Dermatology Flashcards
(148 cards)
1
Q
Diagnosis of bullous pemphigoid
A
Biopsy both lesional skin for histology + perilesional normal skin for direct immunofluorescence
2
Q
Pityriasis (tinea) versicolor presentation
A
- young adult + asymptomatic + oval to round hyper or hypogpigmented macules
3
Q
Treatment of pityriasis versicolor
A
Topical antiseborrheic shampoos or lotions (selenium sulfide or ketoconazole)
4
Q
Tinea diagnosis
A
KOH prep using scale showing fungal hyphae
5
Q
Tinea infection presentation
A
Annular + peripheral scale + central clearing
6
Q
Eczematous dermatitis treatment (specific treatment)
A
- topical glucocorticoids
- mild cleansers, emollients (petrolatum)
7
Q
eczema location
A
antecubital and popliteal fossa
8
Q
diagnosis of urticarial vasculitis
A
Skin biopsy
9
Q
Presentation of urticarial vasculitis
A
Short duration urticarial wheels that resolve + painful + leave bruise-like changes
10
Q
Diagnosis of allergic contact dermatitis
A
Epicutaneous patch testing
11
Q
Treatment of striae and atrophy from topical steroids
A
Stop topical steroids
12
Q
Chickenpox (varicella) presentation
A
Pruritic papules and vesicles on umbilicate center that appear in crops and then crust over
13
Q
What is melanonychia?
A
Brown longitudinal pigmentation of nail plate
14
Q
What is paronychia?
A
Loss of cuticles, tender, edematous nail folds involving multiple fingers
15
Q
Definition of moderate to severe psoriasis
A
30% or more body surface area involvement
16
Q
Treatment of moderate to severe psoriasis
A
Systemic agents (MTX, TNF inhibitors – etanercept, adalimumab, infliximab)
17
Q
Other indications for systemic therapy with psoriasis
A
- psoriatic arthritis, pustular psoriasis, or groin/scalp involvement
18
Q
Treatment of pruritic urticarial papules and plaques of pregnancy (PUPPP)
A
Topical steroids
19
Q
Treatment of intrahepatic cholestasis of pregnancy
A
ursodeoxycholic acid
20
Q
What is miliaria + presentation
A
- “heat rash”
- multiple discrete red papules due to the occlusion of sweat ducts
- often due to sweat gland occlusion from patient being immobilized (after surgery)
21
Q
Candida clinical features
A
Intertriginous areas
22
Q
Treatment of severe nodulocystic acne
A
Oral isotretinoin
23
Q
What is amyopathic dermatomyositis?
A
skin findings characteristic of dermatomyositis but without clinical or laboratory evidence of muscle disease
24
Q
Characteristic findings of dermatomyositis
A
Heliotrope sign, shawl sign, gottron papules
25
Mixed connective tissue disease clinical features
Features of SLE + systemic sclerosis + polymyositis
26
Strongest prognostic indicator in Stevens-Johnson syndrome/toxic epidermal necrosis (TEN
Body surface area
27
Bullous pemphigoid clinical features
Elderly person + trunk and upper legs + intact/nonruptured blisters
28
Treatment of impetigo
IF mild --> mupirocin ointment
| More severe --> oral abx (dicloxacillin, erythromycin)
29
Impetigo clinical features
Honey-colored crust + common in kids
30
Rheumatoid vasculitis clinical features
Elderly male smoker + long-standing RA history +
31
Presentation of actinic purpura
Age and sun damage-related capillary fragility + bleeding under atrophic skin
32
Presentation of subacute cutaneous lupus erythematous (SCLE)
Photodistributed + worsens with sun exposure + erythematous annular scaly patches
33
Common causes of drug induced SLE
```
HCTZ
ACEinhibitors
NSAIDs
PPIs
Terbinafine
```
34
Management of recurrent cellulitis
Source control (treat intertrigo and maceration between toe spaces + treat edema + eczema + venous insufficiency)
35
Cellulitis presentation
Well-demarcated + warm + tender
36
Management of recurrent actinic keratosis
Biopsy to rule out neoplasm (can't completely cut it out because histology is necessary to guide treatment)
37
Presentation of actinic keratoses
Red scaly papules and plaques that occur in sun-exposed areas in old people
38
Treatment of actinic keratoses
IF single --> Cryotherapy
| IF grouped --> 5-Fu or imiquimod
39
Standard treatment of basal cell carcinoma
Typically wide local excision
40
Basal cell carcinoma clinical features
Asymptomatic + translucent/pearly + sun-exposed areas + telangiectasis
41
Keratoacanthoma presentation
(look at picture)
- rapidly growing pink nodule with crusted core and central crater (volcaniform)
- rapidly grow, then slowly involute, eventually resolving completely
42
Squamous cell carcinoma presentation
(see picture)
| - pink hyperkeratotic papule or nodule
43
SCC compared with basal cell
SCC's have scale and do not have translucent, pearly appearance
44
What is lupus pernio
Sarcoidosis of the nose and central face
45
Presentation of lupus pernio
Violaceous subcutaneous plaques or nodules
46
Management of basal cell tumor on the face or genitals
Mohs surgery (also used for large or recurrent tumors, tumors with aggressive features)
47
Erythema multiforme clinical features
Target lesions + mucous membrane involvement + often triggered by drug or infection (mycoplasma or HSV)
48
Disseminated gonorrhea presentation
Vesiculopustular or hemorrhagic macular skin lesions + polyarthralgia
49
Actinic purpura is
age-related bruising due to capillary fragility and bleeding under atrophic skin
50
clinical features of stasis dermatitis
Edema + erythema + scaling + pruritus + more often bilateral
51
treatment of stasis dermatitis
Start with compression stockings and leg elevation
| Can also use topical steroids and emollients
52
stasis dermatitis vs. cellulitis
Cellulitis = tender, not pruritic, hot to the touch, less scaling than stasis dermatitis
53
Psoriasis clinical features
Well-demarcated + erythematous plaques with silvery scale + nail changes
54
Treatment of epidermal inclusion cyst
Excision (NOT I&D, only I&D if they rupture)
55
Term for hair loss with pregnancy + why it happens
Telogen effluvium
| - triggered by physically traumatic event (surgery, parturition)
56
seborrheic dermatitis clinical features
Erythematous patches w/ greasy scale + located on scalp, nasolabial folds and chest
57
Seborrheic dermatitis associations
```
HIV
Neurologic conditions (Parkinson disease)
```
58
Derm conditions associated with chronic hep C
Porphyria cutanea tarda
| Lichen planus
59
Transient acantholytic dermatosis clinical features
Red pruritic papules on the chest, flanks, and back + due to dry skin, heat, and heavy sweating
60
Allergic contact dermatitis clinical features
Pruritic eruption of patches and plaques + vesicular
61
Lichen planus presentation
Pruritic, purple, polygonal papules that coalesce into plaques
62
Melanotic macule clinical feaures
Small, well-circumscribed, brown-to-black macule + often on lower lip but can be on any mucosal surface
63
Precursor to squamous cell carcinoma
Actinic cheilitis
64
Actinic cheilitis clinical features
Chronic red-to-tan scaly patches + typically lower lip
65
localized scleroderma clinical features
isolated sclerotic circumscribed plaques
66
lentigo maligna clinical features
Subtype of melanoma that arises on head and neck of old people + indolent
67
Most aggressive form of malignant melanoma
Nodular melanoma
68
Treatment of mild inflammatory acne in pregnant woman
Topical erythromycin + topical benzoyl peroxide
69
Describe morbilliform drug rash
- Most common form of cutaneous adverse drug reactions
- Erythematous papules coalescing into plaques = often pruritus + no systemic symptoms + peripheral eosinophilia + delayed (several weeks after)
70
Treatment of morbilliform rash
Antihistamines + topical steroids
71
DRESS clinical features
Delayed (2-6 weeks) + eosinophilia + skin pain/facial edema + ...
72
Viral exanthem vs. morbilliform rash
- Viral exanthem occurs immediately after infection, morbilliform rash is delayed several weeks after medication
73
Treatment for vitiligo
Topical steroids or immunomodulators
74
Chancroid presentation
Painful ulcerations + inguinal lymphadenopathy
75
Pyoderma gangrenosum clinical features
Painful, exudative ulcer + purulent base + ragged, edematous, violaceous border
76
Pyoderma gangrenosum primary association
IBD
77
Pyoderma gangrenosum treatment
Topical or oral steroids or immunosuppressive agents (azathioprine, cyclosporine, infliximab)
78
Calciphylaxis presentation
Painful subcutaneous nodules or plaques + overlying red-brown discoloration + superimposed purpuric patches, often with central necrosis
79
Phototherapy used for psoriasis
Narrowband (ultraviolet B) therapy (not absorbed by DNA)
80
Presentation of cutaneous-only PAN
Tender, subcutaneous nodules from vascular inflammation + livedo reticularis
81
Systemic PAN clinical features
GI bleeds + HTN + preceding chronic viral hepatitis
82
What is leukocytoclastic vasculitis?
- A finding, not a diagnosis
| - palpable purpura secondary to another condition (SLE, RA, medications)
83
Erythema nodosum associations
- lymphoma, sarcoidosis, TB, fungal infections (coccidioidomycosis), strep, hormones (OCP, pregnancy), IBD, NOT SLE
84
Erythema nodosum
CLINICAL -- acute onset of tender nodules on bilateral shins typically in a young woman. Biopsy not necessary.
85
Pitted keratolysis clinical features
Bacterial infection of feet leading to waxy/scaly plaques + thickening of plantar skin + punctate erosions in the plaques that may coalesce to form broader erosions and odor
86
Erythrasma clinical features
Bacterial infection of intertriginous areas (axilla) -- skin has wrinkled, cigarette paper texture
87
Management of venous stasis ulcers
Compression therapy
88
Most common leg ulcers
Venous stasis ulcers
89
Location of venous stasis ulcers
Distal lower leg + often medial aspect of the ankle
90
Venous stasis ulcers clinical features
Surrounding venous stasis (irregular border + surrounding hyperpigmentation) + pts often have varicose veins and peripheral edema
91
Why is cilostazol given in PAD?
Increase peripheral blood flow for the treatment of intermittent claudication
92
Term for diffuse erythema following steroids + why this occurs
erythroderma (steroids precipitate erythroderma in patients with underlying psoriasis)
93
DRESS presentation + timing
- weeks after receiving medication
| - rash + facial edema + peripheral eosinophilia + LAD
94
Presentation of dermatophyte infection
Erythematous annular patches + surface scaling + pruritic + (doesn't necessarily have central clearing?)
95
Tzanck preparation used for
Herpes infection
96
HSV description
Grouped vesicles on an erythematous base
97
Wood lamp used for
Vitiligo (to evaluate hypo and depigmentation lesions)
98
Calciphylaxis lesions
- intensely painful, black necrotic tissue, may form hard eschar in ESRD patients
- typically in thighs and lower abdomen
- calcium-phos product greater than 60 typically
99
Nephrogenic systemic fibrosis clinical features
- yellowish, thickened papules and nodules with skin tightening and sclerosis in ESRD patients on HD exposed to gadolinium-containing contrast dyes
100
Management of an abscess
- IF no systemic signs of infection -- I&D
| - IF systemic signs of infection -- I&D + abx
101
Clinical features of inverse psoriasis
Red plaques with variable amounts of scale in the axillae, intergluteal cleft ,and perineum
102
Treatment of dermatitis herpetiformis
dapsone (and check for G6PD deficiency)
103
Common cause of ulceration superimposed on venous stasis
Contact dermatitis from topical abx (neomycin, bacitracin)
104
Treatment of hand dermatitis
- FIRST LINE: topical emollients (petrolatum) + minimize hand washing
SECOND LINE: topical steroid
105
Hand dermatitis etiology + clinical features
- type of irritant dermatitis
- frequent water exposure from over hand washing, AICD, atopic dermatitis
- scaling, fissured skin on palm or dorsal hand
106
Treatment of comedonal acne
Topical retinoid
107
Presentation of comedonal cacne
- open and closed comedones + no inflammatory papules or pustules
108
Management of severe nodulocystic acne with scarring when other therapies have failed
Isotretinoin
109
When topical antibiotics are used for acne
- pustules and inflammatory papules are present
110
Treatment of postscabetic pruritus
- (itching can persist for several weeks after scabies treatment)
- antihistamins + topical steroids
111
Other triggers for erythema nodosum
- hormones, OCPs, hormone replacement therapy, pregnancy
112
Lipodermatosclerosis clinical features
woody indurated tissue in patient with chronic venous stasis
113
Arterial ulcer management
Surgical revascularization
114
arterial ulcer locations
- most commonly tips of and between digits
| - also at sites of increased pressure (lateral malleolus, metatarsal heads, sites of previous trauma)
115
Porphyria cutanea tarda clinical features
see photo online
- fragile skin + easily ruptured vesicles in sun-exposed areas (hands primarily + these then rupture, forming erosions, dyspigmentation and scarring
116
Workup of patient diagnosed with PCT
evaluate for liver disease (hep C and hemochromatosis)
117
Bullous pemphigoid clinical features
- pruritic red plaques that then develop into large bullae + typically on trunk
118
Preferred initial treatment of pyoderma gangrenosum
Prednisone
119
Treatment of severe allergic contact eruptions from poison ivy
Prolonged systemic glucocorticoids
120
Treatment of tinea pedis
```
topical antifungals (any of the azoles or terbinafine)
*can't use topical nystatin
```
121
DRESS features + timing
- rash (morbilliform)
- prominent facial edema
- lymphadenopathy
- fever, hypotension
- 2-6 weeks after initiation of drug
122
DRESS treatment
- cessation of drug
| - systemic steroids with a long taper
123
Typical cause of pruritus in the absence of skin findings
- medications
124
Meds that can cause pruritus in the absence of skin findings
- hctz, calcium channel blockers, opiates, NSAIDS
125
Management of basal cell carcinoma
IF low risk + on trunk and extremities --> electrodessication and curettage
IF high risk OR cosmetically sensitive locations --> mohs surgery
126
Alopecia areata clinical features
+ acute onset hairloss + smooth, hairless patches of skin (most commonly on scalp)
+ commonly in patients with other autoimmune disorders
127
Treatment of alopecia areata
High potency topical steroids
128
Skin manifestations of amyloidosis
- generalized, waxy appearance
- ecchymoses with minor pressure
- ecchymoses around the eyes (racoon eyes)
- yellow waxy papules and plaques perioribitally
129
Description of heliotrope rash in dermatomyositis
- purple or lilac erythema of the eyelids accompanied by edema
130
eruptive xanthomas clinical features
- yellow papules with surrounding erythema
131
Association of eruptive xanthomas
pathognomic of hypertriglyceridemia
132
lipid deposits around eyes associated with
hypercholesterolemia
133
Dermatofibroma clinical features
- see picture online
| - benign firm brown or reddish papules + size of pencil eraser + dimple when pressure applied
134
Pyogenic granuloma clinical features
- similar to cherry hemangiomas (but more firable and tend to bleed)
135
Neurofibromatosis type 1 features
neurofibromas + cafe-au-lait macules + lisch nodules (pigmented hamartomas of the iris)
136
Pretibial myxedema clinical features
- firm nodules and plaques with "peau d'orange" appearance on pretibial area
137
pretibial myxedema association
hyperthyroidism
138
Etiology of pityriasis versicolor
fungal infection
139
What does morbilliform mean?
- Rash that looks like measles (red macules + may be confluent in some places)
140
AK description
- red, rough, scaling patches
- hx of a lot of sunburns
- can be multiple
- forehead, face, legs, arms
141
treatment of AKs
5-Flourouracil cream
142
Management of lacerations
- IF penetrating the subcutaneous tissue OR overlying a joint -- suture closed
- check tetanus vaccine status
143
clinical features of body lice
- homeless patient
- itchy
- arms, legs, and trunks
- linear excorations
144
lichen planus clinical features
- Lichen planus commonly presents as intensely pruritic, pink-to-purple, flat-topped papules or plaques; Wickham striae, a reticulated network of fine, white lines, can be seen on the surface.
145
Acute pustular psoriasis clinical features
- diffuse erythematous rash
- following steroids
- painful
- patches and plaques, with pustules
146
Sweet syndrome clinical features
- fever + arthralgia + myalgia + arthritis + often preceding respiratory or GI illness
147
Management of onychomycosis
Nail clipping for fungal culture (50% of nail dystrophies are caused by conditions other than fungal infection. infection with yeasts and nondermatophyte molds are becoming more common)
148
brachioradial pruritus clinical features
- deep, crawling, tingling sensation of forearms, shoulders, upper back + no visible skin findings
