Omsii - Cps - Derm

Front 1

circumscribed, flat discoloration that may be brown, blue, red or hypopigmented

Back 1

macule

(patch = large macule)

Front 2

elevated lesion off of the skin surface up to .5cm in size

Back 2

papule

Front 3

lesions that are elevated and more than 0.5 cm in size, without induration

Back 3

plaque

Front 4

circumscribed, elevated, solid lesion more than 0.5 cm in diameter

Back 4

nodule

(dermal or subdermal lesions)

**large nodule = tumor

Front 5

lesion filled with fluid and leukocytes (pus)

Back 5

pustule

(deeper collections of pus = abscesses)

Front 6

clear fluid filled, up to 0.5 cm

Back 6

vesicle

Front 7

fluid filled lesion > 0.5 cm in dia

Back 7

bulla

Front 8

elevated, blanched lesions resulting from increased tissue fluid dispersed in dermis

Back 8

wheals

Front 9

thin papule or plaque

Back 9

burrow

Front 10

follicular papule filled with keratinous plug which is open or closed

Back 10

comedone

Front 11

papule or nodule filled with debris

Back 11

cyst

Front 12

dilated blood vessels <1mm wide

Back 12

telangiectasia

Front 13

increased amount of stratum corneum also known as kyperkeratosis

Back 13

scales

Front 14

collection of dried serum and cellular debris

Back 14

crust

Front 15

superficial, often linear ulceration caused by scratching

Back 15

excorations

Front 16

represent loss of epidermis with intact dermis

Back 16

erosions

(heal without scarring)

Front 17

localized loss of epidermis and at least dermis, may involve subdermis

Back 17

ulcer

(ulcers heal with scarring)

Front 18

thin linear ulcer (penetrates dermis) with near vertical walls)

Back 18

fissure

(usually leaves visible scar)

Front 19

pink skin

Back 19

pityriasis rosea

Front 20

violet skin

Back 20

lichen planus

Front 21

orange skin

Back 21

juvenile xanthogranuloma

(or B-carotonemia)

Front 22

blue skin

Back 22

amioderone skin pigmentation

Front 23

green skin

Back 23

pseudomonas

Front 24

yellow skin

Back 24

xanthomas

(or jaundice)

Front 25

black skin

Back 25

eschar

Front 26

brown skin

Back 26

cafe au lait spots

Front 27

results in intracellular and extracellular ice crystal formation, disruption of cell membrane integrity, pH changes, impairment of multiple homeostatic functions and thermal shock

Back 27

freezing with liquid nitrogen

Front 28

name two precancerous skin lesions

Back 28

actinic keratoses

dysplastic melanocytic nevi

Front 29

actinic keratosis - physical description

Back 29

scaly erythematous papule on sun damaged skin

EPAS = erythemetous papule with adherent scale

Front 30

actinic keratosis - precursor for...?

Back 30

squamous cell carcinoma

(10% risk of malignant transformation)

Front 31

actinic keratosis - tx

Back 31

liquid nitrogen
curettage and electrodessication
topical chemo

Front 32

dysplastic nevi - precursors for...?

Back 32

melanoma

Front 33

dysplastic nevi - tx

Back 33

punch excision
shave excision
elliptical excision

Front 34

name three non-melanoma skin cancers

Back 34

basal cell carcinoma
squamous cell carcinoma
keratoacanthoma

Front 35

risk factors for bcc/scc

Back 35

fair skin
family hx
chronic sun exposure
old age
arsenic, tar

Front 36

most common malignant neoplasm

Back 36

basal cell carcinoma

Front 37

describe basal cell carcinoma's appearance

Back 37

pearly papule or nodule with rolled translucent border and telangiectasias; ulcerated papule

Front 38

basal cell carcinoma - tx

Back 38

cryosurgery
electrodessication & curettage
excision
radiation
MOHS micrographic surgery

Front 39

basal cell carcinoma - clinical types

Back 39

nodular
pigmented
infiltrative *
superficial
morpheaform*

Front 40

nodular bcc

Back 40

chronic lesion
easy bleeding
pearly border
surface telangiectasias
head and neck, trunk, extremities

Front 41

pigmented bcc

Back 41

similar to nodular, but with black discolorations (melanin deposits)
pigmented races
face, trunk, scalp

Front 42

superficial bcc

Back 42

erythematous scaly plaque
slow growth
asymptomatic
trunk, extremities, face

Front 43

morpheaform bcc

Back 43

resembles scar
asymptomatic and slow growing
ill-defined margins
marked subclinical extension

Front 44

scc types

Back 44

in-situ (bowen's erythroplasia of queyrat)
invasive
keratoacanthoma

Front 45

in-situ scc associated w/ arsenic, hpv16, radiaton

Back 45

bowen's disease

Front 46

in-situ scc associated with uncircumcised men

Back 46

erythroplasia of queyrat

(may progress to invasive scc)

Front 47

invasive scc

Back 47

erythematous nodule
indurated lesion
sun-exposed skin (men>women)
slow growth

Front 48

keratoacanthoma

Back 48

low grade scc
rapid growth (weeks)
trauma, sun exposure, hpv11/16
may progress to invasive scc

Front 49

does scc metastasize?

Back 49

metastases in 1-3% of cases

**locally invasive and destructive

Front 50

tx for scc (bowen's and erythroplasia of queyrat)

Back 50

efudex or aldara
liquid nitrogen cryotherapy
radiation therapy
curettage electrodessication
surgical excision

Front 51

tx for invasive scc

Back 51

surgical excision (traditional / mohs)
radiation therapy

Front 52

what does malignant melanoma look like?

Back 52

irregular colored tan to black macule nodule
irregular borders
may be ulcerated

Front 53

malignant melanoma - tx

Back 53

excision

sentinal lymph node biopsy for int depth
interferon-alpha (high tox)

Front 54

ABCDs of melanoma

Back 54

asymmetry
border irregularity
color variation
diameter >6mm
(evolving)

Front 55

melanoma with regression - good sign?

Back 55

no way, jose.

Front 56

malignant melanoma - risk factors

Back 56

fair skin, red hair, blue eyes
intermittent sun exposure
freckles and melanocytic nevi
family history

Front 57

malignant melanoma - prognostic features

Back 57

BRESLOW = depth

good --> breslow <1mm
int --> breslow 1-4mm
bad --> breslow >4mm

Front 58

malignant melanoma - tx

Back 58

surgical excision

in-situ = 5mm margin
invasive = 1-3 cm depending on breslow's depth

Front 59

malignant melanoma - does sentinel lymph node biopsy effect survival of patients?

Back 59

negative.

powerful prognostic feature, but does not change survival

Front 60

malignant melanoma - when is sentinal lymph node biopsy recommended?

Back 60

breslow 1-4 cm

Front 61

kaposi's sarcoma - four variants

Back 61

chronic/classic
african endemic (really bad)
iatrogenically immunocomp pts
aids-defining (mc for our pts)

Front 62

viral bad guy in kaposi's sarcoma

Back 62

human herpesvirus 8

Front 63

presents as slow growing blue/red/violet macules on distal lower extremities that my coalesce to form large plaques or develop into nodules or polypoid tumors.

this describes...?

Back 63

classic kaposi's sarcoma

Front 64

AIDS-related epidemic KS commonly appears on which body parts?

Back 64

trunk and midface

**bluish to violaceous macules, plaques and tumors may arise on oral mucosa

Front 65

atopic dermatitis

Back 65

papules, plaques with scale and lichenification

flexures of extremities, neck, torso

Front 66

contact dermatitis

Back 66

papules and vesicles

shape and location correspond to contact

Front 67

involvement of ____ is characteristic in infantile dermatitis

Back 67

cheeks

Front 68

accentuation of skin markings from chronic rubbing

Back 68

lichenification

Front 69

pityriasis alba

Back 69

slight scale and hypopigmented macules
seen in atopic dermatitis pts
often on cheeks

Front 70

atopic dermatitis - tx

Back 70

EMOLLIENTS!!!!!!!!!

bathing daily w/ gentle cleansers
topical steroids & calcineurin inhibitors
antihistamines --> sleep!

Front 71

systemic therapy for atopics

Back 71

prednisone (for flares)
cyclosporine (short term rescue)
azathioprine
mycophenolate mofetil
methotrexate

Front 72

contact dermatitis

Back 72

type IV (rarely type I) hypsen rxn
initial sensitization ~10 days, reexposure rxn ~2days
distribution and config key!

**nickel = MCC

Front 73

seborrheic dermatitis - physical findings

Back 73

yellow, greasy scales on erythema

face, scalp, central chest, axillae, groin

Front 74

seborrheic dermatitis - etiological links

Back 74

active sebaceous glands, abnormal sebum, commensal yeast (malassezia furfur / pityrosporum ovale)

Front 75

seborrheic dermatitis - when do infantile and adult forms peak?

Back 75

infantile - 0-3 m/o
adult - 40-60 y/o

Front 76

infantile seborrheic dermatitis - tx

Back 76

self limited, so just simple care meadures of bathing and emollients

can use ketoconazole 2% cream

Front 77

adult seborrheic dermatitis - tx

Back 77

topical azoles

*otc dandruff shampoos for mild cases, topical steroids for moderate - severe

Front 78

psoriasis - precipitating factors

Back 78

infxn, meds, smoking, etoh

Front 79

psoriasis - topical therapy

Back 79

vit d analogues
corticosteroids
keratolytics (salcylic acid)
coal tar
anthralin
retinoids

Front 80

psoriasis - phototherapy

Back 80

uvb
goekerman tx - tar bath + uv
puva
narrowband uvb
308nm excimer laser

Front 81

psoriasis - oral therapies

Back 81

methotrexate (gold standard)
**also treats psoriatic arthritis!

acitretin

cyclosporine

Front 82

psoriasis - injectable therapies

Back 82

TNF-alpha inhibitors
-infliximab
-etanercept
-adalimumab
-golimumab

alefacept
ustekinimab

Front 83

urticaria

Back 83

red pruritic wheals

evanescent - single lesion <24h, eruptions may last longer

increased serus fluid in dermis

type I hypersensitivity

Front 84

urticaria - dependent on which cells?

Back 84

mast cells

(histamine!!)

Front 85

urticaria - tx

Back 85

antihistamines
systemic steroids (occasionally)
epinephrine

Front 86

drug hypersensitivity - tx

Back 86

discontinue offending agent, give supportive care

topical corticosteroids to alleviate pruritus

Front 87

fixed drug reaction

Back 87

solitary lesions, often dusky
30 m to 8h after administration
occur in same place w/ rechallenge
mouth, genitalia common

phenolphthalein, ibuprofen, sulfonamides, tetracyclines, barbiturates

Front 88

drugs most frequently cited as causes of erythema multiforme - steven johnson syndrome - toxic epidermal necrolysis

Back 88

anticonvulsants
antibiotics
allopurinol
NSAIDs

Front 89

erythema nodosum

Back 89

painful nodules on lower legs
may be related to infxn, drug

Front 90

erythema nodosum - tx

Back 90

supportive, elevation, NSAIDs

Front 91

intensely pruritic eruption with widespread blister formation, predominantly effects elderly

Back 91

bullous pemphigoid

Front 92

bullous pemphigoid - tx

Back 92

first-line = prednisone systemically or super-potent topical corticosteroids

immunosuppressants often used to provide for discontinuation of systemic steroids

Front 93

characterized by intraepidermal blisters due to loss of cell-cell adhesion of keratinocytes

Back 93

pemphigus vulgaris

Front 94

5 P's of Lichen planus

Back 94

purple
planar
polygonal
pruritic papules

Front 95

lichen planus - tx

Back 95

topical steroids
antihistamines
prednisone (2-3 wks)
PUVA
methotrexate
oral retinoids

Front 96

salmon colored oval patches and plaques with collarette of scale

classically on torso following skin folds --> christmas tree pattern

Back 96

pityriasis rosea

Front 97

pityriasis rosea - tx

Back 97

self-limited - no tx needed

if pruritic, may use topical steroids, antihistamines, UV light therapy

Front 98

completely depigmented macules and patches

symmetrical, often over bony prominences, hands, feet, face

Back 98

vitiligo

Front 99

nonscarring alopecia

Back 99

androgenetic (male/female pattern loss)
alopecia areata
telogen efluvium

Front 100

scaring alopecia

Back 100

discoid lupus
lichen planopilaris
central centrifugal cicatrical alopecia

Front 101

alopecia - dx

Back 101

biopsy
koh
vdrl
ana
thyroid funct tests

Front 102

alopecia areata

Back 102

round smooth patches of hair loss
unknown etiology (autoimmune?)
regrowth sometimes gray/white

Front 103

telogen effluvium

Back 103

increased percentage of follicles go into telogen, up to 50% of hair falls out.

causes -> febrile illness, child birth, hospitalization

treatment = reassurance

Front 104

alopecia tx

Back 104

intralesional steroids

topical steroids (areata)

topical immunotherapy (areata)

topical minoxidil (androgenetic)

topical short contact anthralins (alopecia areata)

Front 105

lichen planus - tx

Back 105

topical steroids
antihistamines
prednisone (2-3 wks)
PUVA
methotrexate
oral retinoids

Front 106

salmon colored oval patches and plaques with collarette of scale

classically on torso following skin folds --> christmas tree pattern

Back 106

pityriasis rosea

Front 107

pityriasis rosea - tx

Back 107

self-limited - no tx needed

if pruritic, may use topical steroids, antihistamines, UV light therapy

Front 108

completely depigmented macules and patches

symmetrical, often over bony prominences, hands, feet, face

Back 108

vitiligo

Front 109

nonscarring alopecia

Back 109

androgenetic (male/female pattern loss)
alopecia areata
telogen efluvium

Front 110

scaring alopecia

Back 110

discoid lupus
lichen planopilaris
central centrifugal cicatrical alopecia

Front 111

alopecia - dx

Back 111

biopsy
koh
vdrl
ana
thyroid funct tests

Front 112

alopecia areata

Back 112

round smooth patches of hair loss
unknown etiology (autoimmune?)
regrowth sometimes gray/white

Front 113

telogen effluvium

Back 113

increased percentage of follicles go into telogen, up to 50% of hair falls out.

causes -> febrile illness, child birth, hospitalization

treatment = reassurance

Front 114

alopecia tx

Back 114

intralesional steroids

topical steroids (areata)

topical immunotherapy (areata)

topical minoxidil (androgenetic)

topical short contact anthralins (alopecia areata)

Front 115

velvety hyperpigmentation of intertriginous areas (axillae, neck).

commonly associated with insulin resistance, most pts are obese.

Back 115

acanthosis nigricans

Front 116

tinea versicolor

Back 116

hypo/hyperpigmented macules
caused by m. furfur
frequently recurrent
KOH scraping --> spag & mb

Front 117

tinea versicolor - topical tx

Back 117

ketoconazole/selenium sulfide shampoo
ketoconazole cream

Front 118

dermatophyte infection

Back 118

annular red plaques with scale
named for area involved (tinea capitis)
if scale is present, KOH exam

Front 119

tinea pedis

Back 119

interdigital web space type
inflammatory vesicular form
dry, scaly "moccassin" type
two feet - one hand syndrome

Front 120

tinea tx

Back 120

topical antifungals

systemic (adults) - lamisil, fluconazole, griseofulvin, itraconazole

systemic (kids) - griseofulvin, fluconazole

Front 121

tinea capitis - tx

Back 121

must treat systemically
- griseofulvin
- fluconazole
- terbinifine or itraconazole (adults)

Front 122

candidiasis

Back 122

oral
balanitis
intertrigo
angular cheilitis
chronic paronychia

*look for satellite pustules

Front 123

impetigo - tx

Back 123

local wound care
topical antibiotics
oral antibiotics

Front 124

cellulitis v erysipelas

Back 124

ery - sup dermis
cel - deep dermis, subcu

fever/chills - both

ery - usu legs or face
recurrence common 2/2 lymphatic damage

Front 125

molluscum contagiosum

Back 125

smooth, firm shiny umbilicated papules
trunk, extremities, genitals, face
DNA pox virus, molluscum bodies
most self-limited, may last 2-4 years
may be STD as adult

Front 126

molluscum tx

Back 126

cantharadin
curettage
liquid nitrogen
aldara

Front 127

common wart - verruca vulgaris

Back 127

rough, exophytic papules
digits, periungual

Front 128

mosaic/plantar wart - verruca plantaris

Back 128

multiple punctate keratoses
palms and soles

Front 129

flat wart - verruca plana

Back 129

small translucent flat-topped papules
face & neck

Front 130

genital wart - condyloma acuminata

Back 130

polypoid or papillomatous
genitalia

Front 131

verruca vulgaris/plantaris tx

Back 131

in office - liquid nitrogen, podophyllin, tca (safe in pg), cantharadin

at home - salicylic acid

Front 132

condyloma tx

Back 132

in office - liquid nitrogen, tca, podophyllin, scissor/shave removal

at home - imiquimod cream, podophylin

Front 133

varicella - chicken pox

Back 133

incubation = 14 days
prodrome more severe in adults
eruptive phase

Front 134

varicella zoster

Back 134

shingles
reactivation
postherpetic neuralgia

Front 135

hand, foot, mouth disease

Back 135

usu coxsackievirus A16, enterovirus 71
oral lesions
3-7mm oval vesicles w/ red border
heals within 7d

Front 136

scabies

Back 136

caused by sarcoptes scabiei
burrows, papules, vesicles
in immunocomp/elderly, can be crusted and hyperkeratotic

Front 137

rocky mt spotted fever - tx

Back 137

doxycycline