Term
| cause and two types of acne vulgaris |
|
Definition
obstruction of sebaceous glands and hair follicles by sebum leading to proliferation of propionibacterium acnes (anaerobie)
obstructive: closed comedones/whiteheads, or open comedones/black heads
inflammatory: lesions progress from papules and pustules to nodules, cysts, and scars |
|
|
Term
| treatment of acne vulgaris |
|
Definition
topical benzoyl perixode: kills bacteria, drys skin preventing pore filling
topical retinoids
topical erythromycin or clindamycin
oral contraceptives
systemic antibiotics
oral retinoids |
|
|
Term
|
Definition
teratogenic: go on BC 1mo before and 1mo after
hepatotoxic
depression and suicide
pseudotumor cerebri with tetracycline
dry skin
hyperTG |
|
|
Term
|
Definition
caucasian, woman, 30-50
worse with spicy food, alcohol, temp, emotions
papules, pustules, rhinophyma, conjunctivitis, keratitis, bepharitus, telangiectasia, on forehead, nose, cheeks flushing
tx: topical metronidazole, PO tetracycline, isotrentionin if refractory |
|
|
Term
| seborrheic dermatitis signs and tx |
|
Definition
dandruff of hairline, behind ears, external ear canal, nose folds, eyebrows, armpits, under breast, groin
cradle cap in babies: plaques, yellow greasy, puritic
cradle cap: selenium sulfide, hydrocortisone
adult: selenium sulfide, tar, topical ketoconazole, antifungals |
|
|
Term
|
Definition
red, puritic, patches, flexor surfaces, dorsum of hands and feet, chest, back, face, scalp in infants, possible vesicles
nummular: oval plaques on extremities, puritic, symmetrical
moisturizer with high oil low water, calcineurin inhibitors (tarcolimus), topical steroids (DOC nummular) |
|
|
Term
|
Definition
eczematous dermatitis with inflammatory papules, scaly crusted erosions, increased pigmentation, stippling, recent and old hemorrhages, possible ulceration
compressive stockings, elevation of legs, horse chesnut seed, topical steroid, aspirin |
|
|
Term
|
Definition
papulosquamous herald patch looks like ring worm, 1-2wk later christmas tree rash with oval lesions with white scale, mild puritis
self limited, topical steroid or phototherapy if significant purutis |
|
|
Term
|
Definition
inflammed SC fat causes painful nodules of anterior tibia in young women, low grade fever, malaise, joint pain
self limited, NSAIDs, rest, steroids, elevation |
|
|
Term
| causes of erythema multiform |
|
Definition
| sulfa, PCN, NSAID, OC, phenytoin, carbamazepine, lamotrigine, phenobarbitol, HSV, m. pneumo, S. pneumo, vaccines |
|
|
Term
|
Definition
red macules and papules, symmetric, on palms and soles, target bulls eye lesion, can become bullous, purutic, painful, malaise, fever, artherlgia, headache
minor: on extremities only
major: on extremities and mucosa |
|
|
Term
| morphology of erythema multiform |
|
Definition
| eosinophils, lymphocytes, necrotic keratinocytes, septal panniculitis |
|
|
Term
| defining difference between erythema multiform, SJS, TEN |
|
Definition
EM: target lesions, can become bullous
SJS: detachment of epidermis <10% of body
TEN: detachmend of epidermis and necrosis >10% of body |
|
|
Term
|
Definition
SJS: admit to ICU, stop offending agents, rehydrate, steroids, analgesics, IVF
TEN: stop offending agent, admit to burn unit, IVF, steroids |
|
|
Term
|
Definition
puritic, polygonal, purple, planar, polyangular, papules, shiny, central dimple, coalsed into group, symmetrical
on flexors, shins, oral mucosa, genitals
wickham's striae: lacy rectangles of white lesions on surface of papules, can occur on buccal mucosa
tx: topical steroids, oral steroids or retainoid of refractory |
|
|
Term
| morphology of lichen planus |
|
Definition
| damaged basal epidermal keratinocytes, linear lymphocytic infiltrate in papillary dermis at epidermal interface |
|
|
Term
|
Definition
| thick silver scales, possible pustules, auspitz sign, koebner phenomenon (lesions at sites of injury), oncholysis, on extensors, pitting of nails, arthritis |
|
|
Term
|
Definition
absent granular layer
thick epidermis
nucleated cells in stratum corneam
increased uric acid and ESR, no RF |
|
|
Term
|
Definition
topical: steroids DOC, calcipotrine, calcitrol, coal tar, tararotene, salicylic acid
systemic: NEVER PO STEROIDS, immune modulators, soriatine, triamcinolone, entarecept, UV light |
|
|
Term
| signs and tx seborrheic keratitis |
|
Definition
AD, benign
face, trunk, increase over time, slightly elevated plaques, gradually darken, stuck on appearance, tan-brown, pseudohorns
cosmetic removal only, liquid nitrogen or curettage |
|
|
Term
| seborrheic keratitis morphology |
|
Definition
| mila like cysts, comedo like openings, cerebiform pattern (fissures, ridges), finger like structures, moth eatern borders |
|
|
Term
| what is sign of lesser trelat |
|
Definition
| sudden appearance of many seborrheic keratitis, sign of malignancy |
|
|
Term
|
Definition
| scleroderma of skin, circumscribed, thick, sclerotic |
|
|
Term
|
Definition
| heat rash, small papules and pustules, stinging sensation, on covered areas of skin |
|
|
Term
|
Definition
| low niacin, dementia, diarrhea, purutic erythema, later vesicles and bullae, dorsal hands, feet and neck |
|
|
Term
|
Definition
| hypopigmented patches in kids, worse after sun exposure, negative KOH |
|
|
Term
|
Definition
sharp demacration of amelanotic skin with hyperpigmented borders, usually on face and around body orifices
due to CD8 cytotxic T cells to melanocytes
tx: sunscreen, dyes, makeup, steroids, tarcolumus, UV light with psoralens, surgical grafting, depigmentation of normal skin |
|
|
Term
|
Definition
young, female, dark complexion, sun exposed areas, hyperpigmentation, usually pregnant
hydroquinone, azelatic acid creame
flucinolone, hydroxyquinolone, and trentinoin
DC OC |
|
|
Term
|
Definition
weight loss, DC steroid and OC, identify and remove malignancy
tretinoin or topical steroids for lightening
fish oil supplememnts |
|
|
Term
|
Definition
| hemangioma, purple red lesion on face, does not regress with age, associated with sturge webber syndrome when opthalmic |
|
|
Term
| signs strawberry hemangioma |
|
Definition
| infant, bright red lesion, regresses over months to years |
|
|
Term
|
Definition
| benign, small, red, papule, appears on skin with age |
|
|
Term
|
Definition
| bright red papule, radiating blanching vessels, associated with cirrhosis |
|
|
Term
| signs cavernous hemangioma |
|
Definition
| blue, compressible, does not regress |
|
|
Term
|
Definition
| red pink nodule on child, often confused with melanoma |
|
|
Term
|
Definition
dark spot on lower butt or back, resolves over time
risk: native american, asian, hunter, hurler |
|
|
Term
|
Definition
anti-BM/anti0hemidesmosome, linear band at dermal-epidermal junction
blisters not easily ruptured
not usually on mucosa
puritic
tx: topical steroids |
|
|
Term
|
Definition
IgG to desmoglein, IgG between epidermal cells
positive nicklosky
starts in oral mucosa
tx: systemic steroids, immune suppressants, treat as burns |
|
|
Term
| prophyria cutanea tarda: cause and risk factors |
|
Definition
cause: deficiency of hepatic uroporphyrinogen decarboxylase for heme metabolis
risks: alcoholism, hep C, Fe overload, estrogen use, smoking, HIV |
|
|
Term
| prophyria cutanea tarda: sx, tx |
|
Definition
chronic blistering on sun exposed skin, hyperpigmentation, facial hypertrichosis, pseudoscleroderma, NO ABDOMINAL PAIN, BLISTERS ARE PAINLESS
INCREASED PLASMA AND URINE PROPHYRIN
tx: phlebotomy, chloroquine |
|
|
Term
| dermatitis herpatiformis sx, tx |
|
Definition
IgA deposition in papillary dermis recruits neutrophils and complement
puritic, extensors, butt, papules, vesicles, erythematous
tx: dapsone, gluten free diet (diaminodihenyl sulfone) |
|
|
Term
| stages of decubitus ulcers |
|
Definition
1) skin in tact, signs of impending ulcer
2) partial thickness skin loss (some epidermis and dermis)
3) full thickness skin loss, extends to SC but not fascia
4) full thickness skin loss into muscle, bone, joint, tendon, sinus tracts |
|
|
Term
| treatment of decubitus ulcers |
|
Definition
1) xanaderm protective dressing
2) hydrocolloid dressing (avoid wet to dry)
3/4) debridement, hydrocolloid dressing |
|
|
Term
|
Definition
GAS: local trauma, breaks in skin
S. aureus/MRSA: wounds, abscesses
pseudomonas, aeromonas, vibro: water
H influenza: sinusitis |
|
|
Term
|
Definition
PO cephalosporin or staph penicillin 2wk
if bacteremia: IV antibiotics
if MRSA: IV linezolid or vancomycin
if DM: broad spectrum antibiotics, multiorganism risk |
|
|
Term
| what are the 3 types of skin abscesses |
|
Definition
folliculitis: hair follicle infection, S. aureus/pseudomonas, multiple puritic red pustules
furuncle: deep folliculitis, accumulation of puss (boil)
carbundcle: large furuncle, multiple sites with puss coming out |
|
|
Term
| treatment of skin abscess |
|
Definition
I&D, culture aerobic and anaerobic
if >5cm antibiotics needed 10-14d: TMP-SMX and rifampin, clindamycin and rifampin, linezolid |
|
|
Term
| treatment for hiradenitis suppurativa |
|
Definition
| tetracycline, macrolides, intralesional steroids, OC, spironolactone, isotrentinoin |
|
|
Term
|
Definition
cellulitis confined to dermis and lymphatic tissue due to GAS
well demacrated, red, painfull, usually LE or face, high fever, chills, streaking look due to lymphatic spread, raised, often post pharyngitis or trauma
IM/PO penicillin or erythromycin |
|
|
Term
| erythrasma: cause, dx, tx |
|
Definition
superificial infection of corynebacterium minutissium (GPR) in DM/compormised
scaly plaques between toes, brown patches in interiginous areas, puritic, red under wood lamp due to prophyrins
tx erythromycin PO |
|
|
Term
| necrotizing fasciitis: cause, sx, tx |
|
Definition
S. pyogenes, C. perfringens
unexplained excruciating pain, erythema, blister, cerpitus, fournier gangrene
debridement, IVF and dopamine if shock, imipenem and vancomycin if unknown cause, pen G and clindamycin if strep of clostridia |
|
|
Term
| wet gangrene signs and tx |
|
Definition
necrosis due to vascular obstruction or infection, many bacteria, poor prognosis, sepsis, blistering, swelling, puss
emergent debridement, gulliotine amputation, antibiotics |
|
|
Term
| dry gangrene signs and tx |
|
Definition
gradual necrosis from vascular insufficiency, hard, dry, aching, pallor, blue-black, shriveled
auto-amputation, angiography to evaluate cause |
|
|
Term
| gas gangrene cause, signs, tx |
|
Definition
C. perfringens or other bacteria producing gas
early: pain, swelling
classic: initially pale, then dark purple-red, tense, tender, crepitus
systemic: tachycardia, low fever, diaphoresis, shock, organ failure
emergency debridement or gillotine amputation, antibiotics |
|
|
Term
|
Definition
GAS: red pustules on face and extremities
staph: red vesicles and blisters
both: yellow crusted lesions at mucocutaneous junctions, puritic, lymphadenopathy
erytheomycin, topical antibiotics, no sharing of clothing |
|
|
Term
|
Definition
staph or streph node inflammation, tender, swollen, red streaking on skin
tx: pen G, anti-staph pen, ceph, warm compress, wound drainage |
|
|
Term
|
Definition
GPC blocks NMJ, 2-wk-2d incubation
often deep puncture wound, dirt or saliva
hypertonicity, trismus, risus sardonicus, opisthotonos (Arched back), sympathetic hyperactivity
diazepam for tetany
ICU, respiratory support
neutralize toxin with passive immunization and toxoid
clean, debride
metronidazole, penicillin G |
|
|
Term
|
Definition
spirochete from rodent or farm animals in water
anicteric: rash, lymphadenopathy, increased LFTs
icteric: renal or liver failure, vascular collapse
tx: tetracycline, doxycycline, IV pen G if severe |
|
|
Term
|
Definition
fransciella tularensis GNB from rabbits, rodent, squirrel
fever, headache, nausea, ulcer at bite, painful lymphadenopathy
IM streptomycin or gentamycin |
|
|
Term
| cat scratch disease sx, dx, tx |
|
Definition
bartonella henslae GNB
red, papular, lymphadeniopoathy, can disseminated to liver, spleen, CNS, bacilliary angiomatosis on skin mucosa and bone in compormised
dx: wartharin starry silver stain, AB titer
docycycline, cpiro |
|
|
Term
| toxic shock syndrom cause, sx |
|
Definition
S. aureus
fever, headache, desqumation of palms and soles, strawberry tongue, waem skin, hypotension, N/V/D, increased LFTs, BUN, CR, CK, thrombocytopenia, confusion, disorientation |
|
|
Term
| hansens disease cause, sx |
|
Definition
mycobacterum leprae
hypopigmented anesthetic macular lesions, other neurosigns |
|
|
Term
| what are the dermatophytes |
|
Definition
| microsporum, tricophyton, epidermophyton |
|
|
Term
|
Definition
trunk, pinkish annular lesions, puritic, peripheral scaling, central clearning, hyphae with arthrospores
topical ketoconazole or miconazole |
|
|
Term
|
Definition
scalding, hair loss puriits
woods lamp floresce microsporium
PO griseofulbin, terbinafine, itraconazole |
|
|
Term
|
Definition
tinea ungium
nails of elderly look thick and opacified
terbinafine and itraconazole |
|
|
Term
|
Definition
web spaces of toes, young athlete, scalding, erythema, puritis
topical antifungal |
|
|
Term
|
Definition
groin, inner thigh, adult males, scalding, erythema, spares scrotum
antifungals |
|
|
Term
|
Definition
well demacrated, wont tan, brown to white, scale when scraped, KOH with spaghetti and meatball due to hyphe and yeast balls, woods lamp show blue green tinge
DOC selenium sulfide
topical antifungal
ketoconazole PO if large |
|
|
Term
|
Definition
candidia of skin, red, eroded, satellite lesions, in skin folds, puritic, painful, beefy red, KOH with pseudohyphae
tx: oral nystatin powder, keep skin dry |
|
|
Term
|
Definition
dimorphic fungi, septate hyphae
ohio/mississippi river, bird/bat poo
flu like, erythema nodosum, HSM
tx: PO intrconazole, amphotericin B if compormised |
|
|
Term
|
Definition
dimorphic, inhaled spores
midwest, south central
cough, CP, well demacrated verrucous or ulcerated lesions, bone lesions, CNS signs
KOH with broad based budding
tx: irraconazole, amphotericin B if dissemianted |
|
|
Term
|
Definition
cigar shaped yeast
hard SC nodule, ulcerates, drains, pneumonia, meningitis
itraconizole, potassium iodide, amphotericine B if disseminated |
|
|
Term
| treatment of pediculosis capitis |
|
Definition
| permethrin cream, pyrethrin, wet coambing with conditioner or olive oil, malathion, lindaine (neurotoxic), ivermectin (use if resistant) |
|
|
Term
| treatment of pediculosis pubis |
|
Definition
| permitherin, pyrethrin, malation, ivermectin, treat partner |
|
|
Term
|
Definition
anywhere but often on elbows, knees, fingers, palms
flesh colored, whitish, hyperkeratotic |
|
|
Term
|
Definition
chin, face, dorsum of hands and legs
flesh colored, smooth papule, flat surface |
|
|
Term
|
Definition
plantar foot, pain with pressure
flesh colored, rough, hyperkaratotic |
|
|
Term
| condyloma accuminatum sx, tx |
|
Definition
single or multiple soft, fleshy, perineum, anus, genitalia
spontaneous regression in most, potphylotoxin, potophyllin, trichloracetic acid, imiquimod, cyroablation |
|
|
Term
|
Definition
self limtied 6mo
curettage drops with podophyllin and canthardin, cryosurgery |
|
|
Term
|
Definition
prodrome: fever, malaise, pharyngitis, headache, myalgia
rash (24h): puritic red macule > teardrop vesicle > rupture and crust over. face and trunk to extremities, crusted by 6d |
|
|
Term
| who gets acyclovir for chicken pox |
|
Definition
| >12yo, household contacts, hxchronic cutaneous or cardiopulmonary disorders, taking inhaled steroids, taking chronic salicylates |
|
|
Term
|
Definition
valacyclovir, famicyclovir, acyclovir within 72h of onset, analgesia, prednisone 7d taper
infectious until crusted over |
|
|
Term
| treatment of post herpatic neuralgia |
|
Definition
| gabapentin, pregabalin, TCA, lidocaine patches, capsacin cream |
|
|
Term
|
Definition
| teathered to SC, causes dimpling with lateral pressure, nodular like scar |
|
|
Term
|
Definition
| grows fast, dome with central crater, keratinous materal, regresses over months |
|
|
Term
|
Definition
malignant transformation of chronic wound, usually burn, over 30y into SCC
requires complete excision |
|
|
Term
|
Definition
precancerous
small, rough, yellow brown, scaly
remove with topical 5-FU, freezing, scraping, imiquimod, cryotherapy |
|
|
Term
| basal cell carcinoma signs |
|
Definition
prefers above lip, waxy, pearly, smooth, papule, rolled adges, telangicestsa, rodent ulcer when locally invading
blue ovioid dots, basophilic staining epidermal cells in palisades, leaf like absorbing telangesticas |
|
|
Term
| basal cell carcinoma treatment |
|
Definition
| surgical resection with 1mm margins is curative |
|
|
Term
| squamous cell carcinoma cause, sx, tx |
|
Definition
UVB, actinic keratosis, immune suppression, chronic damage, arsenic, radiation
lower face below lip, crusting, non healing ulcer
excision with 0.5-2cm margins, neck nodes |
|
|
Term
| superificial spreading melanoma |
|
Definition
most common
grows lateral before invading
comes from PRE-EXISTING NEVUS
sun exposed areas
>6mm, asymmetric, irregular |
|
|
Term
|
Definition
most common
grows only vertical, rapidly invasive, difficult to detect
arises de novo
old men, on leg or trunk
bleeds easily |
|
|
Term
|
Definition
melanoma rapid agressive
involves palms and soles, nail bed
AA > asian > latino > caucasian |
|
|
Term
|
Definition
melanoma, long lasting in situ
sun exposed areas
least likley to metastasize |
|
|
Term
|
Definition
|
|
Term
|
Definition
in situ: o.5cm margins
<2mm: 1cm margins
>2mm: 2cm margins and node dissection
metastasis: chemo, radiation |
|
|
Term
| #1 COD of melanoma metastasis |
|
Definition
|
|
Term
|
Definition
type 4 hypersesitivity
red papules, vesicles, oozing, edema, distinct shape, if chronic crust and thicken and lichenification, puritic |
|
|
Term
|
Definition
dariers sign: red and puritic after striking skin
edematous wheels
fleedng: dissipear in hours and return in another location
blanch with pressure
puritis, stinging |
|
|
Term
| hereditary angioedema cause |
|
Definition
| AD C1 esterase inhibitor deficiency |
|
|
Term
|
Definition
appear within 1mo of starting, usually 1wk
uticaria, angioedema, EM like erruptions, erythema nodosum
asthma, pneumonitis, interstitial nephritis, nephrotic syndrome
thrombocytopenia, hemolytic anemia, eosinophilia, agranulocytosis |
|
|
Term
| aloplecia atresia cause, tx |
|
Definition
autoimmune against hair bulb, usually in kids, non scarring hair loss, percipitated by stress
flucionolone shampoo, intralesional steroids, UVA, minoxidal, anthralin cream |
|
|
Term
|
Definition
female, illness, childbirth, surgery, medication, stress
hair loss, diffuse, hair in telogen phase considered antigen |
|
|
Term
| androgenic alloplecia cause, tx |
|
Definition
hair loss due to excess DHT
decreased angen phase (growth)
increased telogen phase (rest)
usually vertex or feontotemporal
men: finasteride +/- minodixil
women: minoxidil +/- spironolactone |
|
|
Term
|
Definition
| comes from healthy tissue on same patient or identical twin |
|
|
Term
|
Definition
| donor tissue from another person |
|
|
Term
|
Definition
aka heterograft
donor tissue from another species |
|
|
Term
|
Definition
| donor tissue from same species but different genetic make up |
|
|
Term
|
Definition
| tissue from body of cadaver |
|
|
Term
|
Definition
epidermis and part of dermis, contracts over time, comes from thigh, abdomen, butt
used for large areas |
|
|
Term
|
Definition
epidermis and full dermis, comes from above ears for face, forearm, groin
used for face or hands |
|
|
Term
|
Definition
graft that has cartilage, nail, fat, etc
comes from finger, ear, etc |
|
|
Term
|
Definition
| left partially attached to donor site and rotated or stretched to cover |
|
|
Term
|
Definition
| flap completely removed from donor site and transfered in whole to wound |
|
|
Term
|
Definition
skin and SC with attached vascular supply
often forehead, groin, deltopectoral, thigh
good for large defect, needing vascular supply, requiring padding |
|
|
Term
|
Definition
transfer of muscle that includes skin or requeres skin graft
tensor fasca lata, gluteal, satorius, rectus abdominus, latissimus dorsi
indicated when vascular tissue needed, exposed deep tissues, or severe radation injury |
|
|
Term
|
Definition
port wine stain hemaniooma in opthalamic (V1) and maxillary (V2) distribution
MR, glaucoma, hemiparesis, seizure, hemianopsia |
|
|
Term
|
Definition
togavirus, german measles
suboccipital and post auricular lymphadenopathy, maculopapular rash starting on face and spreading caudally, arthralgias |
|
|
