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469 Cards in this Set

  • Front
  • Back
Q001. Name the layers of the epidermis
A001. stratum basalis; stratum spinosum; stratum granulosum; stratum corneum
Q002. dark, thick, velvety plaques under arms, breasts, in groin and on neck. Associated with insulin resistance and a predictor of DMII. Dx?; Rx?
A002. Acanthosis Nigricans; Rx. treat underlying disorder (obesity, malignancy, diabetes, cushings, etc.)
Q003. Enlarging pink or brown macular patches on flexor surfaces. Asymptomatic. Caused by corynebacterium. Prevalent in diabetics and warm climates. Dx?; Rx?
A003. Erythrasma diagnosed by Wood's light causing lesions to fluoresce pink. Rx: topical or oral erythromycin
Q004. Scaly, pruritic patches and plaques on flexor surfaces and neck. Associated with asthma and allergies and/or a family history. Dx?; Rx?
A004. Eczema; Rx: avoid triggers, use mild soaps, add steroids, tacrolimus, phototherapy or methotrexate as needed
Q005. presensitized mast cells and basophils bind to antigen and reaction develops rapidly. examples include anaphylaxis, asthma, and local wheal and flare. Type of Reaction?
A005. Type I; (anaphylactic and atopic)
Q006. IgM or IgG bind to antigen leading to lysis by complement or phagocytosis. examples include Rh disease, Goodpasture's syndrome and rheumatic fever. Type of Reaction?
A006. Type II (cytotoxic)
Q007. sensitized T cells encounter antigen and release lymphokines. examples included TB skin test, transplant rejection, contact dermatitis. Type of Reaction?
A007. Type IV (delayed,; cell-mediated)
Q008. antigen antibody complexes activate complement. Examples include serum sickness, SLE, RA, or the arthus reaction. Type of Reaction?
A008. Type III
Q009. large, pruritic, non-painful bullae filled with serous/bloody fluid. rarely involves mucous membranes. negative nikolsky. fluorescence at dermal-epidermal junction. autoantibodies to BP1 and BP2. Dx?; Rx?
A009. Bullous Pemphigoid; Rx: topical or oral steroid
Q010. shallow, painful blisters on epidermal and mucosal surfaces. autoantibodies to desmocollins and desmogleins. positive nikolsky. intercellular fluorescence and acantholysis. Dx?; Rx?
A010. Pemphigus; Rx: oral steroids, plasmaphoresis for severe cases, lesions should be cared for as burns
Q011. coetaneous disorder due to drugs, infection, vaccinations, or malignancy. mild myalgias/malaise. raised erythematous plaques on extremities. biopsy shows perivascular lymphocytes and necrotic keratinocytes. Dx?; Rx?
A011. Erythema multiforme; Rx: mild cases resolve spontaneously, discontinue inciting agent, acyclovir for HSV
Q012. painful, erythematous pretibial nodules due to drug hypersensitivity, infection, sarcoid, rheumatic fever, or IBD. accompanied by fever, rash, and malaise. elevated ESR, positive ASO titer, false positive VRDL. Dx?; Rx?
A012. Erythema Nodosum; Rx: treat underlying cause, elevate leg, KI, NSAIDS, corticosteroids
Q013. polygonal, purple, pruritic papules on inner wrists and lower legs with overlying network of white lines (wickham's striae). induced by drugs and strong association with HCV. Biopsy shows hyperkeratosis. Dx?; Rx?
A013. Lichen Planus; Rx: topical steroids and oral antihistamines, for serious cases can use UV, cyclosporine, oral steroids
Q014. dark red plaques with scales over extensor surfaces due to epidermal proliferation. non-pruritic. also nail pitting, and onycholysis. can have joint stiffness in DIP joints. increased ESR & uric acid. Dx?; Rx?
A014. Psoriasis; Rx: topical steroids and calcipotriol for mild cases, immunosuppressants and phototherapy for severe disease
Q015. pruritic, yellowish, greasy, scaling patches seen on scalp, ears and face. Dx?; Rx?
A015. seborrheic dermatitis; Rx: hydrocorisone and topical antifungals for face, body and interitriginous areas, medicated shampoos for scalp
Q016. coalescing red macules and flaccid blisters with full- thickness epidermal loss due to drug reaction. oral lesions present. + Nikolsky. Dx?; Rx?
A016. Dx: SJS <10% Body surface and perivascular mononuclear infiltrate with degeneration of basal layer on biopsy; TEN >30% BSA, full-thickness epidermal necrosis with macrophages and dendrocytes and reactivity to TNF-alpha; Rx: discontinue offending agent, pain control, IVIG, admit to burn unit
Q017. areas of depigmentation due to loss of melanocytes. associated with thyroid disease, pernicious anemia, Addison’ s disease, and DMI. Dx?; Rx?
A017. Vitiligo; Rx: artificial tanning creams, steroids, or phototherapy.
Q018. comedones on face, neck, arms, back, butt. associated with change in androgen levels. Dx?; Rx?
A018. Acne Vulgaris; Rx: topical clinda or erythro, benzoyl peroxide and topical retinoids for mild cases, add tetracycline for moderate cases. Isotretinoin for most severe cases.
Q019. red, hot, swollen, skin lesions due to infection of subcutaneous tissue. Dx?; Rx?
A019. Cellulitis, or folliculitis if hair follicle involved; Rx: oral antibiotics for mild cases. hospitalize cases with systemic, hand, or orbital involvement.
Q020. small, scaling, hyper or hypopigmented macules on chest and back. can be pruritic. spaghetti and meatballs on KOH prep. Dx?; Rx?
A020. tinea versicolor caused by Malassezia furfur; Rx: topical antifungal and selenium sulfide shampoo
Q021. pruritic ring shaped scaling plaques with central clearing and raised borders. hyphae seen on KOH prep. Dx?; Rx?
A021. tinea corporis (ringworm); Rx: topical antifungal. oral antifungals for tinea capitis
Q022. painful, recurrent vesicular eruptions on erythematous mucocutaneous surfaces. multinucleated giant cells on Tzank smear. Dx? Rx?
A022. Herpes Simplex; Rx: acyclovir reduces viral shedding and frequency and severity of recurrences
Q023. a common, contagious, childhood infection with pruritic facial lesions and yellowish crusts. Dx? Rx?
A023. impetigo; Rx: wash with mild soap, topical mupirocin for coag(+) S.aureus, systemic antibiotics for other staph/strep species
Q024. 2-5mm dome shaped papules with central umbilication. asymptomatic. seen on face trunk and extremities in kids and genitals and perianal area in adults. inclusion bodies on wrights and giemsa stain. Dx? Rx?
A024. Molluscum contagiosum due to poxvirus infection. Rx: resolve spontaneously over months to years. can be removed by cryotherapy, curettage, or TCA application
Q025. rapidly developing skin and fascia infection with swelling, tenderness, induration or bullae with pain and fever. Dx? Rx?
A025. necrotizing faciitis caused by Group A Strep, C.perfringens, or mixed bacteria; Rx: emergent surgery to remove necrotic tissue, culture tissue and treat with antibiotics.
Q026. mild childhood disease presents with diffuse pruritic round/oval erythematous papules covered with "cigarette paper" white scale. Christmas tree pattern on trunk and a solitary patch precedes the rash(herald patch). Dx? Rx?
A026. Pityriasis Rosea associated with HHV-6 infection; Rx: self limited disease, can treat pruritis
Q027. itching worse at night and after hot showers, papules and vesicles can be seen. skin scraping reveals mites or eggs with KOH. Dx? Rx?
A027. Scabies (Sarcoptes scabiei); Rx: permethrin cream, treat close contacts as well.
Q028. painful, unilateral, vesicular eruptions in a dermatomal distribution. Dx? Rx?
A028. varicella zoster; Rx: antivirals within 72 hours of lesions
Q029. white, sharply demarcated confluent macules, papules, and plaques usually in anogenital area of postmenopausal women. may be pruritic and painful. Biopsy shows hyperkeratotic epidermis. Dx? Rx?
A029. lichen sclerosus; Rx: short term high potency glucocorticoids or hydrochloroquine
Q030. thickened areas of skin(shagreen patches), hypopigmentation(ash leaf spots), red papules around nose(angiofibromas), seizures, mental retardation, periventricular tubers. Dx?
A030. Tuberous sclerosis
Q031. Cafe-au-lait spots, neurofibromas, axillary freckling, acoustic neuromas, lisch nodules, optic nerve glioma, meningiomas. Dx?
A031. neurofibromatosis
Q032. Port wine stain on face (over distribution of V1), seizures, mental retardation, visual impairment. Dx?
A032. Sturge-Weber syndrome
Q033. hemangiomas, retinal hamartomas, renal cell cancer, pheo, polycythemia. Dx?
A033. von Hippel-Lindau
Q034. brown, stuck on appearance on face, trunk, upper extremity. uniform appearance over entire surface. Dx? Rx?
A034. Seborrheic keratosis; Rx: no treatment necessary, but can be removed for cosmetic purposes
Q035. bleeding or scabbing sore on head or neck or pearly papules of variable size. associated with sun exposure. Biopsy shows basophilic cells palisading. Dx? Rx?
A035. Basal Cell Carcinoma; Rx: dependent upon location curettage, surgical excision, Moh's, cryosurgery or radiation
Q036. asymptomatic, rough papule with poorly demarcated base and white superficial scaling. premalignant. caused by sun exposure. Biopsy dysplastic squamous epithelium. Dx? Rx?
A036. Actinic keratosis; Rx: cryosurgery, 5-FU, curettage or chemical peel.
Q037. red-purple thin plaques on skin and mucosa. almost always seen in AIDS pts. Dx? Rx?
A037. Kaposi's Sarcoma (due to HHV-8); Rx: Antiretrovirals for HIV, chemotherapy for lesions
Q038. changing pigmented skin lesion found on sun-exposed areas and soles of feet that can be itchy. Characterized by asymmetry, irregular borders, various colors, and >6mm diameter. Biopsy shows melanocytes with atypia, and melanocytic invasion into the dermis. Dx? Rx?
A038. Melanoma; Rx: surgical excision and lymph node dissection may be necessary. Stage determined by depth of invasion (Breslow stage)
Q039. thin scaling patches in sun-protected areas that progress to plaques to nodules to tumors. associated with "lion-like" facies and intractable pruritis. Biopsy shows infiltrate of atypical T-lymphocytes in the dermis. Dx? Rx?
A039. Mycosis Fungoides; Rx: PUVA, topical nitrogen mustard, high potency topical steroids, total electron beam irradiation
Q040. small papules, erythema, and telangiectasias in a symmetric distribution on cheeks chin and forehead. Flushing worsened by heat, spicy food, alcohol, caffeine, and sun. Dx? Rx?
A040. Rosacea; Rx: avoid precipitating factors, topical metronidazole, sulfur lotions, or oral tetracycline are options
Q041. What is rhinophyma?
A041. large porous lobulated nose that can develop in men with Rosacea
Q042. Impetigo
A042. superficial skin infection, honey crusting, highly contagious; SA, GAS
Q043. Dermatitis
A043. a group of inflammatory pruritic skin disorders;; allergy (IV HS), chemical injury of infection
Q044. Atopic dermatitis (eczema)
A044. pruritic eruption, commonly on flexor surfaces, often associated with other atopic disease; (asthma, allergic rhinitis)
Q045. Allergic contact dermatitis
A045. type IV HS reaction that follows exposure to allergen (poison ivy, poison oak, nickel, rubber, chemicals); lesions occur at site of contact
Q046. psoriasis
A046. epidermal hyperplasia (acanthosis) with parakeratotic scaling (nuclei still stratum corneum), especially on knees on elbows; increased stratum spinosum, decreased stratum granulosum; aspitz sigh; silvery scale
Q047. Dermatitis herpetiformis
A047. pruritic papules and vesicles;; deposits of IgA at tips of dermal papillae. Associated with celiac disease
Q048. lichen planus
A048. pruritic, purple, polygonal papules;; infiltrate of lymphocytes at dermoepidermal junction.
Q049. Steven Johnson syndrome
A049. caused by sulfa and anticonvulsant drugs- major form of erythema multiforme. Characterized by high fever, bulla formation, and necrosis, ulceration of skin and high mortality rate
Q050. Erythema multiforme
A050. Associated with infections, drugs, cancers and AI disease. Presents with multiple types of lesions, including macules, papules and vesicles and target lesions (red papules with a pale central area)
Q051. seborrheic keratosis
A051. flat, pigmented squamous epithelial proliferation with keratin-filled cysts (horn cysts) benign
Q052. actinic keratosis
A052. caused by sun expsoure;; small rough erythematous or brown papules. Premalignant lesion. Risk of carcinoma is proportional to epithelial dysplasia
Q053. keloid
A053. tumor of connective tissue elements of dermis that causes raised, thickened scars. Follows trauma to skin, especially in AA; tx: intralesional steroids to thin the skin
Q054. Bullous pemphigoid
A054. AI disorder with IgG antibody against epidermal basement membrane hemidesmosomes (linear IF). Similar to but less severe than pemphigous vulgaris- affects skin but spares oral mucosa
Q055. Pemphigus vulgaris
A055. potential fatal AI skin disorder. Intraepidermal bullae involving oral mucosa and skin. Findings: acatholysis (breakdown of epithelial cell to cell junctions), IgG antibody against epidermal cell surface desmosomes (IF throughout epidermis)
Q056. Verrucae (warts)
A056. soft tan colored cauliflower like lesions. epidermal hyperplasia, hyperkeratosis, kiolocytes; verruca vulgaris on hands, condyloma acuminatum on gentials
Q057. sq cell carcinoma
A057. very common;; associated with excessive sun exps and arsenic. commonly appear on hands and face. locally invasive but rare mets. see keratin pearls; precusor: actinic keratosis
Q058. basal cell carcinoma
A058. most common in sun exps areas. locally invasive but rare mets. see pearly papules; shiny dome; telangiectasias, palisading nuclei
Q059. melanoma
A059. common tumor with significant risk of mets;; associated with sunlight expsoure;; fair skinned persons at increased risk. incidence high. depth of tumor correlates with risk of mets
Q060. acne
A060. hyperkeratosis, sebum overproduction, proprionibacterium acnes proliferation, inflammation; tx: topical vit A, estrogens, steroids, isotrenitoin (accutane), benzoyl peroxide, topical/oral AB
Q061. Psoriasis - Types
A061. 1. Type 1 - Early onset (75%); 2. Type 2 - Late onset (25%)
Q062. Psoriasis - Description
A062. -Papules AND plaques; Marginated with SILVERY white scales
Q063. Psoriasis - 2 phenomenon
A063. 1. Auspitz: removal of scale results in blood droplets; 2. Koebners: physical trauma elicits lesions
Q064. Psoriasis - locations
A064. 1. Hair bearing areas; 2. EXTENSOR surfaces (knee/elbow); 3. Penis, scrotum, buttocks, umbilicus
Q065. Psoriasis - nail findings
A065. 1. Pitting of nails; 2. Oil slick spots in nails
Q066. Psoriasis - common bacteria colonization
A066. S. Aureus
Q067. Psoriasis - what condition accompanies it?; Percentage?
A067. 1. Arthritis; 2. 5%
Q068. Psoriasis - prevalence; Men vs. women?
A068. 1-2%; Equal incidence in men and women
Q069. Psoriasis - family history risk?
A069. 1 parent - 8%; 2 parents - 41%
Q070. Psoriasis - etiology
A070. Autoimmune, T-cell mediated
Q071. Psoriasis - which drugs can exacerbate it? (6)
A071. 1. Lithium; 2. Cigarettes; 3. a-IFN; 4. B-Blocker; 5. Antimalarials; 6. HIV disease
Q072. Psoriasis - Topical Tx (5)
A072. 1. Medium potency steroids; 2. Anthralin; 3. Topical retinoids; 4. Topical Vit D; 5. Cryotherapy
Q073. Psoriasis - Systemic Tx (6)
A073. 1. Light therapy: UVB, PUVA; 2. Methotrexate (most effective); 3. Oral retinoids; 4. Cyclosporin; 5. FK506; 6. Hydroxyurea
Q074. Psoriasis - contraindicated drugs? What can it cause?
A074. Oral steroids; Pustular Psoriasis
Q075. Psoriasis - variant? description? symptoms?
A075. 1. Pustular Psoriasis; 2. Puss superimposed on psoriasis; 3. Leukocytosis & fever
Q076. Seborrheic Dermatitis - aka?
A076. Dandruff
Q077. Seborrheic Dermatitis - description
Q078. Seborrheic Dermatitis - location
A078. Regions where sebaceous glands are most active:; 1. Face; 2. Scalp; 3. Hairy areas; 4. Body folds
Q079. Seborrheic Dermatitis - Etiology
A079. Inflammatory response to oil-loving YEAST
Q080. Seborrheic Dermatitis - yeast?
A080. Pityrosporum Ovale
Q081. Seborrheic Dermatitis - in which pt group do you see an increased incidence?
A081. HIV patients; Parkinson's
Q082. Seborrheic Dermatitis - specific facial finding
A082. Butterfly rash
Q083. Seborrheic Dermatitis - Tx (2)
A083. 1. Anti-seborrheic Shampoos; 2. Ketoconazole shampoo
Q084. Seborrheic Dermatitis - what are the ingredients of the anti- seborrheic shampoo? (3)
A084. 1. Selenium; 2. Sulfide; 3. Zinc pyrinthione or "tar"
Q085. Pityriasis Rubra Pilaris - description
A085. Rare variant of Psoriasis; Involves keratinocytes, part of hair shaft; Follicular accentuation
Q086. Pityriasis Rubra Pilaris - sx
A086. 1. Swelling with deep fissures in palms and soles; 2. Almost universal erythema and scaling typically with islands of sparing
Q087. Pityriasis Rosea - description
A087. Herald Patch - primary lesion; oval, slightly raised plaque, red with scales at periphery
Q088. Pityriasis Rosea - sx
A088. Herald patch, followed by generalized rash
Q089. Pityriasis Rosea - how long til the generalized rash forms?; What is the distribution? Color?
A089. 1. Days - weeks; 2. Christmas Tree pattern; 3. Salmon Pink
Q090. Pityriasis Rosea - does it affect palm/soles?
A090. NO
Q091. Pityriasis Rosea - distribution
A091. Trunk and proximal extremities
Q092. Pityriasis Rosea - what % of pts have pruritis?
A092. 75%
Q093. Pityriasis Rosea - etiology
A093. Likely to be viral infection
Q094. Pityriasis Rosea - what distinguishes it from Psoriasis?
A094. PR resolves in ~3 months or less, whereas Psoriasis in persistent
Q095. Tinea Capitis - description
A095. Dermatophytic trichomycosis of scalp
Q096. Tinea Capitis - sx (2)
A096. 1. Itchy, scaly scalp; 2. Hair loss
Q097. Tinea Capitis - acute infection presentation
A097. Follicular inflammation with painful, boggy nodules that drain pus
Q098. Tinea Capitis - severe infection (aka Kerion) presentation
A098. Indurated, boggy plaques which may rarely cause scarring alopecia
Q099. Tinea Capitis - dx (3)
A099. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q100. Tinea Capitis - tx
A100. 1. Griseofulvin; 2. Shampoo with 2% selenium sulfide; 3. Oral ketoconazole
Q101. Tinea Capitis - are topical agents effective for tx?
A101. NO
Q102. Tinea Corporis - aka
A102. Ring worm
Q103. Tinea Corporis - description and locations
A103. Dermatophytic infection of trunk, legs, arms
Q104. Tinea Corporis - sx
A104. Expanding, centrifugal red plaque; Peripheral enlargement and central clearing, producing an annular configuration
Q105. Tinea Corporis - dx
A105. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q106. Tinea Corporis - Tx (2)
A106. 1. Imidazole creams; 2. Terbinafine (lamisil)
Q107. Tinea Cruris - aka
A107. Jock-itch
Q108. Tinea Cruris - description
A108. Dermatophytic infection of groin
Q109. Tinea Cruris - what is it commonly concurrent with?
A109. Tinea pedis
Q110. Tinea Cruris - what is a common predisposing factor?
A110. Perspiration with exercise
Q111. Tinea Cruris - how often is the scrotum involved?
Q112. Tinea Cruris - dx
A112. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q113. Tinea Cruris - tx (2)
A113. 1. Imidazole creams; 2. Terbinafine (lamisil)
Q114. Tinea Pedis - aka
A114. Athlete's foot
Q115. Tinea Pedis - description/sx
A115. 1. Dermatophytic infection of soles and side of feet; 2. Diffuse plantar scaling; vesicles & pustules on instep
Q116. Tinea Pedis - dx
A116. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q117. Tinea Pedis - tx (2)
A117. 1. Imidazole creams; 2. Terbinafine (lamisil)
Q118. Tinea Manuum - description/sx
A118. 1. Dermatophytic infection of hand; 2. Diffuse dry scaling on palmar surface
Q119. Tinea Manuum - unilateral vs bilateral?; Dominant vs. Non-dominant?
A119. Unilateral; Dominant
Q120. Tinea Manuum - common association
A120. PRE-EXISTING tinea pedis; "One hand, two feet syndrome"
Q121. Tinea Manuum - dx
A121. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q122. Tinea Manuum - tx
A122. 1. Imidazole Creams; 2. Terbinafine (lamisil)
Q123. Tinea Facialis - description
A123. Erythematous ASYMMETRIC eruptions on the face
Q124. Tinea Facialis - features (2)
A124. 1. Sharply demarcated; 2. Serpiginous borders
Q125. Tinea Facialis - findings (2)
A125. 1. Pruritis; 2. Photosensitivity
Q126. Tinea Facialis - dx
A126. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q127. Tinea Facialis - tx
A127. 1. Imidazole creams; 2. Terbinafine (lamisil)
Q128. Tinea Unguium - aka
A128. Onychomycosis
Q129. Tinea Unguium - description
A129. Dermatophytic infection of nail plate
Q130. Tinea Unguium - feature
A130. Subungual debris with separation from nail bed
Q131. Tinea Unguium - common location
A131. Toe nails prior to finger nails
Q132. Tinea Unguium - dx
A132. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q133. Tinea Unguium - tx (1)
A133. Oral Antifungals
Q134. Tinea Versicolor - description
A134. Superficial fungal infection of stratum corneum
Q135. Tinea Versicolor - findings
A135. White, tan or pink patches (macules) with very fine desquamating scales
Q136. Tinea Versicolor - racial differences
A136. Blacks: HYPO-pigmented; Whites: HYPER-pigmented
Q137. Tinea Versicolor - predisposing factor? (2)
A137. 1. Immune suppression; 2. Increased cortisol
Q138. Tinea Versicolor - dx
A138. 1. KOH prep; 2. Wood's lamp; 3. Culture; *Skin Biopsy NOT indicated
Q139. Tinea Versicolor - tx
A139. 1. Imidazole creams; 2. Terbinafine (lamisil)
Q140. Lichen Planus - description
A140. Acute or chronic idiopathic inflammatory dermatosis
Q141. Lichen Planus - findings
A141. Flat-topped purple, pruritic, papules; White streaks in reticulate (net-like) pattern
Q142. Lichen Planus - Locations (5)
A142. 1. Mucous membranes; 2. Wrists; 3. Palms/soles; 4. Genitalia; 5. Ankles
Q143. Lichen Planus - phenomenon
A143. Koebners: papules can be arranged in streaks due to trauma of scratching
Q144. Lichen Planus - Wickham's striae
A144. Fine whitish lines or dots on LP lesions
Q145. Lichen Planus - etiology
A145. T-lymphocytes infiltrate the DE junction
Q146. Lichen Planus - common result
A146. scarring alopecia
Q147. Discoid Lupus Erythematosus - Early lesions
A147. Purplish-red plaque, accumulates scales as it matures
Q148. Discoid Lupus Erythematosus - oldest lesions
A148. -DEPRESSED, scaly, red, ATROPHIC; Center: HYPO-pigmented; Periphery: HYPER-pigmented
Q149. Discoid Lupus Erythematosus - Carpet Tacking
A149. When scale is removed, it's underside shows small spiny projections which correlate with keratinous plugs in dilated hair follicles
Q150. Discoid Lupus Erythematosus - common location
A150. Ears
Q151. Discoid Lupus Erythematosus - common factor
A151. Sun-sensitive
Q152. Discoid Lupus Erythematosus - dx
A152. 1. ANA; 2. Anti-rho
Q153. Discoid Lupus Erythematosus - how to distinguish from psoriasis?
A153. Finding of atrophy
Q154. Discoid Lupus Erythematosus - tx
A154. 1. Topical steroids; 2. Sunscreen
Q155. Cutaneous T-cell Lymphoma - lesions
A155. Generalized, flat, reddish-brownish plaques with scaling
Q156. Cutaneous T-cell Lymphoma - Etiology
A156. NOT fungal; Monoclonal proliferation of Helper T-cells within skin
Q157. Cutaneous T-cell Lymphoma - viral association
A157. HTLV-1 in subset of pts; majority unknown
Q158. Atopic Dermatitis - aka?
A158. Eczema
Q159. Atopic Dermatitis - description
A159. pruritic inflammation of the epidermis AND dermis
Q160. Atopic Dermatitis - types
A160. 1. Acute; 2. Subacute; 3. Chronic; 4. Infantile; 5. Childhood; 6. Adult
Q161. Atopic Dermatitis - Acute features
A161. Poorly defined erythematous papules and plaques with or without scales; Edema, wet, oozy
Q162. Atopic Dermatitis - Subacute
A162. juicy papules
Q163. Atopic Dermatitis - Chronic
A163. 1. DRY; 2. Thickened (acanthosis); 3. Scaly, hyperpigmented skin (dermal fibrosis)
Q164. Atopic Dermatitis - what results from repeated rubbing or scratching?
A164. Lichenification
Q165. Atopic Dermatitis - Infantile
A165. -Age 3 or less; Crusted oozing lesions particularly on scalp
Q166. Infantile Atopic Dermatitis - location
A166. Extensor disease of extremities
Q167. Childhood Atopic Dermatitis - Location
A167. Marked by onset of Flexural disease:; Neck; Antecubital fossa; Popliteal fossa
Q168. Adult Atopic Dermatitis - location
A168. Most commonly Hand eczema; Infantile pattern can persist
Q169. Atopic Dermatitis - specific signs/sx (5)
A169. 1. Denny Morgan Lines: redundant flesh fold under eyes; 2. Hyperlinear palms: increased skin markings on thenar eminence; 3. Xerosis (Dry Skin); 4. Increased sweating; 5. Decreased oil secretion
Q170. Atopic Triad
A170. 1. Atopic Dermatitis; 2. Allergic Rhinitis; 3. Asthma
Q171. Atopic Dermatitis - exacerbating factors (5)
A171. 1. Allergies; 2. Emotional stress; 3. Skin dehydration; 4. Season; 5. Hormonal
Q172. Atopic Dermatitis - pathophys
A172. T-cell and cytokine mediated; Deficiency of IFN-g; Overactivity of IL4 and IL10; Leads to dysregulation of Th2 cells
Q173. Atopic Dermatitis - what bacteria is usually recoverable?
A173. S. Aureus
Q174. Atopic Dermatitis - Tx
A174. 1. Topical Steroids; 2. Oral Steroids; 3. H1 Antihistamines (for pruritis); 4. Oral Antibiotics
Q175. Atopic Dermatitis - when should oral steroids be given?; Dose?
A175. More severe cases; Dose should always be once daily
Q176. Atopic Dermatitis - which antibiotics should be prescribed?
A176. 1. Dicloxacillin; 2. Cephalexin
Q177. Contact Dermatitis - description
A177. Exogenous inflammation of epidermis
Q178. Contact Dermatitis - Types
A178. 1. Allergic; 2. Irritant
Q179. Allergic Contact Dermatitis - timing
A179. Begins within 24-72 hours of exposure to allergen; May last weeks
Q180. Allergic Contact Dermatitis - pathophys phases
A180. Afferent: antigen recognized by dendritic cells in skin and presented to naive T-cells; Efferent: antigen encountered for second time and memory T-cells activated
Q181. Irritant Contact Dermatitis - example causes
A181. 1. HCl; 2. Kerosene; 3. Cotton oil; 4. feces
Q182. Contact Dermatitis - Allergic vs. Irritant
A182. Allergic:; 1. Requires prior sensitization; 2. NOT dose dependent; Irritant:; 1. Does NOT require sensitization; 2. IS dose dependent
Q183. Contact Dermatitis - Dx
A183. TRUTEST - skin test; Definitive test - patch test
Q184. "Dyshidrotic" Eczema - what is it?
A184. Special vesicular type of hand and foot dermatitis
Q185. "Dyshidrotic" Eczema - most common location?
A185. Hands
Q186. "Dyshidrotic" Eczema - features
A186. Sudden onset of pruritic, painful, clear vesicles; Followed by scaling, fissures, and lichenification
Q187. "Dyshidrotic" Eczema - does it involve abnormalities to sweat glands?
A187. NO
Q188. Lichen Simplex Chronicus - description
A188. Initially a pruritic skin condition, which later evolves into a rash; Chronic scratching = lichenification
Q189. Lichen Simplex Chronicus - Pathophys
A189. Psychodermatosis: pruritis precipitated by frustration, depression and stress
Q190. Nummular Eczema - description
A190. Chronic, pruritic, inflammatory dermatitis
Q191. Nummular Eczema - features
A191. Coin-shaped plaques composed of grouped small papules and vesicles on an erythematous base
Q192. Stasis Dermatitis - Location
A192. Eczematous eruptions of LOWER LEGS
Q193. Stasis Dermatitis - etiology
A193. Secondary to peripheral venous disease
Q194. Stasis Dermatitis - Pts have a history of: (3)
A194. 1. Varicose veins; 2. Leg swelling; 3. Thrombophlebitis
Q195. Statis Dermatitis - Lesion features and sx (6)
A195. 1. Juicy papules; 2. Lichenified plaques; 3. Brown Pigmentation (hemosiderin); 4. Petchiae; 5. Edema; 6. Dermatitis
Q196. Urticaria - lesions
A196. TRANSIENT, pruritic, erythematous, edematous papules and plaques
Q197. Urticaria - how long to lesions last?
A197. 1-2 days
Q198. Urticaria - when can angioedema occur?
A198. when edematous process extends to deep dermal and subcutaneous tissues
Q199. Urticaria - in which pt population is chronic urticaria uncommon?
A199. Pediatric pts
Q200. Urticaria - causes (7)
A200. 1. Infection; 2. Drug; 3. Food/Food additives; 4. Physical, cold, light, cholinergic, aquagenic; 5. Contact; 6. Hereditary angioedema; 7. Idiopathic
Q201. Urticaria - what causes Hereditary angioedema?
A201. C1 esterase deficiency
Q202. Urticaria - tx (4)
A202. 1. H1 antihistamines; 2. H1 + H2 antihistamines; 3. Corticosteroids; 4. Epinephrine kits
Q203. Erythema Multiforme - Lesions
A203. 1. TENDER rings; 2. TARGETS; 3. Bull's eyes; 4. Up to 20-40 lesions
Q204. Erythema Multiforme - location
A204. Bilateral and symmetrical; PALMS; Soles; Mucous membranes
Q205. Erythema Multiforme - how deep is the lesion?
A205. limited to epidermis
Q206. Erythema Multiforme - how do blisters form?
A206. Cells along the dermis-epidermis junction die
Q207. Erythema Multiforme - causes (3)
A207. 1. Infection; 2. Drugs; 3. Other
Q208. Erythema Multiforme - which infections can cause it? (4)
A208. 1. *HSV*; 2. Histoplasmosis; 3. ORF; 4. Mycoplasma
Q209. Erythema Multiforme - which types of drugs can cause it? (3)
A209. 1. Sulfa drugs; 2. Seizure drugs; 3. Antibiotics
Q210. Erythema Multiforme - what is an important part of the differential?
A210. Syphilis
Q211. Erythema Multiforme - tx
A211. If recurrent, treat with acyclovir
Q212. Stevens Johnson Syndrome - what is it?
A212. Maximal variant of EM
Q213. SJS - features
Q214. SJS - location
A214. 1. *MOUTH*; 2. GI; 3. Genital; 4. Respiratory
Q215. SJS - how do patients usually present?
A215. Unable to swallow; Need IV fluids
Q216. SJS - lesions
A216. 1. Lesions begin as target form; 2. Become confluent, brightly erythematous and bullous; 3. Sloughing may lead to crusting
Q217. SJS - is the dermis involved?
A217. NO
Q218. SJS - etiology
A218. 50% due to drugs
Q219. SJS - which drugs commonly cause it?
A219. 1. Sulfa drugs; 2. Seizure drugs
Q220. Toxic Epidermolytic Necrolysis - what is it?
A220. Maximal variant of SJS
Q221. TEN - description
A221. Extra/sub-epidermal blistering
Q222. TEN - presentation
A222. 1. Begins with painful skin; 2. Subsequently target lesions and blisters develop
Q223. TEN - common sign
A223. Nikolsky sign: skin sloughs with minimal tension
Q224. TEN - etiology
A224. More often caused by drugs than SJS
Q225. TEN - compared to SJS
A225. -Higher mortality (25%); More body surface area involved (>10-25%)
Q226. TEN - which organ system can be affected?
A226. Risk of acute renal failure
Q227. Staphylococcal Scalded Skin Syndrome - description
A227. Toxin mediated epidermolytic disease characterized by erythema and wide spread detachment of epidermis
Q228. SSSS - how much of skin is involved?
A228. few layers of epidermis remain
Q229. SSSS - lesions
A229. 1. Tender rash; 2. Crusting; 3. Blisters; 4. Desquamation as rash heals
Q230. SSSS - common locations
A230. skin folds
Q231. SSSS - cause
A231. Exfoliation of S. Aureus
Q232. SSSS - common pt population
A232. Pediatric
Q233. SSSS - Tx
A233. Antibiotics to prevent sepsis and conjunctivitis; No tx necessary for skin
Q234. Drug reactions - types
A234. 1. Morbiliform (more common); 2. Fixed
Q235. Morbiliform Drug reactions - description
A235. Generalized eruption of erythematous macules and papules, often confluent in large areas
Q236. Fixed Drug reactions - description
A236. Solitary (sometimes multiple) plaques, bullae, or erosions
Q237. Drug Reactions - common drugs (4)
A237. 1. Penicillin; 2. Allopurinol; 3. Gold salts; 4. Carbemazepine
Q238. Palpable Purpura - what is it?
A238. Cutaneous manifestation of vasculitis
Q239. Palpable Purpura - lesions
A239. -Nontender; Lighten, but do not blanch with diascopy
Q240. Palpable Purpura - location
A240. Acral areas: extremities and peripheral parts)
Q241. Palpable Purpura - causes
A241. 1. Septic emboli; Meningoccocemia, RMSF; 2. Leukocytoplakia (allergic vasculitis); HSP
Q242. Impetigo - description
A242. Superficial purulent bacterial infection of skin
Q243. Impetigo - what layer of skin does it involve?
A243. Epidermis
Q244. Impetigo - 2 types
A244. 1. Nonbullous; 2. Bullous
Q245. Nonbullous Impetigo - description
A245. Transient, superficial, small, vesicles/pustules rupture resulting in erosions which in turn become HONEY-colored CRUSTS
Q246. Bullous Impetigo - description
A246. Vesicles and bullae containing CLOUDY YELLOW fluid arising on normal-appearing skin; rupture causes moist erosions to form
Q247. Bullous Impetigo - common location?
A247. Diaper area
Q248. Impetigo - common causes
A248. 1. S. Aureus; 2. GAS
Q249. Impetigo - Tx
A249. Dicloxacillin, Cephalexin; Topical Antibiotics
Q250. Ecthyma - description
A250. Ulcerative bacterial infection of skin
Q251. Ecthyma - what layer of skin does it involve?
A251. Dermis AND subcutaneous tissue
Q252. Ecthyma - lesions
A252. Vesicles, pustules, or ulcer
Q253. Ecthyma - common causes
A253. 1. Staph; 2. Strep; 3. H. flu
Q254. Cellulitis - description
A254. Soft tissue infection
Q255. Cellulitis - what layer of skin does it involve?
A255. Dermis AND subcutaneous tissues
Q256. Cellulitis - lesions
A256. RED, hot, edematous, shiny, painful area of skin
Q257. Cellulitis - when and how can it disseminate?
A257. 1. When Tx delayed; 2. Lymphatics and hematogenous
Q258. Cellulitis - most frequent cause?
A258. S. Aureus
Q259. Erysipelas - what is it?
A259. Cellulitis caused by B-hemolytic Strep
Q260. Cellulitis - what disorder predisposes to it?
A260. Diabetes
Q261. Folliculitis - description
A261. infection of upper portion of hair follicle
Q262. Folliculitis - lesions
A262. Red papules, pustules, erosions, or crusts
Q263. Folliculitis - most common causes?
A263. 1. S. Aureus; 2. P. Aeruginosa
Q264. Folliculitis - predisposing factors? (7)
A264. 1. Shaving; 2. Plucking; 3. Waxing; 4. Occluding hear-bearing area; 5. Tropical climates; 6. Diabetes Mellitus; 7. Immunosuppression
Q265. Folliculitis - Tx
A265. -S. Aureus:; 1. Topical mupirocin ointment; 2. Systemic Dicloxacillin or cephalexin
Q266. Furunculosis - description
A266. Deep-seated, red, hot, tender nodule or abscess
Q267. Furunculosis - cause
A267. Evolves from Staph Folliculitis; (S. Aureus mostly)
Q268. Furunculosis - Tx
A268. Draining abscess
Q269. Herpes Simplex - types (5)
A269. 1. Oral; 2. Genital; 3. Whitlow; 4. Eczema Herpeticum; 5. Neonatal
Q270. Oral Herpes - description
A270. Grouped vesicles that arise on erythematous base on keratinized skin or mucous membrane
Q271. Oral Herpes - when is oral mucosa usually involved?
A271. Only in primary HSV infection
Q272. Oral Herpes - transmission?
A272. 1. skin-skin; 2. skin-mucosa; 3. mucosa-skin
Q273. Oral Herpes - cause
A273. HSV-1 (80-90%); HSV-2 (10-30%)
Q274. Genital Herpes - cause
A274. HSV-1 (10-30%); HSV-2 (70-90%)
Q275. Genital Herpes - lesions
A275. erythematous plaque surmounted with grouped vesicles, which rupture leading to erosions
Q276. Herpetic Whitlow - lesions
A276. Painful, grouped confluent vesicles with an erythematous, edematous base
Q277. Herpetic Whitlow - location
A277. DISTAL Finger
Q278. Herpetic Whitlow - commonly seen in which population?
A278. Health-care workers
Q279. Eczema Herpeticum - description
A279. Secondary HSV cutaneous infection that occurs in pt with underlying Atopic Dermatitis
Q280. Eczema Herpeticum - lesions
A280. Disseminated vesicles with punched-out (umbilicated) erosions and central crusting
Q281. Neonatal Herpes - lesions
A281. Grouped and confluent vesicles with underlying erythema and edema
Q282. Herpes Simplex - Tx
A282. Acyclovir
Q283. Herpes Zoster - aka?
A283. Primary = Chickenpox; Secondary = Shingles
Q284. Herpes Zoster - cause
A284. VZV
Q285. Herpes Zoster - Shingles lesion
A285. Unilateral, dermatomal distribution
Q286. Herpes Zoster - what often precedes vesicle formation?
A286. Pain
Q287. Verruca Vulgaris - aka
A287. Common wart
Q288. Verruca Vulgaris - lesion
A288. Firm, hyperkeratotic papules
Q289. Verruca Vulgaris - common sites
A289. 1. Hands; 2. Fingers; 3. Knees
Q290. Verruca Vulgaris - cause
A290. HPV 2; HPV 4
Q291. Verruca Plana - aka
A291. Flat wart
Q292. Verruca Plana - lesion
A292. Sharply defined, flesh-colored, flat papules
Q293. Verruca Plana - common site
A293. Face
Q294. Verruca Plana - cause
A294. HPV 3; HPV 10
Q295. Verruca - Tx
A295. 1. Liquid N2; 2. Retin A - helps exfoliation of skin
Q296. Molluscum Contagiosum - skin layer involved?
A296. Self-limited EPIDERMAL viral infection
Q297. MC - lesions
A297. Pearly white or skin-colored papules, often umbilicated
Q298. MC - predisposed population?
A298. HIV, on Face
Q299. MC - cause
A299. MCV, part of Pox Virus
Q300. Condylomata Acuminata - aka
A300. mucosal warts
Q301. Condylomata Acuminata - location
A301. 1. Anogenital mucosa; 2. Oral mucosa; 3. Skin
Q302. Condylomata Acuminata - cause
A302. HPV 16, 18, 31, 33, 35
Q303. Candidiasis - types
A303. 1. Mucosal; 2. Cutaneous
Q304. Candidiasis - cause
A304. Yeast Candida Albicans
Q305. Mucosal Candidiasis - location
A305. 1. Aerodigestive tract; 2. Vulvovagina
Q306. Mucosal Candidiasis - lesions
A306. "cottage cheese"
Q307. Cutaneous Candidiasis - example
A307. Diaper dermatitis
Q308. Sporotrichosis - lesion
A308. Painless ulceronodule
Q309. Sporotrichosis - cause
A309. Sporothrix Schenckii
Q310. Sporotrichosis - how is it usually acquired?
A310. Accidental inoculation of skin with infected soil (gardeners)
Q311. Sporotrichosis - common feature
A311. 1. Chronic nodular lymphangitis; 2. Regional Lymphadenitis
Q312. Blastomycosis - lesion
A312. Ulcerated, inflammatory, verrucous plaques with surrounding erythema, edema and fibrosis
Q313. Blastomycosis - cause
A313. Blastomyces Dermatitidis
Q314. Blastomycosis - systemic mycosis characterized by what?
A314. Primary pulmonary infection
Q315. Blastomycosis - cutaneous lesion common found where?
A315. Face
Q316. Scabies - Lesions
A316. Papules and BURROWS
Q317. Scabies - describe the burrows
A317. Tan or skin-colored ridges with linear configuration
Q318. Scabies - cause
A318. Mite called Sarcoptes Scabiei
Q319. Scabies - typical sx
A319. generalized intractable pruritus
Q320. Scabies - common locations
A320. 1. Finger web; 2. Axilla; 3. Inguinal regions
Q321. Scabies - Tx (5)
A321. 1. Topical Permethrin; 2. Topical Lindane; 3. Systemic Permethrin; 4. Antihistamines; 5. Topical/Oral corticosteroids
Q322. Pediculosis - types
A322. 1. Capitis; 2. Pubis
Q323. Pediculosis Capitis - description
A323. Head lice; infestation of scalp by head louse, Pediculus Humanus Capitis
Q324. Pediculosis Capitis - features
A324. Brown-gray specksin affected areas (lice), with white eggs; Pruritic
Q325. Pediculosis Pubis - description
A325. Pubic lice; infestation of hair-bearing regions by Phthirus Pubis
Q326. Pediculosis Pubis - locations
A326. 1. PUBIC AREA; 2. Chest; 3. Axillae; 4. Upper Eyelids
Q327. Pediculosis Pubis - features
A327. Pruritis
Q328. Syphilis - cause
A328. Treponema Pallidum
Q329. 1 Syphilis - lesion
A329. Genital Chancre - single button-like papule that develops into PAINLESS erosion and then ulcer with raised border and scanty serous exudate
Q330. 2 Syphilis - lesions (4)
A330. 1. Non-specific rash on trunk; 2. Mucus patches; 3. "Copper Pennies" on palm/sole; 4. Condyloma Lata
Q331. 2 Syphilis - Condyloma lata description? Location?
A331. Flat topped and moist, red-pale papules, nodules, or plaques; Commonly in anogenital area
Q332. 3 Syphilis - lesion
A332. Gummas - rubbery lump/deep granulomatous lesion found in subcutaneous tissue;; tendency for necrosis and ulceration
Q333. 3 Syphilis - how common?
A333. Very rare ~1/3 of untreated immunocompetent pts
Q334. Syphilis - Dx
A334. 1. RPR; 2. VDRL
Q335. Syphilis - Tx
A335. Benzathine Penicillin
Q336. Chancroid - description
A336. PAINFUL ulcer at site of inoculation
Q337. Chancroid - location
A337. external genitalia
Q338. Chancroid - lesion
A338. ulcer with sharp borders, with surrounding erythematous halo
Q339. Chancroid - cause
A339. Hemophilus Ducreyi (Gram Neg streptobacillus)
Q340. Nevus - description
A340. Benign Hyperplasias
Q341. Nevus - lesion
A341. Small, acquired pigments; Macules or papules
Q342. Ephilides - aka
A342. Freckles
Q343. Ephilides - description
A343. Common, pigmented lesions of childhood
Q344. Ephilides - Pathophys
A344. Normal melanocyte number, but increased melanin within basal keratinocytes
Q345. Lentigines - aka
A345. Liver Spots
Q346. Lentigines - types (2)
A346. 1. Lentigo Simplex - small, round or oval lesions on skin without correlation to sun exposure; 2. Solar Lentigo - variegated, tan-to-dark brown macules on sun-exposed areas
Q347. Seborrheic Keratoses - description
A347. Benign neoplasms
Q348. Seborrheic Keratoses - how do the lesions begin?
A348. Skin-colored or light tan macules
Q349. Seborrheic Keratoses - what happens to lesions over time?
A349. Pigmentation increases
Q350. Seborrheic Keratoses - what is pathognomonic?
A350. "Horn Cysts"
Q351. Actinic Keratosis - lesions
A351. Discreet, rough, dry, adherent scaly lesions
Q352. Actinic Keratosis - where?
A352. Sun-exposed skin
Q353. Actinic Keratosis - what is it a possible precursor to?
A353. Squamous Cell Carcinoma (~1/1000)
Q354. Angiomas - types (2)
A354. 1. Spider; 2. Cherry
Q355. Spider Angiomas - lesions
A355. -Usually solitary; Red, focal, telaniectasia of dilated capillaries
Q356. Spider Angiomas - common sites (3)
A356. 1. Face; 2. Forearms; 3. Hands
Q357. Cherry Angiomas - description
A357. Moderately dilated capillaries lined with flattened endothelial cells
Q358. Cherry Angiomas - lesions
A358. Bright-red to violaceous, domed, vascular lesions
Q359. Cherry Angiomas - common sites (2)
A359. 1. Trunk; 2. Proximal extremities
Q360. Pyogenic Granuloma - description
A360. Rapidly-developing, bright-red or violaceous or brown-black nodule
Q361. Pyogenic Granuloma - lesions
A361. Sharply demarcated, erosive, partly hemorrhagic surface, constricted base
Q362. Acrochordon - aka
A362. skin tags
Q363. Acrochordon - lesions
A363. skin-colored pedunculated papilloma (polyp)
Q364. Acrochordon - common sites
A364. Intertriginous (skin-on-skin) sites
Q365. Epidermal Cyst - description
A365. Nodule filled with expressible material (liquid or semi-solid)
Q366. Milia - description
A366. Small, white or yellow, epidermal, keratin filled cyst
Q367. Lipoma - description
A367. Benign tumor of subcutaneous fat
Q368. Lipoma - lesion
A368. Flesh-colored, slightly elevated, rubbery nodules
Q369. Lipoma - characteristics (3)
A369. 1. Palpable; 2. Mobile; 3. Painless
Q370. Keloid - description
A370. Excessive proliferation of collagen after skin trauma
Q371. Keloid - common sites (4)
A371. 1. Ear lobes; 2. Shoulders; 3. Upper chest; 4. Back
Q372. Keloid - how does it expand?
A372. Expands beyond limits of original trauma with claw-like extensions
Q373. Hypertrophic Scar - description
A373. Excessive proliferation of collagen after skin trauma
Q374. Hypertrophic Scar - difference btw keloids?
A374. limited to site of original trauma
Q375. Vitiligo - pathophys
A375. Acquired condition with complete absence of melanocytes and pigment in epidermis
Q376. Vitiligo - what layer of skin is involved?
A376. Epidermis only;; dermis is normal
Q377. Vitiligo - what are the depigmented lesions prone to?
A377. sunburn
Q378. Squamous Cell Carcinoma - description
A378. Malignant tumor of epithelial keratinocytes
Q379. SCC - etiology (7)
A379. 1. UVB; 2. Ionizing radiation; 3. Chemical carcinogens; 4. Chronic inflammatory conditions; 5. Immunosuppression; 6. Genetic syndromes; 7. Oncogenic HPVs
Q380. SCC - common sites (3); Metastasis?
A380. 1. Ears; 2. Upper face; 3. back of hands; Definite metastatic potential to LN, liver, brain, bone, lungs
Q381. SCC - lesion
A381. Ulcerated, firm nodules; Verrucous plaques; Keratotic scale; NO telangiectasias!
Q382. SCC - does it have overlying telangiectasia?
A382. NO
Q383. Basal Cell Carcinoma - Types (4)
A383. 1. Nodular (most common); 2. Morpheaform; 3. Superificial (arsenic exposure); 4. Pigmented
Q384. BCC - location?; Metastasis?
A384. 95% above clavicle; Rarely metastasize (still has potential for local destruction)
Q385. BCC - lesion
A385. Pearly papule with telangiectasia (Nodular form)
Q386. Melanoma - description
A386. Cancer of pigment-forming cells (melanocytes) and nevus cells
Q387. Melanoma - evaluation (4)
A387. A: Asymmetry; B: Borders (irregular); C: Color variability; D: Diameter (>6mm)
Q388. Melanoma - Forms (4)
A388. 1. Superficial spreading - long radial growth; trunk; 2. Nodular - no radial growth; 3. Lentigo Maligna - longest radial growth; 4. Acral Lentiginous - palms, SOLES, terminal phalanges; in darker people
Q389. Dysplastic Nevus - what is it?
A389. Hyperplasia and proliferation of melanocytes in basal cell layer
Q390. Dysplastic Nevus - what is it a possible precursor to?
A390. Superficial spreading melanoma
Q391. Erythema Nodosum - what is it?
A391. Painful, tender, warm nodules usually on lower legs
Q392. Erythema Nodosum - cause (6)
A392. 1. Infectious; 2. Drugs; 3. Sarcoidosis; 4. UC; 5. Behcet's; 6. Idiopathic
Q393. Erythema Nodosum - how long does it last?
A393. Spontaneous resolution in 6 weeks
Q394. Acne Vulgaris - what is it?
A394. Inflammatory disorder of pilosebaceous units in skin
Q395. Acne Vulgaris - types of comedomes?
A395. 1. Open Comedone = black head; 2. Closed Comedone = white head
Q396. Acne Vulgaris - Tx (4)
A396. 1. Topical Antibiotics (clinda, erythro); 2. Benzoyl Peroxide; 3. Topical Retinoids; 4. High dose Estrogen
Q397. Acne Rosacea - what is it?
A397. Chronic, acneiform inflammation of pilosebaceous units of face; AND; Increased capillary reactivity to heat
Q398. Acne Rosacea - common vascular findings? (2)
A398. 1. Flushing; 2. Telangiectasia
Q399. Acne Rosacea - are comedones involved?
A399. NO
Q400. Acne Rosacea - are the lesions symmetrical?
A400. YES
Q401. Folliculitis - what is it?
A401. Infection of upper portion of hair follicle
Q402. Folliculitis - causes? (2)
A402. 1. S. Aureus; 2. Pseudomonas
Q403. Folliculitis - Tx (2)
A403. 1. Topical Mupirocin; 2. Systemic Dicloxacillin or cephalexin
Q404. Hidradenitis Suppurativa - what is it?
A404. Chronic, suppurative, cicatricial disease of apocrine gland- bearing skin
Q405. Hidradenitis Suppurativa - locations? (2)
A405. 1. Axillae; 2. Anogenital region
Q406. Pemphigus Vulgaris - what is it?
A406. Intra-epidermal blistering
Q407. Pemphigus Vulgaris - pathophys
A407. Autoantibodies forming against cell walls lead to acantholysis
Q408. Pemphigus Vulgaris - dx
A408. Immunofluorescence staining of IgG autoantibodies or antigens in epidermis
Q409. Pemphigus Foliaceous - what is it?
A409. Benign variation of pemphigus
Q410. Pemphigus Foliaceous - pathophys
A410. acantholysis or loss of intracellular adhesions leading to superficial blisters
Q411. Bullous Pemphigoid - pathophys
A411. Blistering from antibodies forming along basement membrane
Q412. Bullous Pemphigoid - dx
A412. Immunofluorescence staining of IgG along BM
Q413. Bullous Pemphigoid - compared to Pemphigus?
A413. 1. Thicker, lasts longer; 2. Can have ocular involvement
Q414. Herpes Gestaciones - what is it a variant of?
A414. Bullous Pemphigoid
Q415. Herpes Gestaciones - when does it occur?
A415. Occurs only during pregnancy
Q416. Herpes Gestaciones - tx
A416. Can treat with steroids, but usually resolves after pregnancy
Q417. Dermatitis Herpetiformis - what is this a skin equivalent of?
A417. Celiac Disease
Q418. Dermatitis Herpetiformis - histology
A418. Neutrophils on tips of dermal papillae
Q419. Dermatitis Herpetiformis - lesions
A419. 1. Similar to hives, but non-transient; 2. Itch and burn; 3. Symmetric lesions on extremities
Q420. Dermatitis Herpetiformis - tx (2)
A420. 1. Gluten-free diet; 2. Dapsone
Q421. Generalized Pruritus - description
A421. Pruritus occuring all over body
Q422. Generalized Pruritus - lesions
A422. Scratch marks from compulsive scratching; NO primary lesions; Only secondary changes (lichenification)
Q423. Generalized Pruritus - causes
A423. 1. Metabolic/Endocrine; 2. Malignancies; 3. Drugs; 4. Infestations; 5. Hepatic Disease; 6. Hematological Disease; 7. Psychogenic
Q424. Exfoliative Erythroderma - description
A424. Generalized, uniform redness and scaling
Q425. Exfoliative Erythroderma - how much of body is involved?
A425. >90%
Q426. Exfoliative Erythroderma - causes? (5)
A426. 1. 20% Unknown; 2. 20% Psoriasis; 3. Atopic Dermatitis; 4. Drug Allergies; 5. Leukemia/Lymphoma
Q427. Exfoliative Erythroderma - complications (5)
A427. 1. Inability to regulate temp; 2. Electrolyte disturbance; 3. Third-spacing; 4. Hypoalbuminemia; 5. High output cardiac failure from widespread cap dilation
Q428. Exfoliative Erythroderma - mortality rate?
A428. 25%
Q429. Septicemia - what cutaneous manifestations are associated with it? (4)
A429. 1. Petechiae; 2. Palpable Purpura; 3. Ecthyma Gangrenosum; 4. Endocarditis
Q430. Petechiae - what infections is it associated with? (3)
A430. 1. Meningococcus; 2. H. Flu; 3. RMSF
Q431. Palpable Purpura - causes (3)
A431. 1. Septic Emboli (MGC, RMSF); 2. Leukocytoplakia; 3. Vaculitis (HSP)
Q432. Palpable Purpura - locations
A432. Acral regions (extremities and peripheral parts)
Q433. Endocarditis - what are the various signs? (4)
A433. 1. Janeway lesions - hemorrhagic macules on volar fingers; 2. Osler's Nodes - voilaceous tender nodules on volar surface of fingers; 3. Subconjunctival Hemorrhage - submucosal hemorrhage; 4. Splinter Hemorrhage - subungual hemorrhage in midportion of nailbed
Q434. Ecthyma Gangrenosum - description
A434. Ulcerative bacterial infection that extends into dermis AND subcutaneous tissue
Q435. Ecthyma Gangrenosum - lesions
A435. violaceous vesicles, pustules, or ulcer with raised borders
Q436. Ecthyma Gangrenosum - causes (3)
A436. 1. Staph; 2. Pseudomonas; 3. Gram Neg Bacteremia
Q437. Ecthyma Gangrenosum - what happens to skin?
A437. Becomes necrotic and eschar
Q438. Pyoderma Gangrenosum - description
A438. Rapidly evolving; Acute onset of extremely painful, boggy, blue/red ulcers; Purulent necrotic bases
Q439. Pyoderma Gangrenosum - where do lesions typically develop?
A439. At sites of trauma
Q440. Pyoderma Gangrenosum - Causes (8)
A440. 1. Idiopathic; 2. UC; 3. Crohn's; 4. Diverticulitis; 5. Arthritis; 6. Leukemia; 7. Chronic Hepatitis; 8. Behcet's
Q441. Sweet's Syndrome - aka
A441. Acute febrile neutrophilic dermatosis
Q442. Sweet's Syndrome - lesions
A442. Sudden onset of bright red, smooth, tender, inflammatory papules; Coalesce to form plaques
Q443. Sweet's Syndrome - associated with what sx's? (3)
A443. 1. Fever; 2. Arthralgias; 3. Peripheral leukocytosis
Q444. Sweet's Syndrome - associated with what conditions? (3)
A444. 1. Yersinia; 2. Febrile URT infection; 3. Leukemias
Q445. Dermatomyositis - types of lesions (4)
A445. 1. Violaceous inflammatory changes of eyelids and periorbital area; 2. Erythema of face, neck, and upper trunk; 3. Gottron's Papules - flat topped violaceous papules over knuckles; 4. Periungal telangiectasia with erythema
Q446. Dermatomyositis - muscular finding? (3)
A446. 1. Proximal muscle weakness; 2. Muscle atrophy; 3. Muscle tenderness
Q447. Lupus Erythematosus - types
A447. 1. Acute Cutaneous = Systemic; 2. Chronic Cutaneous = Discoid
Q448. SLE - lesions (2)
A448. 1. Butterfly/malar rash; 2. Generalized rash
Q449. SLE - Generalized rash locations
A449. 1. Face; 2. Dorsum of hands (spares knuckles); 3. Arms; 4. V of neck; 5. Periungual telangiectasia
Q450. Discoid LE - what other skin disease does it look similar to?
A450. Psoriasis
Q451. Diabetes-related cutaneous manifestations? (3)
A451. 1. Acanthosis Nigricans; 2. Necrobiosis Lipoidica; 3. Diabetic Dermopathy
Q452. Acanthosis Nigricans - description
A452. Diffuse, velvety, thickening and hyperpigmentation of skin
Q453. Acanthosis Nigricans - Locations
A453. Body Folds - Axillae, neck, groin, etc
Q454. Acanthosis Nigricans - associations? (5)
A454. 1. Insulin resistance; 2. GI tract malignancy; 3. Obesity; 4. Drugs; 5. Hereditary disorders
Q455. Necrobiosis Lipoidica - lesions
A455. Distinctive, sharply circumscribed multicolored plaques; Large symmetric plaques
Q456. Necrobiosis Lipoidica - locations
A456. Anterior and lateral surfaces of lower legs
Q457. Diabetic Dermopathy - lesions
A457. -Circumscribed, atrophic, slightly depressed, brownish lesions
Q458. Diabetic Dermopathy - locations
A458. Lower legs
Q459. Diabetic Dermopathy - what is is accompanied by?
A459. Microangiopathy
Q460. Myxedema - what disease does it occur in?
A460. Thyroid disease
Q461. Myxedema - in HYPERthyroidism?
A461. Pretibial Myxedema
Q462. Pretibial Myxedema - lesions
A462. Bilateral, asymmetric, firm, non-pitting nodules; Later lesions are confluence of earlier lesions covering pretibial region
Q463. Myxedema - in HYPOthyroidism?
A463. Hypothyroid Myxedema
Q464. Hypothyroid Myxedema - pathophy
A464. Insufficient production of thyroid hormones causes accumulation of water binding mucopolysaccharides in the dermis
Q465. Hypothyroid Myxedema - features (5)
A465. 1. Thickening of facial features; 2. Doughy induration of skin; 3. Puffy eyelids; 4. Broadened nose; 5. Lips thickened
Q466. Sarcoidosis - description
A466. Chronic granulomatous inflammation affecting diverse organs but presents primarily as skin lesions, eye lesions, bilateral hilar lymphadenopathy, pulmonary infiltration
Q467. Sarcoidosis - granulomatous skin lesions
A467. Multiple circinate, confluent, firm, brownish-red infiltrated plaques
Q468. Lupus Pernio - what is it associated with?
A468. Sarcoidosis
Q469. Lupus Pernio - lesion
A469. Violaceous, soft doughy infiltration of cheeks and nose; (Grossly enlarged, purple nose)