Dermatology Terms Flashcards

vocabulary
Terms Definitions
tinea
ringworm
Petechiae
 Red-purple nonblanchable discoloration less than 0.5 cm in diameter.
Bulla
-priamry lesion-circumscribed collection of free fluid-greater than 5 mm in diameter
even brown colored papule:
nevus
Fibroblasts
Function is collagen synthesis
Papule
-Primary lesion-Elevated, solid lesion-Up to 5 mm in diameter-Variable colorEx: wart
linear streaking pattern:
acute contact dermatitis
nodular melanoma is __ growing.
rapidly
Beau's Lines
 Horizontal depression occurring across the nail plate of all the nails.Due to interruption in the growth of the nail occurring during an illness, operation, or even prolonged labor.
Dermatophytosis: Tx
-topical creams/ointments-nail: oral ketokonazole-fluconazole (kerions)-NO steriods-monitor LFTs in long term PO med use (ppl with hepatic disorders)
Keratinocytes
Epidermis is mainly composed of
HZ Treatment
immunization. lotions, oral antiviral
Friable
brittle; crumbles or breaks easily
Acne
pin-point inflammation of sebaceous glands
Grouped, cloudy and hemorrhagic vesicles on an erythematous base in a dermatomal distribution:
Herpes zoster
Castration of males before puberty prevents the development of baldness. But if testosterone is administered to a pre-disposed Eunuch, he becomes bald.)
pityriasis rosea distribution:
trunk and proximal limbs
Ecchymosis
What is a red-purple discoloration that is non-blanchable?
Lipoma
 Common benign subcutaneous tumor of the adipose tissue. Composed of fat cells with normal fat cell morphology.
Onychomychosis
-infection w/fungi or yeast -Tx: systemic/topical agents -recurrence is high
Acne rosacea: General characterstics
-chronic-ages 30-50-pilosebacous units: increased activity of caps, =flushing, telangiectasias-episodic outbreaks-response to heat, alcohol, hot/spicy foods, coffee/tea: bc they are hot
Candida (thrush)
Antiyeast is used to treat
Penicillin
Treatment of Strep pyogenes skin infection
bulla
blister greater than 5mm in diameter
:a rapidly evolving, idiopathic, chronic, and severely debilitating skin disease occurring most commonly in association with a systemic disease, especially chronic ulcerative colitis or other bowel disease, and characterized by the presence of irregular,
Pyoderma Gangrenosum
Discoid Lupus
Plaques of alopecia, with erythematous/violaceous border, white atrophic center, telangiectasia and keratin-filled follicles
Pemphigus vulgaris
Lethal, peaks at 30-50
Painful blistering
MHC Class II genes associated: DR4 in Ashkenazi Jews, DQ1 in others.
No real inflammation
Desmoglein 3 and 1 are targeted.
Treat with prednisone and human immunoglobulins.
impetigo
acute, contagious skin infection. it is staph/strepto in origin. characterized by puss filled blisters/ rash
Tense bullae on noninflammatory skin and crusted residual bullae:
Bullous pemphigoid
For ulcers: Healing process is very slow, especially with vascular disease patients or diabetic patients.Never put topical steroid directly on the wound, as this will slow down the healing process.
Possible causes of Telogen Effluvium:
High feverChildbirthChronic illnessMajor surgeryAnemiaSevere emotional disordersCrash diets (gastric bypass, etc…)HypothyroidismDrugs:Starting, stopping or changing birth control pills/hormone replacementWarfarin, Heparin, B-blockers, Lithium, ACE-inhibitors, Retinoids (Isotretinoin, Acitretin)
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 adolescents
Tx for tinea pedis?
1)Topical antifungals (butenafine, terbinifine, sertaconazole) 2)Oral AF (lamisil, sporonex, diflucan) 3)Econazole for bacteria in macerated areas
Scale
 
*ex. psoriasis
What is heaped up keratinized cells that are flaky?
heredity
What is atopic dermatitis most often caused by?
Bullous Pemphigoid
Autoimmune disorder presenting as a spontaneous chronic bullous eruption characterized by pruritic, tense blisters commonly occurring in the elderly.
Impetigo: General characteristics
-highly contagious -gram positive!-2 forms: bullous and non bullous-s.aureus-s.pyogenes
Cellulitis: General characteristics
-acute, spreading inflamm. of dermis/subcutaneous tissue
Seborrheic Dermatitis: Pathophys
-associated with normal levels Malassezia: fungi, abnormal immune response
 
 
What is hidradenitis suppurativa?
 
 
Chronic follicular occlusion and apocrine gland inflammation
 
leads to recurrent abscesses in the groin, axilla, perineum
Purpura
Red skin due to extravasatino of blood, will not Blanche on pressure
Contact dermititis
Important type of dermatitis common case with irritants and allergens (type 4 hypersensitivity)
the pyodermas
purulent bacterial infection caused by staph and strep
:mucocutaneous drug-induced or idiopathic reaction patterns characterized by skin tenderness and erythema of skin and mucosa, followed by extensive cutaneous and mucosal exfoliation, and are potentially life-threatening due to multisystem involvement. (2
Stevens-Johnson Syndrome andToxic Epidermal Necrolysis
Sprays
-New medication for moderate to severe plaque psoriasis is clobetasol propionate spray (Clobex)
Scar
fibrous tissue that forms over a wound
Common skin infections:
Bacterial diseases:
Viral diseases:
Fungal diseases:
Bacterial diseases:Strep (impetigo, erysipelas, cellulitis), staph (folliculitis, furuncles, carbuncles)
Viral diseases: DNA viruses (papova, poxviridae (molluscum), herpesvirus.
Fungal diseases: Malessezia furfur (tinea versicolor), candida albicans (thrush, antertrigo, angular cheilitis).
this disorder results from the activation of numerous inflammatory cells such as mast cells, eosinophils, t-lymphocytes and monocytes.
ATOPIC DERMATITIS
otorrhea
oto means ear. any discharge from ear.
A crust (dried serum or blood) should lead you to think of ___ as the primary disorder.
blisters
Lichen Planopilaris tmt:
- difficult but spontaneous resolution averages after 18 montsh- Plaquenil and oral/topical steroids
Connective tissue disorder causes of fever and rash of purpura:
- SLE- RA
Tan, black, brown assymetrical plaque with scalloped borders and a centrally located red papule
superficial spreading melanoma
Name 5 variants of BCC.
Nodular, Pigmented, Superficial, Micronodular, and Morpheaform.
Acrocyanosis
Cyanosis found in the palms and soles is called what?
Summer
What time of the year is Tinea Versicolor worse in?
Monofilament
Which type of suture would be best suitable for a place with alot of bacteria?
Accutane
What is the only acne medication that actually cures it?
Anogen Effluvium
Rapid growth arrest or damage to anagen hairs that skip catagen and telogen and are shed. Secondary to drugs, intoxication, chemotherapy. Pattern follows telogen effluvium. Diffuse and involves the entire scalp. Generally more rapid in onset and more prominent.
Peri-oral Dermatitis: General characteristics
-occurs in young women-papulopustules on erythematous bases-become confluent w/plaques and scales-satellite lesions are common (forms near primary lesion)-lower left lip-culture to r/u staph infection

 
What is this?
 
What is the hormone connection?
 
What is the pathology?
Spider angioma
 
Estrogen dependent: associated with OCP, liver disease
 
central arteriole dilation caused from high estrogen state
What is the most consistent sx of AD?
Pruritus
Urticaria (hives)
outbreak of wheals caused by contact with an irritant. localized edema in the deep dermis. 60% ideopathic
Most common site of vescicles with Dyshidrotic Eczematous Dermatitis?
Hands (80%)
Marucle
a flat discoloration on the skin like a freckle.
Staph scalded skin
bullous impetigo is mildest form. Often follows URI, sudden fever, irritability, scarlatiniform (fine papules iwth sandpaper feel), soon wrinkles and blisters occur. crusting around mouth from old lesions.
in some cases the inflammation of atopic dermatitis is triggered by what?
staph aureus
Pathogenesis of Bullous pemphigoid
Autoimmune disorder with IgG antibody against HEMIDESMOSOMES (epidermal basement membrane, ABs are "bullow" the epidermis)
Erythema migrans history:
Symptoms onset 3-30 days after tick biteSome pts do not remember tick biteSome pts develop fever, myalgia, arthralgia, headache, malaise or fatigueThe Erythema Migrans skin lesion is usually asymptomatic, but spreading
Therapy for skin tag:
- no therapy necessary- large/necrotic ones should go to pathology- snip off with scissors- cryotherapy with liquid nitrogen
With Glucagonoma Syndrome/Necrolytic Migratory Erythema you would see periorificial, acral, and flexural erythematous scaling __, __, and __ with associated ___. A skin biopsy would show __ __ __. These people are really sick (weight loss, anemia, diarrhe
- papules, patches, and plaques- glossitis- superficial epidermal necrosis
3 drugs that aggravate psoriasis:
- NSAIDs- beta blockers- lithium
What tx is useful for BCC difficult to tx surgically and pts unwilling to undergo surgery?
Radiation
Annular
What word is used for a lesion with central clearing?
Wound Dehiscence
What refers to wounds that appear to be healing but then fall apart?
at the dermal-epidermal junction 
Where is a junctional nevi located?
Nummular Dermatitis: Pathophys
-form of adult onset atopic derm.-with xerosis (dry skin) -permeation of environmental allergbens, induce this type of response

 
What is this?What cell layer is absent?
 
Psoriasis
 
Missing the granular cell layer
Swab with viral transport mediumAntibody test where site inaccesible for swab
Lab confirmation of viral infection
Guttate psoriasis presention in skin
sudden eruption of brightly erythematous round papules. 1 cm or less. trunk and extremities. spares palms and soles.
Management for Contact Dermatitis?
Identify and remove etiologic agent, vesicles may be drained, wet dressings in Burow's solution, topical corticosteroids, or prednisone in severe cases.
Aging with elastin
- Decreased elastin leads to sagging skin- decreased sweat glands in number and function- sebaceous glands maintain in number but increase in size while decreasing output --> dry skin
Pitryriasis Rosea Rx
none, but test RPR because secondary syphilis can look the same. Resolves in 3months
Presentation of Strawberry Hemangioma
Bright red papules usually around the head/neck
Presents in the first few weeks of life (1/200) births;
Grows rapidly & regresses at 5-8 years age
Uriticarial lesions should last less than 24 hours. If they do last more than 24 hous in the same location, think ___ ___ which will resolve with a __ and will have ___ and __ instead of itching.
- urticarial vasculitis- bruise- tenderness and burning
Bacterial infections that cause fever and rash of macules and papules?
- Staphylococcus-Toxic shock syndrome- Streoptococcus- Erysipelas, Rheumatic Fever, Scarlet Fever, Typhoid Fever- Typhus-endemic, Rat-Bite Fever
psoriatic arthritis classically effects ___ and __ __ joints ___. This is a potentially crippling manifestation of psoriasis and an indication for __ therapy.
- DIP - small medium joints- assymetrically- systemic therapy
What is the most common cutaneous malignancy?
Basal cell CA (BCC)
B. Esophagus
A wound in which area would heal much slower than the rest?
 
A. Small Intestine
B. Esophagus
C. Large Intestine
Alopecia Universalis
What type of alopecia is seen over the whole body?
 
 
Why are wound cultures not useful in cellulitis?
 
 
Risk of contamination with normal skin flora
Name 4 tx for alopecia areata.
1)Anthralin cream 2)Topical Minoxidil 3)Intralesional glucocorticoid injection (Kenalog) 4)Oral or topical steroids
Adverse reactions for long term use
-  Local reactions: infection, irritation, atrophy of dermis-thinning of skin, Striae- stretch marks, Purpura-red spots from local hemorrhage, Telangectasia-red lesions from dilatation of capillaries•  Systemic toxicities: (with prolonged therapy) growth retardation in children, adrenal suppression  Pediatric Considerations in Topical Corticosteroid Use•  NOTE! :  Children under 12 years of age should not use topical corticosteroids greater than intermediate strength.
a presentation on the sole and heel as scaling, thickening and cracking of the epidermis?
tinea pedis
Erythema migrans physical findings:
Lesion occurs at site of tick bite, usually waistband, intertriginous areas and extremities> 5cm, but up to 68cm, average 15cm, expanding over days and weeksCentral punctum of tick bite may be present or absentMacular border with central clearingLess common papular border, alternating rings of erythema and clearing and center that is intensely erythematous, vesicular, purpuric, necrotic or even ulceratedMultiple lesions in 15% of pts
Rickettsial causes of fever and rash of purpura:
Typhus- endemic, Rocky Mountain Spotted Fever
Pityriasis rubra pilaris is a chronic idiopathic disorder with ___ __ ___ and ___, yellowish/pink___ that are __demarcated plaques with islands of ___ skin. There is painful ___ of palms and soles.
- scalling follicular papules- confluent yellow-pink patches- well-demarcated - ISLANDS OF NORMAL SKIN- fissuring
what are the only rec. methods of bx on suspicious lesions?
Punch or excision
Males - trunk
Females - legs
The most common sites for the conversion of a congenital nevus to a malignant melanoma are where?
Describe the clinical presentation of perioral dermatitis and distribution areas.
Pustules and papules resembling acne around nasolabial folds and chin, sparing the vermilion border
EIC:
back shoulders face and neck with oily skin.  dome shaped but doesn't point. pt HX of EIC in that area. well difined patch of pink faint erythmia 
ABSCESS: 
surrounded by diffuse poorly defind area of bright red erythemitous 
Differentiate bw EIC and abscess
What is Paronychia? Onychia? (Area affected for each)
Paronychia is the nailfold.Onychia is the nail.
xeroderma
xero means dry. dry skin.....
Cultures can also be done to discover etiology of an ulcer. Cultures are necessary for diagnosing __ or __ infection. Routine cultures are polymicrobial. Antibiotics for ulcers that have become secondarily infected, will not work unless underlying cause o
- topical or unusual- radiography
X-linked icthyosis results from ___ of the __ __ gene. It results in dirty appearing __ __ __ on the ___ __ and __. Often have history of failure of labor to begin or progress. Associated with __ __ and ___.
- deletion- steroid sulfatase gene- large brown scales- extensor extremities and trunk- corneal opacities - cryptorchidism
What tx for BCC is an option for well-defined, small nodular and superficial types, but causes a very slow healing wound?
Electrodessication and Curettage (ED&C)
What are the 5 steps for tx AD?
1)Education 2)Prevention 3)Mild sx despite routine care 4)Mid-potency steroids and Calcineurin inhibitors 5)Referral
How do you treat Psoriasis Vulgaris of the scalp with no plaque?If there is a plaque how do you remove it?
Tar, ketoconazole or cortisone shampoos,vitamin D3 analog.Remove the plaque by salicylic acid in mineral oil, covered in a plastic cap and left overnight. After the plaque is removed, then treat as if there was no plaque.
Staph and Strep toxic shock dx
similar to fever and macular erythema like scalded skin syndrome, but also with hypotension, myalgia, V, D, renal d.
Other causes of fever and rash with nodules and plaques:
- Lymphoma- Erythema Nodosum- Sweet Syndrome
Describe pustular type of tinea capititis.
Pustules or scabbed areas w/o scale or significant hair loss
If MRSA is suspected, what abx are used? The nose is a major reservoir of S. aureus, what would you use?
Bactrim or clindamycin. Mupiricin (bactroban) applied to the nose.
Which etiology usually results in a severe form of Erythema Multiforme Syndrome?
Severe form usually results from a drug reaction.
To diagnose tinea capitis what 4 possible labs should be done ?
- culture of broken hairs- KOH prep (Endothrix = Tricophyton; Ectothrix = Microsporum)- Wood's light if suspecting Microsporum (Ectothrix), will flouresce green- Biopsy and stain with period acid-Schiff (PAS)
What is the least aggressive form of BCC? Describe it.
Superficial. Lesions are flatter, not as deeply invasive, MC on truck and extremities
What is the most common site for Nummular Eczema lesions in older men? Younger females?
Lower legs (older men)Trunk, hands and fingers (younger females)
things to look for in history that may indicate melanoma:
- lesions that rapidly enlarge or change in color is seen with 70% of melanoma cases- new lesion- bleeding, itching- family history

 
What causes this?
What are 2 common locations and types?
HSV 1 or 2 (usually 1 is mouth, 2 is genitals)
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