Dermatology Flashcards

vocabulary
Terms Definitions
Annular
Ring-shaped
Patch
Macule > 1cm
Pustule
-primary lesion-circumscribed collection of purulent material-made of leukocytes and fluid
Renal reasons for itching:
uremia
Vesicle
Small fluid filled blister
Plaque
-primary lesion-elevated, solid lesiongreater than 5 mm in diamter-may be a confluence of papules
Varicella therapy:
Antihistamines and topical agentsVaccine safe in children and healthy adults
scaly, waxy, stuck-on appearance:
Seborrheic keratosis
Dermis
Where are dermal nevus located?
Erysipelas: Clincal features
-Hx recent trauma/pharyngitis-prodromal sx: malaise, chills, fever, (w/in 48hrs)-pruritis, burning, tenderness-small erythematous patch, progress to fiery-red, shiny plaque
Melanosomes
Elongated, membrane bound organelles where melanin is produced
nodule
well-defined deeply seated lesion greater than 5mm in diameter. (a large one is called a tumor)
Purulent
producing or consisting of pus.
Trichobezoar
hairball in the digestive tract
Flaccid intrepidermal blisters above the basal layer. Blistering of skin AND MUCUS MEMBRANES. Positive Nikolsky's sign.
Pemphigus vulgaris
Trichotillomania occurs in both children and adults. The course is usually __ and resistant to treatment, especially in adults. May be a symptom of a serious underlying psychiatric disorder, more often in adults.
- chronic
With Pityriasis Rosea, you should always consider testing for ___, especially if the palms or soles are involved or the patient is ill.
syphilis
Androgen
What hormone stimulates facial hair growth and axillary hair growth?
30%
How much epidermal detachment is associated with TEN?
Contact Dermatitis: Pathophysiology
-Intercellular edema of epidermis-vesicles/bullae (acute)-papules, scaling and lichenification (from scratching) in chronic cases.
Erythema Multiforme: Tx
-control herpes outbreak w/acyclovir-severe: systemic steriods-avoid target substances
Cryotherapy
Liquid nitrogen treatment of viral warts
polygenic35%
Inheritance in psoriasis is...and what percent have a family history
keratin
durable protein polymers that are found only in epithelial cells.
:an acute inflammatory/immunologic reaction pattern of the panniculus characterized by the appearance of painful, tender nodules on the lower legs.
Erythema Nodosum Syndrome
Nails
-derived from keratinization of cells from the nail matrix-firm, rectangular and usually curved; nail plate gets pink color from the vascular bed in which its attached; about ¼ of the nail plate is covered by proximal nail fold; -Lunula is the whitish moon and the free edge of the nail plate-Cuticle extends from the proximal nail fold and functions as a seal and protects the space between the fold and plate-Lateral nail fold covers the sides of the nail plate.
ABCDEs of evaluating melanoma
Asymmetry
Border (irregular?)
Color (uneven?)
Diameter (>5mm?)
Evolution (changing?)
Transdermal
also means through the skin...used differenly by convention
Subepidermal blisters on hands, mottled facial pigment, excess facial hair on temples and cheeks. May be seen in patients with liver problems.
Porphyria Cutanea Tarda
Epidermal repairs require proliferation and migration of __ over a __ __ support matrix.
keratinocytes over a fibrin-fibrinonectin support matrix
Men – begins with bitemporal recession, followed by balding of the vertex.Women – diffuse thinning over the crown of the scalp with an intact frontal hairline. Will see a gradual widening of the part width on the crown at first, then marked diffuse t
Androgenic alopecia
atopic dermatitis therapy:
- moisturizers/bath oil- topical steroids/immune modulators- mild soaps- treatment of any superimposed bacterial infectionsevere cases: short course of cyclosporine(with this condition you don't have normal lipid layer in epidermis, so try to replace it with lotions)chronic relapsing condition, but many outgrow it by late adolescence
Tx for cellulitis?
1)Cool,wet dressings 2)Elevation of limb 3)Empiric abx tx aimed at staph and strep (dicloxicillin, amoxil/clavunate, Keflex)
Bulla
 
What is an elevated, palpable lesion that has vesicles greater than 1cm in diameter?
Diagnosis: Contact Dermatitis
Symptoms: range from pruritus, transient erythema to several swelling, bullae formation.

What is the diagonsis?
Post-inflammatory hyperpigmentation
Increased pigment present over areas with previous inflammation such as scarring or acne.
Impetigo: Labs
-bacterial culture to Id: resistant form of impetigo: MRSA (methicillin-res) and if outbreak occurs-exudate underneath crust
Folliculitis: Clinical features
-lesions: erythematous papules and pustules-not painful, may burn-sycosis: inflamm of beard is severe! =folliculitis w/eczema and crusting-abscesses may form
Macerated
swollen, softened by an increase in water content, appearance skins gets after in water too long (pruny appearance)
 
 
Name 5 treatments of acne vulgaris
Retinoid
Antibiotics
Benzoyl perozide
OCP
isotretinoin
ulcer
area of skin loss extending through epidermis into dermis
Parakeratosis
Persistence of nuclei in the keratin layer
cutaneous candidiasis
clinical presentations 
intertrigo (yeast infection on skin)
angular cheilitis- corners of mouth
balanitis-penis
bulvovaginitis-vaginal area 
:a chronic acneform disorder of facial pilosebaceous units, with increased reactivity of capillaries to heat, leading to flushing and telangiectasia
Rosacea
Urticaria
Immune mediated allergic rxn, IgE - mediated, complement mediated, Immune complex mediated, Nonallergic urticaria (ex.  cold weather)
Nevus
a birthmark, a pigmented blemish of the skin.
Pityriasis rosea
erythematous, oval , thin plaques with long axis along skin lines.
perianal warts characterized by itchy, bleeding, and pain that can grow into a confluent mass and cover the anal opening?
condylomata acuminata
xerophthalmia
abnormal dry eye. usually due to vitamin A deficiency or aging
__ __ has flaccid intraepidermal blisters that also effect the mucus membranes, while ___ ___ has tense blisters that do NOT effect mucus membranes.
Pemphigus vulgarisBullous pemphigoid
If only epidermis is lost, the lesion is considered to be an __.
erosion
Eruptive seborrheic keratoses aka __ __ is a rash of pigmented plaques and patches which may indicate carcinoma, usually GI.
Leser-TrelatTEST KNOW THIS.
pigmented nevi differential diagnosis:
- seborrheic keratosis (SK)- dermatofibromas
What is the most common infecting agent in folliculitis?
S. aureus
Anagen
What is the growth cycle of hair growth called?
Tinea Versicolor
Under the microscope what is commonly seen as "spaghetti and meatballs"?
suborrheic dermatitis
What commonly gets mistaken for infant eczema?
Ears
If a Herpes Zoster lesion occurs here you would be worried about Ramsay Hunt Syndrome.
Hutchinson's sign
 
 
In order to distinguish btwn malignant melanoma of the nail and a hemorrhage you first look for what sign?
Stasis Dermatitis: Clinical features
-c/o heaviness/aching in legs: aggravated when standing, relieved when walks-manifests w/inflammatory papules, scales, crusts. -stippled pigmentation occurs-excortiations common-ulcerations 30% pts-bilateral distribution of dermatitis-worry about cellulitis w/this Dx
Herpes Simplex Virus
Recurring virus that causes extensive ulceration in and around the mouth
Electrodessication and curettage
Why, where 
superficial cancerous and pre cancerous growths are removed from the skin by repeated scraping and burning.
 
works best on trunk and extremities in non hairbearing becuase cancer can go down the hair follicle.
 
Do on skin lines, so minimal scarring 
:an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles.
Dyshidrotic Eczematous Dermatitis
Stage I pressure ulcer
epidermis intact, Erythema not resolved within 30 min
contact derm to plants, dx
vesicles, bullae, erythematous papules in linear distribution
dermititis that usually occurs on the leg due to edema?
stasis dermititis
Epidermis
epi means on, on top of demis, outermost layer of skin
The specific ___ of specialized erythema is key to diagnosis. Specialized erythema represents a __ pattern to an underlying cause (like Erythema multiforme being caused by herpes simplex infection).
- morphology - reactive
___ AKs should be biopsied to rule out cancer.
Indurated
Acute disseminated histiocytosis presents in ___ as ___ __ __. See pink, sometimes hemorrhagic, papules and scaling with slightly eroded patches. Skin biopsy shows proliferation of __ __, stain for __ __ and see __ __ on electron microscopy.
- infancy- recalcitrant diaper rash- Langerhan cells- S-100- Birbeck granules
Nevus usually present at birth that is 20 cm big or covers more than 5% of body's surface. Have a 6-12% of developing into malignant melanoma.
Congenital nevus
Most pts w/ furuncles/carbuncles have normal immune systems, but what 4 things may predispose a pt to develop them?
Malnutrition, obesity, DM, Leukemia
Apocrine sweat glands
Which sweat glands are inactive until puberty and causes body odor?
1mm/day
 
*slower than other tissues
At what rate do nerves heal?
1% retin-A topical
What treatment can you give for lentigines?
Nummular Dermatitis: Clinical features
-small, grouped vesicles coalesce to form COIN SHAPED plaques w/erythematous base-crusting and excoriations
What is this?
What organism?How does it present?  Where do you see the rash?
Name 2 drugs that can treat it.
Rocky Mountain Spotted Fever
Ricketssia ricketssia
 
flu like prodrome
 
starts at wrist and ankles then spreads inwards
Doxycycline or Chloramphenicol
CANESTAN cream for small areaOral TERBINAFINE OR ITRACONAZOLE for extensive infection
Treatmeant of fungal infection
TX of Chronic Plaque Psoriasis
topical steroid ointment(most potent), creams, gel
topical coal tar derivatives, retinoids
topical calcipotrine 
phototherapy, with narrow band and psoralen ultraviolent methotrexate and cyclosporine.
*make sure its not tinea with a scrape b/c steroids will flare.
*main risk with steroids is atrophy, thinning, milky skin 
*last resort is biologics 
What has alleviated a lot of the seriousness of Infantile Atopic Dermatitis?
Topical Corticosteroids
Chronologically versus photoaged skin:
Photoaged skin more leathery, deeply furrowed, blotchy skin, actinic keratoses Chronically aged skin –thin, sagging skin, less hair, decreased vascularity
Abscess
a collection of pus in part of the body formed by tissue disintegration and surrounded by an inflamed area.
excoriation
corium means skin. to tear or wear off skin or other coating
Erythema multiforme have target lesions that have ___ __ that are diagnostic. Recurrent disease is most often precipated by __ __ __. Involvement of two or more mucosal surfaces signifies a poorer prognosis (Stevens-Johnson Syndrome).
- concentric rings- herpes simplex infection
Key signs of cancer:
- hard dermal nodules- chronic chest cellulitis
Psoriasis etiology is unknown. Presents as ___ demarcated erythematous ____ surmounted by silvery ___.
- sharply demarcated - papules- scales2-5% of Caucasians have this
What is lentigo maligna?
In situ melanoma, usu. flat w/ irregular border, brown w/ pigment variation. nodules and ulcers may indicate local invasion.
Decubiti ulcers
What is caused by lack of blood supply to the tissues from poor circulation and physical pressure?
Toxic Epidermal Necrolysis (TEN)
Severe form of SJS. Skin becomes acutely tender with flaccid bullae which begin to sheet leaving a red, raw denuded area. Very similar to the appearance of the skin following a burn.

 
What is this and what causes it?
How do you treat?
Molluscum contagiosum
 
Viral skin infection- pox virus
 
self resolves or cryotherapy
Androgenic alopecia does not occur in men w/ an absence of _____.
5 alpha-reductase type II
What season is Atopic Dermatitis usually worst? Best?
Worst = winterBest = summer
condylomata acuminata can be treated with?
podophyllum, imiquod, or podofilox topical ointments-large lesions may be injected with interferon-alpha or excised
Uriticaria aka hives are characterized by evanescent edematous __ and __. Acute urticaria is often caused by an __ __ __. A cause is rarely found for chronic urticaria (greater than 6 weeks). Treat with ___.
- papules and plaques- upper respiratory infection- antihistamines
Fungal causes of fever and rash of nodules and plaques:
- Histoplasmosis- Blastomycosis- Coccidiodmycosis
Pityriasis Rosea is an ___ _____ inflammatory dermatosis of unknown origin characterized by ___, minimally elevated patches, papules, and macules mainly located on the ___.
- acute self-limiting- oval- trunk
Where does SCC typ. occur on the body?
Head, neck, and hands
Doxycycline
 
*amoxicillin can be used too
What is the drug of choice for Erythema Chronicum Migrans?
A complication of AD is secondary infection w/ what organisms?
Staph (primary), strep, or herpes
Clinical presentation of guttate psoriasis
spares palms and soles. preceded by upper respiratory or strep infection. "not quite getting over the cold" often 1st exposure leading to chronic
How is Lichen Sclerosus et Atrophicus managed?
Symptomatic therapy only, topical corticosteroids and circumcision for males.
macerated lesions should be treated how?
2x daily aluminum subacetate solution soaks, broad spectrum antifungals
When figuring out etiology of an ulcer, what 5 blood tests are used to rule out connective tissue disease?
- ANA- RF- anti-DNA antibody- anti-phospholipid antibody- lupus anticoagulant(side note: would not normally do a blood test for an ulcer, unless you suspect an underlying disease)
1 cm pink/dark brown FIRM button like papule:
Dermatofibroma- REMEMBER DIMPLE SIGN WITH THIS
Who is at increased risk of dev. Kaposi's sarcoma?
Organ transplant pts, AIDS pts
What aggravates the pruritic sx of AD?
Perspiration, dry air, cold, stress, harsh fabrics (wool)
Describe the skin lesions commonly seen with Acute, Subacute and Chronic Contact Dermatitis.
Acute - erythema, edema, vesicles, and erosions that exude serum and lead to crusting.Subacute - erythema, small, dry scales, small, red papules.Chronic - Lichenification, small, firm, rounded satellite papules, excoriations and erythema.
medical history that are pertinent to the evaluation of the skin
Previous skin problems; tolerance to sunlight; systemic or severe disease; sensitivity to sensory stimuli; hair (loss, thinning, growth, brittleness and breakage); thyroid/liver disorder; malnutrition; associated skin disorder; nail injury or infection; congenital anomalies
Dermal nodules may be signs of __, __, ___, or __.
- carcinoma- lymphoma- leukemia- myelomoa
What med is used to tx folliculitis? Why should it be used intranasally as well?
Mupirocin. to tx MRSA.
Difference in Macule and patch
Macule less than 1 cmPAtch 1 cm or greater
What are the 5 layers of the Epidermis from superficial to deep?
Stratum corneum, lucidum, granulosum, spinosum and basale.
Tinea capitis is spread from human to human by __ __. It is spread from cats and dogs to humans by __ __ and __ __.
- M. audouinil- T. tonsurans- M. canis
Why is the BCC pigmented in the pigmented type?
It contains melanin. May resemble malignant melanoma.
What are the most common secondary infections seen with Atopic Dermatitis?
S. aureus, Group A Strep, fungal and HSV.
When should a Sentinel Node Biopsy be done?
When melanoma is greater than 1 mm thick. To do this they inject radioactive tracer into site of the primary melanoma and then the sentinel or first draining lymph node of that tumor can be identified by lymphoscintigraphy. The radiotracer is taken up in the blood vessels and lymphatic system where the lymph nodes act like a collection filter. The radiotracer gives off gamma rays which is then detected by a probe. This node is removed and examined for metastatic melanoma- this step determines if the patient may benefit from lymphadenectomy and further therapy
What is the most common type of BCC? Describe it.
Nodular. Pearly pink paules, often ulcerate, bleed, and become crusted
Pemphix
blister
Urticaria: Tx
-cause eliminated-antihistamines-chronic: H2 blockers added to H1 -maybe addition of steroids-progress to anaphylaxis? epipen given.
Squamous
formed of scales
Erythema Nodosum
Acute inflammatory/immunologic reaction of the panniculus.
chronic inflammatory acneiform disorder of the facial pilosebacceous units that can be classed into 4 stages?
rosacea
Androgenic alopecia Incidence: most common in male caucasians, but approximately 50% of women over 40y/o will experience this patterned hair thinning as well.
An invasive, primary cutaneous malignancy arising from keratinocytes of skin or mucosa that is the 2nd most common skin CA?
SCC
Meningococcemia
Neisseria Meningitides seeding from the nasopharynx (carrier rate 5— 15%) which is transmitted person to person through inhalation droplets of aerosolized nasopharyngeal secretions. Purpura (In fulminant cases, purpura, ecchymosis, and confluent, bizarre shaped grayish black necrosis is present.)

 
What is this?
 
Cellulitis
 
Erythema, swollen, painful
p53
Transcription factor activated in response to DNA damage to stop cell division
Scleroderma
autoimmune, highly disfiguring and potentailly fatal. women 3x more than men. hardened vascular inflammatory changes including skin and internal organs. often affects lungs heart and GI. onset usually 30-50yrs (adult)
Kasabach-Merrit
Solitary, rapidly enlarging atypical hemangioma which sequesters platelets and fibrinogen causing thrombocytopenia and consumptive coagulopathy.
exfoliation
removal of shedding of skin
Therapy for Urticaria:
Discontinue drugs suspectedAvoid Aspirin and NSAIDs and CodieneOral Antihistamines: Atarax (Hydroxyzine) 10-25mg qid, Claritin (Lortadine) 10mg daily, Zyrtec ( Citirizine) 10mg daily, Allegra (Fexofenadine)180mg qidOral Tricyclic drugs: Doxepin 25mg bidOccasionally: Nifedipine 10-40mg modified release qid, Prednisone 0.5mg/kg daily(go down on dosage of antihistamines for elderly- more side effects)
warts are caused by:
multiple papillomavirus types
mycosis fungoides has great prognosis if found early, but often misdiagnosed. if progresses to sezary syndrome> very poor prognosis.
Tinea Unguum
Presentation: Distal and lateral detachment of nail with thickening and deformity.  Difficult to cure due to slow growth rates of the nails.

Diagnosis?
Vitiligo
 Chalk white to off-white macules with a generally round, oval or elongated shape. Borders appear to “flow” into the normal skin.
Hidradenitis suppurativa: Labs
-culture for secondary infections
Stasis Dermatitis: Tx
-compression stockings-sclerosis of veins: inject glucose and strip vein-recurrence is common-vascular bypass/angioplasty for SEVERE cases-ulcers demand chronic Tx (wound clinics, etc)
What is Vitiligo?
Destruction of melanocytes (?autoimmune)
BCC
typically on face, locally invasive, no precursors
Flucloxacillin
Treatment of staph aureus skin infection
:a superficial skin cavity that contains a purulent exudate (can be white, yellow, greenish yellow or hemorrhagic)
Pustule
Group II and III
Diflorasone, (psorcon), Desoximethasone (topicort)- for atopic dermatitis IN ADULTS- not for face, axilla, groin, under breasts- Limit use 21 days
stubborn,itchy rash that forms coin-shaped patches on the skin
nummular eczema
antisudorific
sudo means sweat. capable of inhibiting the secretion of sweat
Herpes zoster course:
- macules> vesicles> pustules> crusting- healing within 2-3 weeks
Rapidly developing, painful ulcer with undermined edge and gangrenous borderUsually occur on lower legsFrequently associated with ulcerative and granulomatous colitis, RA, and myeloproliferative diseases
Pyoderma Gangreosum
Therapy for SCC:
- excision- curettage and electrodesiccation- Moh's micrographic surgery- Radiation- Cryotherapy
ABCDEs of Melanoma:
- Assymetry- Border irregularity- scalloped borders- Color variations-black,red,brown,blue,whit- Diameter (should be less than pencil eraser or 6 mm)- Evolution-rapidly changing mole
Commonly elevated, fleshy and slightly or moderately pigmented that may have coarse, dark hairs growing from them?
Intradermal nevi
via Sweating
How does the skin regulate temperature?
syphilis
What skin infection presents as a painless “chancre” ulcer approx 3 weeks after innoculation?
Clinical diagnosis
How is an atypical nevus diagnosed?
Erysipelas: General characteristics
-superficial bacterial skin infection -common name= St. Anthony's-used to be on face (s.pyogenes) now on legs (strep A)-source in face cases: nasopharynx-local factors affect: venous insuff., bites, incisions
Felon: General/Tx
-subcutaneous infect of pulp space /closed infection that can ruptureTx:-abx -then I & D to preserve venous flow-incision of nail pad (underneath nail)-culture drainage if MRSA-update tetanus
Lichen simplex chronicus: Tx
-topical steroids-tar preps w/occlusive dressing-antihistamines
thin linear crack in the epidermis, often due to excessive dryness.
Fissure
Erythema
Red skin due to vascular dilatation, Blanches on pressure
pityriasis versicolor
lipophilic yeast- colonized skin, hair follicles around puberty
has been implicated in terms of having a role in dandfruff
prefers trunk, where sebum production is high 
:an area of increased or decreased pigmentation without elevation or depression that is approximately 1cm in diameter and is not palpable
Macule
ACANTHOSIS NIGRACANS: signs
Diffuse, velvety thickening and hyperpigmentation of the axillae and other body folds.
Pyoderma
any skin condition that produces a purulent discharge.
Red birthmark in baby
Example: Infantile hemangioma.
4-10% of white infants, female preponderance, prematurity is a risk factor.
watch out for PHACE(S) syndrome.
Treat with systemic steroids or propanolol.
VERRUCA (WARTS) have an incubation period of ?
2-18 months
Presentation of Erythema Nodosum
Inflammatory lesions of subcutaneous fat, usually on anterior shins
The most common cause of erythema multiforme minor is __ __ in teenagers and young adults.
herpes simplex
Androgeic alopcia dx:
Usually straightforward in men, but must consider possible hormonal abnormalities in women – particularly when accompanied by acne or hirsutism.Question about menstrual irregularities, infertility, hypothyroidism.May consider screening for serum-free and total testosterone and DHEAS (dehydroepiandrosterone sulfate).
Langerhans cell histiocytosis formerly known as __ __ is a __ of the Langerhans cells. .
- Histiocytosis X- neoplasm
If mycosis fungoides leave the skin and enters the blood it is called ___ ___, this is a late leukemia variant.
Sezary syndrome
Where do trichilemmal cysts typ. occur? Who are they more common in?
Scalp. Women.
Crust
What is a secondary lesion that is slightly elevated and made from dried serum? 
Actinic Keratoses
What skin infection begins with faint red macules and enlarges into multiple brown, pink, or tan plaques with scale?
Contraction
Which stage of healing is where the body aligns all the new collagen cells and gets the elasticity back?
Actinic Keratosis
What are the precursing lesions for SCC?
Exfoliative Dermatitis
 Scaling and erythema over a large area of the body. Generalized or localized exfoliation which may include loss of hair and nails.
Paronychia: Tx
-warm water soaks-oral abx w/gram + bacteria (staph-Augmentin/clindamycin)-it can progress to abscess, then should be drained
Acanthosis nigricansWhat is this associated with (2 diseases)
Insulin resistance (young people)
 
Gastric adenocarcinoma (old people)
A painful swelling of lateral and proximal nail folds in which pain is immediately relieved /p drainage.
Acute Paronychia
Viral warts
casued by HPV. virus is ubiquitous, spread by skin to skin, virus needs a break in the skin. occupies skin cells in an intracellular fashion.
:oral, white cottage cheese plagues that can be moved by Q tip (unlike leukoplakia or lichen planus)
Pseudomembranous candidiasis (THRUSH)
Retinoid nomenclature:
Vitamin A = all-trans retinol, an alcohol.
Beta carotene is cleaved into 2 Vitamin A's.
All-trans retinaldehyde is formed by oxidation of Vitamin A.
All-trans retinoic acid = Tretinoin, binds RAR receptor (86%).
An isomer of retinoic acid binds RXR (14%).
All retinoids increase collagen synthesis.
CYP450 hydroxylates retinoic acid to eliminate it.
dislodging of epidermis from dermis by lateral shearing pressure with a finger resulting in an erosin?
Nikolsky phenomenon
Presentation of Erythema Multiforme
Presents with multiple types of lesions - macules, papules, vesicles, and TARGET LESIONS (red papules with a pale central area).
Therapy for Erythema Multiforme:
Usually treatment does not alter course of the diseaseTreat infection if it is present.If Mycoplasma infection, use erythromycin, azithromycin or clarithromycinFor recurrent Herpes infection, Valtrex (Valacyclovir) 500mg 1 bid or Famvir (famciclovir) 125mg 1 bid, maintance anti-viral treatment to avoid EMDiscontinue responsible drug, if any
If you get sudden eruption of many seb k’s especially around armpits- called Leser-Trelat sign, sign of cancer (usually GI cancer).
Risk factors for melanoma:
- sunlight/sunburn- CDKN2A and CDKA gene mutations- multiple nevi and dysplastic nevi- familial atypical mole and melanoma syndrome
#1 most common bodily location for dermatophyte:
feet= tinea pedis
A pre-existing nevus that dev. a rim of hypopigmentation.
Halo nevi
osteomyelitis
What should you look for if a diabetic foot ulcer is not responding to treatment?
Estrogen
 
*in OCP's
What hormone can be used for females to control acne?
Piebaldism
What is it called when there is a patch of unpigmented hair within pigmented hair?
Pediculosis: General characteristics
-Lice: three pairs legs, females lay 300 nits-Pediculus humanas variety capititus: infect scalp, P. human var. corporis: infect body, Phitirus pubis: infect pubic area: CRABS! -person:person

 
What is this?What pathogens (2) causes it?
 
Impetigo
 
Staph aureus, Group A strep
An eruption that is created by habitual scratching of eczematous dermatitis in a single localized area, AKA neurodermatitis.
Lichen complex chronicus
DX of dermatomyositis
skin biopsy, biopsy of weak muscle, muscle enzyme test. 24 hr urine,  ANA,
:a vesicle that is greater than 0.5 cm in diameter
Bullae
Cutaneous manifestations of internal diseases:
Paraneoplastic pemphigus (PNP):
Neutrophilic dermatosis:
Paraneoplastic pemphigus (PNP): Severe mucosal ulceration. Similar to pemphigus vulgaris but with different immunoprecipitation charateristics.
Neutrophilic dermatosis: Rapidly expanding painful, ulcerative lesions. Can get worse after debridement!
Presentation of Scalded Skin Syndrome
Characterized by fever and generalized erythematous rash with sloughing of the upper layers of the epidermis.
Seen in children & kids
PUNCHED OUT ULCERS USUALLY ON ANTERIOR OF LOWER LEG, Multiple small ulcers predominant on the lower extremities. Purpuric, hemorrhagic, and necrotic ulcer borders.
Vasculitis(PUNCHED OUT ULCERS= VASCULITIS ON TEST)
LOOK AT PAGE 81 IN BOOK AND KNOW ABOUT BRESLOW DEPTH AND CLARKS LEVELS REALLY WELL FOR TEST.
What is contact dermatitis?
Any inflammation of the skin arising from direct skin exposure to a substance.
Who do digital myxoid cysts occur in?
>60yo, OA or RA
age 20
By what age has a person acquired most of their harmful sun exposure?
Photopatch test, patch testing
general test used to ID substance causing inflammation of skin, ( allergic rxns) (used to Dx Atopic Dermatits)
- 80-90%- 10-20%-
Percentage of scalp hairs in - Anagen- Catagen- Telogen
Steven's Johnsons syndrome/ toxic epidermal necrolysis
not entirely understood.  thought to be a reaction of keratinocytes. lrg areas of epidermis become necrotic and slough off in sheets.  increase in secondary bac. infectinion and water loss of skin. Rare and life threatening. stop drug, hospitalize quickly.
 
*nikolsky sign=pushing on blister causes it to spread laterally without much resistance
Treatment for Urticaria And Prevention
Epinephrine -  0.3 -0.5mg 1:1000 dilution subcutaneously, maintain airway, IV access, Antihistamines, Systemic Corticosteriods
seborrheic dermatitis lesions usually appear how?
dry scales, oily, or yellowish scurf
__ __ is a type of cancer that can result in ulcerated plaques and tumors on the back.
Mycosis fungioides
__ __ is a chronic superficial inflammatory process affecting hairy regions of the body, espcially the __, __, and __.
- Seborrheic dermatitis- scalp, eyebrows, and face
discoid lupus can be diagnosed by:
Diagnosis can be established by biopsy, both with and without direct immunofluorescence.(biopsy the edge, not middle)
1 hour before
 
*and Q4hrs after
How long before exposure should you apply sunscreen?
 
 
Name 2 complications of isotretinoin therapy and what you do to monitor for them
1) Teratogenic: women need 2 negative pregnancy tests and 2 forms of birth control
 
2) hepatotoxic: monitor LFTs
Describe the clinical findings in seborrheic dermatitis.
Moist papules w/ yellow, greasy scaling, erythema, mild pruritus
What is Perleche or Cheilosis?
fissuring at the angles of the mouth
Function of emollients and creams and lotions
·        Restore water and lipids to epidermis·        Prevent further water loss·        Creams are thicker and more lubricating than lotions·        Most effective when applied to moist skin (after bathing)·        Emollients can be applied as often as needed
Pemphigus vulgaris has a __ mortality rate without treatment.
- highOverall mortality rate now 8-10%.
Other causes of fever and rash of macules and papules:
- Erythema multiforme- Kawasaki syndrome
Pityriasis Rosea is usually in a __ ___ person and is more common in ___.
- young healthy person- women
Tip or side of the nose
If a Herpes Zoster lesion occurs here you MUST refer your patient to an Opthamalagist?
Who does perioral dermatitis typ. affect?
Young women and children 7mths to 13yrs (girls=boys)
Describe the complications seen with Morphea of the skin, deep involvement and scalp involvement.Treatment of Morphea?
In time, surface becomes smooth and shiny; hair follicles and sweat duct orifices disappear. Deep involvement of tissue may be associated with atrophy of muscle and bone, flexion contracture, distal edema. Scalp involvement results in scarring alopecia.There is no treatment for Morphea, just symptomatic care.
Erythema migrans is the hallmark sign of __ __, the most common tick-borne illness in the US. It is caused by __ __, which is transmitted by the __ tick species. Treatment with ___ avoids the late complications of __ __.
- Lyme's Disease- Borrelia burdorferi- Ixodes tick- antibiotics - notably arthritis
__ ___ are self inflicted injuries for secondary gain. They are often ulcerated and have __ or ___ outlines.
- Factitious dermatitis- linear or geometric
Describe skin lesions in Kaposi's sarcoma.
Purple patches. In classic on lower legs and progress proximally. In AIDS pts on face, torso, and oral mucosa.
When does infant AD typ occur?
2-6mths of age, 50% resolve by 18 mths
:dried exudate on the skin surfaceWhat results in brown, honey-colored and yellow-green dried exudate?
CrustsBlood gives a brown crust, serum a honey-colored crust, and pus a combination of yellow and green
Merkel cell carinoma is very rare, but more ___ than melanoma. It has a __ rate of local recurrence and metastsis. This usually presents as a solitary __ on the __ or __ of elderly persons.
- deadly- high- solitary nodule- head or neck
a MINIMUM of 4-6 wks even if lesions have resolved
How long should tinea corporis (ringworm) be treated?
What is the etiology of Granuloma Annulare?
Unknown but it may be associated with Diabetes Mellitus.
How can you differentiate a corn from a wart?
Corn - pain from direct pressure. Wart - pain from lateral pressure and pinpoint bleeding w/ removal.
For a venous ulcer that has failed to respond to conservative therapy, a __ __ may be done. Skin usually taken from __.
- skin graft- thighDO NOT DO THIS IF THERE IS AN INFECTIOUS PROCESS OCCURING
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