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Flashcards in SKIN Deck (96):
1

Macule

Circumscribed flat area of skin
Different in color and texture from the surrounding tissue

2

examples of macules

ephelides (freckles), petechiae, flat nevi(moles)

3

PAtch

A large macule
>1cm diameter
texture changes

4

examples of patch

Examples: Mongolian spot, cafe au lait spot

5

Papule

small solid elevated lesion

6

examples of papules

ant bite, elevated nevus (mole) verruca (wart)

7

Plaque

elevation of skin >1cm

8

example of plaque

psoriasis

9

Pustule

a visible accumulation of purulent fluid under the skin

10

examples of pustules

acne, impetigo

11

Vesicle

a circumscribed elevation of the skin, contains serous fluid,

12

examples of vesicles

Herpes simplex, varicella (chicken pox), herpes zoster (shingles)

13

Nodule

A solid mass of skin
observed a san elevation or can be palpated
>1cm in diameter
Often extend into the dermis (deeper)

14

examples of nodules

fibroma and xanthoma

15

Bulla

"blister"
circumscribed elevation containing fluid
>1cm in diameter
Extends only into the epidermis

16

examples of bulla

burns, superficial blisters, contact dermatitis

17

Wheal

Elevated white or pink compressible papule or plaque
A red axon-mediated flare often surrounds it
commonly associated with allergic reactions

18

examples of wheals

PPD test and mosquito bites

19

cyst

any closed cavity or sac
Contains fluid or semisolid material
normal or abnormal epithelium

20

example of cyst

sebaceuous cyst

21

abscess

a localized collection of purulent fluid in a cavity formed by disintegration or necrosis of tissues, >1cm in size

22

Tumor

"mass", > a few centimeters in diameter, firm or soft, benign or malignant

23

What is an annular configuration and example

Circular, begins in center and spreads to the periphery (i.e ringworm)

24

What is the confluent configuration

Lesions run together

25

What is a grouped configuration

Lesion cluster

26

What is a gyrate configuration and give example

Twisted, coiled, spiral, snake-like. Scabies

27

Linear configuration and give example

Contact dermatitis

28

What is polycyclic configuration

annular lesions merge

29

What is solitary or discrete configuration

individual and distinct lesions that remain separate

30

What is target )iris) configuration and give example

Resembles iris of an eye; lesions with concentric rings or color. LYMEs

31

What is zosteriform configuration

linear arrangement on a nerve

32

What 2 s/sx of acne require referral?

Cysts and scarring

33

What are the steps for management of acne?

1) non-pharmacological agents
2)Comedolytic agents
3) combination agents: comedolytic + antibiotic
4) topical antibiotics
5) oral antibiotics
6) oral contraceptives
7) other

34

What are the comedolytic agents?

benzoyl peroxide (bacteriocidal)
salicylic acid (neutrogena 2%) keratolytic, reduces comedone formation
Azalaic acid (azelex)- bactericidal and reduces come done formation
Tretinoin (Retin-A)
Adapalene (differin)- less irritating than tretinoin
Tzazrotene (tazorac)- expensive, category X

35

Both tretinoin and adapalene are pregnancy category

C

36

What are the combination agents of comedolytics and antibiotics?

benzoyl peroxide + erythromycin (needs refrigeration)
Benzoyl peroxide + clinda
Benzoyl peroxide + drying agent (sulfectamide sulfur)

37

Topical antibiotics for acne

Clindamycin
Erythromycin
Metronidazole (also for rosacea)

38

What are common oral antibiotics for acne

Tetracycline (most widely prescribed, contraindicated in pregnancy and children

39

What oral contraceptives are useful for tx acne and what s/e needs consent for?

Ortho tri-cylcen and estrostep
May cause brownish blotches or melanoma (hyperpgmentation) of the skin

40

folliculitis and organism

inflammation of the hair follicle. Staph

41

Furuncle

"boil", spider bite look. localized infection originating in the hair follicle
Staph

42

Carbuncle

much larger than furuncle
May be necrotizing
usually staph

43

Cellulitis causes (outpatient)

strep
s. aureues

44

CA-MRSA treatments and sensitivities

Trimethroprim- sulfa (bactrim) (95%-100%)
Doxy/minocycline (90-95%)
Clindamycin (85-95%)
In areas of very low CA-MRSA prevalence, dicloxacillin or cephalexin (keflex)

45

What can you use if unsure if staph or strep

Trimethroprim/ sulfa + beta lactam (PCN, amoxicillin, 1st generation cephalosporin (keflex) OR
Docy/minocycline + beta lactam (PCN, amoxicillin, 1st generation cephalosoprin (keflex) OR
clindamycin

46

Erysipelas character and organism

strep
Rapid progression of an erythematous, warm, indurated area

47

Hidradenitis suppurativa character and organism

staph
Abscess formation, groin or axilla

48

Impetigo character and organism

Staph
Primary lesion is a thin walled vesicle that breaks easily
Honey colored crusts at the edge
Commonly satellite lesions can appear and spread to remote areas of the skin

49

Management of skin infections

I&D as warranted
culture
systemic treatment as warranted
Minor infection: Consider topical antimicrobials such as bacitracin, bactroban (mupirocin), etc. or first generation cephalosporin (cephalexin) OR PCN (dicloxacillin) or clindamycin or amoxicillin-clavulanate

50

How do you manage a sublingual hematoma

Trephination

51

description and tx of candida balantis

inflammation of the superficial tissues of the penile head caused by candida albicans
tx: topical azole, steroids, fluconazole Pos

52

candida intertrigo and tx

Irritation of the fold of skin, commonly occurring in warm, moist body areas
TX: Drying agents such as tale or cornstarch
2) topical antifungals
3)oral antifungals

53

Tinea capitus and tx

dermatophyte infection of the scalp
tx: selenium 2.5% shampoo
Oral terbinafine, itraconazole, or fluconazole
Griseofulvin (check LFTs)

54

tinea corporis and tx

ringworm. Dermatophyte infection
tx: topical antifungals (azoles)
Severe cases: systemic therapy (ketoconazole)

55

Tinea cruris and tx

dermatophyte infection of the groin
Topical antifungals or oral antifungals if severe cases

56

tinea pedis and tx

athletes foot, dermatophyte infection of the foot
tx: miconazole or clotrimazole
Aluminum subacetate sol. soaks

57

tinea unguium and tx

onchomycosis
Fungal infection of the toenails
tx oral antifungals (itraconazole or terbinafine)

58

tinea versicolor

hypo/hyper pigmentation macules on the limbs caused by fungal infection
tx selenium sulfide or topical antifungals (azoles)

59

Define shingles

herpes zoster
acute vesicular eruption due to infection with varicella-zoster; may be life-threatening in immunocompromised adults

60

treatment options for herpes zoster

acyclovir, famciclovir, valacyclovir

61

When is shingles an emergency

if ocular/ facial involvement

62

treatment for post-herpatic neuralgia

gabapentin (neurontin), pregabalin (lyrica)

63

Characteristics of actinic keratosis

Small patches occurring on sun-exposed parts of the body
asymptomatic; small patches; may be tender
rough, flesh colored, pink or hyper pigmented

64

What can actinic keratosis lead to?

Premalignant (1:1000) lesions progress to squamous cell carcinoma

65

tx of actinic keratosis

liquid nitrogène

66

characteristics of squamous cell carcinoma

Arise out of actinic keratoses
Firm, irregular papule or nodule
Develop over a few months (3-7% metastasize)
prolonged sun exposed areas in fair skin people
keratitic, scaly bleeding

67

tx of squamous cell carcinoma

biopsy and surgical excision (MOhs)

68

Seborrheic keratoses

benign, not painful
beige, brown or black PLAQUES (differentiates them from malignant melanoma- stuck on appearance)
3-20mm in diameter

69

tx of seborrheic keratosis

none or liquid nitrogen

70

Basal cell carcinoma

most common kind of skin CA
slow growing lesion (1-2cm after years)
WAXY, PEARLY, SHINY RED, CENTRAL DEPRESSION OR ROLLED EDGE
May have telangiectatic vessels

71

basal cell carcinoma tx

shave/punch biopsy and surgical excision

72

median age of malignant melanoma diagnosis

40

73

ABCDEE of malignant melanoma

asymmetry
border irregularity
color variation
diameter >6mm
elevation
enlargement
if answers >2 yes, 97% sensitive

74

description of eczema

red, shiny or thickened patches
Inflammed/ scabbed lesions with erythema/scaling
dry, leathery lichenification

75

tx of eczema

topical steroids, rubbed in well

76

Allergic contact dermatitis characteristics

redness, puritus, scabbing, ect
Sharp, defined borders

77

tx of allergic contact dermatitis

topical steroids
do not scrub with soap and water
prednisone taper if severe

78

Characteristic of psoriasis

itching, red, precisely defined plaques with silvery scales
fine pitting of the nails
auspitz sign: droplets of blood when scales removed

79

Treatment of psoriasis

topicals for scalp (tar/salicylic acid shampoo)
Topical steroids (betamethasone)
UVB light exposure

80

definition of psoriasis

benign hyerproliferative inflammation of the skin that can be acute or chronic

81

Pityraisis rosea character

pruritic rash found on trunk and proximal extremities

82

progression of pityriasis

initial lesion 2-10cm: "heralds patch"
generalized rash presents within 1-2 weeks
lesions follow a christmas tress pattern
lasts 4-8 weeks

83

When should you consider syphilis testing for rash

lesions are not itching
lesions are present on palmar or plantar surfaces
lesions are few and perfect

84

treatment of pityriasis

oral antihistamine
topical antipuritic
cool compresses
topical steroids
UVB light
oral erythromycin

85

consider ___ testing for new explosive skin disorder

HIV

86

define xanthelasma

yellow plaques as a result of fat build up under the skin, sully near the inner can thus

87

What is the underlying cause of xanthelasma

hyperlipidemia or secondary to diabetes

88

s/sx of lyme disease

distinctive bulls eye, macular or popular rash
erythema migrans- expanding red lesion with central clearing
Flu-like symptoms

89

labs for lyme disease

ELISA testing initially then western blot as confirmatory

90

treatment of lyme disease

doxycycline, amox

91

what is the pathogen of rocky mountain spotted fever

rickettsiae

92

what are the s/sx of RMSF

MACULOPAPULAR RASH
PETECHIAL RASH
abdominal pain
joint pain
flu-like symptoms

93

What are the labs for RMSF

Polymerase chain reaction (PCR)
immunohistochemical staining (IHC)
Indirect immunofluorescence assay with R. rickesttsii antigen

94

TX of RMSF

doxycycline

95

what is the distribution of small pox?

first lesions on the oral mucosa/palate, face, or forearms
Centrifugal distribution with the greatest concentration of lesions on the face and distal extremities
on any one part of the body, all of the lesions are in the same stage of development
scabs lead to deep, pitted scars
pain!!!!

96

what is the first line tx of erysipelas

PCN