Dermatology Flashcards
(7 cards)
Cavernous hemangiomas
Dilated vascular spaces with thin-walled endothelial cells –> soft blue, compressible masses that can appear on skin, mucosa, deep tissues, and viscera.
Those of brain and viscera are a/w VHL disease.
Dermatofibroma
Due to fibroblast proliferation causing isolated or multiple lesions most commonly in LE.
Typically nontender and appear as discrete, firm, hyperpigmented nodules usually < 1 cm diameter. Have a fibrous component that may cause dimpling in center when pinched (“dimple” or “buttonhole” sign).
Treatment (cryosx, shave excision) usually not required unless bleeding, symptomatic, or changes in color/size.
Treatment of acne vulgaris
Comedonal acne - closed/open comedones on forehead, nose, chin that may progress to inflammatory pustules or nodules –> topical retinoids, salycylic
Inflammatory acne - inflamed papules (<5 mm) and pustules; erythema –> mild give topical retinoids + benzoyl peroxide; moderate add topical abx (erythromycin, clindamycin); severe add oral abx
Nodular cystic acne - large (>5 mm) nodules that can appear cystic that may merge to form sinus tracts with possible scarring –> topical retinoid + benzoyl peroxide + topical abx for moderate; oral abx for severe; oral isoretinoin for unresponsive severe
Drug induced acne vs. acne vulgaris
Drug-induced usually 2/2 to systemic glucocorticoids but can also be topical glucocorticoids, as well as other drugs. Present as MONOMORPHIC papules w/o associated comedones and commonly involves upper back, shoulders, upper arms.
Acne vulgaris usually lesions of various stages of development and typically on face in adolescents.
Telogen effluvium
Acute diffuse non-inflammatory hair loss–one of most common cause of hair loss in adults. Scalp and hair fibers appear normal –> hair shafts easily pulled out (hair pull test, > 10-15%)
Triggered by stressful event, such as weight loss, pregnancy, major illness or surgery, psychiatric trauma.
Self-resolving but may take up to a year to completely resolve.
Actinic keratosis
Crusty scaly non-pruritic/non-bloody papules or plaques most commonly in fair skinned individuals.
Major sun exposure is major risk factor and often skin around has evidence of solar damage (eg telangiectasia, hyperpigmentation). Can progress to SCC.
Individual lesions can be treated with cryotherapy but large areas of involvement may required field therapy (eg fluorouracil).
Frostbite
Clinical findings: superficial pallor and anesthesia; blistering eschar formation; deep tissue necrosis and mummification
Management: rapid rewarming in warm water bath; analgesia and wound care; thrombolysis in severe limb threatening cases
Warming with dry heat = hard to maintain precise temp control.
Debridement NOT indicated until tissue rewarmed and an accurate survey of devitalized tissue can be performed.
