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Flashcards in Dermatology - Matthys Deck (31)
1

Annular, erythematous papules, scaling, eczematous, pruritic in antecubital fossa

What is it?

Often a history of?

Other signs on PE?

Histology

Treatment

Atopic dermatitis

Type 1 Hypersensitivity response

Atopy

Allergic shiners, DM lines, allergic salute

Spongiosis, eosinophilia

Moisture, avoidance, anti-pruritics, anti-inflamm

2

Erythematous, non-scaling, localized w/ sepsis, fever, no muscle involvement, tender and boggy

What is it?

Risk factors?

Initiation?

Treatment?

More mild version on face?

Cellulitis

Infection of skin and CT

Stasis dermatitis, lymphedema

Trauma --> Staph/Strep

Cephalosporin, Macrolide, or Clindamycin... + Elevation

Erysipelas

3

Symmetric erythematous, non-scaling, tender nodules and plaques on anterior LEs.

What is it?

Main differential?

Treatment?

Erythema nodosum

Hypersensitivity inflammation of subQ fat (panniculitis)

Sarcoidosis

Anti-inflam, rest, avoidance

4

Erythematous, scaling w/ silvery plaque, papulosquamous

Histo?

Other findings?

3 subtypes?

Psoriasis

Acanthosis, parakeratosis, clubbed rete ridges, no granulosum, tortuous BVs

Nail pitting, Koebner, Auspitz, Woronoff's ring (after cleared)

Plaque, pustular, guttate

5

Local radicular pain, then eruption of rash 2-3 days later.

Histo?


Treatment?

Herpes zoster - Shingles

Steel gray nuclei, multinucleated giant cells, eosinophilic inclusions

Antivirals, pain control, vaccine

6

HLA-B13

Psoriasis

7

Rash in the webbing of the fingers and toes

Scabies

8

Branny/flaky, greasy, red-yellow scales on scalp, face, chest. Flaking in hair-baring areas.

Cause?

Common in who?

Seborrheic dermatitis

Plasmodium ovale infection

MALES, HIV

9

DM, warm humid areas chronically have red-brown scaly macules that combine to form erosive collarette-like scale.

How to diagnose?

Cause?

Erythrasma


Woods lamp -- redness


Coryne. minutissimus infection (Gram + rod)

10

Middle age patient w/ Hepatitis C. Pruritic papules or plaques.

Things to look for on the rash?

What else to look for? Important why?

Treatment?

Lichen planus

Wickham striae (white lines)

Oral lesions --> can lead to SCC

Low dose topical steroids

11

Woman present at beginning or end of spring/summer. Pruritic rose/pink scaly patches or plaques, with one larger than the rest. Span out in peculiar pattern on thorax.

What is the pattern?

What is the large patch?

Histo?

Treatment?

Pityriasis rosea

Christmas tree pattern

Herald patch (1st one)

CD4+ cells and Langerhaan's cells in the dermis


Light therapy

12

Moving infection of cornified areas (skin/hair/nails). Positive KOH test.

MUST treat which area?

Cause?

Tinea

Nails -- can't kill w/ topicals

Dermatophyte infection -- Trichophyton, Microsporum, Epidermophyton

13

Reddish-orange scaling plaques w/ redness of palms and soles. Glove-type distribution of palms. Follicular keratitis papules. Islands of sparing.

Has features of what?

Treatment?

Pityriasis rubra pilaris


Vitamin A deficiency


Retinoids

14

Pruritic, scaling plaques w/ red-brown shades or hypopigmented shades.

Cause?

Mimics what?

Treatment?

CTCL (mycosis fungoides)

HTLV infection

Eczema

Topical steroids, PUVA, nitrogen mustard

15

Young adult w/ pruritic, scarring, erythematous papules/plaques, scaling, photosensitive rash, worse in sun. On mucosa, palms and soles.

Increased risk of what?

Diagnose w/ what?

Usually does NOT have what?

Treatment?

Discoid SLE


SCC


ANA, biopsy


Systemic symptoms


Sunscreen, topical steroids

16

Purpura - drug reaction?

Argyria - drug reaction?

Phototoxicity - drug reaction?

Coumadin

Silver nitrate

Doxycycline

17

Give antibiotics, patient gets worse. What is this?

Jarisch-Herxheimer Rxn

18

Most drug eruptions are what hypersensitivity type?

Classic look?

Type 4

Expansive erythematous maculopapular rash

19

Erythematous annular plaque, coin-like, with fissures. Worse in winter.

Nummulous dermatitis

20

Child under 6, crusty lesion. Asymptomatic flaccid ruptured blister, commonly on face in hot weather, crowded conditions, or immunocompromised patients.

Commonly also have what? Why?

Cause?

Caution?

Treatment?

Impetigo

Atopic dermatitis --> causes break in skin barrier --> infection

Staph aureus

Very contagious

Antibiotics

21

Painful erythema in kids. Fever, orange-red macules. Skin peels off. Blisters. Positive nikolsky sign.

Cause?

What causes the blisters?

Cultures?

Treatment?

Staph scalded skin syndrome

Staph aureus exotoxin ET1/2

Granulosum desmosome splitting

Negative

Antibiotics, fluids

22

Flaccid bulla on skin w/ erosion in oral mucosa. Positive nikolsky sign. Spreads when press laterally on it.

Associated with?

Cause?

Treatment?

Pemphigus vulgaris


Thymoma, Myasthenia gravis


Auto-IgG to desmoglein 3

Prednisone, then Imuran

23

Itching and burning, followed by recurrent vesicles and ulcers. Oral or genital.

Associated w/ what other symptoms?

Treatment?

HSV

Encephalitis, seizures, headache

Antivirals

24

Herpes on finger

Herpetic Whitlow

25

Grouped vesicles on erythematous base

HSV

26

Childhood, dew drops on rose petal vesicles, aphthous ulcers, anywhere BUT distal extremities.

Treatment?

Chickenpox (VZV)

Antivirals, antihistamines, VZIg

27

Subacute/acute tense bullae, older patient, NOT in mucosal

Cause?

Can be caused by?

Diagnosis?

Treatment?

Bullous pemphigoid

IgG antibodies against hemidesmosomes (BPG 1/2)

UV radiation or drugs

Linear immunofluorescence

Prednisone, other

28

Papules, vesicles, plaques caused by sun exposure. Most common in spring. Skin hardens w/in 30 min of sun exposure.

Common in who?

What is it?

Polymorphous light eruption


Native american descent, females

Type 4 hypersensitivity due to UV-A

29

VERY pruritic, grouped, symmetric, burning skin blisters. IgA at tips of dermal papillae. Stomach aches and diarrhea when eating gluten.

Cause?

Genetics?

Treatment?

Dermatitis herpetiformes

Gluten-sensitive immune skin disease

HLA-B1, B8, DR8, DRQ

Dapson, gluten-free diet

30

Targetoid, dull/dusky red macules and vesicular papules on palms and soles. Sloughing of skin. Bilateral and symmetrical. Mucosal involvement common. Positive koebner phenomenon.

Causes?

***Associated with?

Erythema multiforme

Immune response to drugs (sulfa, phenytoin, PCN, allopurinol), foods, sunlight, contacts


HSV

31

Full thickness skin detachment, fever, tenderness, skin pain, burning. Crinkled surface to skin, positive nikolsky sign, sheets of lost epidermis.

Cause?

Worse in what?

Genetics?

Treatment?

TEN

Cell-mediated hypersensitivity to new drugs

SLE, HIV

HLA-B12

IV fluids, burn unit, steroids, IVIg