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262 Cards in this Set
- Front
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This is the most severe form of acne. Suppurating cystic lesions predominate, and severe scarring results
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Acne Conglobata
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Conglobate means
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shaped in a rounded mass or ball
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This is a severe form of acne characterized by numerous comedones, large abscesses with sinuses, grouped inflammatory nodules, suppuration, & cysts on forehead, cheeks, and neck
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Acne Conglobata
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Acne Conglobata occurs most frequently in this group
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young men
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What is the Follicular Occlusion Triad:
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acne conglobata, hidradenitis suppurativa, dissecting cellulitis of the scalp
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Is scarring present with Acne Conglobata
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yes
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Treatment for Acne Conglobata
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oral isotretinoin for 5 months
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this is the result of Abnormal keratinization (follicular retention hyperkeratosis)
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Acne Vulgaris
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what is the prominent hormonal effector on the sebaceous gland, that can cause acne
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DHT
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In the etiology of acne, this type of plug in lower infundibulum of hair follicle makes the environment more anaerobic
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Keratin plug
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In the etiology of acne, these hormones stimulate sebaceous glands
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Androgenic (DHT)
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In the etiology of acne, proliferation of this organism metabolizes sebum to produce free fatty acids which are chemotactic to components of inflammation. This organism also activates TLR-2 which stimulates pro-inflammatory cytokines
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P. acnes
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Retinoids exert their physiologic effects through these two distinct families of nuclear receptors
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RARs and retinoid X receptors (RXRs)
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Retinoids act to decrease these for factors in acne production
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sebum production, comedongenesis, P. acne, keratinization
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Flat, circumscribed, discoloration less than 1 cm. This is a lesion which can not be felt but only seen.
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macules
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If the above description applies to an area greater than 1 cm it is known as a
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patch
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give 2 clinical examples of a macule or a patch
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Vitiligo
Tinea Versicolor |
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Raised, solid, but superficial lesion less than 1 cm
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papules
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Raised, solid, but superficial lesion greater than 1 cm
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plaques
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Clinical Example of papules
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urticaria
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Clinical Example of plaques:
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erysipelas
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Raised circumscribed collection of clear free fluid less than 1 cm
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Vesicles
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Raised circumscribed collection of clear free fluid greater than 1 cm
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bulla
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Clinical Example of vesicle or bulla (depending on size)
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Bullous Impetigo
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Raised lesion (vesicle) that contains pus, focal accumulation of neutrophils (or eosinophils) and serum.
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Pustule
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Solid lesions above or below skin level, less than 1 cm.
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Nodules
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Solid lesions above or below skin level, greater than 1 cm.
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tumor
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Circumscribed tumor containing semi-solid or liquid material.
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Cyst
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Transient swelling without secondary changes. Edematous transitory plaque
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Wheals
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example of wheal
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Hives
Target lesions |
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the following are examples of?
Scale Crust Excoriation Ulcer Fissure Lichenfication Erosion Atrophy |
secondary lesions
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Particles of shedding dead skin.
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Scale
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Collection of inflammatory cells and serum on the skin surface
Classic disease process with this type of lesion is impetigo |
Crust
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Loss of epidermis caused by scratching.
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Excoriation
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Loss of epidermis and at least part of the dermis, healing usually results with scarring
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Ulcers
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Crack or split in the epidermis extending to the dermis.
Seen in commonly in people with atopic dermatitis and dry skin |
Fissure
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Thickened area with enhanced skin lines due to chronic itching and excoriation or other trauma.
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Lichenification
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Loss of epidermis, dermis intact, heals without scarring
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Erosion
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Loss of substance of skin. Can be epidermal, dermal or subcutaneous. Thinning
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Atrophy
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San joaquin valley farmer has pulmonary symptoms and a rash. Cx grows out arthrospores and ENDOSPORES.*
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Coccidioides immitis
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Spelunker in the Mississippi River Valleys has pulmonary symptoms and rash. Geimsa stain shows intracellular oval bodies surrounded by an artefactual “capsule”
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Histoplasma capsulatum
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HIV pt with contact to pigeons develops pulmonary infection which progresses to meningitis. Lesions on hands look like giant mulloscum contageosum indurated papules. Cx grows Oval thick walled spherule and is stained with india ink
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Cryptococcus neoformans
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Pt in southeastern US has hx of lung infection. Developes nodular, papillomatous and crusted lesions on hands and feet. Cx on sabouraud’s dextrose agar grows Broad Based Budding yeast
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North American Blastomycosis
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Farmer from brazil develops lung infection which procedes to a mucocutaneous rash. CX grows “MARINER’S WHEEL” buds*
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South American Blastomycosis
Aka Paracoccidiomycosis |
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Alcoholic rose gardener is pricked by a rose which starts out as a Localized skin wound and develops into regional lymphangitic spread cx shows “Asteroid body” and CIGAR BODIES*
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Sporothrix schenckii
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characteristic skin lesions as it has a propensity for invasion of blood vessels and therefore leads to infarction, gangrene and black necrotic lesions. Cx grows out branching hyphae at less than 45% angles
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Mucormycosis
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HIV pt has lung infection. Cx shows septate hyphae at 45 degree angles*
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Aspergillus fumigatus
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Identify the most common organisms for Noninflammatory Tinea Capitis infections
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T. tonsurans
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Pt presents with localized spot of hairloss on the scalp accompanied by pronounced swelling, with developing bogginess and induration exuding pus develops--adelayed type hypersensitivity reaction to fungal elements. What is the organism?*
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kerion celsii
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Pt presents with localized spot of hairloss on the scalp which begins as scaly, erythematous, papular eruptions with loose and broken-off hairs, followed by varying degrees of inflammation (Kerion). What is the organism?
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M. canis (or Trichophyton mentagrophytes)
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when pt has a Kerion, giving this tx for short periods will greatly diminish the inflammatory response and reduce the risk of scarring.
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Systemic steroids
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This is the Most severe form of dermatophyte hair infection. It is characterized by thick, yellow crusts composed of hyphae and skin debris (‘scutula’). Hyphae and air spaces seen within hair shaft. Scarring alopecia may develop
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Favus
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Favus is most frequently caused by?
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T. schoenleinii
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Favus (T. schoenleinii) can be diagnosed by Bluish white fluorescence under _______?
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Wood’s light
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Tinea capitis can be cause by any one of several species, the ectothrix types (whose growth and spore production are confined chiefly on the outside the shaft of the hair) are?
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T. verrucosum & T. mentagrophytes, M. canis*
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Tinea capitis can be cause by any one of several species, the endothrix types (whose growth and spore production are confined chiefly within the shaft of the hair) are
types |
T. tonsurans and T. violaceum*
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Wood’s light Fluorescent-positive infections
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T. schoenleinii, M. canis, M. audouinii, M. distortum, M. ferrugineum*
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Hairs infected with [name 3]and others of endothrix do not fluoresce
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T. tonsurans, T. verrucosum, & T. violaceum and
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Pt presents with tinea corporis consisting of concentric circles form rings in one another, making intricate patterns. What organism?
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tinea imbricata
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What is the most common etiology of Tinea Corporis in the US and worldwide?
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T. rubrum
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What is a frequently seen in ringworm in children-particularly those exposed to animals especially CATS & dogs
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M. canis
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Tinea Cruris,Tinea Pedis & tinea manus are commonly caused by these three dermophytes
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T. mentagrophytes & E. floccosum & T. rubrum, Tinea manus
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Onychomycosis (Tinea Unguium) is most commonly caused by
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Epidermophyton, Microsporum, and Trichophyton fungi
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Onychomycosis produced by T. rubrum & T. megninii and may be an indication of this
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HIV infection
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Does Griseofulvin tx nail disease caused by candida
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no
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Culture on Sabouraud’s glucose agar shows a growth of creamy, grayish, moist colonies in about 4 days. What is the dx
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C. albicans
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This Topical Anti-candidal Agent has been reported to be less active against Candida species by some authors
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Terbinafine
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Newborn infection of this may be acquired from contact with vaginal tract of mother
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Oral Candidiasis (Thrush)
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Perleche (AKA angular cheilitis) is Maceration with transverse fissuring of oral commissures. Soft, pinhead-sized papules may appear.
Involvement is usually bilateral. Similar changes may be seen in these 2 nutrient deficiencies. |
riboflavin deficiency, and iron deficiency anemia*
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This may develop during pregnancy, in diabetes, or secondary to therapy with a broad- spectrum antibiotic*
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Candidal Vulvovaginitis
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Tinea Versicolor is caused by this fungus which grows out as a spagetti and meatball yeasts on fungal cx
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Malassezia furfur
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treatment of dermatophytes
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Griseofulvin
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After giving this treatment for Sporothrix schenckii you should check TSH and watch for Wolf Chargot effect
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Potassium Iodide
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this is the main cause of nutritional deficiencies in developed countries
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Alcoholism
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Pt presents with keratotic papules over extremities and shoulders arising from pilosebaceous follicles. Eruption begins on thighs or upper arms. Spreads to shoulders, abdomen, back, and buttocks, face and neck Skin displays dryness and scaling. Phrynoderma or “toadskin” resembles keratosis pilaris.
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Hypovitaminosis A
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Major cause of blindness in children in the developing world! Earliest finding is delayed adaptation to the dark (nyctalopia) Night blindness, xeropthalmia, xerosis corneae, keratomalacia.
Bitot’s Spots; circumscribed areas of xerosis of the conjuctiva lateral to the cornea |
Hypovitaminosis A
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pt presents with loss of hair and coarseness, loss of eyebrows, exfoliation and pigmentation of skin, clubbing, hepatosplenomegaly, anemia, increased LFTs, pseudotumor cerebri with papilledema
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Hypervitaminosis A (children)
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Early signs are dryness of the lips and anorexia. Followed by bone and joint pains, follicular hyperkeratosis, branny desquamation of the skin, loss of scalp hair and eyebrows, dystrophy of the nails.
Fatigue, myalgia, depression, anorexia, liver disease |
Hypervitaminosis A (Adults)
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this can occur with excess Vit A in pregnancy
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Birth defects
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these drugs can cause a vitamin K Deficiency in adults
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COUMADIN, salicylates, cholestyramine
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Vitamin K Deficiency can cause Purpura, hemorrhage, and ecchymosis due to a decrease in these vitamen K dependent clotting factors
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factor II, VII, IX, and X.
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pt presentss with perifollicular petechiae and ecchymoses, subungual, subconjunctival, intramuscular, and intraarticular hemorrhage
“Corkscrew hairs”; hairshafts are curled in follicles capped by keratotic plugs Hemorrhagic gingivitis; bleeding gums, epistaxsis, anemia What is the dx & vitamen deficiency |
scurvy
vit C |
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Scurvy “The Four H’s”
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Hemorrhagic signs
Hyperkeratosis of hair follicles Hypochondriasis [anxiety] Hematologic abnormalities |
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pt presents with photosensative eruption, perineal lesions, thickening and pigmentation over boney prominences, seborrheic dermatitis-like eruption on face. Pt also has scrotal and perineal erosions, fissures, & angular chelitis
What is the dx? What is the nutritional deficiency? |
Pellagra
deficiency of Nicotinic acid, vitamin B3, niacin or its precursor tryptophan |
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“3 D’s" of Pellagra
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diarrhea, dementia, dermatitis
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vesicular or bullous (wet pellegra)photosensitive eruption on neck caused by niacin deficiency
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Casal’s necklace
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pt presents with a pustular and bullous, acral and perioral dermititis. She has
patchy, red, dry, scaling lesions with exudation and crusts. Angular chelitis and stomatitis is present. She also has nail dystrophy, alopecia as well as diarrhea, growth retardation, CNS problems. What is the vitamen deficiency? |
zinc
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Inherited Zinc Deficiency
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Acrodermatitis enteropathica
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these babies are at risk for zinc due to inadequate body zinc stores
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Premies
Weaning from breast from breast milk |
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acral or perioral dermatitis
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Zinc Deficiency
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Chronic diaper rash with diarrhea in an infant
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Zinc Deficiency
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deficiency. of protein and calories. no edema. skin is dry, wrinkled, loose. “Monkey facies” due to lose of buccal fat pad
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Marasmus
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protein deficiency. “Red Children.” Edema due to 3rd spacing and hypoprotienemia, potbelly, hair and areas of skin are hypopigmented, hair is red, gray to white ("flag sign." “Mosaic skin”; areas of hyper/hypopigmentation resemble peeling paint.
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Kwashiorkor
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Adolescent presents with predominant lesions representing benign proliferations of neuronal support structures. It has "bag of worms" feel to it. You notice several Café au-lait spots and mom reports that they appeared within the first year of the childs life. What is the dx? What is the chromosome and the heritance factor?
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neurofibromatosis I
(von Recklinghausen’s disease) Chrom 17, autosomal dominant |
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virtually pathognomonic of NF-1
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Plexiform Neurofibroma
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Diagnostic Criteria for NF requires two or more of the following criteria (give 5)
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Neurofibromas (predominant lesion)
- Plexiform neurofibroma subtype- specific for NF-1 Café au-lait macules Lisch nodules (Iris hamartoma) Optic Glioma Axillary freckling Bone abnormalities (Bowing of long bones, tibial pseudoarthrosis, orbital defects) Other findings Macroglossia Sacral hypertrichosis |
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Sweet’s Syndrome- Painful, inflammatory "see through" plaques and nodules that are sharply demarcated on face, neck, trunk and extremities are associated with this dz
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Acute Myelogenous Leukemia (AML)
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Usually hyperpigmented, velvety, papillomatous, dirty appearing skin in intertrignious areas
Associated mainly with DM or other endocrinopathy |
Acanthosis Nigricans
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Acanthosis Nigricans with mucosal involvement usually signifies this
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adenocarcinoma of the bowel
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Pigmented macules on the lips, oral mucosa, perioral acral areas associated with gastrointestinal polyps, especially prominent in the jejunum.
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Peutz-Jeghers Syndrome
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hereditary hemorrhagic telangectasia (permanent enlargement of blood vessels, causing redness in the skin or mucous membranes) causing AV fistulas
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Osler-Weber-Rendu
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this virus is strongly assoc. and predictive of K.S. in HIV infected individuals
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HHV-8
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This is a very common shronic superficial inflammation of skin that has a different distribution based on the three different phases of age
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atopic dermatitis
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This phase of atopic dermititis is characterized by red, pruritic often symmetrical papules and plaques. With lesions over:
Cheeks Forehead Scalp Trunk Extensor surfaces of extremities |
Infantile Phase (1-6 mo)
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This phase of atopic dermititis is characterized by Dry, Papular, Intensely Pruritic
Circumscribed scaly patches on: Wrists Ankles Antecubital and Popliteal fossae |
Childhood Phase (4-10y/o)
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75% of childhood atopic dermititis improves b/w ages*
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10 & 14
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This phase of atopic dermititis is characterized by marked Lichenification. It involves flexural areas of:
arms neck legs Occasionally on: dorsal surfaces of hands and feet Between fingers and toes |
Adult Phase
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ATOPIC DERMATITIS Immunologic etiology suggested by chronic elevation of ____ in majority of pts
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IgE
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ATOPIC DERMATITIS may have to do with a faulty epidermal barrier which leads to inability to hold water w/in the stratum corneum leading to shrinking of this layer leading to cracking of skin and leaving the skin more prone to what?
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irritants
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What are the 2 most Itch-Provoking Factors in AD
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Heat & perspiration 96%
Wool 91% Emotional Stress 81% Foods 49% Alcohol 44% Common cold 36% Dust Mites >35% |
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TREATMENT options for acute Stages of ACUTE ATOPIC DERMATITIS
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1)Eliminate/avoid predisposing factors
2)Hydration & lubrication of skin 3)Antipruritic to relieve itching 4)Wet dressings 5)Topical corticosteroids 6)Systemic steroids may be needed if severe 7)Moniter closely for secondary infections |
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TREATMENT options for acute Stages of CHRONIC ATOPIC DERMATITIS
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Aimed at avoiding irritants and restoring water to skin
-BID lubrication (Cetaphil) -No soaps or harsh shampoos -Avoid woolens/rough clothing -Minimize bathing to q 2-3 days -Topical Calcineurin Inhibitors |
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PT presents with pruritic, erythematous lesions w/ or w/o distinct margins. Histologically her skin shows Spongiosis (intercellular epidermal edema) w/ lymphocytic &/or eosinophilic infiltrates in the epidermis/dermis
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DERMATITIS (ECZEMA)
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DERMATITIS (ECZEMA)is vesicular during this stage
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Acute
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DERMATITIS (ECZEMA)is scaling & crusting during this stage
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Subacute
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Due to long term rubbing and scratching DERMATITIS (ECZEMA)shows acanthotic w/ hyperkeratosis during this stage
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chronic
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Pt in 45 begins notes a few dark “greasy” appearing lesions on his chest and back in hair bearing areas. What is the dx?
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Seborrheic Keratosis
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Sudden appearance of numerous itchy SK’s. What sign is this?
What does it indicate? |
Sign of Leser Trelat
neoplasm -commonly Adenocarcinoma of Stomach |
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pathogenisis behind Sign of Leser Trelat
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Neoplasm may secrete growth factor leading to epithelial hyperplasia
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Black man has Multiple hyperpigmented sessile to filiform papules on his cheeks and forehead areas. His dermatologist tells him it is a benign condition called Dermatosis Papulosa Nigra. What is this a varient of?
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Seborrheic Keratosis
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45 y/o white man has numerous white lesions on his lower legs near Achilles tendon that are easily scratched off. His dermatologist tells him it is a benign condition called Stucco Keratosis. What is this a varient of?
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Seborrheic Keratosis
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Newborn has a lesion on the vertex of the scalp. The dermatologist diagnoses a Nevus Sebaceus. What neoplasm can develop from the lesion 5-10% of the time
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basal cell carcinoma
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These small translucent papules commonly present on eyelids or upper cheeks. Although they may also may occur on: Axilla, abdomen, forehead, penis, vulva.
They develop slowly and persist indefinitely and occur in 18% of adults with DOWN SYNDROME |
Syringoma-
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These are translucent papules 1-3mm which may have a bluish tint. They occur on the face and are usually solitary, however, multiple lesions may be seen
May become more prominent in hot weather. |
Eccrine/Apocrine hidrocystomas
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this type of CA has been reported to arise from chronic inflammatory pilonidal disease
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SCC
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you can develop in inflammatory conditions and skin diseases such as epidermolysis bullosa, pemphigus, bullous pemphigoid, PCT, herpes zoster, contact dermatitis, and after prolonged use of these medications
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NSAIDS
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these are characterized by an abnormal arrangement of tissues normally present
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Hamartomas
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pt presents with Small vascular papules (Angiokeratomas) all over teh body. The pt has a storage dz caused by deficiency of galactosidase A. What is the dz
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fabre’s dz
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Pt presents with a small, solitary, sessile or pedunculated, rasberry-like vegitation of exuberant granulation tissue on an exposed surface secondary to trauma. What is it?*
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Pyogenic Granuloma
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what drugs can cause Pyogenic Granulomas?*
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Isotretinoin or indinavir
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This dome-shaped lesion is dull red, white streaks when involution occurs. It
is the most common benign tumor of childhood. They may be present at birth or arise within the first few months. They are usually on the head and neck. |
Infantile Hemangioma (Strawberry Hemangioma)
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PHACE syndrome
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Posterior fossa brain malformations (Dandy-Walker), Hemangiomas, Arterial anomalies, Coarctation of aorta, Eye abnormalities
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tx for keloids
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Excision with intralesional injections. Silicone sheeting
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This dz is characterized by itchy, pink, yellow or erythematous patches that may be dry, moist, or greasy
It is a chronic, superficial, inflammatory disease caused by the yeast, Malassezia globosa. It most commonly affects the scalp but may also affect the eyebrows, ears, eyelids, nasolabial creases, lips, sternal area, axillae, submammary folds, umbilicus, groin, and gluteal crease |
Seborrheic Dermatitis
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Seborrheic Dermatitis in babies presents when they are around 1 week old and is often called
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“Cradle cap”
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Treatment-Adolescent & Adult Seborrheic Dermatitis
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Regular use of medicated shampoos (Nizoral, Loprox, Elidel)
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This commonpapulosquamous dz is chronic, recurrent, inflammatory disease of the skin characterized by round, circumscribed, erythematous, dry, scaling plaques of various sizes, covered by grayish white or silvery white, imbricated and lamellar scales. It has a predilection for the scalp, nails, extensor surfaces, elbows, knees, umbilical, and sacral region
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Psoriasis
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This referrs to the appearance of typical lesions of psoriasis at sites of injury
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Koebner’s phenomenon
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This referrs to pinpoint bleeding when the psoriatic scale is forcibly removed, this occurs because of severe thinning of the epidermis over the tips of the dermal papilla
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Auspitz’s sign
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This refers to concentric blanching of the erythematous skin at or near the periphery of the healing psoriatic plaque
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Woronoff ring
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HLA associations of psoriasis
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Cw6
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Give 3 causes of drug-induced psoriasis
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beta blockers, lithium, and antimalarials
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Name 3 things that aggravate psoriasis
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Emotional stress, smoking, and alcohol
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This subtype of psoriasis has flexural or intertriginous location & Shiny erythematous plaques that lack scale.
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Inverse Psoriasis
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This subtype of psoriasis, usually, occurs as an abrupt eruption following an acute infection, such as streptococcal pharyngitis. It is usually rapidly responsive to treatment with topical steroids or UVB
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Guttate Psoriasis(drop like)
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This subtype of psoriasis usually presents as oligoarthritis with swelling and tenosynovitis of one or a few hand joints,
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psoriatic arthritis
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This is a severe type of psoriasis. Typical patients have plaque psoriasis and often psoriatic arthritis
The onset is sudden, with formation of lakes of pus periungally, on the palms, and at the edge of psoriatic plaques. Pt experiences pruritus, pain, fever, and malaise. Fetid odor develops |
Generalized pustular psoriasis(von Zumbusch)
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drug of choice for Generalized pustular psoriasis(von Zumbusch)
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Acitretin
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Treatment for psoriasis
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Topical corticosteroids,etc.
Light therapy Laser Systemic Combination |
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Sudden appearance of a polymorphous eruption composed of macules, papules, and occasional vesicles. Papules are usually yellowish or brownish-red, round lesions, which tend to crust, become necrotic and hemorrhage
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PLEVA
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treatment of PLEVA
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No tx is reliably effective
Tetracycline & erythromycin UV light Methotrexate Dapsone & pentoxifylline |
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Mild inflammatory exanthem of unknown origin, characterized by salmon-colored papules and patches which are oval and covered with a collarette of scale. Disease frequently begins with a single herald patch, which may persist a week or more, then involutes
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Pityriasis Rosea (PR)
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Treatment of Pityriasis Rosea
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Supportive
UVB should be used after acute inflammatory stage has passed Topical corticosteroids Antihistamines Emollients |
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Chronic skin disease characterized by small follicular papules, disseminated yellowish pink scaling patches, and often, solid confluent palmoplantar hyperkeratosis
key features: Hyperkeratosis of palms and soles called, the “sandal”* Nails may be dull, rough, thick, and brittle* islands of sparing* |
Pityriasis Rubra Pilaris (PRP)
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Because the etiology of PRP may include a deficiency of this vitamen treatment includes it
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Vitamin A
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test for these two viruses by scraping the bottom of acute vesicular lesions and doing a tzank smear to show multinucleated giant cells with a jig saw nucleus
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HSV and VZV
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tx of Herpes Simplex
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Acyclovir, Valacyclovir. (valtrex)
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this herpes virus presents as grouped vesicles on an erythematous base
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HSV –1
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Initially the Varicella virus seeds the internal organs at 4-6 days. At _____ days the skin eruption occurs
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11-20
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Individuals with chicken pox are infectious __ days before and __ days after exanthem appears.
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4
5 |
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Shingles is characterized by a prodrome of pain and itching for several days and then a rash distributed in a dermatomal distribution. It arises from reactivation of latent herpes zoster infection from the ________.
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dorsal root ganglia
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Herpes Zoster that involves the ophthalmic branch of the fifth cranial nerve is called
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Ophthalmic Zoster
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Ophthalmic Zoster can cause blindness if tip/side of nose is affected (76%) vs (34%) if not involved. This is called the _______ sign
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‘Hutchinson’s sign’,
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This Zoster Subtypes has Facial and auditory nerve involvement with inflammation of geniculate ganglion.
Zoster of external ear or TM, herpes auricularis, with ipsilateral facial paralysis Herpes auricularis, facial paralysis and auditory symptoms. |
Ramsay Hunt syndrome
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this virus is associated with lymphoma esp. Hodgkin's disease.[test]
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EBV
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This disease of infents presents with a high fever which resolves in about 4 days followed by a morbilliform erythema of rose colored macules on neck, trunk and buttocks and sometimes the face and extremities. Complete resolution in 1-2 days
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Roseola Infantum (sixth disease)
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In Roseola Infantum (sixth disease)what day is the high fever gone and the rash develops*
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7
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what virus causes Roseola Infantum (sixth disease)
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Human Herpesvirus 6 and 7
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Molluscum contagiosum is caused by what virus
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poxvirus
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this viral infection begins with a fever and sore mouth
(90% have oral involvement) Lesions are small rapidly ulcerating vesicles surrounded by a red areola Lesions on hands and feet run parallel to skin lines Red papules that quickly turn to gray vesicles**surrounded by a red halo. The dz typically lasts less than a week. |
Hand-Foot-and-Mouth Disease
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Hand-Foot-and-Mouth Disease is caused by what virus
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Coxsackievirus A-16
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Koplik’s spots are pathognomonic for this dz, and appear during the prodrome
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Measles
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most common complication of measels
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Otitis Media
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treat acute RUBEOLA with this vitamen
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vitamen A
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MMR given at _____ months, and _____ years
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12-15
4-6 |
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arthritis of phalangeal joints may be seen in women women with this TORCH virus
Clinical, posterior cervical, suboccipital, and postauricular lymphadenitis occurs in more than half infected. |
RUBELLA
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In Erythema Infectiosum (Fifth Disease) Viral shedding has stopped by the time the exanthem has appeared
T or F |
T
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common warts are caused by HPV?**
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1,2
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Flat warts are caused by HPV?**
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3
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Condyloma warts (benign but locally invasive and look bd are caused by HPV?**
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6,11
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warts that can cause cervical CA are caused by HPV?**
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16,18
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Koilocytes (squamous cell, often binucleate and having a perinuclear hole) is pathomneumonic for
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HPV
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Warts at angle of mouth bilaterally is a characteristic and often unique manifestation of HPV infection in this condition
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AIDS
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bug that commonly causes Furuncle / Carbuncle
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S. Aureus
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furuncles in this location is considered the ‘danger triangle’, requires prompt treatment with ABX to avoid possible venous sinus thrombosis, septicemia, meningitis
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Upper lip and nose
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tx of furuncles
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Incision and drainage AFTER furuncle is localized with definite fluctuation
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etiology of Staphylococcal Scalded Skin Syndrome
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Exotoxin from S. Aureus infection
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in SSS if you rub skin and it comes off. this is called a positive
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Nikolsky’s sign
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GROUP A STREP OF THE SKIN CAN CAUSE this dz but not this other dz that group A strep of the throat can cause
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ACUTE GLOMERULONEPHRITIS BUT NOT RHEUMATIC FEVER (LIKE GROUP A STREP OF THE THROAT)
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pt presents with 2mm erythematous papule develops into vesicles and bullae. Upon rupture a straw colored seropurulent discharge dries to form yellow, friable crust.
dx is Impetigo Contagiosa. what organism |
S. Aureus > S. Pyogenes
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tx of Impetigo Contagiosa includes topical ____ prophylaxis of traumatic injury. This results in 47 %Reduced infection
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ABX
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Treatment of nares for carriers is a tx for Impetigo Contagiosa. T or F
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T
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bugs that cause Toxic Shock Syndrome
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S. Aureus & Group A Strep
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cutaneous features of this dz presentation: 24 –48 hrs after Strep. Pharyngitis onset
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Scarlet Fever
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cutaneous features of scarlet fever include accentuation over skin folds with petechia, referred to as this. There is also, circumoral pallor, desquamation of palms and soles at appox two wks. &
Strawberry tongue |
Pastia’s lines
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Scarlet Fever is caused by
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erythrogenic exotoxin of group A Strep
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pt presents with erythematous patch with a distinctive raised, indurated advancing border. Affected skin is very painful and is warm to touch. Freq. associated with fever , HA and leukocytosis
Face and Legs are most common sites. dx is Erysipelas. what is the bug |
group A strep (Group B in newborns)
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Cellulitis is local erythema and tenderness which intensifies and spreads. Often associated with a discernable wound. Lymphangitis, fever and streaking may accompany the infection. what organisms cause it.
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Group A strep and S. Aureus
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Fisherman presents with Purple, polygonal, patches occurring on the hands. The central portion of the lesion has faded as the border advances. Cx grows Gram + Rod that forms long branching filaments. What is the dx & bug
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dx: Erysipeloid of Rosenbach
bug: Erysipelothrix Rhusopathiae |
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pt presents with an asymetric, sharply delineated, dry, brown, slightly scaling patches located in intertrignous areas.
what is the dx? what is the bug? what is the tx |
Erythrasma
Corynebacterium Minutissimum erythromycin or clindamycin |
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Hot tub folliculitis is caused by
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Pseudomonas aeruginosa
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child scratched by a cat, 3-5 days later he develops a lesion that looks like a insect bite. It heals without a scar. The child then develops chronic lymphadenopathy, fever, malaise and anorexia.
What is the dz? What is the organism |
Cat-scratch disease
B. henselae, |
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this dz effects both men and women in their 40s & 50s. It is an autoimmune dz and is characterized by easy to rupture bullae that appear first in the mouth and them commonly in the groin, scalp, face, neck, axillae, or genitals
Nikolsky sign is present Esophagus may be involved* |
Pemphigus Vulgaris
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absence of cohesion in the epidermis, upper layers are easily made to slip laterally by slight pressure or rubbing
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Nikolsky sign
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In Pemphigus Vulgaris, this Ab is detected
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Desmoglein-3 antibody (mucosal)
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The hallmark of pemphigus Vulgaris is the finding of IgG autoantibodies directed against the cell surface of keratinocytes. It is characterized by this type of pattern on immunoflurescence
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fishnet pattern
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systemic tx for Pemphigus Vulgaris
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prednisone
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Risk of death in pemphigus from side effect of oral prednisone is greater than the risk of death from the disease itself-T or F
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T
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This is a mild, chronic variety of pemphigus characterized by flaccid bullae and generalized or localized exfoliation.
Nikolsky sign present. Oral lesions rarely seen. Pts with this dz are not severely ill. |
Pemphigus Foliaceus
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Pemphigus Foliaceus is associated with this Ab
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Desmoglein-1 antibody
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This dz occurs most frequently in the elderly (average onset is 65 to 75 y/o) It is characterized by large tense bulla on a subepideral base. When rupture, shows large denuded area and do not materially increase in size. Denuded areas show a tendency to heal spontaneously.
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Bullous Pemphigoid
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This Ag is seen in Bullous Pemphigoid
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Bullous pemphigoid antigen 1 (BPAg1) and 2 (BPAg2) identified in 90% of patients
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Treatment of Bullous Pemphigoid
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Same treatment for pemphigus, with the expectation that disease will respond readily with lower dose of corticosteroid
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Fogo Selvagem is also known as
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Brazilian pemphigus foliaceus
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This is a chronic, relapsing, severely puritic disease. Characterized by grouped symmetrical, polymorphous, erythematous-based lesions
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Dermatitis Herpetiformis
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DH is associated with this sensitivity
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gluten
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87% of pts with DH and IgA deposits in the skin are HLA___ positive
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HLA-B8
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In DH, ____ antibodies are formed in the jejunum, may deposit in the skin
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IgA
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tx of DH is this but a gluten free diet decreases the amount of medication needed
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Dapsone
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_____ in a granular pattern in the dermal papillae in normal skin is specific and pathognomonic for DH
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IgA
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This is an acquired autoimmune blistering disease
whith a clinical pattern similar to dermatitis herpetiformis, or with vesicles and bullae in a bullous pemphigoid-like appearance. It may have mucosal involvement but there is no association with enteropathy or with HLA-B8 It tends to remit over several years. |
Linear IgA Bullous Dermatosis
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Linear IgA dermatosis can occur as a drug-induced disease by this antibiotic*
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Vancomycin
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tx of Linear IgA Bullous Dermatosis
adult form? childhood form? |
dapsone
Sulfapyridine or dapsone |
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Chronic urticaria may be sole manifestation of early _______
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amebiasis
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this is a common cause of vaginal pruritis with burning and frothy leukorrhea. Vaginal mucosa will appear bright red from inflammation and may be mottled with pseudomebranous patches.
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Trichomonas vulvovaginitis
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tx of trichomonas is this
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Metronidazole
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tx of trichomonas in pregnant women is
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clotrimazole
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what are the three forms of Leishmaniasis
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A.) cutaneous form restricted to skin
B.) mucocutaneous form affects both skin and mucosal surfaces C.) visceral leishmaniasis that affects organs of reticulo-endothelial system |
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Host vector of the Old World type of Leishmaniasis
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Phlebotomus sandflies
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Host vector of the New World type of Leishmaniasis
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Lutzomyia sandflies
Phlebotomus perniciosus & |
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Tx of Leishmaniasis
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intralesional sodium stibogluconate antimony
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tx of leishmaniasis in antimony-resistant disease
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Amphotericin B
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Four of the great chronic infections (syphilis, tuberculosis, leprosy, and leishmaniasis) have a predilection for this part of the body
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the nose
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Cx leishmaniasis on this media
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NNN
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Intradermal Montenegro test is for leishmaniasis can be neg in early cases of disease. T or F
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T
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Etiology of Visceral Leishmaiasis
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L. donovani spp
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Visceral Leishmaiasis effects this organ system
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reticuloendothelial system: spleen, liver, bone marrow, and lymph nodes
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In diagnosing Visceral Leishmaiasis, Specimens for examination in descending order of utility are
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spleen pulp, sternal marrow, liver tissue, and exudate from lymph nodes
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DOC for Visceral Leishmaiasis
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pentavalent antimony
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Chagas’ disease (American) vector and parasite
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reduvid bug (kissing bug)
Trypanosoma cruzi |
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African vector of Human Trypanosomiasis
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tse tse fly
Trypanosoma brucei gambiense (West Africa) and T. brucei rhodesiense (East Africa) |
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In American Trypanosomiasis, If bite of the Reduvid bug occurs around the eye unilateral conjunctivitis develops with edema of eyelids, with an ulceration or chagoma in area
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Romana’s sign
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Chagas dz is a common cause of these two visceral dz
|
Common cause of dialated cardiomyopathy leading to CHF
and GI complications(megaesophagus & megacolon) |
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In Gambian Trypanosomiasis (West African) Bite rxn from the tsetse fly develops into a lesion called
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trypanosomal chancre
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Acute form of this dz disease is usually mild with fever, malaise, edema of face and lower extremities and generalized lymphadenopathy. It can progress to cause dialated cardiomyopathy and GI complications like megacolon and megaesophagus
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Chagas’ disease
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Early stages of this dz consist of a chancre occur the site of tsetse fly bite.
Next erythema with circumscribed swellings of angioedema, enlargement of lymph glands, fever, malaise, headache, and joint pain occurs. In West African (Gambian) form, illness is chronic over yrs with progressive deterioration In East African (Rhodesian) form illness is acute with a stormy, fatal course of weeks to months |
African trypanosomiasis
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|
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organism that causes Visceral Schistosomiasis (Bilharziasis).
Cutaneous manifestations begin with mild itch and a papular dermatitis of feet and other parts after swimming in polluted streams containing cercariae. These parasites can then penetrate into bloodstream and eventually inhabit venous system draining the urinary bladder or intestines |
bladder:
Schistosoma haematobium intestines: S. mansoni or S. japonicum |
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|
Hookworm Disease often manifests itself with Urticaria. Onset of constitutional symptoms is accompanied by progressive iron deficiency anemia and debility. Major organisms known to cause hookworm dz are?
|
Ancylostoma duodenale or Necator americanus
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|
|
Tx of Hookworm Disease
|
Albendazole
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|
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Majority of cases of Larva Migrans in this country are caused by penetration by larvae of a cat and dog hookworm known as ________
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Ancylostoma braziliense
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|
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tx for Ancylostoma braziliense
|
Ivermectin or albendazole
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|
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Cutaneous lesion is usually on lower leg, but may occur on genitalia, buttocks, or arms. Spread by contamanated drinking water
|
Dracunculiasis
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|
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tx of Dracunculiasis
|
Surgical removal is TOC
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parasite responsible for Filariasis (lymphedema
Resulting in hypertrophy of skin & subcutaneous parts) |
Wuchereria bancrofti, Brugia malayi
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|
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vector of Filariasis
|
Culex, Aedes, and Anopheles mosquito
|
|
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TOC for Filariasis
|
Ivermectin
|
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Prophylactic measures for Filariasis
|
mosquito control
diethylcarbamazine |
|
|
Loaiasis spread by this fly
|
mango fly
|
|
|
tx Loaiasis with
|
Diethylcarbamazine[test]
|
|
|
Onchocerciasis also known as “River Blindness” can cause Thickened skin (elephant skin) and pretibial depigmentation (leopard skin). Tx is?
|
Ivermectin
|
|
|
obtained by eating inadequately cooked pork. Symptoms are puffy eyelid edema, red conjunctiva and sometimes urticaria, fever, headache, myalgias, neurologic signs/symptoms. SPLINTER HEMHORRAGES.
|
Trichinosis
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|
|
Tx of Trichinosis
|
albendazole
|
