Test 3 Reverse Flashcards
(175 cards)
1
Q
Top layer of skinContains keratin & fillagrin surrounded by lipid matrix that provides a water barrier
A
Describe the stratum corneum
2
Q
A protein in the granular cell layerHolds waterFound in stratum corneum
A
What is fillagrin?
3
Q
- Keratinocytes2. Melanocytes3. Langerhans
A
What are the types of skin cells?
4
Q
90% of skin cellsMigrate from basal layerDesquamation 40-56 daysSpiny layer, held together by desmosomes -stripes/spines
A
Describe keratinocytes
5
Q
atopic dermatitis
A
Defects in fillagrin causes?
6
Q
psoriasis
A
Defects in keratinocytes causes?
7
Q
basal layer of skinproduce melanin which is transferred to the keratinocytes
A
Describe melanocytesres
8
Q
mid-epidermis cellsResponsible for delayed hypersensitivity immune response reactions
A
Describe langerhans
9
Q
- Macule2. Petechiae3. Ecchymosis4. Telangiectasia
A
What are the types of flat lesions?
10
Q
- Papule2. Plaque3. Nodule4. Wheal5. Papilloma6. Vesicle7. Bulla8. Abscess9. Cyst10. Scales11. Lichenification
A
What are the types of elevated lesions?
11
Q
raised, solid lesions <.5cm in daimeter
A
Papule
12
Q
raised, solid lesions >0.5 cm in diameter
A
Nodule
13
Q
plateau-like elevationconfluence of papules
A
Plaque
14
Q
chronic, thickening of the epidermis leading to exaggerated, deep skin lines, usually due to chronic rubbing/scratching
A
Lichnification
15
Q
round of flat topped evanescent lesion, changes rapidly in size & shape
A
Wheal
16
Q
multiple wheals”hives”
A
urticaria
17
Q
fluid filled lesion <0.5 cmoften thin walled
A
Vesicle
18
Q
fluid filled lesion >0.5 cm
A
Bullae
19
Q
abscess where hair follicle is involved
A
Furuncle
20
Q
multiple furuncles
A
Carbuncle
21
Q
liquid nitrogenWarts, seborrheic keratoses, actinic keratoses
A
What is cryotherapy?
22
Q
Pigmented lesions >4mmAll lesions >6mm Deep dermis/subQ involvement
A
When do you perform an excisional biopsy?
23
Q
- Incompletely excised BCC or SCC2. Primary BCC or SCC w/ indistinct borders3. Cosmetic areas4. Aggressive, rapidly growing lesions
A
Indications for Mohs surgery
24
Q
- Nevi-melanocytic-atypical-blue2. Lentigines3. Seborrheic keratoses4. Malignant melanoma
A
Types of pigmented lesions
25
A - SymmetryB - Borders; irregularly, poorly definedC - Color - inconsistentD - Diameter/size >6mmE - Evolving/changing (shape, size, color)
Evaluation of a pigmented lesion
26
1. Hx of melanoma2. Family Hx3. >100 acquired nevi4. Any new lesion >50 y/o5. Fair skin, blue eyes, freckles (Fitzpatrick skin II)6. Big sunburn
Risk Factors of melanoma
27
Meet 3/51. Poorly defined borders2. Irregular borders3. Irregular pigment4. Background erythema5. >5mm diameter
Classification of atypical nevi
28
Benign, may appear in 4th decadeNot on palms & solesPink, tan, dark brownTexture - velvety to wartyStuck on appearanceTx - cryotherapy, curetted
Seborrheic keratoses
29
Melanoma in elderly ptsSun exposed areasSlow growingHorizontal growth Clyde spots!
Lentigo
30
Melanoma common in Asians/blackshands, feet, nails Hutchinson sign - very aggressive w/ mets - line on nail
Acral lentiginous melanoma
31
Subtle w/o pigmentationDDx:diff. types of skin cancerpsoriasisdermatitis
Amelanotic melanoma
32
aka eczema"itch that rashes" Erythematous papules that coalesce into plaquesxerosis
Atopic dermatitis
33
50-80% of children will have another atopic disease1. Asthma2. Atopic dermatitis3. Allergic rhinitis
What is the atopic triad?
34
1. Hx/FH2. Hx asthma/allergic rhinitis3. Xerosis4. Repeated skin infections-S. aureus
Risk factors of atopic dermatitis
35
1. Topical steroids2. Calcineurin inhibitors (Elidel, Protopic)3. Antihistamines4. Tx secondary bacterial infections milds soaps, bath 1x/day, moisturizers, avoid wool & acrylics, sweat, heat & ointments
Tx atopic dermatitis
36
1. Localized area of lichenification2. May be secondary to atopic dermatitis or other itchy conditions3. Hyperexcitability/abnormal itching4. Intense, may be unconscious habit Tx - break the itch! Steroids, antihistamines, occlusive/hydrocolloidal dressing
Lichen Simplex Chronicus
37
Chronic inflammatory conditionBimodal peak 20-30 or 50-60 Familial, waxes & wanes Risk factors:1. BMI2. Smoking3. EtOH4. Medications
Psoriasis & Risk Factors
38
1. Plaque2. Guttate3. Inverse/flexural4. Erythrodermic5. Pustular
Types of psoriasis
39
Most common type of psoriasisSalmon colored plaques w/ silvery scales**May itchHyperproliferative disease - immune response causes excess cytokine release
Plaque psoriasis
40
Psoriasis bleeds when plaques removed
What is auspitz sign?
41
Considered seronegative spondyloarthropathies OFten affects hands, feet & spine
Psoriatic arthritis
42
Drop like lesions 1-10mmAcute onset*Often preceded by strep pharyngitis*
Guttate psoriasis
43
Both rare but can be serious life threatening conditions
Erythrodermic & pustular psoriasis
44
Found in body foldsAxilla commonLacks scales due to moistureMay mimic candidiasis
Inverse/flexural psoriasis
45
Mild:1. Topical steroids2. Vit D analogs3. Keratolytic agents (salicylic/lactic acid)4. Topical retinoids5. Coal tarModerate to sever:1. PUVA (UV therapy)2. Retinoids
Tx psoriasis
46
Fawn/salmon colored plaques May be caused by herpes Peak age 10-35more common in femalesHerald Patch** - 2-10cm patch w/ peripheral scaling, central clearing often located on the back 1-2 wks later, full blown rash on trunk & proximal extremities Xmas tree distribution* Spares the face, palms & soles of feetNeg KOH scraping no Tx
Pityriasis rosea
47
Pityriasis rosea2-10 cm patch w/ peripheral scaling, central clearing often located on the back
What causes a Herald patch?
48
Pityriasis roseaspares the face, palms & soles of feet
Which rash has a Christmas tree distribution?
49
Scaly, greasy looking rashBeard, eyebrows, nasolabial fold, eyelids, under boobs, dandruff/cradle capMost likely caused by inflammatory rxn to fungus (Malassezia) or yeast
Seborrheic dermatitis
50
1. Antifungals & topical steroids2. Selenium sulfide shampoo or zinc pyrithione3. Salicylic acid 4. Tx blepharitis by gently cleaning w/ soap
Tx Seborrheic dermatitis
51
Discoid lupus - DLE chronic scarring lesionsSubacute cutaneous - SCLE nonscarringMalar/butterfly rash -often pptd by sun exposure Sharply marginated w/ irregular borders Expansion peripherally w/ central regression leading to atrophy
Chronic cutaneous lupus erythematosus
52
Prevention - avoid sun1. Topical steroids2. Antimalarials3. Retinoids4. Thalidomide
Tx of lupus rash
53
aka cutaneous Tcell lymphomaIndolentPatches & plaques that may resemble psoriasisSezary cells Tx - PUVA, retinoids
Mycosis fungoides & Tx
54
Small lesions 0.2-0.6 cm Macular or papulesPinkish/flesh colored rough patchesOften in sun-exposed areas Premalignant deformation of keratinocyte may develop into SCC
Actinic keratoses
55
1. Liquid nitrogen2. Topical agents -Fluorouracil cream-Imiguimod 5%
Tx actinic keratoses
56
Usually in sun exposed areas White fair skinInc. mortality rate compared to BCC 1. Papule, plaque or nodule2. Pink, red or flesh colored3. Scaly4. Grows outward5. Firm6. May have cutaneous form7. Friable (bleed easily)8. May be pruritic
Squamous Cell Carcinoma
57
1. In situ- Bowen: localized to intraepidermal layer 2. Invasive - involvement of dermis
Types of SCC
58
1. In situ - curette & desiccation, topical 2. Invasive - wide & local incision, MOHS
Tx of SCC
59
Unilateral red scaling plaqueDx w/ BxTx - mastectomy, chemo
Mammary Paget disease
60
aka vesiculobullous hand eczemaTapioca vesicles affecting hands & feetBlisters, pruritic, may become scaly & fissured Tx - topical/oral corticosteroidskeep dry - white cotton socks
Dishidrotic eczema & Tx
61
Blisters on dorsal surface of hands Skin fragility Hypertrichosis (facial hair)Causes:1. Sun exposure2. Liver disease/alcoholism3. Hep C4. HemosiderosisDx - urinary uroporphyrins
Porphyria cutanea tarda & causes
62
1. Avoid sun (suncreen doesn't help)2. Avoid/remove other triggers3. Phlebotomy4. Antimalarials
Tx of porphyria cutanea tarda
63
Exposure to chemicals or allergensIrritant - additive, soaps, detergentsAllergic - plants, antimicrobials, adhesive tape, jewelry, rubber Hypersensitivity rxn taking 10-14 days 1st time or 12-48 hrs repeated
Contact dermatitis causes
64
Irritant - erythematous, flat, scalyAllergic - vesicular, weepy, crusting Itching & burningLinear distribution
Contact dermatitis presentation
65
Uroshiol1. Poison ivy2. Poison oak3. Poison sumacType of contact dermatitis
Rhus dermatitis causes
66
May appear 8-12 y/oPeaks 15-18 y/oOften resolves by 25 y/o Men>women
Acne vulgaris
67
1. Production of sebum (androgen mediated)2. Keratinous obstruction of sebaceous outlet 3. Baterial colonization - Propionionbacterium acnes4. Inflammatory rxn
Pathophysiology acne vulgaris
68
black head seen w/ acne vulgaris
What is an open comedone?
69
white headseen w/ acne vulgaris
What is a closed comedone?
70
1. Topical antibiotics2. Benzoyl peroxide - helps open pores3. Topical retinoid w/ severe - accutane - contraindicated in pregnancy
Tx acne vulgaris
71
1. Androgenic steroids2. Corticosteroids3. Phenytoin (Dilantin)4. Isoniazid5. Oral contraceptives
What worsens acne vulgaris?
72
Papules & pustules Neurovascular component - flushing & telangiectasia Glandular component - hyperplasia of the soft tissue of the nose (rhinophyma)
Rosacea
73
1. Metronidazole gel or clindamycin gel2. Oral antibiotics 3. Benzoyl peroxide, topical retinoin
Tx of rosacea
74
aka heat rashKeep cool w/ non-restrictive clothingClean skin w/ chlorhexadine Topical steroids
Milaria
75
Swelling of the upper dermisAngioedema - swelling of the deep dermis & subQ tissueOften involves face, tongue & larynx May be manifestations of anaphylaxisacute 6 wks
Urticaria
76
1. Cholinergic - heat & emotion2. Solar 3. Water - aquagenic4. Dermatographism - when skin is rubbed or scratched, leaves sharply localized edema or wheals
Types of urticaria
77
Immunologic - IgE mediated activation of mast cellsNon-immunologic - Release of histamine through other pathways 1. Idiopathic2. Food allergies3. Infections4. Drugs 5. IV contrast dye
Causes of urticaria
78
contact dermatitis
What type of reaction do detergents cause?
79
1. ACE2. PCN3. ASA4. NSAIDSNSAIDS may not be cause but exacerbate it
Which drugs can cause urticaria?
80
Usually caused by Herpes or mycoplasmaPapules evolve into vesicles over ~10 days Target lesionsTx - acyclovir
Erythema multiforme Minor
81
1. Sulfa2. Allopurinol3. PCN4. Anticonvulsants5. NSAIDS
What drugs can cause erythema multiforme major?
82
1. Withdraw insulating agent2. Burn unit3. IV fluids4. IV immunoglobulins5. Corticosteroids maybe-prone to infections
Tx erythema multiforme major
83
RareBullae - tender, painful & ruptureSusceptible to secondary S aureus infection Nicholsky signCauses:1. Autoimmune2. Drug induced3. Paraneoplastic
Pemphigus & causes
84
separation of epidermis w/ contactSeen w/ pemphigus
What is the Nicholsky sign & when is it seen?
85
1. Vulgaris2. Vegetans3. Foliaceus4. Erythematosus
What are the forms of pemphigus?
86
Immunofluorescence - IgG deposits on keratinocytes & other inflammatory processes Tx:1. Corticosteroids, immunosuppressants, IVIG2. Tx of secondary infection3. Chronic, some remission
Dx & Tx of pemphigus
87
Deep, tense bullaeCommon in flexural areasAge >60, menAutoimmune Course: exacerbations/remissions, remits 5-6 yrs Dx: ImmunofluorescenceTx: Derm referral
Bullous pemphigoid & Dx & Tx
88
Hardened hyperkeratotic overgrowthsProtection from friction; pressure areas Calluses are larger on the bottom/plantar surface
Corns & Callosities
89
1. Hard - thickened area w/ packed center2. Soft - thinner surface, nonweight bearing surfaces, more painful3. Seed - smaller, bottom foot, very tender, may be clogged sweat duct
Types of corns
90
1. Better fitting shoes2. Trimming3. Salicylic acid4. Soaking/pumice5. Urea/lactic acidRefer if diabetic
Tx callus & corns
91
MCC of skin cancer Can occur in pale or dark skins Pink pearly papules*** rarely metsLocally invasiveAt risk for other types of skin cancer Follow up q 6mo-1yr
Basal Cell Carcinoma
92
BCC
What is pathognomonic for pink pearly papules?
93
1. Curettage & dessication2. Cryotherapy3. Excision4. Mohs5. Imiquimod6. 5% Fluorouracil 7. Radiation?
Tx BCC
94
1. Lichen planus2. Kaposi sarcoma3. Purpura & vasculitis- petechiae- ecchymosis- vasculitis
Violaceous purple plaques & nodules
95
Inflammatory pruritic condition1. Purple2. Papules3. Pruritic4. Polygonal (cells)Wickham's striae - fine white lacy linesDistribution - flexor surfaces, genitals
Lichen planus
96
1. Idiopathic2. Drugs3. Metals4. Infection (HCV)if erosive/ulcerative - inc risk of SCCTx - PUVA & immunosuppression
Causes & Tx of lichen planus
97
Vascular neoplastic condition caused by HHV8Seen on face, trunk extremities & hard palate, GI tract & lungs Refer!
Kaposi's sarcoma
98
palpable - vasculitis (inflammatory)non-palpable - petechiae 5mm
Types of purpura
99
Blanch - secondary to vasodilationnon-blanch - extravasation of bloodhemorrhagic
Does it blanch?
100
1. Abnormal platelet function2. DIC & infection (meningitis)3 Thrombocytopenia -idiopathic-drug induced-thrombotic
Causes of petechiae
101
1. Coagulation defects2. DIC & infection3. Trauma
Causes of ecchymosis
102
1. Henoch-Schonlein purpura2. Idiopathic3. Malignancy4. Infections5. Drug induced6. Polyarteritis nodosa 7. Takayasu arteritis8. Giant cell arteritis
Causes of vasculitis
103
1. Hemorrhoids, fissures2. Infections- Candidiasis- Erythrasma- Oxyuriasis (pinworms)3. Contact dermatitis4. Irritating secretions- diarrhea - trichomoniasis5. Psoriasis, seborrheic, dermatoses
Anogenital pruritis & causes
104
1. Candidiasis2. Trichomoniasis3. Lichen conditions
Causes of vulvar pruritis
105
1. Hydrocortisone-pramoxine (pramasone)2. Topical doxepin3. Topical capsaicin
Tx anogenital pruritis
106
Painful erythematous nodules**Bright red, brown-yellow & resemble contusions*Inflammation panniculus w/o ulcerations Anterior tibial surfaceUsually symmetric +/- fever, fatigue & arthralgias 2-4th decadewomen>men
Erythema nodosum
107
1. Streptococcus2. Fungal (histoplasmosis, coccidiomycosis), TB, syphilis 3. Drugs - oral contraceptives, sulfa4. Sarcoidosis5. IBD6. Diverticulitis7. Neoplasms8. Idiopathic
Causes of erythema nodosum
108
Address underlying conditionUsually resolves in 3-6 wks 1. NSAIDS2. Oral KI3. Steroids maybe
Tx erythema nodosum
109
Epidermal inclusion cystBenign growths in the upper hairCan become inflamedTypically have a pore, punctate center
Epidermoid cysts
110
Filled w/ cheesy, foul smelling material May need I&D 1st then removal if infected/inflamed
Epidermal inclusion cyst
111
Keratin filled cystsbenign, nonpainful, no Tx needed
Milia
112
Pit forms at gluteal cleftBlocked w/ hair & keratin Abscess may formHigh recurrence rate after TxMay need I&D, surgical referral
Pilonidal cyst
113
1. Solar urticaria2. Lupus3. Porphyria4. Photosensitization due to drugs5. Polymorphous Light Eruption (PMLE)
Causes of photodermatitis
114
1. Antibiotics -sulfa, fluoroquinolones, tetracycline2. NSAIDS3. Diuretics-furosemide, HCTZ4. Retinoids
Drugs that cause photodermatitis
115
PMLE~23 y/oOccurs w/ sun exposure, spring/early summerProbably a photoallergy type response Appears w/in 18-24 hrs of exposure & resolves over 10 days
Polymorphous Light Eruption
116
1. Sunscreen2. +/- antimalarials3. +/- PUVA (to inc. tolerance)
Tx of PMLE
117
Signs of venous insufficiency VaricositiesDusky pigmentation (hemosiderin deposits)Discomfort relieved by elevation Medial ankle most common
Venous ulcers
118
1. Compression Tx (Unna boot)/compression stockings2. Carefully measure/document 3. Keep moist (semipermeable dressings)4. Clean w/ saline5. Weekly dressing changes6. Systemic abx w/ infection7. If not healed w/in 6 wks - wound care referral
Tx of venous ulcers
119
Dependent ruborDiminished pulsesHx claudication Punched out appearanceWell demarcated w/ pale base, minimal exudate
Arterial ulcer
120
NeuropathyCallus is considered pre-ulcerative condition in DM/neuropathyConsider Xray to r/o osteomyelitis Culture, abx
Diabetic ulcers
121
Unknown causeMinor trauma leads to development of pustule that quickly expands, inflammatory processMultiple satellite lesions may form & coalesceViolaceous borderTx - steroids, immunosuppression
Pyoderma granulosum
122
Absence of melanocytes FamilialLinked to autoimmune thyroid diseaseWhite macules, can affect hair
Vitiligo
123
1. PUVA2. Steroids maybe3. Makeup
Tx of vitiligo
124
Defect in tyrosinase - synthesis of melanin1. Ocular - X linked 2. Oculocutaneous - autosomal recessive Inc. risk of SCC & BCC but not melanoma
Albinism
125
Abnormal, irregular facial hyperpigmentation w/ sun exposure Often assoc. w/ pregnancy, BC pills w/ estrogen & progesterone Usually goes away after birth/stopping pills
Melasma
126
"Brown velvety thickening" in neck & axillaassoc. w/ diabetes, insulin resistanceTx underlying condition/wt loss
Acanthosis nigricans & Tx
127
Adrenal insufficiency & excess ACTH stimulates melanocytes
Addisons
128
1. Androgenetic2. Telogen effluvium3. Alepecia areata4. Trichotillomania
Types of aloe pecia
129
Dec. anagen phase (growing phase)Influenced by:1. Inc. androgen levels2. Inc. DHT levels (metabolite of testosterone)3. Women w. inc. 5a reductase androgen receptorsPatterns in men - widows peak & crownwomen - crown
Androgenetic aloe pecia
130
1. Minoxidil (Rogaine) 2. Finasteride (Propecia) - males only3. Spironolactone (women)
Tx of androgenetic aloe pecia
131
Inc. # of hairs in telogen phase (resting)Inc. hair on pillows/shower Causes:1. Pregnancy2. Fever3. Stress (inciting 2-4 mo prior)4. Malnutrition5. BC pills6. Hyper/hypothyroidism7. Anemia
Telogen effluvium aloe pecia & causes
132
1. Hair pluck test - 50 hairs & check for bulbs2. CBC (anemia)3. Iron studies4. Total testosterone, free testosterone, DHEA-5, prolactin5. Syphilis Treat underlying cause
Dx telogen effluvium aloe pecia
133
May be autoimmune disorderPatchy hair loss but may become universal Eyebrows & body hair affected Tx - intralesional steroidsMay resolve spontaneously, often recursPoor prognosis if: atopic dermatitis, FH, early onset
Aloe pecia areata
134
Caused by drugs, occuring 7-10 days later Only affects skinSymmetric macules & papules Resolves after ~1 wkTx:1. +/- Topical steroids 2. +/- Antihistamines
Exanthemeous eruptions & Tx
135
Solitary erythematous patch w/ bullaMay involve mouth, face, genitalia, extremities Occurs in 30min-8hrsLesion may erode, ulcerateResolves over few weeks Causes:1. Abx2. NSAIDS3. Sulfa4. Tetracycline5. Metronidazole
Fixed Drug Eruptions & causes
136
SulfaAllopurinolTetracyclinesAnticonvulsantsNSAIDs& PCN
Common causes of SJS/TEN
137
More common in women & extremitiesReactive process usually at site of mild trauma/insect bite~1 cm, pink-brown Lesion tethered to dermis - pinch sign
Dermatofibroma
138
Dermatofibroma
What lesion has a pinch sign?
139
Benign, dilated capillaries, trunk Appears in 30s
Cherry Angioma
140
Rapidly developing hemangioma Smooth nodule, w/o crustingAge <30 y/oOften occurs at sites of minor traumaBenign but must Bx
Pyogenic Granuloma
141
Skin tagsPedunculated polypFrequently on neck, axilla, groin & chestInc. w/ ageTx - snip w/ scissors
Achrochordon
142
Aka hot tun folliculitis Papulopustular lesions, PruriticTx - may resolve in few weeksQuinolone if needed
Pseudomonas folliculitis & Tx
143
Acute spreading infection & inflammation of the dermis & hypodermis Usually Staph/StrepErythema, warm, tender, swollen, possible lymphangitis w/ cellulitis streaking, adenopathy Tx - demarcate, Abx, surgery if bad/necrotizing
Cellulitis
144
Localized pocket of infectious material - may have surrounding cellulitis Causes - IVs, IVDUMCC - StaphTX:1. Warm soaks2. I&D w/ wick 3. Culture 4. Oral/IV abx if >5cm in diameter
Abscess & Tx
145
Strep pyoderma/staphCrusted, golden & honey crusted yellow lesions Tx - Bacitracin If caused by GABHS - poststrep glomerulonephritis can occur
Impetigo
146
Staph
What usually causes bullous impetigo?
147
Painful, macular, erythematous & well demarcated rash usually on the face Desquamates in 10 days Tx - admit, IV abx
Erysipelas & Tx
148
Strep throat w/ rash Fine red papular, sandpaper like rash on the cheeks, blansh, pastia lines Assoc. w/ circumoral pallor & strawberry tongue Fades in 2-5 fays w/ desquamation Caused by GABHS
Scarlet fever
149
Flesh eating bacteria severe swelling, warmth, pain, erythema, crepitus spreading rapidly along fascia lines, pain out of proportion to exam Risk Factors:1. Age2. DM3. Immune issues4. Renal failure5. Chronic skin infections
Necrotizing fasciitis & risk factors
150
1. Polymicrobial - most common2. Monomicrobial - Group A Strep3. CA - MRSA4. Caused by Vibrio Vulnificus from seawater exposure
Types of necrotizing fasciitis
151
necrotizing fasciitis
What should you suspect when someone has pain out of proportion to the exam?
152
Form of necrotizing fasciitis common in DMAffects perianal area
Fornier's gangrene
153
Bacteremia caused by Staph & StrepDue to toxin mediated inflammatory response Causes - tampons, nasal packing, wounds, rectalAbrupt onset of fever, vomiting & diarrheaDiffuse maculopapular rash & conjunctivitis Multisystem organ failureCultures usually negative
Toxic Shock Syndrome
154
Exfoliative endotoxin - S. aureusChildren under 5 - URI Sx then tender red skin followed by exfoliation+ Niklosky sign
Staphylococcal scalded skin syndrome
155
Infection from contaminated seafoodVomiting, diarrhea, abdominal pain & sepsis Leads to necrotizing fasciitis, hemorrhagic bullae, HOTN/shock, purpuraCDC reportable Tx - Abx, Debridement
Vibrio Vulnificus & Tx
156
Red annular patch w/ central clearing & scaleDx w/ KOH prep/clinical Tx - antifungals 1. Dermatophytosis2. Trichophyton3. Microsporum4. Tinea capitus, cruris, corporis, mnuum, unguium, barbae, pedis, cruris
Tinea infections
157
Nails become white/brown/yellow & thicken Caused by fungus - trichophyton rubrum KOH prep Tx w/ oral antifungals
Onycomycosis
158
Sarcoptes scabiei - arthropodMost common on hands, genitals, axillary Secondary infection due to staph/strep Lesions are pruritic burrows, pustules & nodules Dx - clinical or explore for egg/mite Tx - Lindane, Permethrin
Scabies
159
Pediculus capitis - Headlice, Rx - PermethrinPubic lice - crabs, STI Body lice - can cause trench fever - Bartonella quintana
Pediculosis
160
Cause - PoxvirusSTD, skin to skin Common in AIDS w/ CD4
Molluscum Contagiosum
161
Verrucous papules on skin/mucous membraneCause - HPV Condyloma acuminata - genital warts types 6&11
Warts
162
Spirochete Borrelia burgorferi from ixodes scapularis tick that lives on deer mouse Dx - serum Ab w/ ELISA, confirm w/ western blot, PCRLeukocytosis, elevated ESR, hematuria, moderately elevated LFTs, LP, arthrocentesis PRN Tx w/ abx - Doxycycline
Lyme Disease & Dx
163
Stage 1 - (7-10 days) early localized infection, erythema migrans on groin, thich of axilla, lesion w/ bulls eye, myalgias, fatigue, fever Stage 2 - (wks-mo) early disseminated infection, bacteremia, secondary skin lesions, myocarditis, meningitis, keratitis, cranial neuropathies, ongoing flu-like SxStage 3 - (mo-yrs) late persistent infection, large joint chronic arthritis, encephalopathy - memory loss, behavoiral changes, paresthesias, acrodermatitis chronicum atrophicans
Stages of Lyme Disease
164
Chicken pox! aka varicella Lesions turn pustular then crust
Dew drops on a rose pedal?
165
aka measlesHigh fever, malaise, anorexia, conjuncitivis, cough, Koplik spots, exanthem rash spreading cephalocaudally
Rubeola
166
TORCH infection Aerosolized infection Systematic maculopapular rash - malaise, ocular pain, low fever, HA
Rubella
167
Erythema infectiousumCause - Prvovirus B19 red slapped cheek fac & lacy pink macular rash on torsoSpread - droplet or bloodborne Causes a polyarthropathy syndrome in adult females
5th disease
168
Cause - HHV6 High fever, then goes away, then pink macular morbilliform rash Tx - supportive
Roseola infantum
169
Rubbing a lesion causes urticarial flare
What is Darier's sign?
170
Minor trauma leads to new lesions at site of trauma
What is Koebner's phenomenon?
171
An oval-shaped nevoid plauwSkin is colored or pigmented on the trunk or back & is assoc. w/ tuberous sclerosis
What is Shagreen skin?
172
1. Warts2. Seborrheic keratoses3. Actinic keratoses
When is cryotherapy typically used?
173
1. Measles2. Scarlet Fever3. Rubella4. -No 4th..5. Fifth's disease - Erythema Infectiosum 6. Roseola Infantum HHV-6
1-6th diseases
174
Pansclerosing encephalitis
What is a big complication of measles?
175
Strep throat w/ sandpaper rash Strawberry tongue
Scarlet Fever
