neck, shoulder, back, abdomen, arms, and thighs If fast growing: suspect another diagnosis
94
Treatment of lipoma/epithelial epidermal cyst
Generally not necessary If bothersome, painful, or growing surgical excision or liposuction
95
What is an epidermal inclusion cyst?
Epidermis cyst due to implantation of epidermal elements in the dermis
96
Presentation of epidermal inclusion cysts
Solitary, soft, well defined Mucin-filled lesions Painless Smooth surface and small opening called puncture Benign
97
Treatment of epidermal inclusion cyst
Close observation Surgical management if necessary
98
What is a melanoma
Pigmented lesion with irregular border, irregular surface, or irregular coloration Melanocytes become cancerous
99
Characteristics of melanoma
New, unusual growth Change in existing mole Asymmetrical, unevenly pigmented with nodule and irregular border Asymmetry Border irregular Color variability Diameter increasing or >6 Evolving (change in size, shape, or color)
100
What is prognosis of melanoma most strongly associated with?
Depth of invasion

Family Medicine EOR (15 decks)

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