Flashcards in skin Deck (43):
rocky mountain spotted fever
small red spots on hands/feet that progress toward the trunk
rash day #3
south central common
dry, red round lesions with rough texture
sun exposed areas
"sudden" stiff neck, fever, changes in LOC
hemorrhagic rash in the axillae, flanks, wrist, and ankles
early lyme disease
bulls eye rash 7-14 days after deer tick bite
flu like s/s
most common northeast region
herpes zoster opthalmicus
herpes soter on the trigemnal ( V) nerve. sudden vesicular lesions on the ONE side of the scalp, forehead, and tip of the nose. blurry vision. ED
>6mm, irregular borders. can appear in the nail pads or retina
basal cell carcinoma
pearly or waxy lesion with ulcerated center.
acral lentiginous melanoma
most common type of melanoma in AA and asians. located on the nailbes, palmar, and plantar surface. longitudinal brown to black bands on the nail beds
use heated paperclip or 18 g neede press down to create 3-4mm hold. blood may drain for 24-36 hrs
steven johnson syndrome (erythema multiform major)
bulls eye lesions
involves eyes nose, mouth, esophagus
fever before rashes appear
hypersensitivity caused by medicines, infections,a nd malignancies
PNS, sulfas, barbiturates, and phenytoid ( dilantin)
HIV have 40 fold risk of SJS dt to trimethoprim/sulfa
lyme disease s/s
erythema migraines ( rash that can span 12 inches bulls eye), facial palsy, swollen knee
what skin lesions show bulla (superficial blister >1cm)
impetigo, 2nd degree burn, SJS lesion
soft wart like growths, esp on the back
yellow colored plaques under the brow or upper.lower lids of the eyes. hyperlipidemia if
soft fatty cystic tumors, painless, located on trunk, legs/arms, neck
extremely dry skin and may involve mucosal or eyes (xerostomia, xeropthalmia)
thickening of the skin behind the neck/axilla. DM, metabolic syndrome, obesity, cancer of the GI tract
skin cells undergo rapid mitotic division=plaques
koebner phenomenon= new plaques over area of skin trauma
auspitz sign- pinpoint areas of bleeding when plaque is removed
black box warning for topical tacrolimus: skin malignancy. use spf . biologics/anti TNF agents
tx: steroids, retinoids, tar prep (psoralen)
humira, enbrel, ad remicade are associated with malignancy, TB, sepsis. Take baseline PPD
precurser to squamous sell.
cryotherapy of 5fu
yeast. hypo pigmented maculates that "appear" after skin becomes tan.
labs- koh (potassium hydorxide) slide shoes hphae and spores.
topical selenium sulfide or ketoconazaole
atopic dermatitis (eczema)
pruritic rash on the hands, neck, folds. worse with stress, winter, related to allergies
topical steroids hydrocortisone
nystatin (mycostatin) oral suspension
severe- lidocaine, diphenhydramine, and maalox mouth wash.
bacterial infection of the sebaceous glands of the axilla
mupirocin ointment to nares/fingernails
skin infection by gram +, s. progenies or s. auras. contagious and pruritic. honey colored
tx: keflex qid x 10 days
if pcn allergy, azithroymycin
life threatening infection by N. meningitides spread by droplets
The skin rash may advance from a few ill-defined lesions to a widespread petechial eruption within a few hours. Meningococcemia’s potential rapidity of progression cannot be stressed enough.
ie: college students
labs: lumbar CSF, blood culture, throat culture, mdi brain
tx: cefriaxone (rocephin) 2g IV q 12 hours plus vancomycin IV q 8-12 hours
lyme disease tx
erythema migraines by tick B. burgdorferi.
labs: antiboy igM and igG.
rocky mountain tx
dog tick or wood reck infected with rickettsia rickets.
small papules on hands/feet and spread to trunk
doxy or tetracycline x 21 days. refer STAT
biospy lesion 3mm punch
chickenpox- contagious 1-2 days before onset and unit chicken pox crusts over (1-2 wks)
shingles: contagious with onset of rash until crusts over
medications: acyclovir (zovirax) or valtrex
viral infection of the fingers (herpes)
painful red bumps on fingers.
self limited, or tx with acyclovir.
vacterial infection of the cuticle . painful smollen area of the nail that becomes abscessed.
soak in warm water for 20 minutes tie, topical antibiotic, incision and drainage prn
christmas tree rash on trunk
self limiting, 4-8 wks
if high risk std, check PRP to r/o syphilis
tx: permetherin for 8-14 hrs
rash on webs of hands , breats, buttocks, scrotum. rash appears snakelike (serpinginous) or linear burrows
labs- scarpe burrow or scales with glass slide
treat everyone in the house
most common in AA children
block dot tines capitis- ring worm
hairs break off and leave block dots on the scalp
medications: antifungal tx Griseofulvin daiy (microsize/ultramicdrosize), 6-12 weeks
avoid hepatotoxic substances (alcohol, statins, acetaminophen)
baseline LFT and repeat 2 weks after initiating
Total body surface area (TBSA) burns
each arm: 9%
each leg 18%, anterior trunk 18%, posterior trunk 18%
3 types: cutaneous, GI, and pulmonary
pulmonary- (animals, wool, hides, hair)
post exposure (bioterrorism) cipro
ricin toxin (castor beans)
oral ricin causes vomit, diarrhea, multi organ failure in 6 hours. no antidote
eliminated in 1977. vaccine 3-4 days post exposure. incubation 2 weeks
pruritic rashes located in the webs of fingers, penis are scabies until proven otherwise. treat entire family.
preferred antibiotic for human or animal bites
post herpatic neuralgia prophylaxis
TCA (antidepressents), amitriptyline (elavil)