Exam 1 Flashcards

Question

Tinea cruris (jock itch)

Answer 1

etiology: T. rubrum usually from auto inoculation of tinea pedis or onychomycosis well-marginated, annular plaque with scaly raised border inguinal fold to inner thigh (scrotum typically spared) pruritic and painful KOH prep Treatment: topical antifungals, daily talcum powder

Answer 2

etiology: T. rubrum acute - self-limited, pruritic, painful vesicles/bulla after sweating chronic - slowly progressive with erosions/scales between toes and interdigital fissures KOH prep Treatment: topical antifungals, oral (ie. fluconazole), proper footwear

Answer 3

etiology: T. rubrum or candida (yeast) 4 subtypes: 1. Distal subungual (most common) - discoloration starts distally and spreads to cuticle 2. Proximal subungual - opposite of distal 3. White superficial - dull, soft white spots that can be scraped off for sample 4. Yeast - thickening of nail with yellow/brown discoloration sometimes accompanied by paronychia KOH prep Treatment: oral terbinafine or fluconazole *check liver function because meds can be hard on liver

Answer 4

infectious or noninfectious inflammatory condition of 2 closely opposed (intertriginous) skin surfaces erythematous, macerated plaques and erosions pruritic SATELLITE papules/pustules KOH prep Treatment: nystatin, topical or oral antifungals, weight loss

Answer 5

etiology: malassezia -- normal skin flora that becomes pathologic risk factors: tropical climates, hyperhidrosis, genetics macules, patches, plaques on trunk and UE hypopigmentation, hyperpigmentaion or erythematous typically asymptomatic KOH prep or Wood's Lamp (fluorescence) Treatment: topical or oral antifungals

Answer 6

common skin disorder on central face persisting for months, not well understood Subtypes: 1. erythematotelangiectatic - flushing and skin sensitivity treat with light therapy and behavior modifications (avoid triggers) 2. papulopustular - papules and pustules on central face with inflammation treat with topical or oral -cyclines and -mycins 3. phymatous - tissue hypertrophy with irregular contours (mostly on the nose) treat with surgery 4. ocular (50% of rosacea cases) - may precede, coincide or follow other rosaces --> dry eyes, pain, pruritic, blurry vision, etc. treat with referral to ophthalmologist Triggers: emotions, alcohol, sunlight, exercise, cosmetics, etc.

Answer 7

etiology: host-specific mite transmission via direct contact host harbors, excavates a BURROW in stratum corneum to lay eggs that then hatch in 10 days initial lesion/burrow severe pruritis, worse at night primarily webbed spaces and groin (spares back and head) Immunocompromised = CRUSTED SCABIES Treatment: scabicide repeated in 1-2 weeks (eggs hatch) antihistamines for itching

Answer 8

etiology: Hymenoptera species *remove stingers ASAP can cause anaphylaxis --> treat with IM epinephrine local rxn - swelling and erythema for 1-2 days treat with cold compress large local rxn - exaggerated erythema and swelling resolves in 5-10 days treat with cold compress, prednisone, NSAIDs, antihistamines secondary bacterial infection = worse symptoms 3-5 days post sting that may cause fever and should be treated with antibiotics

Answer 9

Widows blanched circular patch with red perimeter central punctum venom triggers catecholamine release --> sweating, N/V, h/a, ab pain, muscle spasms TREAT - antiemetics, local wound care, tetanus Recluse specific geographical region known for ulcerative necrotic bite --> dark, depressed center 1-2 days post-bite painless initially followed by severe pain 2-8 hours later usually resolved in 1 week Hobo no deaths or necrosis not aggressive or found in the house

Answer 10

acquired skin depigmentation via autoimmune process against melanocytes (none found in epidermis) onset 20s-30s --> family history plays a role milk-white macules with well-defined borders slowly progressive spontaneous repigmentation in 10-20% Treatment: corticosteroids, UV light, skin grafts

Answer 11

chronic inflammatory skin disorder involving the hair follicle follicular occlusion --> follicular rupture --> associated immune response inflammatory nodules sinus tracts (2 lesions connect) scarring comedones (black heads) Treatment: weight loss/diet, smoking cessation, hygiene, corticosteroids, retinoids, antibiotics Complications: fistulae, SCC, depression/suicide, lymphatic obstruction

Answer 12

type I hypersensitivity reaction (IgE mediated) "the itch that rashes" - pruritic ATOPIC TRIAD: atopic dermatitis sinus rhinitis (hay fever) asthma ill-defined erythematous scaly patches (mild) edematous papules and vesicles (severe) ``` infants = face, scalp and extensor surfaces adults = flexor surfaces, hand/feet ``` Complications: excoriation, lichenification, painful fissures, secondary cellulitis Treatment: avoid triggers, rubbing/scratching, use emollients, antihistamines prn pruritis, topical steroids if necessary

Answer 13

secondary skin condition from excessive scratching or rubbing dry,leathery appearance with pigmentation common on back of neck, wrists, forearms, lower legs Treatment: topical steroids and moisturizers

Answer 14

deep-seated vesicles with TAPIOCA appearance coalesce and rupture 80% on hands INTENSELY PRURITIC emotional stress and hot weather triggers

Answer 15

keratinization disorder horny plugs in hair follicles rough, raise papules improves with age Treatment: scrubs, topical retinoids, salicylic acid

Answer 16

Allergic delayed hypersensitivity (ie poison ivy, nickel, latex) linear appearance with lots of vesicles TREAT with bacitracin Irritant (80%) repeated friction/mechanical irritation (i.e. water, detergents, saliva, etc) treat with bland emollient (oil based)

Answer 17

yeast mild dandruff to more extensive inflammatory dermatitis Infants - yellow, greasy scales "CRADLE CAP" Adults - greasy scales and yellow-red coalescing macules, patches and papules Treatment: Selenium sulfide or ketoconazole shampoo

Answer 18

benign VIRAL skin eruption large primary patch on trunk - "HAROLD PATCH" secondary rash of fine scaled papules and plaques 1-2 weeks later in a "CHRISTMAS TREE" pattern Treatment: self-limiting goes away in 6-12 weeks, oral antihistamines (ie. claritin, zyrtec, benedryl) to help symptoms

Answer 19

4 P's - purple, pruritic, polygonal, papules 50% mouth, wrists, back, shins, scalp WICKAM'S STRIAE = fine white lines on top of plaques Treatment: topical or oral steroids, self-limiting 18 months

Answer 20

chronic, recurrent, hyper proliferative skin disease thickened red plaques with silvery scale pitted nails, onycholysis, "OIL SPOTS" Comorbidities: IBS, heart disease, metabolic syndrome Vulgaris (most common) AUSPITZ SIGN - removal of scale = punctate bleeding KOEBNER PHENOMENON = plaques develop in areas of skin injury Treatment: depends on type and severity sunshine/baths/emollients/rest oral steroids = worse flare-up upon discontinuation coal tar phototherapy and Vit D analogs retinoids

Answer 21

purple-red plaques and scales with spiny projections when scale is removed may see permanent hair loss or loss of pigmentation lesions well-localized on head, neck, face and ears Labs: ANA, double stranded DNA Treatment: protect from sunlight and photosensitizing drugs (tetracyclines), injectable steroids into lesions once a month

Answer 22

sub-epidermal blistering of skin on DORSUM of hand may be associated with ingestion of estrogens, liver disease or hepatitis Treatment: phlebotomy, stop potential meds, sun protection

Answer 23

commonly caused by Staph aureus pustules with hair growing out of them pruritic and burning complication: abscess Treatment: antibiotics

Answer 24

pathogenesis: Borrelia burgdorferi rash 3-32 days post tick bite (Lyme disease) slightly raised, warm red with central clearing "TARGET" Treatment: systemic antibiotics (ie. amoxicillin)

Answer 25

immunologica reaction caused by circulating immune complexes viral, bacterial, fungal, or drug eruption (typically NSAIDs, antibiotics or sulfonamides) TARGET lesions Treatment: symptomatic with either topical or systemic steroids, anti-viral if indicated

Answer 26

B. hemolytic streptococci superficial form of cellulitis seen on cheeks pain, malaise, chills edema, warm to touch, spreading and well-circumscribed papule/plaque Treatment: IV antibiotics against Group A strep and staph *can become toxic if not treated quickly

Answer 27

bacterial infection of staph or group A strep *deeper than erysipelas --> diffuse spreading at risk: venous insufficiency and DM swelling and STREAKING erythema and pain Treatment: oral or IV antibiotics

Answer 28

bullous - intraepidermal bacterial infection of skin caused by Staph non-bullous (most common) - lesions begin as papules and progress to vesicles with erythema auto inoculation with satellite lesions YELLOW CRUST appears over ruptured bull Treatment: topical antibiotics (ie Bactroban), oral antibiotics (ie Dicloxicillin)

Answer 29

similar to Stevens-Johnson syndrome, but affects skin surface more (30% vs 10%) caused by meds bullae and SLOUGHING off of epidermal layers

Answer 30

intensely pruritic vesicular disease IgA deposits in dermal papillae 75% have GLUTEN SENSITIVITY Treatment: Dapsone

Answer 31

pressure of soft skin over bony prominences causing ulcerations best treatment is PREVENTION categorized by stages 1-4

Answer 32

Glucocorticoids atrophy, striae, purpura moonface/buffalo hump (Cushing's disease) ``` ACTH adrenal failure (Addison's disease) causing hyper pigmentation of the skin especially the gingiva ``` Androgens (effects pilosebaceous unit) increased sebum, acne, androgen alopecia and hirsutism Growth hormone epidermal hyperplasia and hyperpigmentation ``` Insulin-resistant DM Acanthosis nigricans (velvety) ``` Norepinephrine profuse sweating Thyroid hormone excess (hyperthyroidism and Grave's Dss) warm moist skin pretibial myxedema - thickening of skin on anterior tibia Hypothyroidism dry cool skin and generalized thickening ``` Parathyroid hormone metastatic calcification (rare) ```

Exam 1 Flashcards

(56 cards)