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109 Cards in this Set

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macule
flat, <1cm

lentigo, freckles, measles, richettsia, rubella, tattoos
patch
>1cm flat; votelligo
papule
superficial raised lesion <1cm
molluscum contagiousum, insect bite, acne
plaque
superficial raised lesion >1cm

psoriaisis, granuloma anulare
nodule
in the dermis >.5cm

dermatofibroma, tumor, cysts
excise
pustule
filled w/ pus epidermal to deep subdermal; fluid and leukocytes

color change from different than vesicle
vesicle
fluid filled superfical <.05 cm
herpes, contact dermatitis, AA, blisters
bullae
>.05 cm, superficial, fluid filled, burns friction, intraepidermal, subepidermal

pemphigus vulgaris, bullous pemphigoid, skin is FRAGILE
wheal
HST1 reaction, hives and urticaria
dermatographism
burrow
thin linear papule or plague become serpingous
mites
comedone
follicular papule w/ keratinous plug ope or close
black head
cyst
papule or nodule folled w/ debris
telangiectasia
dilated bv commonly in BCC <1mm wide
scale
inc amount of stratum corneum

hyperkeratosis
seborrheic cdermititis; fungal infection
crust
collection of dired cerum and cellular debris

contact dermatitis, herpes
excoriations
superficial, linear by scrapting
erosions
superficial lesions NO SCAR, dermis is intact

vulvar atrophy by scratching rubbing picking
ulcers
deep past the dermis will SCAR
fissure
thin linear ulcer; in dermis; SCAR
near vertical walls
atrophy
thinning of the skin not normal

more prominent vascularity
commonly in topical steroids, SLE lymphoma
scar
hypertrophic, keloids (not assoc w/ the initial trauma-->grows out)
lichenification
rub, skins defense is to thicken
annular
circular, plauwe patch ect
ring worm--KOH in atopy, dermatophte
arcuate
circular
discrete
lone lesion by self
reticulated
net like; 5ths disease/slapped cheek
target
erythema multiform; RMSF
punctate
pinpoint, fine papules
umbilicated
mulluscum contagiousum; belly button like
induration
deep thickening, edema, infallation
morbiliform
measles like
verrucous***
wart like
liquid nitrogen
-196 coldest agent; freezes ice crystal formation changes pH; damage when thawing; vascular stasis
atopic dermatitis
papules, plaques scales on flexures of extremiites neck torso; nummular

cheeks in infantile AD; lichenification; flexural
pruitis + creases (cheeks), hx of asthma hay fever OR primary relative <4 y/o; dry skin, lexural ecema

treat w/ emollients (bladn moisturizings) and bathing; antihistamines to sedate; poss prednisone
nummular
coin shaped patches; atopic dermatitis
contact dermatitis
clear vesicle, tapioca pudding palms; T1HS; RIST test measures IgE
OR usually T4HS poison ivy in a linerar line approx 10 days w/ reexposure
nickel is most common
patch test!!!
treat w/ topical steroids
eczema herpeticum
HSV inffection
pityriasis alba
hypopig w/ sligh scale; seen in atopic dermatitis pateitns esp on the cheeks
seborrheic dermatitis
yellow greasy scales; M furfur tinea versicolor
on scalp ad face; 0-3 mo or in 4-6th decades
active sebaceious glands, abnormal sebum, commensal yeast
treat w/ shamboo, poss ketoconazole
psoriasis
koebner phenomen; plaque type
on chrom 6
MTX IS GOLD STANDARD; injectable TNFa inhibitors infliximab
poss infection, meds, smoking,a lochol precipitate
plaque-silver scaly (assoc w/ arthrtis); distal onycholysis (not attached to nail bed); obesity and CV risks; sausage fingers in arthritis
tx: vit D, corticosteroids, coal tar, anthralin, retinoids, dec epidermal prolif
t cells prob antagonist of inflammaton and neturophils
phototherapy--UVB
Goekerman therapy--tar bath then UV light
urticaria
wheals; evanescent--one lesion
superficial dermis; inc serious fluid T1HS
tx- antihistamine
angioedema
dermis subcutis wheals; T1HS w/ serious fluid
tx-epinephrine
drug hypersensitivity
morbilliform, exantheamous
T4HS
can be slightly palpable
symmethric distribution
fixed drug reaction--comes back insame place
erythema multiorme
minor damage <SJS<TEN; kids HSV drugs in adults

TARGET appearnace; less concerning
---anticonvulants>allopurinol, NSAIDs, Abs
SJS
one of the few derm emergencies
anticonvulsants>allopurinol, abs, NSAIDS,
<10% body surface area covered
mucosal involvement
TEN
one of the few derm emergencies
drug rxn--anticonvulsants>allopurinol, Abs, NSAIDS
sloughing of skin; >30% of body surface area covered; mucosal involvement
causes of TEN, SJS, EM
drugs--As anticonvulsants> Abs>allopurinol, NSAIDs
erythema nodosum
nodules; common on lower legs
bacteria, fungal infection, sarcoid, crohns, drugs--OCPs, Abs,
treat: supporative, elevation, NSAIDs
bullous pemphigoid
MC autoimmune subepidermal blistering disease; elderly
autoantibodies; HEMIDESMOSOMES; TENSE, must biopsy

tx: prednisone
pemphigus vulgaris
AI blistering disease
intraepidermal (falccid bullae) loe KERATINOCYTES adhesion, mucosal membrane erosions; FRAGILE
ooze and bleed easily
lichen planus
flat topped, violaceous polygonal papules and plaues; shiny scaly (wickham's stria)
white and lacy
P's purple, planar polygonal, puritic, papules

topical steroids, antihistamines; poss prednisone
vascular rosacea
persistent erythema, often w/ telangiectasia
rosacea
papulopustular-erythematous papules and or pustules
sebaceous hyperplasia-thickened, firm follicles usually on nose
ocular-erythemia, irrat of conjunctiva, hordeolum cholazion
granulomatous-ard pauples nodules, yellow, brown or red
perioral dermatitis
acneiform spares around the mouth; poss around eyes; mostly females
oral topical ab
acne vulgaris
propionibacterium gram + aerobe; keratization of follicular epithelium inc sebum by androgens; lipases on sebum, irritation FA in inflammatory pilosebaceious; comedones; 95% of adults
DHT stim
tx: topical retinoid (vit A)--keratolytic, antiinflamatory; benzyl peroxide---antibacterial drying
erythromycin, clindamycin; systemic--minocycline, odxycline bactrim
testracyclines are 1st line
OCPs and spironolactone
acutane--dec sebum production
acne rosacea
etiology unknown; persistent flushing; exacerbaed by VD heat, exercise, hot food drinks
more in anglo saxons
oral tetracycline ab
pityriasis rosea
slamon colored oval; HERALD PATCH, christmas tree pattern
self limited
idiopathic
skin rash
vitiligo
depigmented macules patches; bony prominences, hands, feet, face
wood's light
can be universal
MJ?
topical steroids-clobetasol
alopecia
HAIRLOSS

scarring vs nonscarring;
nonscarring is androgenetic, alopecia areata, telogen efluvium
scarring--discoid lupus, lichen planopilarus, central centrifugal cicatricial alopecia
dx: biopsy, KOH, ANA, tyroid, VDRL
diff to treat, intralesional steroids for alopecia areata, discoid lupus, lichen planopilaris; topical steroids--alopecia areata, topical immunotherapy w/ sensitzers---alopecia areata; topical minxidil--androgenetic alopecia; topical short contact anthralins---alopecia areata
alopecia areata
round smooth patches of hair loss; unknown
assoc w/ thyroiditis vitiligo, down's
regrowth can be gray/white tx: intralesional steroids, topical, topical immunotherapy w/ sensitizers, topical short contact anthralins
telogen effluvium
normal hair cycle 85% growing 15% resting; stress leads to inc telogen---3 mo hair falls out at same time
febril illness, chid birth, hosp
tx: reasurrance
acanthosis nigricans
velvety hyperpig
axillae, neck, groin
obeses, DM, darly pigmented individuals usually
actinic keratosis
sun damaged; EPAS-erythematous papule w/ adherent scale
-->SCC 10%
tx: nitrogen E&C, topical chemo, 5-fu, aldara
punch biopsy

chelitis on the lip
dysplastic nevi
precursors for melanoma; punch biopsy or shave
mole irregular
nitrogen SE
residual hypopigmentation, blister fromation
BCC
most freequent skin cancer 80%, 4x>SCC rare mets; local destruction of tissue

MC malignant neoplasm; pearly papule or nodule; telangiectasisas, ulcerated papule
tx: E&C, cryosurgery, excision, radiation; topical therapy--imiquimod 50-75%
face and neck sunlight
morpheaform--scarlike, nodular---easy bleed; pigmented--black discoloration w/ melanin
superficial BCC
erythematous scaly plaque, slow, asymptomatic, trunk extemities face
morpheaform BCC
scarlike, slow, ill defined margins
bowen's disease
in situ SCC, aresenic, HPV 16 radiation
erythroplasia of querat
in situ SCC, uncirc men poss become invasive SCC
invasive SCC
invasive and destructive; mets 1-3% of cases
LN-50-72% of survival; lungs=incurable

bowen's and erythroplasia of querat--efudex or aldara, liquid nitrogen, radiation, ED/C
surgical exision if invasive, mohs, traditional

erythematous nodule (red or pink base hill like); indurated lesion, sun-exposed skin
M>W; slow growth, can be scaly ulcer like
lower lip
keratoacanthoma
low grade SCC, rapid growth, trauma, sun, HPV 11, 16
poss-->invasiveSCC
tx SCC
bowen's and erythroplasia of querat--efudex or aldara, liquid nitrogen, radiation, ED/C
surgical exision if invasive, mohs, traditional
malignant melanoma
irregular color tan to black
asymmetry-->border-->color-->diameter-->evolving >6mm eraser tip

tx: excision (in situ 5mm; invasive 1-3 cm); sentinal node biopsy--1-4mm does not affect survial of patients
poss sentinal LN biopsy
IFNa
ugly duckling sign
risk: red hair, blue eyes, fair skin, sun
back is MC location, legs comon for women
can be nodular
good prog <1mm, intermediate prog 1-4 mm; bad >4mm
kaposi's sarcoma
african ednemic--fulminant lymphadenopathic; immunocmp-AIDS
HHV-8
classic KS-slow, blue red lower extrem
AIDS-related epidemic--HIV CD$ T cell <500; trunk midface
AIDS related KS
trunk and mid face <500 CD4 T cell
HHV8
classic KS
lower extremities slow
seborrheic keratosis
tan papules; head/back-->liquid nitrogen
weight loss and stool guiac are signs fro stomach adenocarcinoma
Leser-Trelat sign nephritis sign
acrocordons
skin tags
tinea versicolor
seborrheic dermatitis (dandruff); hypopig or hyperpig; common in HIV an dinfants
lipophilic yeast M. Furfur, KOH prep speghtetti and meatballs or p. ovale
treat w/ shampoo Ketoconazole, selenium
dermatophytes
annular red plaques named for area
capitis, corporis, manum, facei, pedis, cruris;
KOH if scale
tinea! RING WORM

tx: antifungals topical
systemic in adults lamisil, fluconazole, grisofulvin, itraconazlole
chidlren-griseofulvin, fluconazole
inflammatory--w/ scale
tinea pedis
feet, interdigit, moccassin type; try; two feet one hand
tinea corporis
buttocks
tinea cruris
jock itch ring worm
tinea capitus
poss scale
MUST TREAT SYSTEMICALLY-griseofulvin or fluconazole in chidren
terbinifine or itraconazole in adults
tinea unguium
onychomycosis; toenails; systemic

tx: terbinafine, fluconazole
children-fluconazole or grseofulvin
candidiasis
oral, blaanitis, intertrigo (groin); angular chelitis)-densures crease;
impetio
bact infection honey crusted children 2-5 day cares, nasal-staph
strep pyrogenes-post strep GN
red cell casts
treat-clean, remove crsts
Ab topical=oral
mupirocin, fusidic acid
strep- B lactamace, macrolide-erythromycin
1st or 2nd gen cephalosporins
cellulitis
deep dermis subQ tissue no border; fever and chills
erysipelas
superficial dermis; fever, chills
legs or face; recurrence is common
lymphatic damgage
molluscum contagiosum
umbilicated papules; trunk extrem, genitals, face
Pox virus
children-catharadin
curettage older, liqueid nitrogen, aldara
warts
verrucus, HPV
rough, mosaic,plantar
verruca plana-flat-topped paules

tx liquid nitrogen, podophyllin, TCA, cantharadin
condyloma acuminate
HPV verrucus warts genitalia
tx liquid nitrogen, podophyllin, TCA, cantharadin
herpes simplex
goruped vesciles, neruons to DRG; latency
HSV 1-buccal mucosa, ginvgiva
recurrent-lip
HSV 2--genital, painful, erosive

dx: fluorescent Ab assay replaces Tzanch smear, culture 2-5 days; often misdiagnsoed as recurrent zoster

tx-acyclovr, valacyclovir
HSV 3
chicken pox incubation 14 days; mild in children; rose petal macule eruptive phase; cloudy vesicle, trunk and spreads; centripeta
zoster
shingles, reactivation; pain--postherpetic neuralgia; dermatome
coxsackievirus
A16/enterovirus 71; hand food mouth disease; oral lesions
scarlet fever
strep, strawberry tongue, desquamation
erythema infectiosum
parvo B19,
roseola infatum
HHV 6/7
kawasaki disease
mouth lesions
mono
commonly misdiagnosis as strep
amoxicillin (b lactam)-->rash, dysphagia
scabies
sarcotes scabiei, mite in stratum corneum; eggs burrows
mostly immunocomp and elderly
RMSF
can be spotless; dermacentor ticks; rickettsia rickettsiii
1week after bite, fever, HA, myalgias, N/V
rash
erythematous macules peripheral to central centrifugal
PETICHIAL
tx: doxycyline
gas gangrene
clostridial mynecrosis
progressive, lethal infeciton of mm, myonecrosis, truama
peripheral vascular disease ro DM
skin is dark or bronze
C. perfringens

surgical debridment treats, broad-spectrum ab and hyperbaric oxygen;
Not penicillin G anymore now CLINDAMYCIN + aminoglycoside like choloramphenicol
C perfringens
gas gangrene
surgical debridment treats, broad-spectrum ab and hyperbaric oxygen
Not penicillin G anymore now CLINDAMYCIN + aminoglycoside like choloramphenicol
decubitus ulcers
stage 1-non blanch intact skin, impending ulcerwarmth, edema, discolor indurations
stage 2-partial-thickness skin loss invovling epidermis, dermis or both; superficial lesion, erosion, blister or shallow ulcer
stage 3-full thicness skin loss subQ damage or necrotic; deep crater like
stage 4- full thick, necrosis, extends to mm, bone, tendons; sinus tracts
pityriasis
flaking or scaling of the skin
major cause of mortality in DM
CVD