Dermatology

Front 1

flat lesion, <1 cm in diameter: what am i?

Back 1

macule

Front 2

bullae v. vesicle

Back 2

raised lesion that can be filled w/stuff, bullae is large (>1 cm), vesicle is small (<1 cm) --> DIFFERENCE IS SIZE

Front 3

name 1 reason someone should get a total body screening exam

Back 3

first degree relative w/history of melanoma

Front 4

solar lentigo

Back 4

flat pigmented lesions on sun-exposed areas (dorsum of hands, face, etc.), result from sun damage, one/many small brown macules. (solar lentigo is just the medical term for sunspots)

Front 5

how do you treat actinic keratosis?

Back 5

liquid nitrogen keratosis --> freeze cells, kill keratinocytes

Front 6

how can you protect yourself from sun damage?

Back 6

wear sunscreen (>= spf 30), wear protective clothing, seek shade, avoid water/snow/sand/reflective surfaces, safely get vitamin D, avoid tanning beds, check your skin regularly

Front 7

ABCDE of melanoma

Back 7

asymmetry, border, color, diameter, evolution

Front 8

what is the main thing that make a mole less likely to be melanoma?

Back 8

follows signature pattern of rest of someone's moles (absence of the ugly duckling sign)

Front 9

what treatment can cause a risk of hypopigmentation?

Back 9

liquid nitrogen cryotherapy

Front 10

acrochordons - what are they? (what do we call them in lay people speak?)

Back 10

fleshy papules arise in axillae, neck, groin, and eyelids, skin colored-brown, often pedunculated (skin tags)

Front 11

what is the breslow depth?

Back 11

measures from epidermis-dermis junction down --> is the most important prognostic factor for melanoma

Front 12

the most important prognostic factor of a melanoma is ___

Back 12

tumor thickness. (NOT sun exposure, family history, etc.)

Front 13

something on the toe looks like a melanoma. what should you do?

Back 13

refer to dermatologist for excisional biopsy!

Front 14

if someone has a mole on the nose that has been there since they were born, what do you tell them?

Back 14

congenital nevus. totally benign! any treatment is cosmetic

Front 15

seborrheic keratosis - what does it look like? is it cancer?

Back 15

stuck-on cracked, dark look, dry surface. totally benign - not cancer

Front 16

how do you treat dermatosis papulosa nigra?

Back 16

light electrodessication is safest. DO NOT USE LIQUID NITROGEN

Front 17

a patient has dermatosis papulosa nigra (small seborrheic keratosis, all over face maybe). should you freeze it?

Back 17

NO! can cause hypopigmentation --> melanocytes are very sensitive to temperature

Front 18

what is the medical term for skin tags? (fleshy papules, skin colored to brown, often pedunculated)

Back 18

acrochordons. (helpful tip: usually in axillae, neck, groin, eyelids)

Front 19

what is a dermatofibroma

Back 19

hyperpigmented lesion often on the thigh, dimples when you squeeze it (this is key). dermatofibroma is not a mole. it is totally benign.

Front 20

pemphigus vulgaris presentation

Back 20

open erosion, bullae have top layer shed off

Front 21

pepmphigus vulgaris pathophysiology

Back 21

antibody against desmoglein in desmosomes --> destroys links b/w keratinocytes

Front 22

bullous pemphigoid presentation

Back 22

large tense bullae, all over body

Front 23

bullous pemphigoid pathophysiology

Back 23

targets BPAG in hemidesmosomes --> interrupts junction between keratinocytes and basal layer

Front 24

staph scalded skin disease presentation

Back 24

widespread erosions, denuded area where flaccid bullae have fallen off, erythema; usually in children, present w/prodrome of fever + infectious signs

Front 25

you see a patient with what you suspect is staph scalded skin disease (widespread erosions, very erythematous). should you biopsy the lesions and culture?

Back 25

no! staph scalded skin is caused by a TOXIN produced by staph, not the bacteria itself --> staph will not be present in the culture.

Front 26

you see a dermatomal distribution of grouped vesicles on an erythematous base. what disease are you thinking of? what is the treatment of choice?

Back 26

zoster (VZV, shingles). treatment is ACYCLOVIR

Front 27

what's the best therapy for VZV: acyclovir v. gancyclovir v. valcyclovir

Back 27

acyclovir. good treatment AND much more cost effective

Front 28

how do you diagnose tinea versicolor?

Back 28

KOH test --> look for malassezia furfur (fungal elements). (recall that tinea versicolor is a diffuse macular rash, often presents in summer time)

Front 29

28yo woman presents w/scattered red macules on legs, ankles, and feet. what do you do first? what would be the second step?

Back 29

FIRST: look to see if they BLANCH when you press on them. if they don't blanch, the next step would be to biopsy.

Front 30

triad of clinical features of henoch-schonlein purpura (HSP, usually in kids, related to IgA)

Back 30

rash on lower extremities (legs/feet), abdominal pain, joint pain. (also remember to look for a history of bleeding - if +, may need to think about hemophilias, etc.)

Front 31

a 32yo presents w/8 wks of hives that are very itchy. what can you treat her with? (hint: especially if she doesn't want to feel sleepy)

Back 31

2nd generation antihistamine, like LORATADINE (claritin)

Front 32

a patient presents w/a 1 wk history of hives on neck, trunk, and proximal extremities. these are very pruritic in appearance. what do you do next?

Back 32

you don't need to do anything! urtricaria (hives) is a CLINICAL DIAGNOSIS. no need to biopsy, etc. the treatment of choice here is to avoid triggers.

Front 33

a 3yo presents w/a rash on his face and cold symptoms, these started a few days ago. i'm going to do a thorough skin exam looking for a ___

Back 33

morbilliform rash (e.g., scarlet fever, 5th disease...)

Front 34

6 month old boy comes in post-hospitalization for fever and seizure, now has a rash on trunk. what disease might this be? what's the causative agent?

Back 34

rash after prodrome illness --> think ROSEOLA (6th disease). caused by HHV-6, HHV-7