Dermatology (389-430) Flashcards
(95 cards)
1
Q
flat discoloration
A
macule
2
Q
elevated skin lesion
A
papule
3
Q
elevated skin lesion >1cm
A
plaque
4
Q
small fluid containing lesion
A
vesicle
5
Q
pruritic erythematous area that can enlarge to form urticaria
A
Wheal
6
Q
Large fluid filled lesion >0.5cm in diameter
A
Bulla
7
Q
accentuated skin markings as thick as epidermis as a result of scratching
A
lichenification
8
Q
irregular raised lesion from scar tissue hypertrophy
A
keloid
9
Q
flat pinhead NON BLANCHING red-purple lesion caused by hemmorhage into skin
A
petechiae
10
Q
larger than petechiae
A
purpura
11
Q
closed epithelium lined cavity or sac continaing liquid or semi solid material
A
cyst
12
Q
increased thickness of the stratum corneum seen in chronic dermatitis
A
hyperkeratosis
13
Q
hyperkeratosis with retention of the nuclei in stratum corneum on histopathology and thinning of stratum granulosum (seen in psoriasis)
A
parakeratosis
14
Q
loss of cohesion between the epidermal cells (seen in pemphigus vulgaris)
A
acantholysis
15
Q
intercellular edema causing strethcing and loss of desmosomal attachment allowing formation of blisters (seen in acute and subacute dermatitis)
A
spongiosis
16
Q
Herald patch
A
pityriasis rosea
17
Q
What bacterium is often the cause of acne (inflammation of the pilosebaceous unit)
A
Propionibacterium acnes
18
Q
open comedones
A
blackheads
19
Q
closed comedones
A
whiteheads
20
Q
Tx for acne
A
Retin-A, benxoyl peroxide. If acne is scarring, consider accutane or in females spironolactone
21
Q
superficial skin infection causing honey crusted lesions esp in children around nose and mouth
A
Impetigo caused by strep pyogenes or staph aureus
22
Q
Hot tub folliculitis organism
A
Pseudomonas aeruginosa
23
Q
What are the classic signs of inflammation?
A
rubor (red)
calor (hot)
dolor (pain)
tumor (swelling)
24
Q
pus collection of one hair follicle often by S. aureus
A
Furuncle
25
Pus collection involving many hair follicles
Carbuncle
26
Cellulitis in which infection remains in the superficial dermal layer leading to edema localized beneth skin
erisypelas (a/w strep, tx with penicillin)
27
Infection of skin surrounding nail margin, can extend to tendons within hand
Paronychia
Tx with warm compress, I&D if area is purulent, add abx if severe
28
Infection from skin layers down to fascial planes with severe pain out of proportion, fever, white count. Tx?
Necrotizing faciitis
Tx with immediate surgical debreidment. Tx with ceftriaxone or penicillin
29
Prognosis of necrotizing fasciitis
increased mortalitiy unless debreidment is rapid
30
Sunburn with "goosebumps", strawberry tongue, Patia's lines (rash in axillae and groin)
Scarlet Fever
31
plugged apocrine glands presents in inflammed masses in the groin and axilla,
Hiradenitis suppurativa
32
irregular erythematous rash found along major skin folds, commonly seen in adult diabetics and caused by corynebacterium spp.
Woods lamp shows - coral red flourescense, KOH prep negative
Dx? Tx?
Erythrasma
Tx with erythromycin
33
silvery white scaling with pink plaques on EXTENSOR SURFACES like elbows and knees and scalp (esp behind ears) Also associated with FINGERNAIL PITTING WITH ONYCHOLYSIS a/w rheumatoid arthritis
psoriasis
34
What is Auspitz sign?
removal of overlying scale causes pinpoint bleeding --> psoriasis
35
What is Kobner's phenomenon
psoriatic lesions appear at sites of cutaenous physical trauma
36
What type of psoriasis typically presents in child/young adult after streptococcal infection with drop like 1-10mm salmon-pinnk papules with a fine scale?
Guttate psoriasis
37
What type of psoriasis is often localized to the plams and soles, but can be generalized with pustules
Pustular psoriasis
38
What type of psoriasis presents with lesions in the interdiginous areas?very erythematous and look amost like candidal or tinea cruris?
Inverse psoriasis
39
How do you diagnose psoriatic lesions?
biopsy
40
How do you treat psoriatic lesions?
Localized - topical steroids
UVB light and PUVA (Psoralens+UVA) good for diffuse dz
Methotrexate, cyclosporine and TNF antagonists for refractory cases
41
an "itch that rashes" -- rash secondary to chronic pruritis
Atopic dermatitis
42
Inherited predisposition to asthma, allergies and dermatitis. Dx is clinical
Atopy
43
Treatment for atopy?
avoid irritants, keep skin moist with lotions. Use steroids or antihistamines for symptomatic relief
44
Linear pruritic rash at site of lesion, tx?
Contact dermatitis
| tx with oral steroid taper
45
What kind of eczema causes multiple pruritic papules and vesicles on the hand and sides of fingers?
dyshidrotic eczema
46
Chronic inflammatory disorder affecting head and trunk where sebacous glands most prominent. Can be secondary to Malassezia. Aka "Cradle cap" in infants. Tx?
Seborrheic dermatitis
Tx with slenium shampoo
47
Rash caused by mast cell degranulation and histamine release. Can be tested by dermographism.
Urticaria (hives)
dermogrphaism is when you write a word in the skin and it remains imprinted as werythematous wheals.
48
Loss of melanocytes in discrete areas of skin appearing sharply demarcated
Vitiligo
49
How can you treat vitiligo?
Grafting, total depigmentation, chronic UVA/UVB light tx
50
Melanocytes are present, but fail to produce pigment because of tyrosinase deficiency
Albinism --> more disposed to skin ca
51
normal melanocyte number but increased melanin within basal kertainocytes --> darken with sun exposure
Freckle (ephelis)
52
pigmented macules caused by melanocyte herplasia that does not darken with sun
lentigo
53
Common mole, benign tumor derived from melanocytes
nevocellular nevus
54
Variations of nevi
Blue nevus
Spitz nevus
Dysplastic nevus
Blue nevus - black blue nodule present at birth mistaken for melanoma
Spitz nevus - red-pink often seen in children confused with hemangioma or melanoma
Dysplastic nevus - atypical irregularly pigmented lesion with increased risk of transformation to malignant melanoma
55
a benign macular blue-gray birthmark usually on the sacral area of healthy infants
mongolian spot - don't mistake for child abuse, can disappear spontaneously
56
Masklike hyperpigmentation on face seen in pregnancy. Sun accentuates pigmentation
melasma (cholasma)
Tx: hydroqunione cream
57
Capillary hemangiomas present at birth tx?
resolve on own.. consider b blocker if large or surgical excision
58
Derm finding a/w Sturg Weber syndrome
Port wine stain
59
What must you always screen for with Sturg Weber pts with port wine stain?
Glaucoma and CNS disease
Tx: laser Tx, will not regress spontaneously
60
yellowish papules often accumulations of foamy histiocytes. Name? If seen on eyelids?
Xanthoma
xanthelasma
a/w familial hyperlipidemia or idiopathic
61
Erythematous maculopapular rash aka "herald patch" in christmas tree distribution
Pityriasis rosea
62
Tender red nodules occuring on lower legs, sometimes forearms. Common causes include mycoplama, chlamydia, coccioides, mycobacterium leprae, sunfonamides, OCPs, IBD, sarcoid, rheumatic fever, pregnancy
Erythema nodosum
63
Black or brown benigh plaques appear to be stuck on skin surface
seborrheic keratosis
64
Black velvety plaques on flexor surfaces and interdiginous areas
acanthosis nigricans
seen in diabetics or if theres underlying malignancy (lymphoma)
65
Familial defect causing intestinal hyperabsorption of iron. causes increased skin pigmentation, cirrhosis and DM
hemachromatosis --> Bronze diabetes
66
Osteoarthritis involving the metacarpophalengeal joints
HEMACHROMOTOSIS * pearl
67
Seborrheic keratosis is a sign of what dz?
Lesses- Trelat --> adenocarcinoma of the GI tract
68
hand wart
verruca vulgaris
69
flat wart seen on hands and face
varruca plana
70
Which HPV causes skin and plantar warts?
HPV 1-4
71
Which HPV cause anorectal and genital warts?
HPV 6 and 11 (condyloma acuminatum
72
Which HPV cause cervical CA?
HPV 16,18, 31, 33, 35
73
flat warts caused by treponema pallidum
condyloma lata
74
What is the treatment for verruca?
verrucae salicylic acid, liquid nitrogen or topical imiquimod.
75
Most common skin Ca. Rodent ulcer seen on face with translucent borders and fine telangectasias. Not usually found on lips
Basal cell Ca
76
Common in elderly on areas like lower lip, ears and nose. Frequently preceded by actinic keratosis which are rough epidermal lesions on sun exposed areas
Squamous cell ca
77
What are ABCDEs
```
Asymmetry
Boarder (irregular)
Color (multicolor)
Diameter (>6mm, malig)
Elevation (raise)
Enlargement (growing)
```
78
Connective tissue CA caused by HHV8 that appears like red purple plaques, often seen in AIDS, elderly or Mediterranean males
Kaposi's sarcoma
79
Mycosis fungoides presents with erythematous patches and plaques that ulcerate. What is the ca?
Cutaenous T cell lymphoma.
Leukemic phase of the dz is called Sezary syndrome
80
Ash leaf patches (hypopigmented macules) Shagreen spots (leathery cutaenous thickeing) ademoma sebaceum of the face, SZ, MENTAL RETARDATION
Tuberous sclerosis
81
Cafe o Lait spots, neurofibromas, meningiomas, acoustic neuromas, kyphoscoliosis
Neurofibromatosis.
NF2 causes bilateral acoustic neuromas.
82
Port wine distribution of the face in CN V distribution, mental retardation SZ
Sturge Weber
83
Multiple hemangiomas in various organs, increased frequency of Renal Cell Ca and polycythemia
Von Hippel Lindau syndrome
84
Rare autoimmune disorder affecting 20-40 yr olds with flaccid epidermal bullae that easily slough off. How to dx?
+Nikolsky's sign
Pemphigus vulgaris
Dx: immunoflourescence surrounding epidermal cells with "tombstone" flourescent pattern
85
How to tx pemphigus vulgaris? (4 drugs)
High dose steroids, cyclosporine, Moflitel, antibiotics
86
Common autoimmune dz often affects elderly with hard tense bullae that do not rupture easily
Bullous pemphigoid
87
What does biopsy of bullous pemphigoid show?
linear band along the basement membrane with increased eosinophils
88
How do you treat bullous pemphigoid?
steroids
89
Hypersensitivity reaction to drugs/ infxn / systemic disorders that cause diffuse erythematous target like lesions
Erythema multiforme
90
What is the severe febrile form of erythema multiforme that can cause hemorrhagic crusting and affects lips and oral mucosa
Strevens johnson syndrome
91
autosomal dominant defect in heme synthesis that causes decreased uroprophyrinogen decarboxlase activity in the RBC and liver
porphyria cutanea tarda
92
What are the sx of porphyria cutaena tarda
blisters on sun exposed areas
hair on temples and cheeks
no abdominal pain
93
How do you diagnose porphyria cutaena tarda
urine flouresces with distinctive orange pink color bc of increased levels of uroporphyrins
94
Tx for porphyria cutanea tarda?
sunscreen, phlebotomy, cholorquine, no alcohol
95
From .423-430
Do sketchy micro
