Dermatology Flashcards
(95 cards)
1
Q
primary lesion < 1cm
A
macule
papule
vesicle
2
Q
primary lesion > 1cm
A
patch
plaque
bulla
3
Q
secondary changes
A
scale erosion crust ulcer scar
4
Q
configuration
A
annular linear grouped nummular reticular targetoid
5
Q
other descriptive terms
A
color
border
presence of pain, pruritis, alopecia
distribution & its changes w/ time
6
Q
what begins as a small red bumps that become cloudy & vesicular or bullous
A
impetigo
7
Q
a yellow, “honey” crust indicates what?
A
impetigo
8
Q
MCC of impetigo
A
S. aureus
S. pyogenes
9
Q
tx for impetigo
A
topically if not widespread
systemic tx occasionally necessary
10
Q
small follicle-associated papules & pustules
A
folliculitis
11
Q
boil including hair follicle
A
furuncle
12
Q
multiseptate abscesses including several hair follicles & involves subcutaneous tissue
A
carbuncle
may progress to abscess
13
Q
acute, diffuse, spreading, edematous, suppurative inflammation of the subcutaneous tissues, which may be associated w/ abscess formation
A
cellulitis
14
Q
what sometimes starts w/ skin trauma or superficial infxn & has ill-defined borders?
A
cellulitis
15
Q
what are the top 3 causes of cellulitis
A
S. aureus Strep pyogenes (Group A strep)-watch closely for necrotizing fasciitis Haemophilus influenzae type b- in the unimmunized
16
Q
clinical findings of benign intraepidermal tumors caused by HPV
A
skin-colored papules
irregular (verrucous) surfaces
17
Q
tx of benign intraepidermal tumors caused by HPV
A
salicylic acid duct tape tretinoin cream liquid nitrogen canthradin imiquimod (podophyllin)
18
Q
what causes molluscum contagiosum
A
pox virus- induces epidermis to proliferate
19
Q
what do you see w/ molluscum contagiosum?
A
umbilicated, skin colored papule
chronic course of proliferation & gradual resolution
20
Q
coxsackie A virus causes what?
A
enteroviral infxn
“hand, foot, mouth” & sometimes diaper area
21
Q
enteroviral infxn
A
low grade fever
malaise
pharyngitis
22
Q
“hand, foot, mouth”, sometimes diaper area
A
oral & pharyngeal ulcers
peeling macules on palms & soles
*oral aversion may lead to dehydration
23
Q
first disease
A
rubeola (measles)
24
Q
second disease
A
scarlet fever (GAS)
25
third disease
rubella (German measles)
26
fourth disease
"Duke's Disease" (no single dz)
27
fifth disease
erythema infectiosum (parvovirus B19)
28
sixth disease
roseola, exanthem subitem (human herpes viruses 6 & 7
29
significance of parvovirus B19 infection
immunocompromised or susceptible pts w/ hemoglobinopathies can experience severe anemia w/ parvovirus
pregnant females w/ infxn can result in fetal complications including fetal death
30
parvovirus B19 S&S
aka erythema infectiosum/ fifth dz
often asymptomatic
fever, malaise, sore throat
rash
31
characteristics of parvovirus B19 rash
red "slapped cheek" rash
lacy reticular pattern on limbs & trunk
rash spreads distally
32
complications of parvovirus B19
arthritis (in adolescents)
| aplastic crisis
33
aplastic crisis in parvovirus B19
parvovirus B19 replicates in erythroid progenitor cells
not a problem for nml individuals
big problem in individuals w/ rapid red cell turnover
34
what type of d/o's have problems w/ rapid red cell turnover
sickle cell dz
hereditary spherocytosis
AIDS
chronic hemolytic anemia
35
roseola (exanthem subitem)
human herpes virus 6 or 7
3 days of fever, often high
eruption of rash for ~12 hrs after fever ends
36
varicella zoster S&S
- often painful & preceded by burning/pain
- rain drop on a rose petal (vesicle on red base)
- grouped in dermatomal pattern (scattered & evolving in crops in varicella)
- vesicles evolve to become crusted
37
varicella zoster is tx'd w/ what?
analgesics
| antivirals (acyclovir, valacyclovir)
38
clinical findings in diaper candidiasis
red w/ irregular borders
satellite lesions
starts in intertriginous areas (contact dermatitis is on exposed surfaces)
39
tx of diaper candidiasis
remove barrier to evaporation
nystatin
clotrimazole
gentian violet
40
tinea capitis S&S
thickened skin, mild erythema (if any)
black dot appearance of scalp (broken hair shafts)
+/- cervical lympadenopathy
may progress to boggy, swollen, crusted scalp mass called a kerion
41
what types of organisms may cause tinea capitis
Trichophyton tonsurans
| Microsporum canis
42
tinea capitis tx
oral griseofulvin for 6 wks
43
black dot appearance of scalp associated w/ what?
tinea capitis
44
what do you call a boggy, swollen, crusted scalp mass
kerion
45
infection on body (not including on inner thigh or foot) that is annular in appearance, red w/ peripheral fine scale & expansive
tinea corporis (ringworm)
46
infection associated w/ tight garments, obesity & sweating?
tinea cruris (jock itch)
47
tinea cruris (jock itch) s&s
pruritic scaly pink patch on inner thigh
48
tinea pedis (athlete's foot)
between toes & on dorsum of foot
| fissures, scale & pruritis
49
tinea's are tx'd w/
topical antifungals
50
what spp causes tinea versicolor?
Malassezia sp.
51
where is tinea versicolor found on the body?
face, trunk, neck
52
tinea versicolor s&s
light or dark colored patches, sometimes w/ fine scale
| more common in teens & young adults
53
what do you use to treat tinea versicolor?
topically w/:
miconazole/ clotrimazole
sometimes w/ selenium
54
what causes scabies?
female mite (Sarcoptes scabiei)
55
the scabies mite likes to burrow into___________and do what?
stratum corneum
| deposits eggs
56
appearance of scabies
burrows in linear pattern
characteristically in intertriginous areas
intensely pruritic, esp. at night
57
intertiginous areas
finger webs
waist line
bra line
58
scabies tx
application of permethrin 5%
tx of household contacts
for pruritis: anti-histamines, topical hydrocortisone
59
lice appearance
nits (eggs) firmly attached to hair
louse (grey bug)
pruritic
scalp, back of head
60
lice tx
Lindane gamma benzene hexachloride shampoo
| permethrin shampoo
61
irritant contact dermatitis
diaper- moisture
| frequent handwashing
62
allergic contact dermatitis
T-cell immune response to a specific antigen
| e.g. nickel, Rhus (poison ivy/oak/sumac)
63
clinical findings of allergic contact dermatitis
red base
vesicles/bullae
match areas of exposure
extreme itchiness 1-2 days after exposure
64
tx of allergic contact dermatitis
remove offending agent
cool soaks
topical steroids
severe cases-oral steroids
65
seborrheic dermatitis (aka cradle cap) clinical findings
mild erythema
thick, waxy, yellow scale
often to hairline, but sometimes extends past
66
tx of seborrheic dermatitis
combing thru olive oil
more frequent shampoo
more severe cases- zinc pyrithione shampoo, selenium shampoo/lotion, topical steroids
67
tx for sunburn
```
NSAIDs, acetaminophen
anti-histamines
cool compresses
topical aloe
low potency steroids
```
68
hemangioma
benign vascular tumors
usually grow after birth & involute by school age
different from vascular malformations, which grow along with the child
69
complications of hemangioma
```
may ulcerate, bleed profusely & scar
lumbosacral- spina bifida
periorbital- obstruct vision
airway
Kasabach-Merritt syndrome
PHACES syndrome
```
70
PHACES syndrome
```
P-posterior fossa brain malformations
H-hemangiomas
A-arterial anomalies
C-carciac anomalies, coarct of the aorta
E-eye abnormalities
S-sternal cleft
```
71
appearance of urticaria
soft areas of raised skin (papules & plaques) of varying sizes (also called wheal or welt)
pink & red
anywhere on body; may coalesce in various areas
pruritic
72
cause of urticaria
interaction of antigen & mast cell (can be substance, viral infxn)
mast cell release of histamine causing vasodilation & increased vascular permeability
73
tx of urticaria
remove offending agent
antihistamine
tx underlying rxn: epinephrine, corticosteroids, cyproheptadine (periactin)
74
erythema multiforme minor cause
most minor form of widespread immune- mediated skin necrolysis as rxn to drug/ infxn
e.g. HSV, mycoplasma
75
appearance of erythema multiforme minor
targetoid red lesions w/ inner pale rings & violet centers
centers sometimes bullous
either one mucosal surface affected or no mucosal involvement
little to no systemic sx's
76
tx of erythema multiforme minor
antihistamines may help
| acyclovir for pts w/ HSV lesions
77
SJS (erythema multiforme major) appearance
papules progressing to bullae
involvement of multiple mucosal surfaces- oropharyngeal, conjunctiva, nasal, esophageal, tracheal, urethral, vaginal, rectal
78
SJS may include systemic dysfunction of what?
hepatitis
| nephritis
79
causative agents of SJS
mycoplasma, HSV
| drugs: sulfa Abx, anticonvulsants, etc
80
tx of SJS
```
hydration
pain control
emollients
prevention of superinfxn
controversial: steroids, IVIG
```
81
toxic epidermal necrolysis
massive sheet-like denudation of skin
>30% of body surface area involvement
drug rxns include NSAIDs
82
tx of toxic epidermal necrolysis
```
same as SJS
hydration
pain control
emollients
prevention of superinfxn
controversial: steroids, IVIG
```
83
acne vulgaris
may begine at age 8
comedones
inflammatory
84
comedones
closed
| open- blackhead
85
inflammatory acne vulgaris
papular
nodular
pustular
86
pathogenesis of acne vulgaris
1. obstruction of sebaceous follicle
2. overproduction of sebum
3. overgrowth of nml skin flora (produces irritating free fatty acids)
4. redness, swelling, pustule formation
87
acne vulgaris may also result from
hair oil/pomade or corticosteroids use (topical or systemic)
88
tx for inflammatory acne
keratinolytic meds
| topical Abx
89
tx for pustular inflammatory acne
consider oral Abx
90
keratolytic agents
benzoyl peroxide
salicylic acid, azelaic acid
topical tretinoins
91
Abx for acne vulgaris
topicals (clindamycin, erythromycin)
oral_considered in pustular acne
-tetracycline- also has anti-inflammatory activity
-erythromycin
92
oral contraceptives for acne vulgaris
may be used for teens who have had regular menses
93
oral retinoids (isotretinoin, Accutane)
indicated in severe, nodulo-cystic acne
| usually prescribed by dermatologist
94
side effects of oral retinoids
dry lips
elevated transaminases, lipid levels
teratogen
95
other considerations for acne vulgaris
```
diet (milk, high glycemic foods)
cosmetics & hairspray
acne improves during summer
worsens w/ stress
scrubbing vigorously may worsen
long hair
jobs w/ high oil/grease exposure
```
