Secondary Skin Lesion Flashcards Preview

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Flashcards in Secondary Skin Lesion Deck (20):
1

Dry, rectangular scales that resemble cracked pavement

What is this?

what causes the scales?

Ichthyosis- an autosomal dominant disorder of keratinization that begins in childhood.

It is associated with Atopy (a genetic predisposition to develop allergies)

scaling results from retention of scalw (not proliferation)

tx: moisturizers w/ lacti acid, urea, or alphy hydroxy acids

2

Red, sharply defined, scaling papules that coalesce to form stable, round to oval plaque

What is the most likely diagnosis?

What allel is associated with this condition?

what is the most common location of this plaque?

Plaque Psoriasis:

HLA-B27

plaques are commonly found on the extensor surfaces

the onset of the disease is bimodal.  Early onset = worse clinical course

A sudden onset is highly suspicious for HIV

 

3

Small sterile pustules that evolve from a red base on palms and soles.  The pustules do not rupture, but turn rusty brown and scaly.  They are painful.

most likely diagnosis?

Chronic Recurrance of this condition is associated with?

Localized pustular psoriasis

chronic recurrance is associated with tobacco use

4

Sudden appearance of innumerable, monomorphic, 2-5 mm psoriasiform papules on the trunk with silvery scale

What is the most likely diagnosis?

What other conditions are associated with these types of lesions?

 

Gluttate psoriasis

Group A strep pharyngitis and viral infections

5

This rash occurs in the intertriginous area (groin, axillae, or under the breasts).  It is a smooth, red, sharply defined plaque w/ a macerated surface, and often has an odor.

What is the most likely diagnosis?

How can you diagnosis it?

Inverse psoriasis

KOH test if you suspect a superimposed candida infection

6

How do you treat psoriasis?

  1. Topical tx:
  2. Phototherapy
    1. UVB
    2. Psoralen plus UVA
  3. Systemic Tx
    1. Methotrexate
    2. cyclosporine
    3. bioligics

7

planar, polygonal, purple, papules that are very puritic.  The surface shows a lacy reticulated pattern of whitish lines.

What is the most likely diagnosis?

What are these lines called?

Lichen Planus

Wickham's Striae

8

How do you treat Lichen Planus?

Treatment

  1.  Sedating antihistamines
  2. topical steroids (local disease)
  3. prednisone for generalized skin or erosive mucosal involvement
  4.  

9

A red, raised border

What is the most likely diagnosis?

 

Tinea (fungal) the location determines the rest of the name

foot=pedis

groin= cruris

boy= corporis 

face= faciei

hand= manuum

 

10

Brown hyperpigmentation, loss of scaling at borders, loss of a well-defined border

What is the most likely diagnosis?

T. incognito.  The appearance of the infection changes by the application of topical corticosteroids.

 

11

This is found in the axilla and fluoresces red under a wood's lamp

What is the most likely diagnosis?

Erythrasma

12

Red-purple eyelid discoloration (heliotrope rash), gottron's papules (papules on the fingers) and shawl sign.

What is the most likely diagnosis?

this is associated with an increased/decreased risk of malignancy

what type of inflammation is seen with this condition?  What type of cell is also associated?

Dermatomyositis

a/w increased risk of malignancy

perimysial inflammation and atrophy w/ CD4+ T cells

13

What other lab values would we expect with a dx of dermatomyositis?

increased CK

Increased CRP

+ANA, +anti-Jo-1 antibodies

 

14

what is the treatment for dermatomyosistitis?

steroids

methotrexate

cyclosporine

hydroxychloraquine

15

"mechanic's hands" with Endomysial inflammation with CD8+ T cells

What is the most likely diagnosis?

what other s/s is associated with this disease?

Polymyosistitis

progressive symmetric proximal muscle weakness (shoulders, hips, thighs) 

16

Xerophthalmia, zerostomia, arthritis

What is the most likely diagnosis?

this increases the risk of developing what?

 

Sjorgren's

increased risk of B-Cell lymphoma

(zerophthalmia= no tearing)

(zerostomia= no salivation)

17

malar rash

What is the most likely diagnosis?

what other s/s are likely to see?

What about labs?

SLE (s/s fever, fatigue, weight loss, Raynaud pehnomenon)

IM DAM SHARP (Immunoglobulins, Malar rash, Discoid rash, Mucositis, Neurologic disorder, Serositis, Hematologic disorder, Arthritis, Renal disorders, Photosensitivity)

anti-dsDNA Ab (v specific w/ poor prognosis) , anti-Sm Ab (specific, but not prognostic)

false positives to syphilis

18

diffuse, atrophy of the skin, tight skin w/o edema

Raynaud's Syndrom is usually the first sign

What is the most likely diagnosis?

labs?

Scleroderma

other s/s: GERD, intestinal pseudo-obstruction, HTN, renal failure, interstitial lung dz, pericarditis w/ effusion, MSK changes similar to RA but w/o joint destruction

Anti Scl-70 Ab

 

19

Limited skin involvement usually of the fingers and face.

Involvement of the viscera (esophageal lesions, pulmonary HTN, biliary cirrhosis) occurs late in the disease

What is the most likely diagnosis?

labs:

CREST Syndrome

Calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangiectasia

Anti-Centromere Ab

20

What is the most common cause of mortality after a burn?

C. Albicans