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25 Cards in this Set
- Front
- Back
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Actinic Keratosis - what is it?
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precancerous neoplasm dt UV exposure
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Actinic Keratosis - morphology
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rough scaling macule or plaque 1-10 mm; reddish-pink base, ill-marginated w/ rough scale; inc w/ age; usu blonds, redheads w/ light skin
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Actinic Keratosis - dx
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biopsy
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Actinic Keratosis - DDX
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seborrheic keratoses, squamous cell carcinoma, psoriasis
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Chronic effects of sunlight
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fine & coarse wrinkles, rough leathery texture, mottled hyperpigmentation, telangiectasia
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Psoriasis - description
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chronic recurring inflammation of epidermis & dermis with INCREASED EPIDERMAL PROLIFERATION resulting in SCALING
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Psoriasis - definitive signs
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Auspitz sign
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Koebner's phenomenon
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lesions appear where skin is broken, disturbed
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Psoriasis - who gets it?
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more common in light-skinned people; gradual onset age 10-40; familial tendency
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Psoriatic arthritis
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5-30% of those with psoriasis get it (combo of RA & psoriasis) - 1st presentation single joint - SAUSAGE DIGIT - skin lesions mb only pittied nails
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Psoriasis - S/Sxs
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dry, SHARPLY DEMARCATED erythmatous papules & plaques topped with SILVERY SCALES. May itch. Limited or systemic. Comes& goes, better in summer.
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Psoriasis - systemic S/Sx
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arthritis; fever, chills, deformed (pitted) nails.
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Psoriasis - where do you see it?
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scalp, extensor surfaces, buttocks & back mostly; also nails, eyebrows, axilla, umbilicus & anogenital
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Psoriasis - Dx
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H&P, Auspitz sign. Biopsy rarely necessary (only if unusual or tx doesn't work)
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Psoriasis - DDX
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seborrheic dermatitis, squamous cell carcinoma, dermatophytoses (fungal); cutaneous/discoid lupus, dermatitis, lichen simplex chronicus
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Pityriasis rosea - what is it?
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acute, self-limited (few wks->mos), mild inflammatory, scaling skin dz. Some to lots of itching. Viral?
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Pityriasis rosea - S/Sx
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Oval, minimally elevated scaling papules & plaques. Mainly on trunk - CHRISTMAS TREE distribution along skin lines; larger "HERALD PATCH"; young adult females, cooler months. Mild fever, malaise, mild joint pain poss
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Pityriasis rosea - Dx
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by examination - history mb unremarkable
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Pityriasis rosea - DDX
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tinea corporis, tinea versicolor, drug eruptions, psoriasis, 2ndary syphilis (syphilis test to R/O)
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Lichen planus - what is it?
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recurrent itching inflammation with small, discrete ANGULAR papules (can coalesce); autoimmune? drug rxn - Beta blockers, NSAIDS, Ace inh, more
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Lichen Planus - S/Sx
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2-4 mm papules w ANGULAR borders & violaceous color. Oral lesions 50% stay forever, can ulcerate. Mb severe itching. SYMMETRICAL distribution on FLEXOR surfaces of trunk, genitals, abrupt or gradual onset, Koebner phenomenon, rare in children
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Lichen Planus - mnemonic
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PURPLE, POLYGONAL, PRURITIC PAPULES
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Lichen Planus - dx
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H&E; itchy? biopsy ("lichenoid infiltration" - lymphocytes at dermal/epidermal jct)
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Lichen Planus - DDX
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mouth: leukoplakia, candidiasis, herpes stomatitis, carcinoma, aphthous ulcers, erythema multiforme
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Drug eruptions - types
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Exanthems (full body rash)
Urticaria (IgE mediated) Fixed drug eruptions Acneiform |
