STEP 2: DERM: Identifying Skin Lesions Flashcards
(136 cards)
1
Q
________ is the most common malignancy of the lip w/95% of cases occuring in the lower lip vermilion border
A
SCC, likely due to sunlight exposure
2
Q
This is concerning for
A
SCC
SCC typically presents as firm scaly papules, plaques, or nodules
3
Q
painful, shallow, round ulcertations w/ white/yellow bases. They are recurrent and self-limiting and affect only the oral mucosa, not the keratinuzed epithelium of the lips
A
Aphthous ulcers aka kanker sores
4
Q
This is most concerning for…
A
BCC
5
Q
Most likley dx:
A
Herpes labialis
6
Q
Most likely Dx:
A
Verruca vulgaris
aka Common wart
7
Q
Well differentiated SCC vs poorly differentiated SCC
A
Well diff: firm scaly papules/plaque/nodule w or w/out ulceration
Poor diff: beefy red papules or nodules that may bleed or ulcerate
8
Q
A
Acute allergic contact dermatitis
note that these lesions have a hx of exposure to external allergens and the lesions are pruritic
9
Q
The most common skin lesion in general population
A
BCC
Head or neck 70%
trunk 15%
10
Q
(BCC or SCC) is more likely in immunosuppressed pts and is more likely to cause neural invasion
A
SCC
11
Q
Small vascular tumors composed of abnormal capillaries and granulation tissue. Occur in young adults and particuarly pregnant women.
A
Pyogenic granuloma
12
Q
Lipoma vs epidermal inclusion cyst
A
Lipomas are benign, painless and irregular compared to epidermal inclusion cyst
13
Q
A high suspicion of ______________ secondary infection should be maintained in pts w/atopic dermatitis who develop sudden onset of vesicles.
A
Eczema Herpeticum
Overlying HSV infection on top of atopic dermatitis. People w/this have hx of atopy or active atopic dermatitis and then can have an HSV outbreak. Note that pts w/atopic derm have a faulty skin barrer making them particuarly susceptiple to secondary infections in a way that contact dermatitis does not present.
14
Q
Vesiculobullous disorder characterised by small, tense vesicles on extensor sites (elbow, knees, buttocks) that are extremely pruritic.
A
Dermtitis herpetiformis, closely associated w/celiac and tx is to avoid gluten.
15
Q
A
Tinea corporis, fungal infection normally by Trichophyton rubrum, normally treated w/topical antifungal w/ clotrimazole, terbinafine, or ketoconazole.
Note that there are specific dermatophyte infections:
groin: tinea cruris
foot: tinea pedis
Scalp: tinea capitis
Nail: tinea unguium
16
Q
Chronic erethematous rash most prominent on convex areas of the face, symptoms include flushing, skin sensitivity, and sometimes telangiectasias or small papules and pustules
A
Rosacea, there are 4 major kinds. See table.
17
Q
23 yo female w/recent hx of miscarriage comes in concerned for diffuse hairloss. There is no erythema or scaling of the scalp and over 20% of fibers are pulled out. Most likely cause?
A
Telogen effluvium. Acute, diffuse, noninflammatory hair loss
18
Q
34 yo w/ following lesion on neck and groin areas. They occasionally feel itchy:
A
Acanthosis nigrans
This 34 yo w likely has PCOS and the AN is due to insulin resistance
Hyperkeratotic, hyperpigmented plaques w/velvety texture. Often seen in flexural areas. There are two type of AN: benign or malignant.
19
Q
A
dome-shaped papules with central umbilication: likely Molluscum contagiosum.
In kids, its viral and spreads via skin contact, outbreaks on trunk, face, and genitalia.
In adults, its considered an STI.
NOTE THAT DISSEMINATED MC CAN BE SEEN IN IMMUNOCOMPROMISED INDIVIDUALS ie HIV+
In healthy patients, molluscum contagiosum is generally self-limiting and heals spontaneously after several months. However, in immunosuppressed individuals, lesions can be very large, widespread, and persistent. If treatment is indicated (e.g., for sexually transmitted molluscum contagiosum), cryotherapy with liquid nitrogen is usually the first treatment option.
20
Q
What other disease is this pt likely to have if they are displaying this skin lesion?
A
1: this skin lesion is pyoderma gangrenosum
2: inflammatory bowel disease like crohns
21
Q
A neutrophilic dermatosis that manifests with painful, rapidly progressive, erythematous papules and/or pustules that can develop into deep, ulcerated lesions with central necrosis. Associated with inflammatory bowel diseases and autoimmune and hematologic disorders.
A
Pyoderma Gangrenosum
22
Q
Characterized by symmetrical, hyperpigmented, velvety plaques in the axilla, groin, and neck. It is associated w/ insulin resistance states (in younger patients) and GI malignancy in older individuals.
A
Acanthosis Nigrans.
23
Q
A
Tinea Corporis
Presents w/ round pruritic plaques that typically form an annual pattern.
24
Q
A
Ecthyma
Strep skin infection related to impetigo. It can form eruthematous plaques but presents acute and it often associated w/pusutles and small ulcers.
25
Nummular eczema
Seen sometimes in the setting of chronically dry skin. Characteristic pruritic, round, scaly, fissured plaque that would fit under a large coin.
26
1 week old neonate w/rash on back and bilateral groin areas. No fever or new exposures. Swaddled in fleece blanket. No medications.
Milia Rubra
Benign neonatal rash.
Erythematous papular rash on occluded and intertriginous areas.
27
Rash that may appear at brith to age of 3 days. Presents w/ pustules w/erythematous base on trunk and proximal extremities. Resolves w/in a week
Erythema toxisum neonatorum
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Typically presents age 40-60 and mucosal surfaces are almost always affected, oral mucosa being the most common inital site of involvment. These lesions rupture to form erosions.
Pemphigus vulgaris
29
How can you tell the difference between pemphigus vulgaris and bullous pemphigoid?
Pemp Vulg: erosions, mucosal involvment is common
Bullous: tense bullae, less likely to erode, mucosal involvment is RARE
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Net like intercellular igG against desmosomes on immunoflurourescence
Pemphigus vulgaris
31
Linear IgG against hemidesmosomes along basement membrane
Bullous pemphigoid
32
Which is more likely, pemphigus vulgaris or bullous pemphigoid: age over 60
bullous pemphigoid
33
Which is more likely, pemphigus vulgaris or bullous pemphigoid: erosions
pemphiguus vulgaris
34
Which is more likely, pemphigus vulgaris or bullous pemphigoid: mucosal involvement
Pemphigus vulgaris
35
Pruritic, purple, polygonal, papules and plaques
Lichen planus
## Footnote
Lichen planus is a skin and mucous membrane condition often affecting adults aged 30-60, presenting with itchy purple bumps and plaques, and diagnosed clinically or by biopsy. Early specialist consultation and hepatitis C screening are recommended due to potential treatment resistance and a risk of malignant transformation in certain forms, with high-potency topical steroids as the primary treatment.
36
Onychomycosis likely caused by trichophyton rubrum infection
37
What is the clinical approach to IDing features of melanoma?
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Mild pruritis, no fever, chills or pain.
papules w/indented centers
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Condylomata acuminata caused by HPV. Lesions are verrucous, papilliform, and are ususally asymtpomatic but can hace mild itching or burning.
## Footnote
Pathogen: HPV types that infect the mucosal epithelium (e.g., HPV types 6 and 11)
42
Recurrent prritic rash caracterized by deep vesicles that affect palms, soles, and sides of digits.
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Chronic, scaly, irregular or annular patches on hands.
Tinea Manuum
44
Presents with papules, vesicles, and burrows often on hands/web speces/flexural surfaces
scabies
45
Lichenification fur to chronic allergic contact dermatitis
46
What is the difference in mechanism between Atopic Dermatitis and Allergic contact dermatitis?
Atopic= type I hypersensitivity
Allergic Contact: type IV hypersensistivity
47
Pt w/hx of eczema
Bullous impetigo
48
Yellow greasy scales of the face/scalp, seen in infants
Seborrheic dermatitis
49
Chronic, scaly, irregular erythematous plaques w/ulceration and central hypopigmentation surrounded by hyperpigmentation.
Discoid Lupus Erethematosus
50
Pretibial skin in a pt w/diabetes
Necrobiosis lipoidica
## Footnote
A rare, chronic granulomatous disease of the skin commonly associated with diabetes mellitus; starts as a reddish brown papule and progresses to a yellow-brown papule or plaque with visible telangiectasias. Ulceration of the lesion may also occur following minor trauma.
51
Fragile blisters and erosions on dorsum of hands and face
Porphyria cutanea tarda
52
Systemic Sclerosis
53
Two likely etiologies of diaper dermatitis
54
Cutaneous T-cell lymphoma sometims referred to as mycosis fungoides
55
Irritant Contact Dermatitis
56
Candidia dermatitis
57
How can you ID Telogen effluvium from alopecia areata?
Telogen eff is characterized by DIFFUSE not patchy hair loss and is triggered by stressors.
58
Patchy hairloss not brought on by stress
59
defined as the abrupt appearance of multiple seborrheic keratoses caused by an associated cancer and the rapid increase in their size and number.
Leser-Trelat, concerning for melanoma
60
Ecthyma gangrenosum
skin infection often due to Pseudomonas aerginosa
Not to be confused w/pyoderma gangrenosum (ulcers, purulent, associated w/crohns)
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Erethema nodosum
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What comorbidities are associated with these skin findings:
Inflammatory bowel disease
Erythema nodosum (EN) is an inflammation of subcutaneous fat caused by a delayed hypersensitivity reaction. Women in early adulthood are commonly affected. Most cases are idiopathic, but an association with a variety of diseases, including infections and autoimmune disorders (e.g., ulcerative colitis), is possible. The characteristic lesions are painful nodules on the lower legs (particularly shins). EN is a clinical diagnosis. The condition typically heals spontaneously within a few weeks and, therefore, generally requires no more treatment than supportive care (e.g., analgesia).
63
Hidradentitis supprativa
Hidradenitis suppurativa is a chronic inflammatory skin condition characterized by recurrent follicular inflammation, typically in the intertriginous areas. Manifestations include painful skin lesions (nodules and abscesses), draining sinus tracts, and scarring; the severity of symptoms varies. The disease typically affects young adults. The exact etiology is unknown but likely multifactorial and thought to involve blockage of hair follicles. Diagnosis is clinical and treatment includes wound care, pain management, and pharmacotherapy. Psychological support may be required for mental health conditions that can be associated with hidradenitis suppurativa. Surgical interventions may be needed for severe and/or recurrent disease. Complications include disfigurement resulting from excessive scarring, bacterial superinfection, and, in affected areas, cutaneous squamous cell carcinoma.
64
Keratoacanthoma
65
Diffuse cutaneous scaling, rough dry
66
Note that LP is usually idiopathic but it is often seen in pts w/hep C and can be drug induced by ACE inhibitors, thiazide diuretics, beta blockers, and hydroxycloroquine.
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Plantar warts likely caused by HPV
69
Presents in children and young adults with friction induced blisters at the palms and soles. Hx might have issues w/ oral blisters as an infant.
Epidermolysis Bullosa Simplex.
There are 4 subtypes (simplex, junctional, dystrophic, and kindler syndrome)
70
NONSCARRING patchy hair loss with NORMAL underlying scalp
Alopecia areata
71
Angiofibromas in the malar region, acne not responsive to normal therapy, and hypopigmented macules (ash leaf spots) are characteristic of
tuberous sclerosis
72
What other disorders should you test for if you have this kind of skin finding?
Vitiligo raises concern for autoimmune thyroid disease
73
Senile purpura
in older pts w/ no concerns for abuse or bleeding disorder (normal blood bounts and normal coagulations studies)
74
Inflamed papules and pustules w/ erethema is consistent with what kind of acne?
Inflammatory
75
Closed or open comedomes on forehead, nose and chin are cinsistent with what kind of acne?
Comedonal
76
Large nodules that don't respond to normal acne treatments raises concern for what kind of acne?
Nodular (cystic)
77
itty bitty at 3 weeks
78
How can you tell erysipelas from cellulitis?
Erysipelas: RASIED sharp edges, fever early in course
Cellulitis: flat esges, fever later in course
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Erysipelas
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Pseudofolliculitis barbae
## Footnote
First line
Advise patients to stop shaving for at least 8 weeks. [3]
Educate patients on shaving techniques to minimize the risk of recurrence.
Advise photoprotective measures to reduce the risk of postinflammatory hyperpigmentation.
Persistent lesions or definitive treatment::
Permanent hair-removal techniques (e.g., laser hair removal with or without eflornithine)
Chemical peels
81
What is the greatest risk factor for this condition?
Tobacco use
Hiradentitis supprativa
## Footnote
Patient education on disease process and management
Recommend smoking cessation if relevant. [2][4]
Wound care
Warm compresses
Cover open wounds.
Discuss ways to improve physical comfort, e.g., wearing loose-fitting clothes.
Pain management
82
Erythrasma, superficial bacterial infection (corynebacterium minutussumum)
## Footnote
General: improved skin hygiene, maintaining dry skin (e.g., with cotton or linen cloth)
Medical therapy
Localized disease: topical antibiotic treatment (e.g., clindamycin, erythromycin)
Extensive disease: systemic antibiotic treatment (e.g., erythromycin)
Prognosis: Recurrence is common.
83
Pityriasis rosea
84
Lentigo, from intraepidermal melanocyte hyperplasia
85
lower leg. Most concerning for...
SCC.
This would not be BCC even though BCC is most common. BCC presents w/pearly papule, raised borders, not a flat lesion like the one here. Remember that Actinic Keratosis is precursor to SCC and this looks closer to those kinds of lesions.
86
Herald patch (mother patch) in pityriasis rosea
The primary plaque (located on the trunk) in this image is the initial and largest lesion in pityriasis rosea. The surface shows irregular scaling.
87
How do we treat the following:
This is pityriasis rosea
Advise patients that spontaneous resolution typically occurs within 6–12 weeks. [1][4]
Consider symptomatic treatment for pruritus as necessary. [3][7]
Topical emollient (e.g., calamine lotion)
Topical corticosteroid
Acyclovir
Oral antihistamine
Oral macrolide, e.g., erythromycin
UVB phototherapy
88
A chronic inflammatory disease of unknown cause that is characterized by white, atrophic plaques with intense pruritus affecting the skin, nails, hair, and/or mucous membranes. It most commonly affects the anogenital area and women. Well-demarcated, white papules and plaques potentially with a surrounding red inflammatory halo
Lichen Sclerosis
| Other presentation:
## Footnote
First-line: Initiate a high-potency or ultra-high potency topical steroid ointment. [3][4][6]
Clobetasol
Betamethasone
Mometasone
Second-line options [6]
Intralesional corticosteroid injections
Topical calcineurin inhibitors (with caution): tacrolimus, pimecrolimus
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First line treatment:
First-line: Initiate a high-potency or ultra-high potency topical steroid ointment. [3][4][6]
Clobetasol
Betamethasone
Mometasone
## Footnote
Second-line options [6]
Intralesional corticosteroid injections
Topical calcineurin inhibitors (with caution): tacrolimus, pimecrolimus
90
Purple (violaceous)
Polygonal, irregular borders
Planar (flat-topped)
Pruritic, often severe
Papules
Plaques
Lichen Planus
## Footnote
chronic inflammatory disease characterized by lesions involving the skin (i.e., cutaneous), mucosa (i.e., mucosal), and hair or nails (i.e., appendageal). It most commonly affects adults aged 30–60 years. The exact etiology is unknown. Cutaneous lichen planus typically manifests as pruritic purple papules and plaques with well-demarcated irregular borders and Wickham striae on the extremities (e.g., wrists and ankles).
First-line treatment consists of high-potency topical steroids; intralesional preparations are indicated for hypertrophic cutaneous disease and appendageal involvement.
91
The sloughing of epidermis when lateral pressure is applied to the skin. Suggests detachment of the epidermis from the dermis.
Nikolsky sign
## Footnote
Characteristic of pemphigus vulgaris, staphylococcal scalded skin syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis, and certain forms of epidermolysis bullosa.
92
Nikolsky sign is positive in what dermatological conditions?
Characteristic of pemphigus vulgaris, staphylococcal scalded skin syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis, and certain forms of epidermolysis bullosa.
93
Stevens-Johnson syndrome
Back, buttocks, thighs, and legs of an 8-month-old infant 2 weeks after primary vaccination
Irregularly shaped, partially confluent, erythematous macules with bullae are visible.
Patient history suggests Stevens-Johnson syndrome triggered by vaccination.
## Footnote
Toxic epidermal necrolysis (severe Stevens-Johnson syndrome)
Right arm of an infant in whom toxic epidermal necrolysis was likely triggered by smallpox vaccination
94
What differentiates SSSS from SJS?
Mucosal involvement differentiates SJS from staphylococcal scalded skin syndrome.
## Footnote
Make a clinical diagnosis of SJS based on history and mucocutaneous lesions
95
Tx for SJS
Discontinue the offending drug.
Consult dermatology, ophthalmology, and/or gynecology.
Supportive management is similar to that of extensive burns, including:
Goal-directed IV fluid therapy
Pain management
Wound care
See also “Supportive care for burn injury.”
## Footnote
Monitor for acute complications, including:
Infection, septic shock
Hypovolemic shock
96
What is your differential:
SJS/TEN
SSSS
Erythema Multiforme
97
A rare, acute type IV hypersensitivity reaction triggered by certain infections (e.g., Mycoplasma pneumoniae, herpes simplex virus, SARS-CoV-2), medications (e.g., sulfonamides), or vaccines (e.g., influenza vaccine). Manifests as a polymorphic rash that develops into target lesions. Disease severity ranges from minimal mucosal involvement and localized lesions to severe mucosal involvement and extensive lesions with or without systemic symptoms
Erythema multiforme
98
How do you differentiate SJS from erythema multiforme?
EMF minor does not typically involve mucous membranes.
Lesions of EMF (both major and minor) are more acrally distributed and have limited skin detachment.
99
What are the pediatric exanthems?
Measles (paramyxoviru)
Scarlet Fever ( Streptococcus pyogenes)
Rubella (rubella virus)
Erythema Infectiosum (Fifths) (parvovirus B19)
Roseola (sixth) (human herpesvirus 6)
Chicken Pox (varicella)
100
I am caused by HHV8 infection
Kaposi Sarcoma
| Lesions resemble those of bacillary angiomatosis and histology is requir
## Footnote
Can occur at any CD4 count (typically < 500/mm3)
Initial stage:
Painless, nonpruritic, violet papules or nodules on skin and mucosa (especially face/oral cavity and chest)
Solitary, darkly pigmented plaques, which can evolve into nodular, bluish, submucosal, and painful skin changes
Lesions resemble those of bacillary angiomatosis.
Progression: may disseminate to the organs, particularly the gastrointestinal tract, respiratory tract, and lymph nodes.
Gastrointestinal tract involvement: abdominal pain and diarrhea; hemorrhage and bowel obstruction in severe cases
Pulmonary involvement: Lesions cause dyspnea, cough, and/or hemoptysis.
101
# What are the most likely locations to find kaposi sarcoma?
especially face/oral cavity and chest
102
# What is your top teo differential for the following lesion:
Kaposi sarcoma and bacillary angiomatosis. Lesions resemble those of bacillary angiomatosis and histology is required to differentiate between the conditions.
## Footnote
Bacillary angiomatosis: A condition caused by Bartonella bacteria (e.g., Bartonella henselae) that most commonly develops in patients who are immunocompromised. Causes vascular proliferation, which leads to the development of solitary or multiple, red-purple papules that bleed easily.
103
I am seen in immunocompromised individuals (especially CD4 less than 100). I am caused by bartonella henselae
Seen primarily in immunocompromised patients (especially patients with AIDS and/or CD4 count < 100)
Solitary or multiple, red, flesh-colored or colorless papules and nodules that bleed easily
Fever, chills, malaise, anorexia
| Solitary or multiple, red, flesh-colored or colorless papules and nodule
## Footnote
Seen primarily in immunocompromised patients (especially patients with AIDS and/or CD4 count < 100)
Solitary or multiple, red, flesh-colored or colorless papules and nodules that bleed easily
Fever, chills, malaise, anorexia
104
The development of skin lesions in traumatized skin that was previously normal.
Koebner phenomenon
## Footnote
Koebner's phenomenon is seen in psoriasis, lichen planus, and vitiligo.
105
This lesion is associated with HEP C and presents with purple, polygonal, planar, pruritic, papules and plaques
Lichen Planus
106
Caused by bartonella, seen in immunocompromised patients and can be mistaken for kaposi sarcoma
Bacilliary angiomatosis
107
How to treat:
If hypertrophic or keloid scars develop in the first 6 months:
--Encourage patients to regularly moisturize.
--Apply silicone cream or dressings.
--Use pressure treatments.
Widespread hypertrophic scars or growing keloid
--Refer to a specialist.
--Start intralesional **corticosteroid injections. **
108
Allergic Contact Dermatitis
## Footnote
Contact dermatitis due to poison oak, poison ivy, or poison sumac is the most likely cause in a patient presenting with erythematous, pruritic, and burning skin lesions in a linear pattern that appear 24 hours after a camping trip
DIFF DX:
Irritant contact dermatitis (see “Irritant vs. allergic contact dermatitis”)
Atopic dermatitis
Seborrheic dermatitis
Dyshidrotic eczema
Psoriasis
Scabies
Tinea pedis
Dermatitis herpetiformis
Mycosis fungoides (cutaneous T-cell lymphoma)
109
How do you differentiate alleric contact dermatitis from irritant contact dermatitis?
One is more related to occupational exposures (irritant) and allergic contact dermatitis tends to have vesicles and recent expsure to previously sensitized allergens.
110
Miliaria crystallina
| Cousin to miliaria rubra
## Footnote
Definition: transient, papular exanthem following exposure to heat
Etiology: blockage of the eccrine sweat ducts in hot and/or humid environments
Localization: mainly on the trunk, neck, and intertriginous areas
111
The most common skin malignancy in individuals who are on immunosuppression for transplant
SCC
112
BCC is most likely to be found where?
head or neck (70%) or trunk (15%)
113
This is usually seen in immunosuppressed patients, the skin is the most common site. It presents with multiple, discrete, flesh to red colored papules with slight central umbilication
Disseminated cryptococcus
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7 yo m w/atopic dermatitis comes in with this
This is infection complication. He's got impetigo. Tx involves topical mupirocin or oral antibiotics
118
Dermatofibroma is a benign fibroblast proliferation that typically appears as a firm, hyperpigmented nodule, most often on the lower extremities. Dermatofibromas have a fibrous component that causes dimpling in the center when the area is pinched ("dimple" or "buttonhole" sign).
119
# Mobile mass, spont resolves and recurs
epidermal inclusion cyst (EIC), also known as an epidermal cyst, a discrete benign nodule lined with squamous epithelium that contains a semisolid core of keratin and lipid. An EIC occurs when the epidermis becomes lodged in the dermis due to trauma or comedones, or it can arise de novo. EICs can be seen anywhere on the body, but are most common on the face, neck, scalp, or trunk. The lesion can gradually increase in size and may intermittently produce a cheesy white discharge. Some patients may develop significant inflammation with rupture and involvement of surrounding tissue. An EIC will usually resolve spontaneously but can recur.
Diagnosis is made clinically with examination showing a dome-shaped, firm, and freely movable cyst or nodule with a central punctum (small, dilated, pore-like opening). Excision is typically performed only for cosmetic reasons. Incision and drainage are occasionally needed for infected and fluctuant cysts that are painful and erythematous.
120
How do you differentiate an epidermal inclusion cyst from a lipoma
Lipomas are benign, painless subcutaneous masses with normal overlying epidermis. In contrast to epidermal cysts, lipomas are usually soft to rubbery and irregular, and do not typically regress and recur.
121
Basal cell carcinoma typically presents as a shiny, pearly/translucent, skin-colored nodule with intralesional telangiectasia. Rolled, smooth borders and central ulceration can also be seen. In contrast, squamous cell carcinoma has an opaque appearance with a hyperkeratotic (scaly) surface.
122
neonatal cephalic pustulosis
123
2 yo w/ atopic dermatitis presented with eythematous vesicles on her neck that spread. They put her in TMP-SMX and shes back in the ed with this 4 days later:
Eczema herpeticum, or herpes simplex virus infection associated with atopic dermatitis, presents with painful vesicles that evolve into "punched-out" erosions with hemorrhagic crusting. Due to the risk of visceral dissemination and death, systemic acyclovir or valacyclovir should be initiated immediately.
124
Seborrheic keratosis
## Footnote
A sharply demarcated darkly pigmented papule with a greasy nodular surface is visible. The papule appears to be stuck onto the skin.
This is the typical appearance of seborrheic keratosis, a benign skin tumor that arises from keratinocytes and is common in the elderly.
An explosion of them is leser-trelat
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Keratosis pilaris: benign condition characterized by retained keratin plugs.
127
What normally exacerbates the condition pictured:
This is keratosis pilaris which worsens with cold, dry weather
128
Flat hyperpigmented pataches associated with McCune albright syndrome or neurofibromatosis
Cafe au lait
129
Blue grey patches usually located on the lower back or sacrum
Congenital dermal melanocytosis
130
flat, blanchable, and erythematous vascular birthmarks. There are two kinds of this; one is primarily located on the eyelids, glabella, and nape of the neck and regress with time. The other does not regress and are located unilaterally on the face.
Nevus simplex and nevus flemmeus
## Footnote
Nevus flemmeus is also known as a port wine stain
131
Associated with mccune albright:
cafe au lait
132
Perifollicular hemorhages as seen in vitamin c def (scurvy)
133
## Footnote
AK is caused by UV exposure; seen in sun exposed areas; has dyspigmentation, rough texture, atrophy, and telangiectasia. Often diffuse involvement 'field cancerization'. Precursor to SCC.
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What topical would you rx this pt?
topical fluoracil,imiquimod, or tirbanibulin
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