Inflammatory Nodule Disorders

Question 1

Lipoma

most common?

type of skin problem

Answer 1

benign soft tissue neoplasm

Question 2

Lipoma

benign, subQ tumors composed of?
enclosed by?

Answer 2

1. mature adipocytes
2. thin, fiberous capsule

Question 3

Lipoma

clinical manifestations

Answer 3

1. soft, painless, subQ nodules that are easily mobile
2. most commonly found in trunk, neck, upper extremities

Question 4

Lipoma

dx

Answer 4

clinical

Question 5

Lipoma

when is biopsy indicated?

Answer 5

• pain
• rapidly enlarging
• firm
• restricts movement

Question 6

Lipoma

tx

Answer 6

• observation
• excision for cosmetic or sx purposes

Question 7

Epidermal Inclusion Cyst

general overview

Answer 7

• benign, encapsulated, subepidermal nodules filled w/ fibrous tissue & keratinous material

Question 8

Epidermal Inclusion Cyst

most common in who?

Answer 8

• 30s, 40s
• males 2x more likely than females

Question 9

Epidermal Inclusion Cyst

pathophys

Answer 9

results from plugging follicular orifices

Question 10

Epidermal Inclusion Cyst

clinical presentation

3 components

Answer 10

• asx
• skin coloral dermal, freely mobile, compressible cyst
• clinically visible central punctum

Question 11

Epidermal Inclusion Cyst

what happens to ruptured, infected cysts?

Answer 11

• fluctuate
• painful
• erythematous
• may have foul smelling discharge

Question 12

Epidermal Inclusion Cyst

tx

non-infected vs infected

Answer 12

1. no tx necessary (excision for cosmetic)
2. incision & drainage

Question 13

Furuncle & Carbuncle

define a furuncle

Answer 13

deep infection of the hair follicle

Question 14

Furuncle & Carbuncle

define carbuncle

Answer 14

coalescence or interconnection of several furuncles into a single mass w/ purulent drainage from many follicles

Question 15

Furuncle & Carbuncle

most common bacteria?

Answer 15

• S. aureus
• staph

Question 16

Furuncle & Carbuncle

clinical manifestations

6 things

Answer 16

1. erythematous
2. tender
3. indurated
4. nodule
5. fluctance
6. (+/-) cellulitis

Question 17

Furuncle & Carbuncle

tx

Answer 17

1. incision & drainage
2. abx: trimethoprim-sulfamethoxazole, doxy, clindamycin

Question 18

Hidradenitis Suppurativa

general overview

Answer 18

painful, chronic, inflammatory suppurative condition involving the skin and subq tissue

Question 19

Hidradenitis Suppurativa

risk factors

5

Answer 19

• obesity
• females
• smoking
• hx of acne
• family hx

Question 20

Hidradenitis Suppurativa

pathophys

Answer 20

thought to be due to chronic infra-infundibular follicular hiar follicle obstruction, followed by secondary rupture of the sebofollicular junction, resulting in an inflammatory rxn

Question 21

Hidradenitis Suppurativa

clinical presentation

Answer 21

1. recurrent, painful, deep-seated inflammatory nodules & abscesses
2. draining tracts
3. fibrotic hypertrophic scars that most commonly affect intertriginous skin

Question 22

Hidradenitis Suppurativa

dx

Answer 22

clinical

Question 23

Hidradenitis Suppurativa

components of lifestyle modification for tx

Answer 23

• avoid high glycemic foods
• smoking cessation
• local skin care
• eliminate irritants
• wt loss

Question 24

Hidradenitis Suppurativa

tx when only inflammatory lesions present

Answer 24

• topical clindamycin
• can have anti-angiogenic drugs or metformin

Question 25

Hidradenitis Suppurativa

tx when inflammatory lesions w/ sinus tracks or scarring

Answer 25

• oral tetracycline (doxy)
  or
• clindamycin w/ rifampin