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Flashcards in Dermatology Deck (30):
1

What are keloids? Next best step in mgmt?

Keloid: excessive collagen deposition at wound sites that tend to grow outside the boundary of the original wound and have "crab-like" projections from original wound site.
- Tend to recur following excision
- Painful

Tx: intra-lesional corticosteroids after liquid N2 cryotherapy

2

What is the mechanism behind photoxicity from medications? What meds are responsible?

Non-immune reaction where ROS are formed after UV light interacts with the medications --> only occurs on sun-exposed areas

*Doxycycline, thiazides, sulfonamides, fluoroquinolones, NSAIDs

3

Multiple small, light-brown, pedunculated lesions on a person's neck. What are they?

Acrochordon ("skin tags")

4

Small keratotic papules on the palms and soles of a retired miner. He has had no sun exposure in these areas. The biopsy shows invasive SCC arising from SCC in situ. Chronic exposure to what compound is most likely responsible?

Arsenic

*Aside from sunlight, arsenic is MCC

Wart-like keratosis on palms & soles, particularly over eminences.

5

What is cutaneous larva migrans?

What does rash look like?

Tx?

Hookworm infection that lives in tropical areas and found in soil or sand.

Pruritic, red papules --> serpinginous red/brown lesion from larva migration in skin

Tx: thiabendazole

6

Preferred method of assessing suspected melanoma?

What are ABCDEs?

Excisional biopsy --> if (+) then do wide surgical excision

Asymmetry
Border irregularity
Color differences
Diameter >6mm
Evolution over time

7

Most important factor for resection of melanoma?

DEPTH of tumor

8

Describe a chalazion?

Painful swelling that progresses to a nodular rubbery lesion --> a granulomatous condition that develops when meibomian gland becomes obstructed.

If persistent despite treatments --> may be sebaceous carcinoma or basal cell carcinoma

9

Person with sun-exposure and non-healing ulcer on the bottom lip?
What is on histology?

Squamous cell carcinoma

Invasive cords of squamous cells w/ keratin pearls

10

What does pyoderma gangrenosum look like?
What is associated with it?

Inflammatory pustule/vesicle that rapidly progresses into an ulcer w/ purulent base and ragged violaceous borders

**Associated with:
1) Inflammatory bowel disease (Crohn, UC)
2) Arthropathies (RA)
3) Hematologic conditions (AML)

11

In a lesion suspicious of melanoma, what is best initial treatment method?

Excisional biopsy --> narrow margins first

12

Pruritic erythematous plaques with fine, loose, yellow, and greasy-looking scales starting on the face. What is it?

What 2 systemic diseases is this associated with?

Seborrheic dermatitis

Parkinsonism, HIV

13

Rash with rosy hue and telangectasias interspersed throughout the rash usually on nose, cheeks, and chin?

What else can precipitate this?

Rosacea

Hot drinks, heat, emotion, rapid body temp changes

14

What are the 3 types of acne vulgaris and treatments for each?

Mild (non-inflam) comedonal acne --> topical retinoids

Mod-sev inflammatory acne --> above + topical Abx

Unresponsive acne --> oral isotretinoin

15

Newborn develops blanching, non-painful, erythematous papillose and pustules throughout body except for palms and soles. What is it? Tx?

Erythema toxic neonatorum (ETN)

*Blanching, red papules/pustules after birth

Resolves spontaneously

16

Waxy, greasy, "stuck-on" and well-circumscribed - what is it?

Seborrheic keratosis

17

Pearly, rolled border with overlying telangiectasia - what is it?

Basal cell carcinoma

18

Ring-shaped, scaly patches with central clearing and distinct borders on the trunk that are very itchy?

Tinea corporus (ringworm)

19

What type of surgery is employed for removal of BCC on the face?

Mohs surgery

20

Child with papular, scaly rash affecting head, face, and neck?

Sehorrheic dermatitis

21

Small, red, cutaneous papules most common in aging adults?

Cherry hemangiomas

22

Bright red lesions that grow rapidly during first weeks of life and resolve by age 5-8?

Strawberry hemangiomas

23

Intensely pruritic rash on wrist, sides of fingers and finger webs. Small, crusted, red papules are seen. What do you suspect?

Tx?

Scabies

Topical permethrin

24

Tingling and burning of the hand with a vesicular rash?

Herpetic whitlow

25

What things tip you off to contact dermatitis?

History of atopy (allergies)
Occupation needing to wear GLOVES (latex)
Just on hands (pruritus, erythema, swelling, vesicles)

26

Man has 2 days of pain, itching, and rash over L side of his neck. He initially had red papules that developed into vesicles and bullae. He is also on infliximab for RA therapy. What does he have? Tx?

Herpes zoster (shingles)
*Dermatomal distribution w/ pain sometimes prior to rash

*Immunocompromised status predisposes to shingles

Tx: acyclovir, fam-, valacy-

27

Non-healing, painless bleeding skin ulcer that develops associated with chronic scar - what do you think?

Squamous cell carcinoma
(Marjolin's ulcer)

28

Description of actinic keratosis?

Red papules with central scaling (from hyperkeratosis)
*Sandpaper-like texture

Sun-exposed areas --> face, ears, scalp, dorsum of hands/arms

29

Hypopgimented areas that do not tan or hyper pigmented areas with salmon-colored changes. They scale on skin scraping?

Tinea versicolor

30

Child with history of atopic dermatitis had eczema 1 week ago and was treated with topical steroids. Now he has numerous umbilicated vesicles over erythematous skin of both cheeks. What is most likely cause?

Eczema herpeticum

**HSV associated with atopic dermatitis --> vesicles over area of dermatitis