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93 Cards in this Set
- Front
- Back
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What are the 4 types of Basal Cell Carcinoma
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nodular, pigmented, superficial and scarring
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What is Basal Cell Carcinoma
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Malignant neoplasm arising from the basal cells of the epidermis wiht low metastatic potential
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Recommended evaluation, f/u and tx for BSS
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punch or shave biopsy, referral to dermatologist, f/u every 12 months
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What is a carbuncle
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group of furuncles that spreads the subQ causing severe inflammation and local skin destruction.
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What are the two skin lesions that involve both the dermis and the epidermis
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nodule and pustule
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What is an acute, spreading infection of the dermis and sub Q tissue, with tenderness, erythema and heat
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Cellulitis
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At what point should a case of cellulitis be referred to a dermatologist
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if symptoms do not dramatically improve in 48 hours.
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What are the most common causes of paronychia
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S. aureus, pseudomonas, proteus or C. Albicans
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What is a idiopathic hypo-pigmented condition appearing as white patches with fine 'bran-like" scales. It occurs mainly in 3-16 y/o and mostly in blacks
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pityriasis alba
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What is an acute, self limiting dermatosis of unknown etiology with tree-shaped distribution, thought to have a viral trigger and be preceded by an URI?
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Pityriasis Rosea
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What is Leser-Trelat
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rapid increase in size and number of seborrheic keratoses along with itching. Cutaneous sign of an internal malignancy.
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What is gastrointestinal disorder is associated with Rosacea
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hypochlorhydria, can be tested for with the Heidleburg Test
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What type of infection causes acne vulgaris
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propionobacterium
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What are well established herbal txs for acne vulgaris
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Melaleuca alternifolia - oil topical
Vitex agnus-castus - premenstrual acne |
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What population is isotretinoin CI in? What additional medication is required when using this medication d/t this concern
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Pregnancy - should be used with OCTs when used in female population.
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What is the typical size of a sebaceous cyst
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0.5 to 5 cm, when greater than 5 cm they do not usually resolve on their own.
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What is the typical size of a skin tag
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1-10 mm
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How long does it typically take for contact dermatitis to resolve
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3-4 weeks
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What herbs are indicated in the tx of contact dermatitis
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Calendula officinalis, plantago (lanceolata and major) and Quercus alba.
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What condition do exclamation point haris suggest
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alopecia areata
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What are associated risk factors for scarring alopecia
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burns, physical trauma, radiation exposure, SLE, deep infection, sarcoidosis, tinea capitis
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What are associated risk factors for toxic alopecia
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febrile illness, thyroid dz, hypopitutiarism, syphilis, after pregnancy, cytotoxic drugs, Vit A over dose
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How long does toxic alopecia last
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max 4 months
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What dermatological condition should be considered a possible rxn to lomatium dissection
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whole body rash when herb is unprocessed
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How long does wheals exist with acute urticaria
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<24 hours
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How long does wheals exist with chronic urticaria
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> 24 hours
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What is the appropriate f/u to urticaria
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liver fnx to r/o hepatitis, monitor skin.
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What is the superinfection that occurs frequently with eczema
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Staphylococcus aureus
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Describe erythema multiforme
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acute, life-threatening hypersensitivity rxn of skin and mucous membranes. erythematous macules or papules with fatigue, fever, arthralgia
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What are risk factors for erythema multiforme
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recent viral illness, recent medication use (penicillin, sulfonamides, barbiturates, phenytoin, phenylburazone), recent vaccination
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How long does it take erythema multiforme to resolve
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mild - 2-3 weeks
severe - up to 6 weeks |
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How can you differentiate Pemphygus vulgaris from bullous pemphigoid
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Pemphygus vulgaris i- pos Nikolsky's sign, pos Tzanck smear, erosions outnumber intact blisters, no pruritis
bullous pemphigoid - neg Nikolsky's sign, prurutis, blisters outnumber the erosions. |
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What season is psoriasis better in, when is it worse
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better in summer, worse in winter
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What is are important r/o when psoriasis is present
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celiacs dz and hypochlorhydria
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What drugs should be avoided with psoriasis
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lithium, NSAIDs, beta blockers, ethanol and smoking
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What herbs are indicated in the tx of psoriasis
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Berberis spp (topical), capsicum annuum (topical for itching)
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Name the dermatological autoimmune conditions
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Vitiligo (autoantibodies to melanocytes), Bullous pemphigoid (to hemedesmisomes), pemphigus vulgaris (to desmiosones)
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How does stasis dermatitis present
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eczematous eruption d/t venous incompetence. Painless, preceded by chronic pruruits, edema, swelling, ankles erythematous, mild scaling, varicose veins
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What homeopathics are indicated for acute dermatological conditions
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Arnica
Calendula Graphitis Sulphur Urtica urens |
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What herbs are CI on extensive broken skin
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Arnica montana, Gaultheria procumbens Larrea tridentata, Melaleuca alternifolia, symphytum officinale (prolonged periods)
Tussilago farfara (prolonged periods) |
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Describe Actinic Keratosis
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Considered pre-malignant, however rarely pre-malignant
Indurated sun exposed skin |
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What is the most common form of skin cancer
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Basal cell carcinoma
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Describe Basal Cell Carcinoma
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Occurs on fair complexion w/skin exposure
Most common Slow growing Rare metastasis |
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Describe Squamous Cell Carcinoma
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Faster growing
Metastatic DDX: Trichoepithelioma |
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What is the correct insicion type for a suspicious skin lesion?
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Remove an eliptical shape around the lesion with a 3 to 1, middle to outer area, being clear to get an area out completely around the boarders.
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What patient is at increased risk for cellulitis and are at increased risk for rapidly progressing?
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Pts with decreased lymphatic drainag
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In a pt that doesn't usually have urticaria what do you need to be thinking of if there isn't an obvious allergic rxn?
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Cancer, Calligen Dz, Endocrine, Chronic Viral dz
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How do you differentiate btw tinea and erythema multiforme
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There are usually a lot more eruptions with erythema
Always want to do a skin scrapping and dx this way |
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What is an important thing that will clue you into a drug rxn
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it will start right after taking a drug - must stop the drug. If there is any mucous membrane swelling need to go to the hospital!!!
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The ability of the neuromuscular system to contract eccentrically, isometrically, and concentrically in all three planes of motion.
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Functional Strength
P. 119 |
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Describe a dermatofibroma
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Papules that develop mainly on legs
2ary to trauma Overgrowth of fibroblasts Color- usually brown and firm (feels like a BB under the skin) |
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Describe a Epidermal inclusion cyst (sebaceous cyst)
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Movable skin colored papules to nodules (will usuallly move with the skin)
Subcutaneous Face, back, ears, groin Sack of epidermis under skin, filled w/keratin/sebum Smell Can get inflamed, usually not infected |
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Describe a lipoma
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Subcutaneous movable nodule
Fatty growth/lobules Hereditary/ numerous Arms, trunk Usually asymptomatic or painful Sometimes can not differ from an EIC until surgery Can recur after removal |
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What type of discetion do you use with any lesion in the subQ
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blunt dissection
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What is a pilar cyst
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On scalp, subcutaneous movable nodule
Have firmer keratin then EIC/ no smell Usually, pop out during surgery |
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What strands of genital warts (HPV) can lead to cervical dysplasia
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HPV 16, 18, 31, 33
These are usually flat warts |
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What strands of HPV cause big genital wart and don't lead to cancer
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smaller numbers like 4, 6, and 11
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How should you approach removal of an HPV lesion
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burn or freeze
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What is the one approach to a hemangioma that would not be a good idea
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any sort of cutting - they have blood in the !!!
Can freeze or do an electrical procedure |
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What things stop bleeding and what things do not
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Stop bleeding - heat (ht cautery, bipolar cautery)
No Hemostasis - Unipolar (hyfrecator) |
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What is the infectious agent in impetigo
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Streptococcus pyogenes and/or Staphylococcus aureus can also be infected by mursa
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Where are the most likely areas for scabies infections
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Hands. Wrists, elbows,axilla, umbilicus, groin/penis
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What are the two types of contact dermatitis
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1. Irritant contact dermatitis
- Organic solvents or soaps 2. Allergic contact dermatitis - Delayed hypersensitivity - Hapten (low molecular weight substance) - Cross-sensitization |
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What occurs if you knock a patch of psoriasis off the skin
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pinpoint bleeding
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What type of condition is rosacea
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inflammatory, therefore reacts to high tannin foods
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What is the first condition you should screen people for when presenting with vitilago
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autoimmune conditions
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What is Koebner’s phenomenon
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rash starts after emotional stress, trauma to skin (in psoriasis)
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What is Auspitz phenomenon
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removal of Red scaly-white papules and plaques resulting in blood drops - psoriasis
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Describe Rosacea
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-In adults
-Two components redness/flushing/telangiectasia -burning papules/pustules No comedones Location-mid face, around eyes |
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What are the triggers of Rosacea
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Emotional stress- people who blush
Hot/cold air (exercise) Food cheese, wine, spicy food, coffee |
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What is Acute Paronychia
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Painful, bright red swelling of proximal and lateral nailfold
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Describe Ezcema/Atopic Dermatitis
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Pruritus
Flexural lichenification (thickening of the skin) and linearity in adults Facial and extensor involvement in infants and young children Chronic or chronically relapsing dermatitis Personal or family history of atopy (asthma, allergic rhinoconjunctivitis, atopic dermatitis) |
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What do labs in ezcema/atopic dermatitis show
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elevated IgE and eosinophils
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What is the Chronic superficial inflammatory process of hairy regions of the body
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Seborrheic dermatitis
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Acute illness; hypersensitivity; drugs
Round lesions on forearms, hands, knees or feet lesions appear like a target with fluid filled blister in center |
Erythema multiforme
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Describe Toxic Epidermal Necrolysis / Stevens-Johnson Syndrome
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Severe life threatening blistering disorder - swelling of mucous membranes
Patients normally have fever, pruritis, conjunctivitis |
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Greasy,scaly, or verrucous, flat papules to plaques
Appear stuck on skin Occur more in sun exposed areas More in aging adults Can get inflamed & simulate a skin ca. |
Seborrheic Keratosis
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What should you never do with a hemangioma
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Cut into them - you can cauterize it or zap it, but don't cut it or poke it
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Pruritic pustules, vesicles, bullae with “honey-colored” crust
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Staph aureus - Impetigo
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Where do infants get psoriasis
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All over the body
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Where do people >1 y/o get psoriasis skin outbreaks
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on the extensor surfaces
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Where is the classic place for eczema to present
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on the flexor surfaces
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Describe Granuloma annulare
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Characterized by a ring of small, firm, flesh-colored or red papules
Lateral or dorsal surfaces of hands and feet Begins with asymptomatic, flesh-colored papule that undergoes central involution Over months size increases up to 5 cm Spontaneous involution or lasts for years Histology shows collagen degeneration |
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How can you tell the difference btw Vitiligo and tinea versicolor
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Vitiligo and tinea versicolor appear white; borders are distinct in vitiligo; tinea versicolor is rare on the face and areas more numerous and often confluent; KOH to settle the debate
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Teenagers and young adults; benign
No known cause but linked to mycoplasma, picornavirus and human herpesvirus 7 “Harold Patch” (plaque) precedes eruption then followed by smaller plaques (0.5 to 2 cm in diameter) Follows long axes parallel lines of cleavage starting at spine (Christmas tree-like pattern) |
Pityriasis rosea
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Describe Lichen planus
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Very pruritic rash on palms, wrists
Polyangular, flat topped pink papules w/ wickham’s striae criss/cross white lines |
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Describe Lichen simplex (neurodermatitis)
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Common disorder, usually adults
Repeated rubbing or scratching resulting in itchy patch of skin Sharply demarcated, red, scaly plaque with prominent skin lines |
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Describe Dyshidrotic Eczema
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Symmetric, vesicular hand and foot dermatitis
Preceded by moderate to severe itching Palms may be red and sweating Aggravated by contact with irritants such as water, detergents and solvents High incidence of nickel allergy |
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Pigment cells are destroyed resulting in white patches
Associated with increased risk of autoimmune disorders (thyroid, pernicious anemia, Addison’s, and alopecia areata) |
Vitiligo
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Erythematous finely punctate blanchable rash. Rash develops on her trunk and neck then to extremities. Worse in axillae and groin. Erythematous oropharynx and paleness round mouth.
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Scarlet fever
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What are Koebner's papules
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results of trauma, lesions on the skin common in psoriasis and ezcema
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What are Gottron's papules
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Hallmark of dermatomyositis - polygonal plaques w/reticular surface which may exude calcium (thickening of skin around the knuckles)
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What two signs of dermatomyositis
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Heleoptrop eyelids - red around the eyelids
Gottron's papules |
