dermatology

Question 1

nickel sized oval plaques on legs/trunk/hand/feet but spares and scalp. lesions are pruritic and scaly, excoriated

Answer 1

nummular eczema

Question 2

tx nummular eczema

Answer 2

avoid triggers/frequent bathing/emollients and topical steroids

Question 3

flexor surfaces…xerosis..lesions/dry/thickened skin..IgE sensitization

Answer 3

eczema

Question 4

eczema treatment

Answer 4

lukewarm baths, emollients, hydrocortisone/triamcinolone

Question 5

dry/oily yellow scales with underlying erythema on scalp, eyelids, face, body folds. common in infants and elderly

Answer 5

seborrheic dermatitis

Question 6

dry/oily yellow scales with underlying erythema on scalp, eyelids, face, body folds. common in infants and elderly

Answer 6

seborrheic dermatitis

Question 7

tx seborrheic dermatitis

Answer 7

selenium sulfide shampoo for scalp. hydrocortisone cream for face or intertriginous areas. ketoconazole if needed

Question 8

statis dermatitis can be caused by what anti HTN medication?

Answer 8

amlodipine

Question 9

pathophys of statis dermatitis

Answer 9

venous insufficiency, increased hydrostatic pressure–>increased permeability of dermal capillaries–>fibrinogen leaks and forms around capillaries, hypoxia/cell damage, release of pro-inflammatory cytokines results in cutaneous inflammation and fibrosis

Question 10

pathophys of statis dermatitis

Answer 10

venous insufficiency, increased hydrostatic pressure–>increased permeability of dermal capillaries–>fibrinogen leaks and forms around capillaries, hypoxia/cell damage, release of pro-inflammatory cytokines results in cutaneous inflammation and fibrosis

Question 11

erythematous, scaling, eczematous patches on lower extremities. most common is medial ankle. weeping, reddish-brown discoloration

Answer 11

statis dermatitis

Question 12

stocking erythroderma/inverted champagne bottle

Answer 12

stasis dermatitis

Question 13

tx stasis dermatitis

Answer 13

compression stockings, topical triamcinalone for itching, elevate legs

Question 14

small clear vesicles like a grain of tapioca in the skin. can be pruritic. can lead to scales/dry/fissures

Answer 14

dyshydrosis

Question 15

tx dishydrosis

Answer 15

topical and systemic corticosteroids. second line is puva therapy or botox

Question 16

second degree process…thickening and scaling of skin

Answer 16

lichen simplex chronicus

Question 17

what is lichen simplex chronicus associated with?

Answer 17

emotionally stressed patients, anxiety, women 30-50, hair dye

Question 18

tx lichen simplex chronicus

Answer 18

topical steroids, consider antibiotics…may need to refer to allergist or psych for stress/scratching

Question 19

what is lichen planus associated with?

Answer 19

ulcerative colitis, vitiligo, alopecia areata, dermatomyositis, lichen sclerosis, myasthenia gravis (it is cell mediated)

Question 20

tx lichen planus

Answer 20

topical steroids. second line is triamcinolone IM

if in oral or vaginal area, can use topical tacrolimus

Question 21

characteristic white lines (wickham stria)

Answer 21

lichen planus

Question 22

planar, polygonal, pruritic, purple, papules

Answer 22

lichen planus

Question 23

extensor surfaces, silvery scales on bright red plaques

Answer 23

psoriasis

Question 24

extensor surfaces, silvery scales on bright red plaques

Answer 24

psoriasis

Question 25

tx psoriasis

Answer 25

phototherapy, topical corticosteroids, PUVA, vitamin D analogues

Question 26

tx psoriasis on scalp

Answer 26

tar shampoo or salicyclic acid gel

Question 27

tx sporiasis body folds

Answer 27

tacrolimus ointment or pimecrolimus cream

Question 28

tx pityriasis rosea

Answer 28

topical antipruritics, oral antihistamines

Question 29

bullous erpution with raised purpuric target-like lesion with 2 zones of color change.. central blister.

Answer 29

erythema multiforme

Question 30

medications that commonly can induce EM/SJS

Answer 30

sulfonamides, allopurinol, NSAIDs, anticonvulsants

Question 31

benign pruritic disease characterized by flisters in flexural areas

Answer 31

bullous pemphigoid

Question 32

how to dx bullous pemphigoid

Answer 32

biopsy/direct immunofluorescence exam. IgG and C3 are found at dermal-epidermal junction

Question 33

tx bullous pemphigoid

Answer 33

topical corticosteroids, prednisone 75mg/kg daily if intense

Question 34

tx comedomal acne

Answer 34

topical retinoid (not in pregnancy). benzyoyl peroxide, topical antibiotics

Question 35

papular or cystic inflammatory acne

Answer 35

topical antibiotics and benzoyl gel...tetracycline or coxy or mino...BCP....severe may need isotretinoin (accutane)

Question 36

tx rosacea

Answer 36

avoid triggers. metronidazole cream. fulfur topicals. benzoyl peroxide/retinoids...systemic antibiotics

Question 37

tx folliculitis

Answer 37

anhydrous ethyl alcohol with aluminum chloride, topical antibiotics...topical permethrin...PUVA

Question 38

beige to brown/black velvety or water stuck on plaques

Answer 38

seborrheic keratosis

Question 39

flesh colored, pink and hyperpigmented/sandpaper feeling...bleeds when scales scraped away

Answer 39

actinic keratosis

Question 40

rings or erythema with advancing border, central clearing, scaling or fissuring of skin web spaces

Answer 40

tinea corporis/pedis

Question 41

tx tinea

Answer 41

terbinafine (lamisil)

Question 42

well marginated oval to round macules scattered with darker or lighter than the surrounding skin..fine scales over the lesions...mild pruritis...

Answer 42

tinea versicolor

Question 43

wood's lamp appears coppery-orange

Answer 43

tinea versicolor

Question 44

KOH shows short, cigar butt hyphae (spaghetti and meatballs)

Answer 44

tinea versicolor

Question 45

tx tinea versicolor

Answer 45

selenium sulfide topical, ketoconazole/fluconazole

Question 46

tx tinea versicolor

Answer 46

selenium sulfide topical, ketoconazole/fluconazole

Question 47

muscle pain, spasm and rigidity from bite

Answer 47

black widow

Question 48

local necrosis, swelling and redness

Answer 48

brow recluse

Question 49

tx black widow

Answer 49

parenteral opioids/muscle relaxants

Question 50

tx brown recluse

Answer 50

oral corticosteroids or excision of bite site

Question 51

pearly papules, erosion or ulceration, central depression, surface telangectasis

Answer 51

BCC

Question 52

atypical nevia

Answer 52

malignant melanoma

Question 53

keratocathoma (central keratin plug and rapid growth) may turn in to what skin cancer?

Answer 53

SCC

Question 54

what is bowen's disease?

Answer 54

SCC in situ

Question 55

erythroplasia of Queyrat?

Answer 55

SCC in situ of uncircumcised men

Question 56

smooth, hairless patches on scalp without scarring

Answer 56

alopecia areata

Question 57

pattern baldness and tx

Answer 57

androgenic alopecia...minoxidil

Question 58

onchomycosis tx

Answer 58

fingernails: grisovulvin toenails: terbinafine

Question 59

what is the name for HPV genital warts?

Answer 59

condyloma accuminatum

Question 60

single/multiple dome-shaped waxy papules that are umbilicated. become soft, white/pearly and may suppurate

Answer 60

molluscum contagiosum

Question 61

verrucae (wart) tx

Answer 61

liquid nitrogen ever 2-4 weeks, keratolytic agents like salicylic acid, podophyllum resin, imiquimod, laser therapy

Question 62

slapped cheecks/lacy reticular rash

Answer 62

erythema infectiosum / fifths disease

Question 63

causative organism of fifths disease

Answer 63

parvovirus B19

Question 64

causative organism of fifths disease

Answer 64

parvovirus B19

Question 65

causative organism of roseola

Answer 65

human herpes virus 6

Question 66

bright red spot then spreads to forma a tense, sharply demarcated, glistening hot plaque. also have pain, chills, fever

Answer 66

erysipelas

Question 67

tx erysipelas

Answer 67

bed rest with head of bed elevated. IV abx...PEN VK, dicloxacillin or cefazolin

Question 68

dark coloration and velvety appearance and texture

Answer 68

acanthosis nigricans

Question 69

recurrent tender abscesses in axillae, groin, buttocks and sometimes sinus tracts

Answer 69

hidradenitus suppurativa

Question 70

hyperpigmentation of face usually due to estrogens

Answer 70

melasma

Question 71

tx of melasma

Answer 71

avoid sunlight, hydroquinone cream, tretinoin cream, laser treatment

Question 72

hypopigmentation or depigmentation

Answer 72

vitiligo

Question 73

tx vitiligo

Answer 73

topical tacrolimus, PUVA thearpy

Question 74

nodules or blotches that may be red, purple, brown, or black, and are usually papular (in other words, palpable or raised) may be accompanying lymphedema of the affected extremity. During the course of the disease (rarely initially), mucous membranes of mouth and gastrointestinal (GI) tract and regional lymph nodes may be affected. GI tract involvement is usually asymptomatic, but bleeding, diarrhea, protein-losing enteropathy, intussusception, and perforation have been reported

Answer 74

kaposi sarcoma

Question 75

tx kaposi sarcoma

Answer 75

surgery, radiation, cryo