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97 Cards in this Set
- Front
- Back
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Tzanck Smear
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use to detect HSV, VZV, but cannot distinguish between the two
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Scabies
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lesions look powdery/crusty, especially on the hands. get bite-like marks; burrows interdigital tunels
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pemphigus vulgaris
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positive nicolsky sign, chicken wire/fishnet pattern on IF, ruptured blister that was intraepidermal
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allergic contact dermatitis
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occurs in areas of contact with allergen, and not on first exposure; type IV hypersensitivity
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patch testing
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use to confirm contact dermatitis
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Side effects of topical steriods
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stretch marks (striae), telangiectasias, skin atrophy, ulcers are possible
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treatment of psoriasis
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can include phototherapy, TNF-alpha inhibitors; DO NOT USE SYSTEMIC STERIODS
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bullous pemphigoid
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intact subepidermal blisters with a negative nicolski sign and linear C3 and IgG on IF
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Indications for MOHS surgery
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on face or acral surfaces, in areas of radiation, if px is a trasnplant px, if >2cm, if infiltrative
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Causes of Stephens Johnson Syndrome
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SULFA DRUGS - Bacteram... secondarily mycoplasm/herpes/pneumonia
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pustule
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vesicle with pus...indicates presence of neutrophils
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granules in stratum granulosum
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contain keratohyaline
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erosion vs. ulcer
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an erosion has epidermis left, and ulcer doesnt
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causes of diabetic ulcers
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neuropathy and microvascular disease both contribute
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blanchable
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means blood cells are in the vessels
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grouped verrucous papules
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wart associated with HPV
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clinical presentation of leukocytoclastic vasculitis
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palpable purpura, one example is henoch schonlein
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symmetric vs. assymetric
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internal vs. external problem
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Ps of Lichen planus
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purple, pruritic, palpable, papule, polygonal
WITH overlying wickham striae AND can have koebner phenom with scratching |
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Extensor vs. flexor rash
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psoriasis vs atopic dermatitis
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color of lesion affected by
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Mainly LOCATION of pigment in skin, bluer as deeper
Also, hydration, color of skin, type of pigment |
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association with Lichen planus (probs other than skin)
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Hep C, nail involvement
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guttate psoriasis
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rain drop lesions that are associated with a strep infection
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nail changes in Psoriasis?
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yes... pitting and oil spots
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spongiatic psoriasis
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lots of edema
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irritant contact dermatitis
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cuased by direct exposure
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cause of Seb dermatitis
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yeast overgrouwth...pityrosporum
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peaks of Seb derm
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infantile: cradle cap
adult: ears, scalp, nasolabial folds |
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findings in langerhans cell histiocytosis
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seb derm from hell in an infant, with failure to thrive, and lytic bone lesions
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problem in acne
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pustule of pilosebacious glands
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easy tx for roseacea (or to keep it from getting wrose)
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use sunscreen!!
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follicular involvement in roseacea?
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NO...so NO commodones
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UNIQUE findings in atopic dermatits
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hertoghes sign - loss of lateral third of eyebrow
denny morgan fold - infraorbital folds |
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auspitz sign
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removal of scab results in pinpoint bleeding in psoriasis
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Associations with atopic dermatitis and at risk for what?
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assoc - allergic rhinitis and asthma
at risk for viruses, bacteria, and fungi infections |
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presentation of psoriatic arthritis
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oligoarthritis that is asymmetric (possibility)
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what drug should not be given to psoriasis px?
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SYSTEMIC STERoiDS
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spaghetti and meatballs
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tenia versicolor - KOH stain
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reaction in Rhus derm
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Type IV delayed... distinguish b/w this and bullous pemphigoid b/c of linear arrangment of vesicles
also this is not the koebner phenom |
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rash in lupus... how diff than DM and psoriasis
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Lupus - rash between joint
DM - rash over joints psoriatic rash can be over joints too |
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Ab with crest...what phenom?
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anti-centromere ab...can have raynauds
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subacute lupus probs
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Ro and LA can cause CHB in babby
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heliotrope rash
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associated with DM
is a rash on eyelids, these px can aslo have joint rash |
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tests in DRESS
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CBC with eosinophils and LFTs for possible hepatic invovlement
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DRESS presentation
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facial edema
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Major cuase of DRESS, which drugg???
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ALLOPURINOL
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Skin probs with Hep C
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other than lichen planus.... cryoglobulinemia, telangiectasias
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lyme disease
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borellia burgdorferi, target lesion, deer tick
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RMSF presentation
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acral rash, acral palpable purpura
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syphillis presentation
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ham-colored lesoins on palms and soles (as opposed to erythema multiforme target lesions on palms)
allopecia where it looks like a moth ate the hair painless chancre |
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strawberry gums and leukocytoclastic vasculitis
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wengener's granulomatosis, so it will have palpable purpura
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churg struass
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asthma and vasculitis
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janeway lesions
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nonpainful, on palms or soles, endocarditis
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osler nodes
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painful, "ouch" endocarditis on hands and feet
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Kawasaki disease
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mobilliform rash in children, assoc with coronary artery aneurysm
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erythema nodosum
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macules on anterior shins, painful
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Necrobiosis Lipoidica Diabeticorum (NLD)
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window pane into skin???
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Diabetic dermopathy
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rash that physical guy had, scaly, yellowish
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acanthosis nigricans
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insulin resistance, armpits, back of neck, under breasts
rarely assoc iwth cnacer |
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leser trelat syndrome
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explosion, lots of seb ks with in a few days related to stomach cancer
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presentation of hyperthyroidism
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hyperhidrosis (not hypertrichosis!!!...actually have thin hair!), edema (nonpitting) on front of shins, weight loss
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acrochordan
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skin tags
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location of good melanocytes
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basal cell layer
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innner root sheath
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is continuous with stratum granulosum
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nevi description and locations
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hamartomas, junctional (at jxn of epidermis and de3rmis), compound (in e and d), interdermal (all in dermis)
should move down into dermis with age |
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white dots on dermascope with seb ks
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pseudo horn cyst
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cysts
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epidermal and trichilemmal
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dermatofibroma
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pisitive dimple sign, overgrowth of epidermis makes it look brown
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actinic keratosis
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precancerous lesion, SCCA risk
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keloid
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overgrown area of trauma
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basal cell CA color on histology
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blue... Blue Basal
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location of basal cell cancers
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head, not lips or ears though
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swuamous cell cancer (which risks) risks increased by what?
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immunosupressed, increased risk of mets or reoccurance
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location of SCCA
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hands, lips, ears
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what to tell px with basal cell ca?
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counsel px that there is a risk of getting a similar lesion with same histology
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melanoma prognosis basis?
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depth of invasion
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nevi in ppl over 35
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should not get new ones, they shouldnt change
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dermatofibrosarcoma protuberans
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honeycombing, is bad, rare mets to lungs
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kaposis sarcoma
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HHV8 required, HIV is a copromoter but is not required
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erythema multiforme presentation
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looks like target lesion, lesions may slough, but not all the skin will... looks at how many mucus surfaces are invovled to determine extent
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Stephnes johnson syndrome /TEN major complaint
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tender skin
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SJS/TEN cause
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DRUGSS!!! sulfa
somtimes mycoplsm and HSV |
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what does skin do in SJS and TEN
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falls off in sheets
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What does rash look like in SJS and TEN
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sunburn
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What (other than skin) should you check in SJS/TEN
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optic check! (also mucosal surface in mouth)
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What drug can cause DRESS?
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ALLOPURINOL
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What presentation with DRESS?
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facial edema
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What do you do with px who presents with DRESS?
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take them off of the medication
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What do you culture when suspect SSSS
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nares
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What is complain in SSSS
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tender skin (like SJS/TEN...neither are itchy)
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What happens with skin in Toxic shock syndrome
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desquamation of acral surfaces, facial swelling
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What causes TSS?
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tampon, surgical packing, leaving stuff in during surgery,
diabetic nephropathy?!?!?!?!? i dont know |
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What is first step in tx TSS?
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remove the infection
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What is pian like in necrotizing fasciitis?
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WAY OUT OF PROPORTION
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How tx necrotizing fasciitis
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generous debridement ( SURGICAL...whirpool therapy is not enough!!!)
hyperbaric O2 broad spectrum ABX |
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what is worst thing with meningococcemia
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amputation
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rash in RMSF
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acral palpable purpura
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