Flashcards in Dermatology Deck (74)
A 30-40 y/o pt presents with oral erosive lesions and bullae that are thin and break easily with positive Nikolsky sign most likely suffers from ...
What is the diagnostic test for cutaneous malignancy?
What is the treatment for cutaneous malignancy?
Surgical removal (except karposi sarcoma)
A pt presents with a skin lesion that is increasing size, uneven color, irregular borders and are asymmetric in appearance most likely suffers from ...
What is diagnostic test for melanoma?
Full thickness biopsy
What is the most common site of metastasis for melanoma?
A pt with hx of organ transplant on immunosuppresive drugs that presents with skin lesion on sun-exposed area that can ulcerate most likely suffers from ....
Squamous cell carcinoma
A pt presents with waxy, shiny, pearly lesion on skin of sun-exposed area most likely suffers from ...
basal cell carcinoma (rarely metastasize)
What is the diagnostic test for basal cell carcinoma?
shave or punch biopsy
What is treatment for basal cell carcinoma?
Mohs microsurgery (can just remove affected skin)
An HIV pt with CD4 count < 100 presents with purplish lesions on skin, GI tract and lung most likely suffers from ...
What organism is associated with Kaposi sarcoma?
Human herpes virus B (HHV-8)
What is the diagnostic test for kaposi sarcoma?
by appearance (dont biopsy b/c vascular and bleeds alot)
What is treatment for kaposi sarcoma?
1. anti-retrovirals to increase CD4 count
2. liposomal doxorubicin HCL or vinblastine
A light skin colored pt presents with multiple tender lightly colored lesions on sun-exposed skin most likely suffers from ..
Actinic keratosis (remove b/c precancerous)
An elderly pt presents with hyperpigmented lesions that have a stuck on appearance on back, chest, shoulders, face and commonly referred to as liver spots most likely suffers from ...
(benign; only remove for cosmetic reason)
A pt with atopic disorder history (family or personal) present with erythematous plaques, pruritus and scatching that leads to thickened skin (lichenification), elevated IgE levels most likely suffers from ...
atopic dermatitis (rash that itches)
What is treatment for atopic dermatitis? (5)
1. emollients (moisten skin)
2. topical steroids
3. avoid overbathing and irritable detergents/soaps
4. tacrolimus and pimecrolimus (t-cell inhibitor)
A pt presents with scaly, greasy, flaky skin on a red base on the scalp, eyebrows, and nasolabial fold most likely suffers from....
A pt presents with silvery, scaly plaques with associated arthritis most likely suffers from ...
What organism is associated with Seborrheic dermatitis?
What is the treatment for localized psoriasis? (4)
1. topical high potency steroids
2. vitamin A (tazarotene) and vitamin D (calcipotriene ointment
3. coal tar
4. pimecrolimus and tacrolimus
What is the treatment for invasive psoriasis? (3)
1. UV light
2. TNF inhibitors (etanercept, adalimumab, infliximab)
What are common side effects of methotrexate?
1. liver fibrosis
2. lung fibrosis
What is treatment for seborrheic dermatitis?
1. topical low potency steroids (hydrocortisone)
2. topical antifungal (ketoconazole)
A pt presents with erythematous, salmoned colored lesion that spares palms and soles, usually starts with single lesion (herald patch), characterized as christmas tree appearance on back and has negative VDRL/RPR most likely suffers from...
(steroids if very itchy)
What is the pathophysiology associated with pemphigus vulgaris?
antibodies to epidermal layer
What is Nikolsky sign and what disease is it associated with?
loss/ denuding of skin with mild pressure (removal of superficial layer of skin in single sheet); pemphigus vulgaris
What is the diagnostic test for pemphigus vulgaris?
biopsy with immunofluorescent showing deposits of IgG and C3 in epidermis
What is treatment for pemphigus vulgaris?
1. oral steroids
2. azathioprine, mycophenolate
A 70-80 y/o pt presents with thick walled bullae that remain intact and do not involve oral mucosa most likely suffers from ...
What is the most accurate test for bullous pemphigoid?
biopsy with immunofluorescent antibodies to dermo-epidermal junction (basement membrane)
What is the best initial treatment for bullous pemphigoid?
What are other treatments
1. erythromycin or tetracycyline w/ nicotinamide
2. azathioprine, mycophenolate
A pt with hx of liver disease/ alcoholism/ OCPs use presents with blistering skin on sun exposed areas (back of hands and face), hyperpigmentation, hypertrichosis of face most likely suffers from ...
Porphyria cutanea tarda
(especially associated with hep C)
What is the defect in porphyria cutanea tarda?
uroporphyrinogen decarboxylase deficiency
What is the most accurate test for porphyria cutanea tarda?
urinary uroporphyrins (> than coproporphyrins)
What is treatment for porphyria cutanea tarda?
1. correct underlying disease
2. stop drinking
3. stop estrogens
3. remove iron (via phlebotomy or deferoxamine)
... is hyperpigmentation from hemosiderin buildup in tissue due to venous incompetence of lower extremities
What is treatment for statis dermatitis?
elevate legs and lower extremities
What is the definitive diagnostic test for contact dermatitis?
A pt presents with linear, streaked vesicles on skin most likely suffers from ....
(tx: antihistamines & topical steroids)
A superficial bacterial skin infection due to Staph and Strep and associated with weeping, oozing, and honey crusting is .....
impetigo (topical abx)
What is the treatment for MRSA associated impetigo?
A pt presenting with bright red, hot, tender, swollen skin infection with associated with leukocytosis most likely suffers from ...
(mainly strep with some staph)
What is the only cephalosporin that covers MRSA?
A pt with warm, erythematous, swollen, tender skin infection of subcutaneous tissue most likely suffers from ...
What are the terms for hair follicle infection?
What is the treatment for tinea?
topical antifungal (as long as no hair/ nails involved)
What is the best intial test for tinea?
What is the most accurate test for tinea?
A pt presents with fever, SBP
Toxic Shock Syndrome
What is the treatment for fungal infection involving hair or nails?
What is treatment for toxic shock syndrome?
1. remove source of infection
2. fluid resuscitation and pressors
3. clindamyacin with vancomycin (until cx)
An immunocompromised pt presents with loss of superficial skin, positive Nikolsky sign and normal blood pressure and internal organ function most likely suffers from ..
Staphylococcal scalded skin syndrome
(tx in burn unit w/ oxacillin or vancomycin)
A pt presents with wheals and hives after exposure to certain medication/ insect bite/ food and has associated intense itching most likely suffers from ...
What is the treatment for urticaria?
H1 antihistamines (diphenhydramine, hydroxyzine)
A pt presents with generalized maculopapular rash that blanches with pressure after exposure to allergic medication and skin stays intact without mucous membrane involvement most likely suffers from ...
(similiar to measles)
A pt presents with multiple target like lesions, especially on palms and soles that can be confluent and does not have associated mucous membrane involvement most likely suffers from ...
What are two infections associated with erythema multiforme?
1. herpes simplex
A pt presents with erythema multiforme appearance with mucous membrane involvement leading to sloughing off of respiratory epithelium after allergic medication most likely suffers from ....
What treatment is used for severe Stevens Johnson syndrome?
IV immunoglobulins (IVIG)
A pt presents with denuding of skin involving large portion of body surface area, positive Nikolsky, mucous membrane involvement after use of allergic medication most likely suffers from ...
Toxic epidermal necrolysis (TEN)
What is treatment for mild acne?
1. topical antibacterials (benzoyl peroxide)
2. then add topical antibiotics (clindamycin, erythromycin)
3. then add topical retinoids
What is treatment for moderate acne?
1. benzoyl peroxide with topical retinoids
2. add oral antibiotics
What is the treatment for severe acne (recurrent)?
oral vitamin A (isotretinon)
... is due to antibodies attacking hair follicles thereby destroying hair production
... is loss of hair in response to overwhelming physiologic stress (cancer, malnutrition)
... is a sore that occurs in the pressure areas of the body where the bone is closer to the skin in a pt who is immoblized or bedridden
decubitis (pressure) ulcers
What are the 4 stages of decubitus (pressure) ulcers?
stage 1: nonblanchable redness
stage 2: superficial epidermis or partial dermal destruction
stage 3: full thickness skin destruction
stage 4: destruction to bone
What is the definitive diagnostic tool for microbiologic cause of decubitus ulcer?
A pt presenting with a round, sharply demarcated lesion that leaves a hyperpigmented spot at the same site after medication use most likely suffers from ...
Fixed drug reaction
(associated with aspirin, NSAIDs, tetracycline, barbituates)
A pt presenting with multiple painful, red, raised nodules on the anterior surface of the lower extremities (shins) most likely suffers from ...