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Details Title: Dermatology Description: Dermatology NYCOM MS2 Total Flash Cards: 101 Created: 11/15/2003 15:53:40	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term Define a Macule Definition ...a flat well circumscribed to illdefined discoloration ...can be any color or hypopigmented (paler than normal skin) ...you will not feel a macule when you run your finger across it Term Define a Patch Definition ...a confluence of macules ...you will not feel this when you run your hand across it Term Define a Nodule Definition ...an elevated and circumscribed solid lession that is greater than 0.5cm...this lession is well defined and will be felt because it is raised Term Define a Vesicle and the three subtypes Definition ...it is a fluid containing lession of which there are 3 types...1) a bullae is greater than 0.5cm...2) pustules are a collection of leukocytes...3) cysts are a sac containing fluid Term Define CRUSTS and 3 examples Definition ...crusts are dried exudates...serous dried exudates are honey colored... purulent dried exudates are yellow to brown... bloody exudates are rusty brown colored Term Define Scales Definition ...it is excess dead epidermal cells produced by abnormal keratinization and shedding Term What is bandlike distribution? Definition lessions along a dermatome... shingles or herpes present like this...you won't see crossing of the body's midline unless the patient is HIV positive Term What is Photodistribution and what are its sites? Definition ...lessions occur in sun exposed areas like the face, neck, arms, etc... lupus presents in this distribution pattern Term Where are intertriginous areas of the bidy? Definition ...the axilla, breast fold, and groin...diseases that present this way are yeast, fungus, and psoriasis Term Describe the Woods light dx tool Definition a uv light that causes color changes in certain diseas states...fungal infections like microsporum audouini will appear green...bacterial infections like corynebacterium minutissimum will appear orange...pigmentary disorders like viteligo will appear ivory-white Term describe diascopy as a diagnostic tool Definition ...it is a slide you put over a lession that distinguishes between vascular disorders(vessels disapear) and melanoma(don't disapear)...purpuric lesions will not disapear...and lupus vulgaris will look like apple jelly Term what is auspitz sign? Definition in psoriasis you will have bleeding points under scales when you pry them up Term what is the darier sign? Definition in urticaria pigmentosa rubbing the skin will make it edematous and erythramatous Term what is dermatographism? Definition in a person prone to urticaria (hives) if you scratch the back you will raised area Term what is the nikolsky sign? Definition describes pemphigus= a mobile blister under pressure to contrast pemphigoid is a tense blister that is non-mobile Term waht is a tzanck smear? Definition it is a viral culture usually used to dx HSV Term what is a weak topical steroid? Definition hydrocortizone Term what is a weak topical steroid? Definition hydrocortizone Term what is a medium strength topical steriod? Definition triamcinolone Term what is a strong topical steriod? Definition fluocinonide Term name 9 adverse reactions to topical corticosteriods Definition 1) rosacia 2)skin atrophy =stria 3)tinea incognito 4)allergic contact dermititis 5)systemic absorbtion=cataracts 6)miliaria 7)folliculitis 8)nonhealing leg ulcers 9)hypopigmentation Term what is seborrheic dermatitis? Definition an inflamation of the skin that is chronic and known as craddle cap in infants and pityriasis sicca (dandruff) in adults Term what are the predisposing factors to seborrheic detmatitis? Definition heredity, parkinsons ds, facial paralysis, euroleptic drugs, hiv...it is also caused by thr yeast pityrosporum ovale Term what is the DDX for seborrheic dermatitis? Definition psoriasis, dermatophytosis (fungus), pitoryasis rosea, candidiasis, SCLE (lupus) or nutritional deficiency Term what is koebners phenomenon and in what ds does it occur? Definition it is a trigger in psoriasis vulgaris of rubbing and scratching that stimulates psoriasis proliferation Term what is the pathogenesis of psoriasis? Definition the kell kinetics are altered so that there is a shortening of the cell cycle from 311 days to 36 hours whick results in 28 times the production of epidermal cells Term what does psoriasis vulgaris look like on PE? Definition salmon-pink papules and plaques that are sharply marginated with silver white scale Term what is the primary DDx for psoriasis vulgaris? Definition seborreic dermatitis Term what are the 5 "P's" of lichen planus? Definition purple, polygonal, pruritic, planar, papules Term what does lichen planus look like on PE? Definition flat topped, violacious, shiny papules with white lines called wickhams striae Term what is a pterygium? Definition a term specific to lichen planus where you don't see the nail folds Term what is a herald patch? Definition it is an oval, slightly raised plaque with fine scales at the perifery of the body. it is found in 80% of patients with pityriasis rosea Term what dermatophyte occurs in a moccasin type distribution? Definition tinea pedis Term on hand, 2 feet syndrome refers to what dermatophyte? Definition tinea manuum Term what are the common causes of tinea capitis? Definition in u.s. trichophyton tonsurans (black dot) ...worlswide it is microsporum canis (grey patch) Term what is a kerion? Definition tinea capitis that is not treated correctly and becomes inflamed Term what is tinea incognito? Definition a dermatopphytosis that occurs after the topical application of steroids to a dermatophyte site... will not look like fungus after steroid use even though it is Term what causes tinea versicolor? Definition pityrosporum orbiculare Term how do you Dx tinea versicolor? Definition microscopicaly you see spaghetti (hyphae) and meatballs (spores) Term describe candidiasis upon PE? Definition firery red with satellite pustules Term what are acne myths? corrected Definition 1. there is no DIET correlation 2. COSMETICS are not a cause 3.CHOCOLATE does not cause acne 4. DIRT not due to being dirty 5. SUN it does not relive acne 6. TEENAGERS ONLY not true, occurs in adults too Term what causes acne? Definition androgen excess, stress, medication like lithium and mechanical irritation Term how do you treat moderate to severe acne? Definition you add an oral antibiotic to the topical regime, this is the next step and goes beyond topicals. add- tetracycline, minocycline, doxycycline, erythromycin Term how do you treat recalcitrant acne? Definition this is long term acne and is treated with 13-cis-retinoic acid (accutane) Term what do you have to be aware of with accutane? Definition user must not get pregnant, beware of depression or suicide int he family history, and triglycerides increase always. you have to monitor to make sure no one gets into a very high range Term what are other effective acne treatments? Definition intalesional injections with triamcinalone. this is a steroid and usually causes acne but here by injecting it it gets rid of inflamation and prevents scarring. Term what is perioral dermatitis? Definition it is an acne rosea like dermatitis that occurs around the mouth and eyes almost exclusivly in women 20-40 yoa Term what does periorbital dermatitis look like upon PE? Definition small erythramatous papules that coalesce to form eczematous patches with satellite papules and pustules ***this eruption looks like eczema but is actually acne, the name is a misnomer*** Term what is the DDx for perioral/orbital dermatitis? Definition allergic contact dermatitis, atopic dermatitis, seborreheic dermatitis, sarcoidosis ***all of these are treated with topical steriods but we are actually dealing with an acne!*** steroids will exacerbate it Term how do you treat perioral/orbital dermatitis? Definition do not use topical steriods and start toical antibiotic, most patients require an oral antibiotic also Term what is telogen effluvium? Definition loss of hair in the telogen phase- since 10% of hair is in this phae only 10% is lost- Term what are the causes of telogen effluvium? Definition post partum, crash dieting, surgery, birth control pills, HIGH FEVER, drugs like anticoagulants and accutane Term how do you treat telogen effluvium? Definition reassurance, hair will grow back in time Term what is pseudofolliculitis barbae? Definition hair grows out of the follicle then curls upa nd repenetrates the skin Term how do you treat pseudofolliculitis barbae? Definition discontinue close shaving and use retinoids Term what is a habit tic deformity? Definition it is a nail deformity that occurs from the patient constantly pushing back on his cuticle, mostly on thumbs and it wwill leave horiz. impressions. this will go away when a patient breaks this habit Term what is an onycomycosis? Definition subungal debris of fungus Term what are beau's lines? Definition stress (the same that causes telogen effluvium) on the body puts the nail into a temporary growth arrest. you see horiz. ridges in nail that represent no growth over time. differentiate from habit tic b/c this happens on all nails not just thumbs Term what is the most common type of drug reaction? Definition exanthematous drug eruption Term what are the non-allergic causes of urticaria, angioedema, and anaphalaxis? Definition nsaids, and radiographic contrast media Term what drug can induce pigmented skin findings? Definition zidovudine- brown macules on lips or oral mucosa and longitudinal brown bands in nails Term a deficiency in waht can lead to warfarin necrosis? Definition protein c Term what is the atopic dermatitis triad? Definition will occur with a personal or family history of hay fever, asthma, or allergic rhinitis Term what is the dennie-morgan sign? Definition in atopic dermatitis there will be an infraorbital wrinkle below the eyelid Term what causes seborrheic dermatitis? Definition lipophilic yeast, pityrosporon ovale Term what is the common distribution of seborrheic dermatitis on the face? Definition in a butterfly area of face, behind ears, forehead, nasolabial fold, glabella Term what is a blue nevus? Definition it represents a localized proliferation of melanin producing dermal melanocytes called the tindle effect Term when does a blue nevus occur? Definition childhood or late adolesence Term what is the treatment and course of a blue nevus? Definition it is an aquired lesion that is usually biopsied to rule out melanoma, they are usually benign Term what is a halo nevus? Definition a mole encircled by a halo of leukoderma or depigmentation (white) Term where do halo nevi usually occur? Definition the trunk Term what diseases is a halo nevus usually associated with? Definition vitiligo or metastatic melanoma Term what is the age of onset for a spitz nevus? Definition 1/3 of patients are under 10, 1/3 are 10-20, and 1/3 are over 20 but rarley over 40 Term where do spitz nevi occur? Definition usually the head and neck and 90% are aquired Term what is the course and treatment of a spitz nevus? Definition full excision with a border of 5mm to prevent reoccurance and biopsy to rule out melanoma b/c the can lookalike histologically Term what is the histology of nevus spilus? Definition a combination between a lentigo and a nevus Term what does a nevus spilus look like on physical exam? Definition light brown macule with many dark brown spots scattered throughout the lighter background Term describe a compound nevus? Definition they are a combination of junctional (flat and uniform color nevi) and a dermal (flesh colored and elevated nevus)...this skin lesion is usually darkly pigmented and dome shaped Term what is nevus flammeus? Definition called also stork bite, it occurs in infants on the neck, face and looks likea port wine stain. it is treated with a pulsed dye laser Term what is sturge weber syndrome? Definition a port wine stain varient that includes vascular malformations of the eye and leptomeninges of the brain Term what is klippel trenaunay? Definition may be associated with port wine stain that overlies the deeper vasculature and malformations of the soft tissue and bone Term what is actinic keratinosis? Definition a common sun induced premalignat lesion Term what do actinic keratinosis look like? Definition thay are discrete, rough and adherent scaly papules that occur in areas of dermatoheliosis (sun damaged skin)head, neck, hands, earlobes... Term why are we worried about actinic keratinsis? Definition they have premalignant potential and may develop into SCC, it should be treated with 5-FU (flourouracil) it attacks the premalignant cells and turns them red thereby helping to determine cancer status Term what are the 5 types of basal cell carcinoma and which has the worst prognosis? Definition superficial, nodular, pigmented, ulcerative (rodent ulcer) and morpheaform (worst prognosis) Term what are the 5 cardinal features of melanoma? a-e Definition assymetry, borders (irregular), colors (mottled-haphazard), diameter >6mm, enlargment or elevation Term what is a pyogenic granuloma? Definition a bright red and smooth dome shaped nodule that bleeds frequently...it occurs on fingers, lips, mouth, trunk, toes...it must be surgically removed Term what is a dermatofibroma? Definition it is abutton like nodule which is a fibrous rxn to a trauma or bite Term what is the dimple sign? Definition associated with dermatofibroma...it is a lateral compression with the thumb and index finger that produces a dimple frequncy is legs>arms>trunk Term what is the sign of leser trelat? Definition in seborrheic keratosis an acute exacerbation can be related to adnocarcinoma or gi carcinoma Term what is kasabach-merritt syndrome? Definition a bv disorder of a deep cavernous type with platlet entrapment and trombocytopenia Term what are keloids? Definition scars with over expressed fibrous repair, mc in blacks on the earlobes and upper parts of body Term to what organ ds is spider angioma related? Definition liver ds Term what are the melanoma risk factors? mm risk Definition moles atypical >5, moles common >50, redhair, inability to tan, sunburn, kindred (family hx of melanoma) Term where are common nevi found? Definition on sun exposed areas Term where are dysplastic nevi found? Definition on sun protected areas Term what is huchinsons sign? Definition in malignant melanoma a mole around a nail that bleeds into normal skin Term what are the side effects of accutane? Definition teratogenic (cat x), inreases triglyserides, and suicidal depression Term what is hydradenitis suppuritiva? Definition an abcess of the apocrine sweat glands in the anogenital or axillary region Term What are the viral manifestations of hiv 6 of them? Definition acute exanthem of hiv (early aids rash), HSV, cytomegalovirus, oral hairy leukoplakia, molluskum contagiosum, HPV Term describe oral hairy leukoplakia? Definition it is highly correlated with the progression of aids... it is white corrugated plaques on the lateral margins of the tounge...it may become verrocous and lead to dysphagia...candidiasis may be superimposed