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Family Medicine EOR > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is acanthosis nigricans?

A

a skin condition characterized by dark, velvety patches in body folds and creases

  • typically occurs in people who are obese and is associated with insulin resistance, PCOS, and diabetes
  • more rarely, it can be a warning sign of a cancerous tumor particularly gastric adenocarcinoma
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2
Q

What is the tx of acanthosis nigricans?

A

treating underlying conditions, such as obesity or tumor, may restore the skin

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3
Q

What is acne vulgaris?

A

characterized by areas of open comedones (blackheads) incomplete blockage, closed comedones (whiteheads) complete blockage, papules, pustules, nodules or cysts, may result in scarring
-I - comedonal: comedones (+/- small amounts of papules and pustules)
-II - papular: moderate number of lesions, little scarring
III - Pustular: lesions > 25, moderate scarring
IV - nodulocystic: severe scarring

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4
Q

How is acne differentiate?

A

by the presence of comedones

-open comedones (blackheads) incomplete blockage, closed comedones (whiteheads) complete blockage

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5
Q

What is the tx of acne vulgaris?

A
  • most acne - topical retinoids
  • cystic acne - tetracyclines, then oral retinoids - isotretinoin (causes dry lips, liver damage, increased triglycerides/cholesterol, pregnancy category X, must obtain 2 pregnancy test prior to starting it and monthly while on it
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6
Q

What is actinic keratosis?

A

flesh-colored, pink or yellow-brown lesions with a rough sandpaper feel

  • occurs on sun-exposed surfaces and is a precursor to squamous cell carcinoma
  • it is mot common on the face, lips, ears, back of hands, forearms, scalp, and neck
  • the rough, scaly skin patch enlarges slowly and usually causes no signs or symptoms
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7
Q

What is the tx of actinic keratosis?

A

because it can become cancerous, it’s usually removed as a precaution
-treat with observation (many resolve on their own), cryosurgery, 5 FU cream, electrodeiccartion or Imiquimod

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8
Q

What is alopecia?

A

sudden hair loss that starts with one or more circular bald patches that may overlap - oval shaped well-demarcated hair loss 90% of alopecia cases are due to the following disorders

  • alopecia is preceded by a psychologically or physically stressful event 6-16 weeks prior to onset of hair loss
  • growing hairs convert rapidly to resting hair
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9
Q

What is tinea capitis?

A

hair loss secondary to fungal infection of the scalp

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10
Q

What is alopecia areata?

A

oval-shaped well-demarcated hair loss, autoimmune - attack against hair follicles, onset usually prior to 30 years of age; men and women are equally affected, well-documented genetic predisposition

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11
Q

What is traction alopecia?

A

caused by pulling force being applied to the hair (tight hairstyles)

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12
Q

What is telogen effluvium?

A

scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (the resting phase of the hair follicle)

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13
Q

What is androgenic alopecia?

A

typical male pattern baldness

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14
Q

What is basal cell carcinoma?

A

a type of cancer that begins in the basal cells

  • basal cells produce new skin cells as old ones die
  • limiting sun exposure can help prevent these cells from becoming cancerous
  • typically appears as a white waxy or a brown scaly patch, raised pearly and rolled borders, telangiectasis, a central ulcer on sun-exposed areas, such as the face and neck
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15
Q

What is the tx for basal cell carcinoma?

A

prescription creams fluorouracil (FU) and imiquimod, photodynamic therapy (PDT) and surgical excision with clear margins

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16
Q

What is bullous pemphigoid?

A

a rare, chronic acquired autoimmune sub-epidermal blistering skin disorder caused by linear disposition of autoantibodies (IgG) against hemidesmosomes in the epidermal-dermal junction

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17
Q

What are the characteristics of bullous pemphigoid?

A
  • bullous pemphigoid is less severe than pemphigus vulgaris, does not affect mucous membranes and has a negative Nikolsky sign
  • large bullae and crusts located on axillae, thighs, groin, abdomen, more tense, less fragile and deeper than pemphigus vulgaris
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18
Q

How is the dx of bullous pemphigoid made?

A

by skin biopsy with direct immunofluorescence exam shows deposition of IgG and C3 basement membrane

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19
Q

What is the tx of bullous pemphigoid?

A

systemic corticosteroids

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20
Q

What is cellulitis?

A

acute bacterial skin and skin structure infection of the dermis and subcutaneous tissue; characterized by pain, erythema, warmth, and swelling

  • margins are flat and not well demarcated
  • caused by staphylococcus and streptococcus in adults
  • H. influenzae or strep pneumonia in children
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21
Q

What is the tx for cellulitis?

A

treat mild cellulitis (MSSA) with cephalexin or dicoxacillin

  • treat methicillin-resistant staphylococcus aureus infection (MRSA) with
  • trimethoprim-sulfamethoxazole (TMP-SMZ) 1 DS tab PO BID
  • clindamycin 300-450 mg PO
  • doxycycline 100 mg PO BID
  • intravenous vancomycin or linezolid
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22
Q

What is condyloma acuminatum?

A

(also known as genital warts or anogenital warts) refers to an epidermal manifestation attributed to the epidermotrophic human papillomavirus (HPV)

  • flesh-colored, cauliflower appearance genital warts caused by HPV types 6 and 11
  • the HPV quadrivalent vaccine (Gardasil) protects against 6 and 11 and the 2 most cancer-promotion types, 16 and 18, treated with imiquimod (Aldara), podofilox, cryotherapy, surgery, or TCA
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23
Q

What is contact dermatitis?

A

well-demarcated erythema, erosions, vesicles

  • allergic: nickel, poison ivy, etc. type 4 hypersensitivity
  • irritant (diaper rash): clearers, solvents, detergents, urine, feces
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24
Q

What is the tx of contact dermatitis?

A

avoid offending agent, Burrow’s solution (aluminum acetate), topical steroids, zinc oxide (diaper rash)

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25
Q

What is atopic dermatitis?

A

pruritic, eczematous lesions, xerosis (dry skin) , and lichenification (thickening of the skin and an increase in skin markings)

  • most common on flexor creases (ex. antecubital and popliteal folds)
  • IgE, type 1 hypersensitivity
  • infant - face and scalp
  • adolescent - flexural surfaces
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26
Q

What is nummular eczema?

A

coin-shaped/disc-shaped

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27
Q

What is seborrheic dermatitis?

A

(cradle cap)

  • erythematous, yellowish greasy scales, crusted lesions
  • infants - scalp (cradle cap)
  • adults/adolescents - body folds
  • treatment: ketoconazole shampoo
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28
Q

What is perioral dermatitis?

A

young women, Papulopustular, plaques, and scales around the mouth

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29
Q

What is the tx for perioral dermatitis?

A

topical metronidazole, avoid steroids

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30
Q

What is a drug eruption?

A

an adverse cutaneous reaction in response to the administration of a drug

  • skin reactions are the most common adverse drug reactions
  • severity can range from mild eruptions that resolve after the removal of inciting agent to severe skin damage with multi organ involvement
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31
Q

What is dyshidrosis?

A

characterized by a pruritic vesicular eruption comprised of clear, deep-seated vesicles without erythema erupting on the lateral aspects of fingers, the central palm, and plantar surfaces

  • the eruption has been described as resembling tapioca pudding
  • the onset may be acute, recurrent, or chronic
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32
Q

What is the tx of dyshirdrosis?

A

petroleum jelly, moisturizer, cold compresses, and topical steroids

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33
Q

What is erysipelas?

A

a distinct form of cellulitis notable for acute, well-demarcated, raised superficial bacterial skin infection with lymphatic involvement almost always caused by streptococcus pyrogens

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34
Q

What are the symptoms of erysipelas?

A

redness and pain at the affected site, fevers, and chills

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35
Q

What is the tx of erysipelas?

A

mild disease can be treated with penicillin G

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36
Q

What is erythema multiforme?

A

an acute, self-limited and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction associated with certain infections - most commonly herpes simplex virus (HSV), medications (sulfa drugs), and other various triggers

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37
Q

What are the characteristics of erythema multiforme?

A
  • skin lesions predominantly involving the extremities (hands, feet, and mucosa)
  • target-like shape, raised, blanching and lack of itchiness help characterize this rash
  • erythema multiforme is divided into major and minor forms and is now regarded as distinct from Stevens-Johnson syndrome and Toxic Epidermal Necrolysis
  • infections are probably associated with at least 90% of cases of erythema multiforme - most commonly HSV
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38
Q

What is erythema infectiosum (fifth disease)?

A
  • parvovirus B19 - “slapped cheek” rash on face - lacy reticular rash on extremities, spares palms and soles
  • resolves in 2-3 weeks
  • treatment is supportive, anti-inflammatoires
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39
Q

What are the characteristics of hand-foot-and-mouth disease?

A
  • children <10 years old caused by coxsackievirus type A virus producing sores in the mouth and a rash on the hands, feet, mouth, and buttocks
  • the virus usually clears up on its own within 10 days
  • treatment is supportive, anti-inflammatories
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40
Q

What are the characteristics of measles (rubeola)?

A
  • the 4 C’s - cough, coryza, conjunctivitis, and cephalocaudal spread
  • morbilliform - maculopapular, brick red rash on face beginning at hairline then progressing to palms and soles last - rash lasts 7 days
  • Koplik spots (small red spots on buccal mucosa with blue-white pale center) precedes rash by 24-48 hours
  • treatment is supportive - anti-inflammatories, isolate for 1 week after onset of rash
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41
Q

What are the characteristics of Rubella (German measles)?

A
  • “3-day rash” pink light red-spotted maculopapular rash first appears on the face, spreads caudally to the trunk and extremities and becomes generalized within 24 hours (lasts 3 days)
  • cephalocaudal spread of maculopapular rash, lymphadenopathy (posterior cervical, posterior auricular)
  • although the distribution of the rubella is similar to that of rubeola, the spread is much more rapid, and the rash does not darken or coalesce
  • teratogenic in 1’st trimester - congenital syndrome - deafness, cataracts, TTP, mental retardation
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42
Q

What are the characteristics of roseola (sixth disease)?

A

Herpesvirus 6 or 7, only childhood exanthema that starts on the trunk and spreads to the face
-high fever 3-5 days then rose pink maculopapular blanch able rash on trunk/back and face

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43
Q

What is folliculitis?

A

infection of one or more hair follicles (packers form which hair grows) characterized by papules and pustules

  • the lesions are erythematous papules or pustules, they are usually not painful but may burn
  • commonly caused by S. aureus but can be caused by other organisms, Pseudomonas folliculitis is seen in hot tub users
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44
Q

What is the tx of folliculitis?

A
  • mupirocin ointment and topical benzoyl peroxide cream are first-line
  • in more extensive cases, oral antibiotics may be necessary - dicloxacillin and cephalexin, if methicillin - resistant S. aureus is suspected, patients should be treated with trimethoprim/sulfamethoxazole, clindamycin or doxycycline
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45
Q

What is hidradenitis suppurative?

A

chronic follicular occlusive disease manifested as recurrent inflammatory nodules, abscesses, sinus tracts, and complex scar formation

  • pea-to marble sized nodules under the skin that can be painful and tend to enlarge and drain pus
  • they usually occur where skin rubs together, such as in the armpits, groin, and buttocks
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46
Q

What is the tx of hidradenitis suppurative?

A

intralesional triamcinolone is 1’st line treatment

-oral and topical antibiotics, hygiene, warm soaks, and sometimes surgery can help manage symptoms

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47
Q

What is impetigo?

A

a highly contagious skin infection that causes red sores on the face

  • the main symptom is red sores that form around the nose and mouth
  • the sores rupture, ooze for a few days, then form a yellow-brown crust
  • “honey-colored” and weeping
  • most commonly caused by S. aureus
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48
Q

What is the tx of impetigo?

A
  • topical mupirocin, dicloxacillin, cephalexin for more severe illness
  • complications: post streptococcal glomerulonephritis
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49
Q

What is Kaposi sarcoma?

A

causes lesions to grow in the skin, lymph nodes, internal organs, and mucous membranes lining the mouth, nose and throat

  • it is associated with human herpesvirus 8 and is an AIDS-defining cancer
  • purple, red or brown skin blotches are a common sign
  • tumors also may develop in other areas of the body
50
Q

What is the tx of Kaposi sarcoma?

A

may include radiation or chemotherapy

-rarely, surgery may be needed

51
Q

What are lice?

A

pruritic scalp, body or groin

  • nits are observed as small white specs on the hair shaft
  • body (corporis); pubic (pubis)
52
Q

What is the tx for lice?

A

launder potential formites such as sheets in hot water (>131 F or 55 C)
-permethrin topical is the drug of choice: capitis: shampoo to towel-dried hair and wash after 10 minutes; pubis: permethrin lotion x 8 hours

53
Q

What is lichen planus?

A

a chronic papulosquamous inflammatory dermatosis of unknown etiology, probably autoimmune in origin

54
Q

What are the characteristics of lichen planus?

A
  • appears as purplish, itchy, flat-topped bumps
  • on mucous membranes, such as in the mouth, it forms lacy white patches, sometimes with painful sores
  • clinically characterized by 5Ps purple, papule, polygonal, pruritus, planar
  • wichham striae: which lines visible in the papules of lichen planus and other dermatoses
55
Q

What is the tx for lichen planus?

A

topical steroids

56
Q

What is lichen simplex chronicus?

A

is chronic dermatitis resulting from chronic, repeated rubbing or scratching of the skin

  • skin becomes thickened with accentuated lines (“lichenification”)
  • the contrast scratching caused thick, leathery, brownish skin
  • a long-term manifestations of scratching atopic dermatitis
57
Q

What is the tx of lichen simplex chronicus?

A

break the itch-scratch cycle (anti-histamines, occlusive dressing)

58
Q

What is a lipoma?

A

benign fatty tumors, generally slow-growing, and usually harmless

  • lipomas are just under the skin and move easily when pressure is applied
  • they commonly occur in the neck, shoulders, back, abdomen, arms and thighs
  • if the presenting lesion is fast-growing, suspect another diagnosis
59
Q

What is the tx of a lipoma?

A

generally isn’t necessary, but if the lipoma is bothersome, painful or growing, surgical excision or or liposuction may be needed

60
Q

What is an epidermal inclusion cyst?

A

refers specifically to an epidermoid cyst that is the result of the implantation of epidermal elements in the dermis

  • most of the cysts appear at solitary, soft, well defined, mucin-filled lesions
  • characteristically, they have a smooth surface and a small opening to the surface of the skin, known as a puncture
  • epidermoid cysts are benign lesions; however, very rare cases of various associated malignancies have been reported
61
Q

What is the tx of a epidermal inclusion cyst?

A

close observation of the tumor in asymptomatic cases and surgical management, if necessary

62
Q

What is melanoma?

A

usually a pigmented lesion with an irregular bored, irregular surface, or irregular coloration
-occurs when the pigment-producing cells that give color to the skin (melanocytes) become cancerous

63
Q

What are the characteristics of melanoma?

A
  • symptoms might include a new, unusual growth or a change in an existing mole
  • can occur anywhere on the body
  • asymmetrical, unevenly pigmented patch/plaque with a nodule and an irregular border
64
Q

What are the ABCDE of melanoma?

A 
Asymmetry 
Border is irregular 
Color variability (blue, red, white) 
Diameter (increasing or >6 mm) 
Elevation (raised) 
-prognosis of melanoma is most strongly associated with the depth of the lesion, based on the Clark Classification system of Microstaging
65
Q

What is the Clark Classification System of Microstaging for melanoma?

A
  • Level 1: confined to the epidermis (in situ)
  • Level 2: invasion into the papillary dermis
  • Level 3: penetration to the papillary-reticular interface
  • Level 4: invasion into the reticular dermis
  • Level 5: penetration into the subcutaneous fat
66
Q

What is the tx for a melanoma?

A

may involve Mohs surgery, radiation, medications, or in some cases chemotherapy

67
Q

What is Melasma?

A

can be due to increase in estrogen during pregnancy or from sun exposure

68
Q

What are the characteristics of Melasma?

A
  • hyperpigmentation of the sun-exposed areas of the face (cheeks, forehead, nose and chin)
  • appear dark, irregular, well-demarcated macule/patches
  • also known as chloasma = “mask of pregnancy”
  • in women, melismas often fades on its own after pregnancy or after an affected women goes off birth control
69
Q

What is the tx for melasma?

A

treat with sunscreen and topical hydroquinone (bleaching agent)

70
Q

What is molluscum contagiosum?

A

caused by the poxvirus, pearly papules with central umbillication

71
Q

What is the tx of molluscum contagiosum?

A

the bumps usually disappear on their own

-may be removed with curettage, cryotherapy, or acid or exfoliative peel-tretinoin, imiquimod (alder)

72
Q

What is nummular eczema?

A

also known as nummular dermatitis or discoid eczema, is a chronic condition that causes coin-shaped rashes or sores to appear on the skin

  • it may occur after an injury
  • these spots are often itchy and well-defined
  • the condition may results in one patch or multiple patches of coin-shaped lesions
73
Q

What is the tx of nummular eczema?

A

high or ultra-high potency topical corticosteroids are first-line therapy for nummular eczema
-for patients with recalcitrant disease, a short course of systemic corticosteroids is an alternative treatment

74
Q

What is onychomycosis?

A

a nail fungus causing thickened, brittle, crumbly, or ragged nails

  • the main symptoms are change in the appearance of nails
  • rarely, the condition causes the pain or a slightly foul odor
  • a typical workup includes a fungal culture plus a test that yields faster results, such as a (KOH) preparation or periodic acid-Schiff (PAS) stain
75
Q

What is the tx of onychomycosis?

A

terbinafine x 6 weeks for fingernails and 12 weeks for toenails
-LFT monitoring is necessary for most oral anti fungal regimens

76
Q

What is a paronychia?

A

superficial inflammation of the lateral and posterior folds of skin surrounding the fingernail or toenail
-caused by candida if chronic and staph aureus if acute

77
Q

What is the tx for paronychia?

A
  • without abscess formation - topical antibiotics and warm water of antiseptic soaks (eg, chlorhexidine, providone-iodine) multiple times per day is usually effective
  • empiric oral antibiotic therapy may be needed in more severe cases: an anti staphylococcal agent such as dicloxacillin (250 mg four times daily) or cephalexin (500 mg three to four times daily) is appropriate first-line therapy
  • paronychia with abscess - incision, and drainage
  • tetanus booster if indicated
78
Q

What is pilonidal disease?

A

an abnormal skin growth located at the tailbone that contains hair and skin

  • will usually present as a teenager with pain, discomfort, and swelling above the anus or near the tailbone that comes and goes
  • often includes drainage of pus or blood
79
Q

What is the tx of pilonidal disease?

A

involves drainage and surgical removal of the cyst - look for sinus tract

80
Q

What is Pityriasis rosea?

A

typically occurs in childbirth and young adults

  • characterized by an initial herald patch, followed by the development of a diffuse papulosquamous rash
  • easier to identify when the general eruption appears with smaller secondary lesions that follow Langer’s lines (cleavage lines) in a Christmas tree-like pattern
  • herald patch: large oval plaque with central clearing and scaly border, 1st sign
  • pruritic erythematous plaque with central scale in Christmas tree pattern on the trunk
81
Q

What is the tx of Pityriasis rosea?

A

self-limiting: topical or systemic steroids and antihistamines are often used to relieve itching
-asymptomatic lesions do not require treatment

82
Q

What is a pressure ulcers?

A

injury to the skin and underlying tissue resulting from prolonged pressure on the skin over a bony prominence

  • sacrum and hip most often affected
  • prevent by repositioning every 2 hours
83
Q

What are the stages of pressure ulcers?

A
  • Stage 1: erythema of localized area, usually non-blanching over the bony surface
  • Stage 2: partial loss of dermal layer, resulting in pink ulceration
  • Stage 3: full dermal loss often exposing subcutaneous tissue and fat
  • Stage 4: full-thickness ulceration exposing bone, tendon, or muscle, osteomyelitis may be present
84
Q

What is the wound management by the stage of the ulcer?

A
  • Stage 1: aggressive preventive measures, thin-film dressing for protection
  • Stage 2: occlusive dressing to maintain healing, transparent films, hydrocolloids
  • Stage 3-4: debridement of necrotic tissue, exudative ulcers will benefit from absorptive dressings such as calcium alginates, foams, hydrofibers, dry ulcers require occlusive dressings to maintain moisture, including hydrocolloids, and hydrogels
85
Q

What is psoriasis?

A

an immune-mediated disease that causes raised, red, scaly patches to appear on the skin

86
Q

What are characteristics of psoriasis?

A
  • typically affects the extensor surfaces of the elbows, knees, or scalp, though it can appear on any location on any location
  • the classic clinical appearance is a well-demarcated, erythematous plaque with silvery scaling
  • patients may also present with no rash and only join symptoms - pain in both hands and nail changes such as pitting and onycholysis
  • Auspitz sign (bleeds when the scale is picked). Koebner’s phenomenon (minor trauma causes new lesion)
  • Psoriasis Vulgaris: most common, noted on extensor surfaces
  • Guttate psoriasis: children, after URI, small lesions
  • Inverse psoriasis: intertriginous areas
  • pustular psoriaisis: contains pustules
87
Q

What is the tx for psoriasis?

A

topical steroids

88
Q

What is rosacea?

A

women aged 30-50, facial erythema, telangiectasis, papules, may cause rhinopehyma

  • triggers include heat, alcohol, spicy foods, treat with topical metronidazole
  • differentiate from acne by lack of comedones (blackheads)
89
Q

What is scabies?

A

pruritic papules, s-shaped or linear burrows on the skin

  • often located in web spaces of hands, wrists, waist with severe itching (worse at night)
  • diagnose with microscopic observation of mite, egg or feces after skin scrape
90
Q

How do you treat scabies?

A
  • treat with topical permethrin 5%
  • all clothing bedding, towels washed and dried using heat
  • have no contact with body for at least 72 hours
  • oral ivermectin for adults and children weighing at least 33 pounds who can swallow pills (OK for nursing women, but avoid in pregnancy)
91
Q

What is seborrheic keratosis?

A

most common benign skin tumor seen in fair-skinned elderly patients with prolonged sun exposure
-brown, black, or tan growth with waxy, “stuck on” appearance, commonly referred to as barnacles of old age

92
Q

What is the tx of seborrheic keratosis?

A

not premalignant and needs no treatment unless the lesions are irritated, itchy, or cosmetically bothersome
-lesions may be removed with little or no scarring by cryotherapy (which can cause hypo pigmentation) or by electrodesiccation and curettage after local injection of lidocaine

93
Q

What are the characteristics of a brown recluse bite?

A
  • brown violin on the abdomen
  • necrotic wound - local tissue reaction causes local burning at the site for 3-4 hours - blanched area (due to vasoconstriction) - central necrosis erythematous margin around an ischemic center “red halo” - 24/7 hours after hemorrhagic bullae that undergoes Eschar formation - necrosis
94
Q

What are the characteristic of black widow bit?

A
  • red hourglass on the abdomen
  • neurologic manifestations - may not see much at bite site: toxic reaction: nausea, vomiting, HA, fever, syncope, and convulsions
95
Q

What is the tx for brown spider bites?

A

wound care, local symptomatic measures and sometimes delayed excision

96
Q

What is the tx for black widow spider bites?

A

includes wound care, local symptomatic measures, sometimes parenteral opioids, benzodiazepines
-treat with anti-venom available for elderly and kids

97
Q

What is Stevens-Johnson syndrome?

A

a rare, serious hypersensitivity complex that affects the skin and the mucous membranes
-usually a reaction to a medication or an infection commonly caused by anticonvulsants and sulfa drugs

98
Q

What are the characteristics of Stevens-Johnson syndrome?

A
  • SJS is 3-10% of the body
  • begins with a prodrome of flu-like symptoms, followed by a painful red or purplish rash that spread and blisters
  • layers of skin peel away in sheets (+) Nikolsky’s sign (pushing blister causes further separation from dermis)
  • SJS is milder form of toxic epidermal necrolysis (TEN) with less than 10% of body surface area detachment
  • biopsy - shows nectotic epithelium
99
Q

What is the tx of Stevens-Johnson syndrome?

A

treat the underlying cause and supportive (burn unit)

100
Q

What are tinea infections?

A

a highly contagious, fungal infection of the skin or scalp

-KOH - long, branching fungal hyphae with septations

101
Q

What is tinea barbae?

A

papules pustules, around hair follicles

102
Q

What is tinea pedis?

A

athlete’s foot: pruritic scaly eruptions between toes

  • trichophyton rubrum is the most common dermatophyte causing athlete’s foot
  • mgmt: topical antifungals
103
Q

What is tinea cruris?

A

“jock itch” diffusely red rash in the groin or on the scroum

104
Q

What is tinea capitis?

A

most common fungal infection in pediatric population

  • occurs mainly in prepubescent children (between 3 and 7 years
  • asymptomatic carriers are common and contribute to spread
105
Q

What is tinea corporis?

A

(ringworm): usually seen in younger children or in young adolescents with close physical contact with others (i.e. wrestlers)

106
Q

What is tinea versicolor?

A

caused by Malassezia furor, a yeast found on the skin of humans
-lesions consist of hypo or hyper pigmented macule that do not tan

107
Q

What is tinea versicolor?

A

is caused by Malassezia furfur, a yeast found on the skin of humans

  • lesions consist of hypo or hyper pigmented macule that do not tan
  • it is classified as an “other” superficial mycoses since it not caused by dermatophytes
  • seen in adolescents and young adults
  • scaling, oval patches that are either hypo or hyper pigmented
  • distributed on the upper trunk, neck, and proximal arms and in areas where there is a high amount of sebum and free fatting acids, which the organism requires, occasionally on the face
108
Q

What is the tx of tinea versicolor?

A

selenium sulfide 2.5% applied to the affected skin for 10 minutes, wash off thoroughly, apply daily for 7-10 days, monthly applications may help prevent recurrences

109
Q

What is toxic epidermal necrolysis?

A

a rare, life-threatening skin condition that is usually caused by a reaction to drugs

110
Q

What are the characteristics of toxic epidermal necrolysis?

A
  • TEN is >30% of body
  • very similar to Steven-Johnson syndrome - the difference is the age of the individuals (in toxic epidermal necrolysis older patients vs SJS younger patient) and percentage of the body affected (in TEN >30% of body surface area affected vs. SJS <10% of body surface area affected
111
Q

What is urticaria?

A

(hives) is a skin rash triggered by a reaction to certain foods, medications, stress, or other irritants
- symptoms include blanch able, pruritic, raised, red, or skin-colored papules, wheels, or plaques on the skin’s surface
- (+) Darier’s sign: localize urticaria appearing where the skin is rubbed (histamine release)
- angioedema: painless, deeper form of urticaria affecting the lips, tongue, eyelids hand and genital

112
Q

What is the tx of urticaria?

A

usually go away without treatment, but antihistamine medications are often helpful in improving symptoms

  • if anaphylaxis given epinephrine: 0/3-0.5 mg; use 1:1,000 dilation for IM route and 1:10,000 for IV route
  • peds: epinephrine 0.01 mg/kg SC/IV
113
Q

What are warts caused by?

A

by Human papillomavirus (HPV),

-most resolve over 2 years

114
Q

What are verruca vulgaris?

A

common warts

-skin-colored papillomatous papules

115
Q

What are verruca plana?

A

flat warts

-hands, face, arms, legs

116
Q

What are verrucae plantaris?

A

plantar warts

  • bottom of the foot
  • rough surface
  • dark spot (thromboses capillaries)
117
Q

What are condyloma acuminatum?

A

venereal warts

-flesh-colored, cauliflower appearance genital warts caused by HPV types 6 and 11

118
Q

What is epidermodysplasia verruciformis?

A

a rare, lifelong hereditary disorder characterized by chronic infection with HPV

119
Q

What is the tx of verrucae (warts)?

A

most resolve without treatment over 2 years

  • cryotherapy with liquid nitrogen may be applied with a cotton swab or with a cryotherapy gun (cryogen)
  • self-administered topical therapy such as salicylic acid
120
Q

What is vitiligo?

A

caused by autoimmune destruction of melanocytes causing these pigment - producing cells to die or stop functioning

121
Q

What are the characteristics of vitiligo?

A
  • loss of skin color can affect any part of the body, including the mouth, hair, and eyes
  • it may be more noticeable in people with darker skin
  • wood’s light examination reveals a “milk-white” fluorescence over the lesion
122
Q

What is the tx of vitiligo?

A

sunscreen, cover-up, corticosteroids, tacrolimus (an immunosuppressive drug) and vitamin D
-treatment may improve the appearance of the skin but doesn’t cure the disease

Family Medicine EOR (14 decks)

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