Term
[image]
White Spots
•Most Likely Diagnosis?
•Test?
•Treatment?
•Important Points
|
|
Definition
•Most Likely Diagnosis? Tineaversicolor
•Test?
–Koh: hyphae and spores
•Treatment?
–Oral fluconazole
•Important Points
–If it scales, scrape it
–Months for repigmentation |
|
|
Term
[image]
Bleeding Growth
•Differential diagnosis?
•Next step?
•How is prognosis determined?
•Important points
|
|
Definition
•Differential diagnosis?
–Nodular malignant melanoma
–Blue nevus
–Pyogenic granuloma
–hemangioma
•Next step?
–Excisional or deep shave bx
•How is prognosis determined?
–Tumor thickness
•Important points
–All bleeding pigmented lesions need bx
–Thick melanomas have a poor prognosis
–Thin melanomas can be removed and cured
|
|
|
Term
[image]
recurrent vesicles
•Diagnosis?
•Lab tests?
•Recommendations?
•Important points?
|
|
Definition
•Diagnosis?
–Herpes simplex virus
•Lab tests?
–Tzanck preparation
–Viral culture
•Recommendations?
–Acyclovir, valacyclovir, or famciclovir
•Important points?
–Tzanck smear is easy and confirmatory
–Antivirals are DOC but not curative |
|
|
Term
[image]
papulovesicular rash
•Differential diagnosis?
•Treatment?
•Diagnosis?
•Important points
|
|
Definition
"MRSA can look like this"
•Differential diagnosis?
–Contact dermatitis
–Fungal or bacterial infection
•Treatment?
–Stop offending agent
–Topical steroids
•Diagnosis?
–Patch testing - will tell them what they are allergic to in 36 hours
•Important points
–Suspect topical in rashes of their application area
–Avoidance of allergen, steroid hasten resolution
–Patch testing confirms diagnosis
|
|
|
Term
[image]
fever & purpura
•Description?
•Most likely diagnosis?
•How to diagnose?
•Treatment?
•Important points
|
|
Definition
•Description?
–Palpable purpura and petechiae
•Most likely diagnosis?
–Meningococcemia
–sepsis
•How to diagnose?
–Blood and CSF bacterial cultures
–Gram stain
–Latex agglutination test of CSF
•Treatment?
–IV antibiotics
•Important points
–Fever & palpable purpura, must consider sepsis which is a medical emergency
–Immediate abxtx if sepsis suspected |
|
|
Term
[image]
firm nodule
•Diagnosis?
•Next step?
•Other lesions?
•Important points |
|
Definition
•Diagnosis?
–Malignancy
•Size
•Firmness
•Next step?
–biopsy
•Other lesions?
–Scar from previous biopsy: reviewed and found to be a primary malignant melanoma
•Important points
–Suspect malignancy in firm nodules
–Complete skin exam revealed source of primary disease |
|
|
Term
[image]
generalized itching papules
•Description?
•Likely Diagnosis?
•How to diagnose?
•Important points
|
|
Definition
•Description?
–Discrete, excoriated papules
•Likely Diagnosis?
–scabies
•How to diagnose?
–Look for burrows
–Scrape skin and look for mites, eggs, or fecal matter
•Important points
–Suspect scabies for generalized itching, especially if pruritic papules are on the penis
–Mites can be scraped from burrows or papules
"may complain of itching more at night b/c that is when the mites are awake" |
|
|
Term
[image]
hair loss
•Differential diagnosis?
•Next step?
•Treatment?
•Important points |
|
Definition
•Differential diagnosis?
–Stress induced alopecia, androgenic alopecia, trichotillomania, alopecia areata, lupus, fungal infection
•Next step?
–KOH preparation of broken hairs
–Fungal culture
–Biopsy usually not needed
•Treatment?
–Oral griseofulvin or terbinafine 4-6 weeks
"something systemic b/c hair folicles are too deep"
•Important points
–KOH needs plucked hairs, scale may be negative, if KOH equivocal or negative, do fungal culture
–Topical treatment ineffective, requires oral antifungals |
|
|
Term
[image]
pearly nodule
•Differential Diagnosis?
•Treatment?
•Future patient precautions
•Important points |
|
Definition
•Differential Diagnosis?
–Basal Cell Carcinoma
–Squamous Cell Carcinoma
•Treatment?
–Mohs Surgery - "for face or neck"
–Excision
–Electrodessication and Cautery
•Future patient precautions
–Sun protective clothing
–Sunscreen SPF 30 or greater "new reccomendations are 50!"
–Full skin exams regularly
•Important points
–New pearly nodule or non-healing ulcer may be cancer
–BCC are treatable and rarely metastasize
–Sun protection, as UVR is most common cause of BCCs |
|
|
Term
[image]
generalized erythema
•Most likely diagnosis?
•Most likely drug?
•How can you prove it? |
|
Definition
•Most likely diagnosis?
–Drug eruption
•Intense erythema
•Confluence of rash
•Pruritus
•Absence of fever or other constitutional symptoms
•Most likely drug?
–Most recently administered drug.
–Antibiotics, especially sulfa and penicillin
•How can you prove it?
–No confirmatory test, based on clinical history and finding
Very itchy---
They can have or not have fever
Sulfa has a bad rap--- it is the culprit a lot of times--- never ever treat someone with a sulfa drug again!
|
|
|
Term
[image]
scaling rash
•Differential Diagnosis?
•Next Step?
•Important point |
|
Definition
•Differential Diagnosis?
–Tineacorporis (ringworm), pityriasisrosea, secondary syphilis, discoid lupus, mycosis fungoides, psoriasis
•Next Step?
–KOH
•Important point
–If it scales, do KOH exam |
|
|
Term
[image]
Pustules and papules surrounding an ulcer
•Description?
•Differential?
•First diagnostic test?
•Treatment? |
|
Definition
•Description?
–Erythematous eruption with satellite pustules and papules
•Differential?
–Contact dermatitis
–Candidiasis
•First diagnostic test?
–KOH: + hyphae
•Treatment?
–Topical imidazole cream
–Keep areas dry |
|
|
Term
1.Best test for scaly rashes? |
|
Definition
|
|
Term
2.Best test for new firm nodules? |
|
Definition
|
|
Term
3.Best test for recurrent vesicles? |
|
Definition
|
|
Term
4.How do determine prognosis of melanoma?
|
|
Definition
|
|
Term
5.Most common skin cancer?
|
|
Definition
|
|
