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35 Cards in this Set
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Contact dermatitis |
Irritant-skin injured by friction, environmental factors such as cold, over-exp to water, chem such as acids, alkalis, detergents and solvents Allergic to plants, poison ivy, chemicals, topical meds Pruritic erythematous rash, denies hx, good hx, skin rxn within 6-12 hours of exposure Infam of epidermis and erythema, no hivesm roughened patches without thickening and discrete demaraction of psoriasis; weeping lesions with tiny vesicles, burning or stinging Sx relief and underlying cause: avoid allergens, cool wet compresses, Trimacinolon BID x 10days, calamine/antihist, antibiotics, oral steroids-severe |
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Seborrheic Dermatitis |
Autosomal dominant trait Benign skin lesions with aging Slightly raised, skin colored, light brown-->thickened and take on rough, warty surface (darken and turn black) Covered and uncovered >65, cosmetic, irritation Well defined, scaly, hyperpigmented and warty Round to oval black in AA Refer to Derm: cryosurgery, currettage, snip and shave |
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Atopic dermatitis |
Chronic, relapsing, pruritic inflamm skin disease more common in children a/w increased serum IGE levels, asthma, allergic rhinitis, food allergies, chronic bronchitis Pruritis, scratching worsens when itch appears Eruthema, excoriated macules, papule inflamed lesions; crusting, symmetrical lesions, may weep decreased itching, prevent secondary infection; ed patient, cetaphil, no bubble baths, burrow soaks and corticosteroids, Aquaphor |
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Acne Y |
Inflammatory disorder of the sebaceous gland and the accompanying hair follicle Highest incidence in teens and younger adults, may appear in 20-40s More common in females, more severe in males Mild: non inflammatory comedones , topical OTC (Benzoyl, Retin-A, Differin, Tazorac) Mod: non comedonal ((pustules, papules)-> inflammatory; oral tetracycline antibiotic in addition to topical (4-6 months: minocycline, doxy, erythromycin) Severe: cystic (for females, hormone therapy; Accutane) -derm for aggressive therapy |
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Brown recluse spider |
found in dry, dark spaces (violin shaped marking) stinging sensation mild inflammation, erythema, swelling at site of bite leading to tissue destruction; rarely systemic rxns and necrosis Management: ice, clean and irrigate wound, elevate wound, tetanus, hospitaliation; doxy, cephalex, erythromycin x 10 days |
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Scabies |
Mites HIghly contagious, crowded areas Papules: burrows, erythema, intense itching esp at night Commonly located interdigital web spaces, wrists, anterior axillary folds, ankles and penis Rx: Elimite-neck down coverage at HS repeat in 1 week Household: treat everyone, wash clothes and linens, vacuum furniture and rugs Bag things that cannot be washed x 1 week |
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Paronychia |
Acute or chronic inflammation of tissue surround the nail more common in women than men localized to 1 finger, throbbing pain on nailfold, erythema, edema, foul purulent discharge (pain relief) warm water soaks, topical antibiotic, oral if mrsa (bactrim, clinda, amoxicillin, cephalexin) |
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Basal cell carcinoma |
Most common: face and nose, cheeks and ears, neck Elevated papules that have pearly appearance with some crusting, blood vessels on border of lesion, central ulceration seen in late stages slow growing, locally invasive, rarely metastasizes Same as skin color, brown, blue, black |
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Clark's levels: |
invading depth of lesion and metastatic potential: Level I: in situ, confined to epidermis Level II: extends through basement membrane and into upper dermis Level III: extends into lower dermis Level IV: extends into reticular dermis Level V: invades SC tissue |
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Cellulitis presentation |
Dermis to SC tissue: if untx--> infection Tender, warm and erythematous area of skin May report insect bite/small cut that got infected Lesion getting large over several days May have tender and enlarged lymph nodes near affected area Could have c/o fever, chills in more severe cases |
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Breslow's method |
Tumor thickness Stage 1: <0.75mm dermis Stage 2: 0.76-1.5mm Stage 3: 1.51-2.25mm Stage 4: 2.26-3.0mm spread to muscle, bones, cartilage, lymph nodes Stage V: >3.0 |
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Skin cancer prevention |
Stay in shade, do not burn, avoid tanning and UV tanning booths, cover up with clothing, use broad spectrum UVA/UVB sunscreen Apply 1oz of sunscreen to entire body 30 minutes before going outside; every 2 hours or immediately after swimming or excessive sweating |
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Brown recluse spider |
found in dry, dark spaces (violin shaped marking) stinging sensation mild inflammation, erythema, swelling at site of bite leading to tissue destruction; rarely systemic rxns and necrosis Management: ice, clean and irrigate wound, elevate wound, tetanus, hospitaliation; doxy, cephalex, erythromycin x 10 days |
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Hyperhidrosis |
Sweaty feet, sweaty palms, axilla, offensive body order overactivity of thoracic sympathetic ganglion Med hx: oral hypoglycemics, SSRIs, ETOH; hx of DM, ovarian function, menopause, thyroid, malignancy, damage to ANS Dryol or keralyt, Xerac, liposuction of axillary glands; rx not effective |
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Tinea capitus |
Ringworm of the scalp Most contagious; causes epidemics in schools, work, home etc More common in toddlers and children painless bald spot, no pain, fever or malaise black dot, painless patchy, gray patch, kerion (bright red, boggy large lump) Topical: 1st line miconazole, lamisil, clotrimazole, ciclopirox, continue for 1 week until lesions have cleared; Burrow's solution; if on systemic antifuncals: LFT, CBC baseline and 4 weeks; baseline pregnancy |
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Tinea pedis |
athlete's foot/ages 20-50 but elderly more susceptible to outbreaks strong foot odor, soft, macerated white tissue between toes; starts in 3rd to 4th digit and spreads to toe webs and soles; macerated white skin between toes; if infected-itching with painful fissure; look for signs of cellulitis |
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Tinea cruris |
Jock itch; rare in children, more common in adult men obese male with c/o rash on groin, spreading to medial inner aspect of thigh; may have pruritis Round to have circle; lesions to inner medial upper thigh; not on scrotum; color can be bright red to dull discoloration; with scratching can get secondary bacterial of c. albicans |
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Urticaria (hives, wheals) |
sudden generalized eruption of pale, evanescent wheals or papules a/w severe itching Angioedema-urticaria: edema of dermis and SC tissues-may be part of IgE mediated response -can be life threatening Intense itching, hives, wheals that resolve within a few hours and reappear later; enlarge and form round irregular shapes; most cases of acute urticaria spontaneously resolve in 1-2 weeks Find cause and stop exposure, avoid NSAIDS, aspirin, ACE-I; avoid tight clothing hot showers and baths H1 antihistamines, advise about sedation; refer if angioedema and if >6 weeks |
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Tinea unguium |
Onchomycosis (nails) poor circulation, PVD Fungal culture (KOH exam-spaghetti and meatballs) Topical: up to 18 months: Penlac Naftin Systemic: Itraconazole 200mg x 12 weeks; Terbinafine 12 weeks; Grispeg 6 months (teratogenic to sperm) |
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Scabies |
Mites HIghly contagious, crowded areas Papules: burrows, erythema, intense itching esp at night Commonly located interdigital web spaces, wrists, anterior axillary folds, ankles and penis Rx: Elimite-neck down coverage at HS repeat in 1 week Household: treat everyone, wash clothes and linens, vacuum furniture and rugs Bag things that cannot be washed x 1 week |
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Erysepalis |
diffuse, superficial spreading infection of the skin Confined to superficial dermis and lymph erysipelas classically involves more superficial layers of the skin and cutaneous lymphatics, whereas cellulitis extends more deeply into subcutaneous tissues features that favor diagnosis of erysipelas include area of inflammation raised above surrounding skin distinct demarcation between involved and normal skin in cellulitis, no clear distinction between infected and uninfected skin is present both erysipelas and cellulitis may present with signs of local inflammation (warmth, erythema, and pain) as well as lymphangitis and lymphadenitis
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Herpes zoster |
painful blistering rash caused by reactivation of varicella, chickenpox virus more common in adults, elderly infectious: virus leasions and nose and throat First sign: abnormal skin sensation along dermatone, feel ill, no lesions; then blistering rash (does not cross midline) Postherpetic neuralgia: persistence of pain: TCA, gabapentin, Lyrica, opioids, lidocaine patches Antivirals within 72 hours of rash onset-Valtrex, Famvir, Zovirax Tylenol, NSAIDS, Tylenol with Codeine, Tramadol Mod-sev pain: opioids Corticosteroid therapy |
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Herpes simplex virus patient presentation |
clear vesicles, erythema, low grade fever, generalized malaise, flu-like symptoms, painful vesicles and ulcer on tongue, palate, gingiva, buccal mucosa, lips Pain in legs, buttocks of genital area; genital burning, itching, vaginal discharge Grouped lesions on an erythematous base in mouth, face or genitals if on eyelid or cornea: ophthamologist referral No cure, lip, acyclovir, valtrex, Genital: Valtrex, fambir, zirovax 7-10 days |
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Psoriasis presentation and treatment |
chronic relapsing condition with remission and flares itchy, well-circumscribed, raised, erythematous papules and plaques covered with silvery-white scales; worsen over time; nails with stippling or pitting and yellow-brown color elbows, knees, scalp, flexural surfaces of body CBC, chem, uric acid, ANA, rheumatoid factor, ESR Topical <20% of body: OTC emollient creams or ointments, keratolytic agents, topical corticosteroids Exacerbations: super potent corticosteroid: Diprolene, Psorcon, Temovate, Ultravate 2 weeks Scal: Zetar, sebutone, Pentrax shampoo methotrexate, photo therapy |
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Paronychia |
Acute or chronic inflammation of tissue surround the nail more common in women than men localized to 1 finger, throbbing pain on nailfold, erythema, edema, foul purulent discharge (pain relief) warm water soaks, topical antibiotic, oral if mrsa (bactrim, clinda, amoxicillin, cephalexin) |
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Rosacea |
Chronic and progressive skin disorder that resembles acne fair skinned adults, no blackheads, whiteheads or nodules perissten erythema followed by small clusters of blood vessels recurrent acneiform erythematous papules or pustules around central face persistent yellow papules around nose NO known cure, ivermectin cream daily 8-10 weeks, metronidazole cream, clind or erythomycin if not effective; systemic therapy for flare ups: tetracycline, minocycline, doxycycline |
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MRSA tx |
I& D with cultuyre Bactrim Doxyxline, minocycline |
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Folliculitis |
inflamed hair follicles (filled with pus); superficial or deep anywhere there is hair Cause: infection (s. Aureus), chemical irritants, mechanical irritation or injury TxL mupirocin, altabax, clindamycin solution |
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Vesicles impetigo |
Impetigo is a contagious skin infection that can occur at any age, but is most common in children aged 2-5 years and can present in either bullous or nonbullous forms. distinction between impetigo and ecthyma, based on clinical presentation (often ulcers plus pain) is necessary to guide appropriate management3 confirmation of diagnosis not usually required, but may be done with Gram stain and bacterial culture: a positive culture does not differentiate between infection and colonization1 cultures of fluid, pus, erosions, or ulcers may inform treatment, particularly in recurrent or recalcitrant cases or outbreaks causes of impetigo may be primary (direct bacterial infection of skin) or secondary to other dermatological conditions (chickenpox, atopic dermatitis, scabies) or skin trauma (cuts, abrasions, insect bites) (J Drugs Dermatol 2020 Mar 1;19(3):281) |
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Furuncles *boil |
deep bacterial infection of hair follicle with abscess formation -caused by gram-positive staph aureus; tender to touch, red in color; become fluctuant; drain and resolve spontaneously Warm compresses promote spontaneous rupture and drainage Topical abx: gram positive coverage: Bactroban, neosporin |
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Carbuncle |
Large abscess made up of multiple furuncles Large, painful red lumps with multiple openings, will drain puss Must drain before healing spontaneously within 2 weeks, may need I& D |
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Basal cell carcinoma |
Most common: face and nose, cheeks and ears, neck Elevated papules that have pearly appearance with some crusting, blood vessels on border of lesion, central ulceration seen in late stages slow growing, locally invasive, rarely metastasizes Same as skin color, brown, blue, black |
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Squamous cell carcinoma |
Face, lip, ears, upper cheeks, scal, dorsa of hands and forearms Malignant non-melanoma skin cancer originating from keratinized epithelial cells: roughened area that does not heal and bleeds when scraped Caused by actinic damage due to chronic sun exposure More common in men and older individuals firm papule with scaly, rough surface with irregular borders, may have horns and bleed easily |
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Malignant melanoma |
Tumor of melanocytes, most commonly found in skin, intestine, brain, eye; very aggressive Presence of large or multiple nevi Concerns about changing mole, may be burning, itching, bleeding Sites of sun exposure: asymmetric lesion with irregular border, notching >6mm, mixture of blue, red, tan, brown, black and white colors, typically flat |
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Clark's levels: |
invading depth of lesion and metastatic potential: Level I: in situ, confined to epidermis Level II: extends through basement membrane and into upper dermis Level III: extends into lower dermis Level IV: extends into reticular dermis Level V: invades SC tissue |
