Flashcards in Dermatology Deck (29)
What does acetowhite testing evaluate for?
Wart evaluation using acetic acid
A 15-year-old male presents with lichenification of the dorsal aspects of his feet. He says that he has itching there and a rash several times per year as long as he can remember. Diagnosis? What is the treatment of choice?
Atopic dermatitis - Topical steroids, UVB phototherapy as an adjunct
A 65 yo F describes a group of vesicles on her arm which started earlier this fall evolved in to the coin shaped plaques you observe on exam with an erythematous base and clearly demarcated borders. She reports pruritus. What is the diagnosis? Tx?
Nummular dermatitis - topical steroids
A young woman has an outbreak on her lip that does not affect the vermilion boarder, they are papulopustules on erythematous bases a few of which have become confluent. What is the diagnosis? Tx?
Perioral dermatitis - rule out infection, usually improves with topical antibiotics. Avoid steroids - will worsen
Pt complaining of pruritic plaques on flexural surfaces, dorsum of hands and feet with relapsing remitting course since childhood. Diagnosis? Cause? mainstay of treatment?
Atopic dermatitis, type 1 IGE hypersensitivity reaction, topical steroids
Pt with a long standing area of pruritus and lichenification has a negative KOH prep and biopsy shows hyperplasia and hyperakeratosis. Diagnosis? management?
Lichen simplex chronicus, control itch-scratch cycle
Pt had a solitary round pink plaque with a raised border of fine scales that disappeared then 1 week later she developed a trunkal rash of oval, salmon-colored, slightly raised, papular and macular lesions about 1cm in diameter. In looking at her back, the rash appears to have a christmas tree like distribution. Diagnosis? treatment?
Pityriasis rosea, watchful waiting
9 year old patient presents with discrete, flesh-colored, waxy, dome shaped umbilicated papules on the face, trunk and extremities 3-6mm in size which appear in groups. A white material cam be expressed from the lesions. Diagnosis? Treatment?
Molluscum contagiosum , watchful waiting
A patient presents with flat-topped, shiny, violaceous papules with fine white lines on the surface. The lesions are very painful and grouped together on her wrists and eyelids. How do you confirm the diagnosis? Diagnosis? Concominant condition? Treatment?
confirm with biopsy and immunofluorescence
Dx: Lichen Planus
Screen for Hep C
Topical steroids or cyclosporine wash in mouth
A patient presents with large pruritic plaques on the knees with distinct margins and adherent silvery scales which, when peeled away, produces specks of bleeding from the capillaries. Diagnosis?
Pt presents with painful bullous lesions in the oral mucosa that she knows are common in her family. Diagnosis? treatment?
pemphigus vulgaris, systemic prednisone + immunosuppression
Patient has an infected area of scalp after a hot tub experience. Likely organism? treatment?
What are the most common offenders of steven-johnson's syndrome (3 categories, 1 specific meds)
abx (sulf/pcn/fq/cef/cyclines), psych/EP (phenobarb/phenytoin/carbamazepin/valproic acid), steroids, allopurinol
Pt presents with fever, sore throat/mouth, oral eruptions, photophobia. Hx of sinus infection being treated. Diagnosis? confirmatory testing? treatment?
steven johnson's syndrome, biopsy is diagnostic, removal of causative agent, transfer to burn unit
What is the treatment for hidradenitis suppurativa?
I&D, local triamcinolone, oral abx until lesions resolve
What is the treatment of an abscess with fever? without?
with: systemic abx + I&D, otherwise just I&D
What is the treatment duration for dermatophytosis?
4 weeks of topical applications
What is the major contraindication to systemic antifungal treatment?
With what condition is the organism Malassezia furfur associated?
Scraping and KOH prep of a hypopigmented scaling macule shows hyphae and spores. What is the diagnosis? treatment?
tinea versicolor, selenium sulfide shampoo left on for 15 minutes for 7 days in a row
A patient with small pruritic papules in webs of fingers and toes. How do you diagnose? diagnosis? treatment?
mineral oil scraping for microscopy is confirmative for scabies, treat with lindane (>age 2) or permethrin for 8 hours twice over 7 days and wash all contacting fabrics
How are the neurologic manifestations of a black widow spider managed?
diazepam and calcium gluconate
Patient presents thinking that they may have had an insect bit but now there is a sinking macule that is pale gray in color and slightly eroded at the center with a halo of very tender inflammation. diagnosis? treatment?
brown recluse spider bite: local analgesia, regresses in 5-10 days spontaneously
Patient presents with small beige to brown plaques with a velvety, warty surface that appears stuck on. diagnosis? treatment?
seborrheic keratosis, electrodessication of 5-fluorouracil (will look worse before better) for 2-4 weeks
What is the most common type of melanoma?
spreading malignant melanoma
What type of melanoma is associated with the palms, soles and nail beds?
acral lentiginous melanomas
What stage decubitus ulcer may be described as superficial necrosis or partial thickness involving the epidermis and/or dermis; shallow ulcer
What stage decubitus ulcer may be described as being deep necrosis, a crater ulcer with full-thickness skin loss, damage or necrosis can extend down to, but not through fascia