Term
| Reaction pattern of blood vessels in the dermis with secondary epidermal changes |
|
Definition
|
|
Term
Age of onset- 50% under 20 years
Sex - males > females |
|
Definition
|
|
Term
| ___ minor or major (SJS & TEN) |
|
Definition
|
|
Term
| Consensus leaning towards that __ and __ are different |
|
Definition
EM
SJS
Erythema multiforme
|
|
|
Term
| Etiology- A cutaneous reaction to a variety of antigenic stimuli |
|
Definition
|
|
Term
| Infection- Herpes simplex (MC), Mycoplasma |
|
Definition
|
|
Term
| Drugs; Sulfonamides, phenytoin, barbiturates, phenylbutazone, penicillin, allopurinol |
|
Definition
|
|
Term
| Idiopathic (undetected Herpes or Mycoplasma) |
|
Definition
|
|
Term
| History- Evolution of lesions over several days. May have history of prior episode. May be pruritic or painful, particularly mouth lesions. In severe forms, fever, weakness, malaise may be present |
|
Definition
|
|
Term
| Lesions may develop ≥ 10 days |
|
Definition
|
|
Term
| Macule → papule (1 to 2 cm) |
|
Definition
|
|
Term
| Vesicles and bullae in the center of the papule, iris or targetlike lesions result and are typical |
|
Definition
|
|
Term
Dull red
Bilateral and often symmetric |
|
Definition
|
|
Term
| Localized to hands and face or generalized |
|
Definition
|
|
Term
| Mucous membranes- erosions or ulcers |
|
Definition
|
|
Term
Treatment:
herpes, treat w/oral valacyclovir or famciclovir
Severely ill patients, systemic glucocorticoids |
|
Definition
|
|
Term
| Acute life-threatening mucocutaneous reaction characterized by extensive necrosis and detachment of the epidermis |
|
Definition
| Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis |
|
|
Term
| Drug induced or idiopathic |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
(SJS- 50%, TEN- 80%) |
|
|
Term
Cell-mediated cytotoxic reaction
Onset of symptoms; 1-3 weeks |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| <10% epidermal detachment |
|
Definition
|
|
Term
overlap 10% to 30% epidermal detachment
> 30% epidermal detachment |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
TEN > 30%
|
|
|
Term
| Age of onset- Age, but most common in adults > 40 years, M=F |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Risk factors- SKE, HLA-B12, HIV/AIDS |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
|
Definition
|
|
Term
| Prodromes: fever, malaise, arthralgias 1-3 days before rash |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
Mild to mdoerate skin tenderness
|
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Conjunctival burning/itching |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Skin pain, burning sensation, paresthesia |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Mouth lesions are painful/tender |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Prodromal rash- targer-like |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Early- Necrotic epidermis first appears as macular areas with crinkled surface that enlarge and coalesce |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Sheetlike loss of epidermis |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| With trauma, full-thickness epidermal detachment yields exposed, red, oozing dermis resembling a second-degree thermal burn |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Recovery- Regrowth of epidermis begins within days; completed in 3 weeks. Pressure points and periorificial sites exhibit delayed healing. |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Distribution: widely distributed with prominent involvement of trunk and face |
|
Definition
|
|
Term
| Distribution: generalized, universal |
|
Definition
|
|
Term
| Mucous membranes- Invariably involved: i.e., erythema, painful erosions: lips, buccal mucosa, conjunctiva, genital and anal skin |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Eyes- 85% have conjunctival lesions: hyperemia, pseudomembrane formation; synechiae between eyelids and conjunctiva; keratitis, corneal erosions |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
| Hair & Nails- Eyelashes and nails may be shed in ___ |
|
Definition
|
|
Term
| Treatment: Early diagnosis and withdrawal of suspected drug(s) are very important |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
Treatment:
ICU
IV fluids and electrolytes
Systemic Glucocorticoids (early- ok, late- CI)
High dose IV immunoglobulins-early
Surgical debridement not recommended
Treat complications
Eyes w/erythromycin ointment |
|
Definition
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
|
Definition
Erythema multiforme
Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis
|
|
|
Term
Autoimmune disorder
Age of onset >60, M=F |
|
Definition
|
|
Term
| Blister formation is believed to begin w/binding of IgG to ____ Ag, activation of complement, infiltrate of neutrophils and eosinophils. |
|
Definition
|
|
Term
| Often starts with a prodromal eruption (urticarial, papular lesions) and evolves in weeks to months to bullae. |
|
Definition
|
|
Term
| Initially no symptoms except moderate or severe pruritus; later, tenderness of eroded lesions |
|
Definition
|
|
Term
Erythematous, papular or urticarial-type lesions
May be localized or generalized |
|
Definition
|
|
Term
| Bullae: large, tense, firm-topped, oval or round w/serrous or hemorrhagic fluid. |
|
Definition
|
|
Term
| Sites of predilection- Axillae; medial aspects of thighs, groins, abdomen; flexor aspects of forearm; lower legs (often first manifestation), mucous membranes 10-35% |
|
Definition
|
|
Term
| Bullous pemphigoid Treatment |
|
Definition
Systemic prednisone with starting doses of 50 to 100 mg/d continued until clear
+/- azathioprine
IVIG
Plasmapheresis |
|
|
Term
|
Definition
|
|
Term
| Inflammation of the pilosebaceous units of certain body areas |
|
Definition
|
|
Term
| Manifests itself as comedones, papulopustules, or nodules and cysts. |
|
Definition
|
|
Term
Age of onset- Puberty; 10 to 17 years in females; 14 to 19 in males
FHx?: Genetics? |
|
Definition
|
|
Term
| Key factors are follicular keratinization, androgens, and Propiouibacterium acnes |
|
Definition
|
|
Term
| Contributory factors- Acnegenic mineral oils, drugs, emotional stress, Occlusion and pressure on the skin. |
|
Definition
|
|
Term
| ___ is not caused by chocolate or fatty foods or, in fact, by any kind of food |
|
Definition
|
|
Term
Duration- Weeks to months
Season- often worse in fall and winter |
|
Definition
|
|
Term
| Symptoms- Pain in lesions (especially nodulocystic type) |
|
Definition
|
|
Term
| Comedones- open (blackheads) or closed (whiteheads) |
|
Definition
Acne Vulgaris
Skin lesions |
|
|
Term
Papules and papulopustules
Nodules or cysts- 1 to 4 cm in diameter |
|
Definition
Acne Vulgaris
Skin lesions |
|
|
Term
|
Definition
Most often clears spontaneously
Mild
-Topical antibiotics (clindamycin and erythromycin)
-Benzoyl peroxide gels (2%, 5%, or 10%)
-Topical retinoids
If moderate, add "cyclines," (women- high dose estrogens + progesterone + antiandrogens)
Accutane??? (be aware of FDA restrictions- iPLEDGE) |
|
|
Term
| Common chronic inflammatory acneiform disorder of the facial pilosebaceous units, increased reactivity of capillaries leading to flushing and telangiectasia. |
|
Definition
|
|
Term
Age of onset- 30 to 50 years; peak incidence between 40 and 50 years
Sex- female predominantly; rhinophyma occurs mostly in males |
|
Definition
|
|
Term
Race- Celtic persons (skin phototypes I and II) but also southern Mediterraneans
Duration- Days, weeks, months |
|
Definition
|
|
Term
Staging (Plewig and Kligman Classification)
|
|
Definition
The rosacea diathesis: episodic erythema, "flushing and blushing"
Rosacea |
|
|
Term
|
Definition
| Persistent erythema with telangiectases |
|
|
Term
|
Definition
| Persistent erythema, telangiectases, papules, tiny pustules |
|
|
Term
|
Definition
| Persistent deep erythema, dense telangiectases, papules, pustules, nodules; rarely persistent "solid" edema of the central part of the face |
|
|
Term
History
-Usually a history of episodic reddening of the face (flushing) with increases in skin temperature in response to heat stimuli in the mouth (hot liquids); spicy food; alcohol |
|
Definition
|
|
Term
History
-Exposure to sun __ is often associated with solar elastosis and heat (such as chefs working near a hot stove) may cause exacerbations |
|
Definition
|
|
Term
Skin lesions
Early
-Pathognomonic flushing (red face); tiny papules and papulopustules (2 to 3 mm), pustule often small (<1 mm) and on the apex of the papule. No comedones |
|
Definition
|
|
Term
Skin Lesions
Late
-Red facies and dusky-red papules and nodules scattered, discrete lesions. Telangiectases. Marked sebaceous hyperplasia and lymphedema in chronic rosacea, causing disfigurement of the nose, forehead, eyelids, ears, and chin |
|
Definition
|
|
Term
Management
Rule out Staph infection, watch for Demodex infestation
Recurrences are common, may disappear spontaneously.
Marked reduction or elimination of alcoholic and hot beverages may be helpful |
|
Definition
|
|
Term
Rosacea Treatment
Topical |
|
Definition
| Metronidazole gel or cream, 0.75%, twice daily or 1% daily |
|
|
Term
Rosacea Treatment
Systemic |
|
Definition
| Minocycline or doxycycline (watch sunlight), 50 to 100 mg BID; oral metronidazole 500mg BID |
|
|
Term
|
Definition
|
|
Term
| Most common of the benign epithelial tumors |
|
Definition
|
|
Term
Onset- ~ 30 years and progresses
Sex- Slightly more common and more extensive involvement in males |
|
Definition
|
|
Term
| History- Evolve over months to years. Rarely pruritic; tender if secondarily infected |
|
Definition
|
|
Term
| Distribution- Isolated lesion or generalized. Face, trunk, upper extremities |
|
Definition
|
|
Term
Skin Lesions
Early
-Small, 1 to 3 mm, barely elevated papule, later a larger plaque with or without pigment, feels greasy |
|
Definition
|
|
Term
Skin Lesions
Late
-Plaque with warty surface and "stuck on" appearance, "greasy," size from 1 to 6 cm. Flat nodule. Brown, gray, black, skin-colored, round or oval |
|
Definition
|
|
Term
| Seborrheic keratosis Treatment |
|
Definition
Light electrocautery then cauterized
Curettage after light freezing w/cryospray (best)
Punch biopsy may be indicated |
|
|
Term
| Single or multiple, discrete, dry, rough, adherent scaly lesions occur on the habitually sun-exposed skin |
|
Definition
| Actinic (Solar) keratosis |
|
|
Term
Age of onset- Middle age
More common in males
Occupation- Outdoor workers and outdoor sportspersons |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
| Considered "precancerous" → SCC |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
| Pathogenesis- Prolonged and repeated solar exposure in susceptible persons leads to cumulative damage to keratinocytes |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
Duration- Some lesions may be tender
Distribution- Isolated single lesions or scattered discrete lesions, "sun exposed areas" |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
Skin Lesions
Adherent hyperkeratotic scale, which is removed with difficulty and pain
May be papular. Skin-colored, yellow-brown, or borwn; often there is a reddish tinge |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
Skin lesions
Rough, like coarse sandpaper, "better felt than seen" on palpation with a finger
Most commonly <1cm, oval or round |
|
Definition
Actinic (Solar) keratosis
|
|
|
Term
Actinic (Solar) keratosis
Treatment |
|
Definition
Prevention- use sunscreens
May disappear spontaneously, but in general remain for years
Cryosurgery
5-Flourouracil cream BID for 2-4 wks
Imiquimod BID wk for 16 wks
Facial peels- Trichloroacetic acid (5 to 10%)
Laser surgery |
|
|
Term
|
Definition
Seborrheic keratosis
Actinic (Solar) keratosis
|
|
|
Term
| Infestation of the scalp by the head louse, which feeds on the scalp and neck and deposits its eggs on the hair |
|
Definition
| Pediculosis capitis (Head Lice) |
|
|
Term
| Subspecies Pediculus humanus capitis |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
Sex, age of onset- girls > boys, 3 to 11 years, but all ages
Transmission- shared hats, caps, brushes, combs; head-to-head contact |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
Etiology
Sesame seed size, 1 to 2 mm. Feed every 4 to 6h. Move by grasping hairs close to scalp; can crawl up to 23 cm/day |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
| ___ lay nits within 1 to 2 mm of scalp. Nits are ova within chitinous case. Young __ hatch within 1 week, passing through nymphal stages, growing larger and maturing to adults over a period of 1 week. |
|
Definition
Lice
Lice
Pediculosis capitis (Head Lice)
|
|
|
Term
Females can lay 50 to 150 ova during a 16-day lifetime.
Males live longer off scalp than females |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
| Skin symptoms- pruritus of the back and sides of scalp |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
| Identified by eye or with hand lens, look for nits on hair shaft |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
| Woods lamp- live nits fluoresce with a pearly fluorescence; dead nits do not. |
|
Definition
Pediculosis capitis (Head Lice)
|
|
|
Term
| Most Pt's have < ___ lice |
|
Definition
|
|
Term
Pediculosis capitis (Head Lice)
Treatment |
|
Definition
Avoid contact with possibly contaminated items
Vacuum area and disinfect (wash & dry) affected item, soak combs in rubbing alcohol or lysol 2% solution for 1 h
Recommended
-Permethrin- OTC (1%) or prescription (Elimite 5%) apply for 10 min, reapply in 7-10 days
- Malathione (ovide)- apply to infected area for 8-12 hrs. (Lindane resistance). Not for children < 6 mo.
Alternate
-Lindane 1% shampoo
-Ivermectin 0.8% lotion or shampoo
-Ivermectin 200 μg/kg, repeat in 10 days |
|
|
Term
| Pediculus humanus humanus |
|
Definition
| Pediculosis Corporis (Body Lice) |
|
|
Term
| Larger than head louse: 2 to 4 mm; otherwise indistinguishable. Life span 18 days. Female lays 270 to 300 ova. Nits: ova within chitinous case. Nits incubate for 8 to 10 days; nymphs mature to adults in 14 days. |
|
Definition
Pediculosis Corporis (Body Lice)
|
|
|
Term
| Habitat: live in seams of clothing; can survive without blood meal for up to 3 days. Grab body hairs to feed. |
|
Definition
Pediculosis Corporis (Body Lice)
|
|
|
Term
| Risk factors- Poor socioeconomic conditions, when clothing is not changed or washed frequently: poverty, war, natural disasters, indigence, homelessness, refugee-camp populations |
|
Definition
Pediculosis Corporis (Body Lice)
|
|
|
Term
-Lice and nits are found in clothing seams
Skin findings |
|
Definition
| -Lice and nits are found in clothing seams |
|
|
Term
Pediculosis Corporis (Body Lice)
Treatment |
|
Definition
| Pyrethrins/pyrethroids or malathion for 8 to 24 h |
|
|
Term
| Infestation of hair-bearing regions, most commonly the pubic area, can be other areas |
|
Definition
| Pediculosis pubis (Pthiriasis) |
|
|
Term
Mild to moderate pruritus, papular urticaria, and excoriations
|
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Age of onset- Most common in young adults
Sex- More extensive infestation in males |
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Etiology- Pthirius pubis
-Size 0.8 to 1.2 mm. Life span 14 days. Females lays 25 ove. Nits incubates for 7 days; nymphs mature over 14 days. Mobility: adults can crawl 10 cm/day. Prefers a humid environment; tends not to wander. |
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
| Transmission- Close physical contact: sexual exposure, sharing bed; possibly exchange of towels. Nonsexual transmission occurs in homeless persons who have pubic lice in hair on head and back. |
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Skin findings
Lice appear as 1 to 2 mm, brownish-gray specks in hairy areas involved. |
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Skin findings
Nits attached to hair appear as tiny white-gray specks. Few to numerous. Eggs at hair-skin junction indicate active infestation. |
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Skin Symptoms:
Often asymptomatic
Mild to moderate pruritis for months
|
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Skin symptoms
Excoriations and 2ndary infections
Pt may notice "hair nodules"
Papular urticaria
|
|
Definition
| Pediculosis pubis (Pthiriasis) |
|
|
Term
|
Definition
Pediculosis pubis (Pthiriasis)
|
|
|
Term
Pediculosis pubis (Pthiriasis)
Treatment |
|
Definition
Treat pt and partners
Screen for other STD's
Decontaminate clothing
Same as for head louse |
|
|
Term
| Sarcoptes scabiei var hominis |
|
Definition
|
|
Term
| Transmission; skin-to-skin contact, fomites |
|
Definition
|
|
Term
| Tunnel into epidermis ("burrow/tunnel" usually at night, lays eggs during day) |
|
Definition
|
|
Term
Female lifespan; 4-6 weeks, lays 40-50 eggs, 3 eggs per day per tunnel, eggs hatch in 4 days
Eggs hatch and migrate to surface to mature
Females burrow and males fall off |
|
Definition
|
|
Term
| Burrow- Gray or skin-colored ridges, 0.5 to 1 cm in length either linear or wavy, with minute vesicle or papule at end of tunnel |
|
Definition
|
|
Term
| ID by placing drop of mineral oil over a burrow, scraped off with a no. 15 scalpel blade and placed on a microscope slide |
|
Definition
|
|
Term
Clinical Manifestations
Crusted scabies = IC |
|
Definition
|
|
Term
Clinical Manifestations
Pruritis- intense, prevents sleep
Rash- none to erythroderma (spares head & neck) |
|
Definition
|
|
Term
|
Definition
Permethrin (Elimite) 5% Cream- applied to all areas of the body from the neck down. Wash off 8 to 12 h after application.
Lindane 1% lotion or cream- applied thinly to all areas of the body from the neck down; wash off thoroughly after 8 h
Ivermectin (Stromectol) |
|
|
Term
| Poisonous spiders in North America: |
|
Definition
Black Widow & Northern Widow
Recluses
Hobo spider
Yellow sac |
|
|
Term
|
Definition
Localized care
-Elevation
-Ice
-Clean
Benadryl
Tylenol
Identify spider or most likely culprit
Call poison control or follow protocol |
|
|
Term
|
Definition
Pediculosis capitis (Head Lice)
Pediculosis Corporis (Body Lice)
Pediculosis pubis (Pthiriasis)
Scabies
Spider bites |
|
|
Term
|
Definition
|
|
Term
| Cause; UVR, PTCH gene mutation |
|
Definition
|
|
Term
Very limited capacity to metastasize
Age of onset- >40 years, M>F |
|
Definition
|
|
Term
| Distribution- Isolated single lesions; > 90% occur in the face. Search carefully for "danger sites": medial and lateral canthi, nasolabial fold, behind the ears |
|
Definition
|
|
Term
Predisposing factors
Skin phototypes I & II
Heavy sun exposure as youth |
|
Definition
|
|
Term
Predisposing factors:
X-ray therapy for facial acne
Ingestion of arsenic |
|
Definition
|
|
Term
| Nodular: Papule or nodule, translucent or "pearly" with telangiectasia |
|
Definition
|
|
Term
| Ulcerating: Ulcer with a rolled border, which again is translucent, pearly, smooth with telangiectasia |
|
Definition
|
|
Term
| Sclerosing: Appears as a small patch of morphea or a superficial scar, often ill-defined, skin-colored, whitish but also with peppery pigmentation. |
|
Definition
|
|
Term
| Superficial multicentric: Appear as thin plaques. Pink or red; characteristic fine threadlike border and telangiectasia |
|
Definition
|
|
Term
| Pigmented: May be brown to blue or black. Smooth, glistening suface; hard, firm |
|
Definition
|
|
Term
Basal Cell Carcinoma
Treatment |
|
Definition
Detect early- excision
Detect late- excise but referral
Can use cryosurgery or electrosurgery for small lesions not in danger sites or on scalp
Radiation Tx
Topical 5-Fluorurical or imiquimod |
|
|
Term
| Multifocal systemic tumor of endothelial cell origin |
|
Definition
|
|
Term
|
Definition
|
|
Term
4 variants
Stage/variant dependent
-localized and/or generalized disease: pathes, plaques, noduels |
|
Definition
|
|
Term
Risk- 20,000x greater than general population
Currently 18% incidence in this risk group
Young males, rare in females |
|
Definition
|
|
Term
|
Definition
|
|
Term
Pathogenesis
Derived from endothelium of blood/lymphatic microvasculature
|
|
Definition
|
|
Term
Pathogenesis
Widespread reactive polyclonal proliferation, then become monoclonal |
|
Definition
|
|
Term
Pathogenesis
Promotes own growth & growth of other cells
Not sure how HHV-8 induces proliferation |
|
Definition
|
|
Term
Manifestations
Mucocutaneous lesions usually asymptomatic (may ulcerate and bleed) |
|
Definition
|
|
Term
Manifestations
Large lesion on palms/soles may limit function |
|
Definition
|
|
Term
Manifestations
LE lesions may produce severe pain if ulcerated/tumorous/edematous |
|
Definition
|
|
Term
|
Definition
|
|
Term
Skin lesions
Eccymotic-like macule |
|
Definition
|
|
Term
Skin lesions
Evolve to patches, papules, plaques, nodules and tumors (violaceous, red, pink, tan then purple-brownish with greenish halo) |
|
Definition
|
|
Term
Skin Lesions
Palpable (firm to hard)
Can enlarge and become confluent |
|
Definition
|
|
Term
|
Definition
|
|
Term
Distribution
Widespread or localized
Almost always on hand/feet/legs and spreads centripetally |
|
Definition
|
|
Term
Distribution
Trunk rare (except HIV)
Early face= HIV then to trunk |
|
Definition
|
|
Term
Course and Prognosis
Based on type |
|
Definition
|
|
Term
Kaposi Sarcoma
Treatment: Limited intervention |
|
Definition
Control not cure
Limited intervention
-Radiation
-Cryo/laser/excisional surgery
-Vincristine inj
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Term
Kaposi Sarcoma
Treatment Aggressive intervention |
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Definition
Single chemo: Adriamycin or Vinblastine
Combo chemo: Vincristine + Bleomycin +Adriamycin |
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Term
| Most often caused by UVR or HPV infection |
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Definition
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Term
Most often asymptomatic but may bleed
Nodule formation= invasice |
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Definition
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Term
Skin lesions
Appears as a sharply demarcated, scaling, or hyperkeratotic macule, papule, or plaque |
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Definition
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Term
Skin lesion
Solitary or multiple lesions are pink or red in color and have a slightly scaling surface, small erosions, and can be crusted (Bowen's disease) |
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Definition
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Term
Skin lesions
Red, sharply demarcated, glistening macular or plaque-like SCCIS on the glans penis or labia minors are called erythroplasia of Queyrat |
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Definition
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Term
Squamous Cell Carcinoma
Treatment |
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Definition
Topical chemotherapy- 5-Fluorouracil cream applied QD or BID. Imiquimod
Cryosurgery- Highly effective
Photodynamic therapy
Surgical excision- Has the highest cure rate but the greatest chance of causing cosmetically disfiguring scars |
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Term
| Most malignant tumor of skin |
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Definition
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Term
Arises from:
-Transformation of melanocytes at dermalepidermal junction
-Dysplastic nevi
-CNMN gone invasive |
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Definition
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Term
Risk Factors:
CDKN2a mutation
Skin types I & II
FHx or PHx
UVR exposure
Number (>50) and size (> 5mm) of melanocytic nevi
Congenital nevi |
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Definition
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Term
Melanoma
Morphology Look for ___ |
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Definition
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Term
| What does ABCDE for melanoma stand for? |
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Definition
Asymmetry
Borders
Colors
Diameter > ~6mm
Elevation/Evolution/Enlargement |
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Term
| What are the 4 major types of Melanomas? |
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Definition
Lentigo maligna (5%0
Spreading Superfcial (70%)
Acral-lentiginous (5-10%)
Nodular (15%) |
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Term
Median age ~ 65
Sunlight pathogenic factor
Flat macule, border well defined "geographic" shape
tan to brown/black |
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Definition
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Term
Age: 30-50 (~37)
Upper back
Elevated plaque
Brown, dark brown, black, blue and red |
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Definition
| Superficial spreading melanoma |
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Term
Median age ~65
MC in Asians, AA
Sole, palm; macule w/focal papules/nodules
Finger or toe nail; macule to papules/nodules |
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Definition
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Term
"Middle Life"
Uniformly elevated "blueberry-like" nodule or ulcerate or "thick" plaque
"thundercloud" |
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Definition
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Term
| Horizontal growth better prognosis |
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Definition
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Term
| Vertical growth prognosis worsens |
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Definition
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Term
| Metastasis rapid after vertical growth begins |
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Definition
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Term
|
Definition
Excision
Malignant- pallative
Chemotherapy encompasses a large list of drugs (*dacarbazine/temozolomide, cisplatin, vindesine/vinblastine, fotemustine, taxol/taxotere) |
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Term
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Definition
Basal Cell Carcinoma
Kaposi Sarcoma
HIC/AIDS assoc. KS
Squamous cell Carcinoma
Melanoma |
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Term
Risk Factors
Age (most > 40)
Race/Skin complexion
Sun exposure (watch certain medications)
Tanning Beds
# of Moles/freckles
Atypical nevi
Medical/Family Hx
Smoking
Immunosuppression |
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Definition
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Term
Other warning Signs:
sore that does not heal
Spread of pigment from the border of a spot to surrounding skin
Redness or new swelling beyond the border
Change in sensation (itchiness, tenderness or pain)
Change in surface of a mole (scaling, oozing, bleeding or the appearance of a bump or nodule)
Mole that looks different from to other moles |
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Definition
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Term
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Definition
Total body
-every 3 years for ages 20-39
-Annually for ≥ 40
Pt counseling |
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Term
Seek shade, especially between 10AM and 4 PM
Do not burn
Avoid tanning beds/salons
Use sunscreen SPF 15 or higher, apply 30 minutes prior and every two hours
Clothing
Keep newborns out of sun, use sunscreen |
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Definition
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Term
| Localized loss of hair in round or oval areas without any visible inflammation of the skin in hair-bearing areas; the most common presenting site is the scalp |
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Definition
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Term
Age of onset- young adults (<25 years); children are affected more frequently
Sex- Equal in both sexes |
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Definition
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Term
| Prevelance- Relatively common. About 1.7% of the U.S. population has at least one episode of __ by age 50 |
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Definition
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Term
| Etiology- Unknown, autoimmune? (autoreactive T-cells) |
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Definition
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Term
Duration of hair loss- Gradual over weeks to months
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Definition
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Term
Skin symptoms- None. Minimal erythema?
Associated findings- Hashimoto's thyroiditis, Vitiligo, Myasthenia gravis |
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Definition
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Term
Alopecia areata
Treatment |
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Definition
Trial of topical (usually not effective) or intralesional steroids (Triamcinolone)
Systemic steroids/Cyclosporine?
PUVA
May end just as suddenly as it started
Can last months to years |
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Term
| Common progressive balding that occurs through the combined effect of (1) genetic predisposition, and (2) action of androgen (DHT) on scalp hair follicles |
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Definition
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Term
Male pattern baldness
Hereditary thinning in females
Age of Onset
-Males: may begin any time after puberty, as early as the second decade; often fully expressed in 40s.
-Females: 40% occurs in the sixth decade
Sex- Males >>females |
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Definition
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Term
Androgenetic alopecia
Treatment |
|
Definition
Finasteride- 1 mg PO QD
Topical Minoxidil 2 or 5%
Women- Antiandrogens (Spironolactone)
Wigs, toupees, prosthetics; hair weaves
Hair transplantation |
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Term
| Agent- T. rubrum or mentagrophytes |
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Definition
| Tinea Unguium/Onychomycosis |
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|
Term
MC in IC and Diabetes
ID with scrapings w/KOH |
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Definition
Tinea Unguium/Onychomycosis
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Term
Pt presents with:
Onycholysis
Debris under nail
Thickening, crumbling |
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Definition
Tinea Unguium/Onychomycosis
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Term
Tinea Unguium/Onychomycosis
Treatment |
|
Definition
Debridement and/or nail removal
Topical agents- Sporanoz, Lamisil, Ciclopirox
Terbinafine- 250mg/d for 6 weeks for fingernails and 12-14 weeks for toenails
Itraconazole- 200mg/d for 6 weeks (fingernails) and 12 weeks (toenails). Pulse dosing- 200mg BID for 1st 7 days of each month for 2 months (fingernails), 3-4 months for toenails |
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Term
| Acute infection of lateral or proximal nail fold. Usually associated with break in integrity of epidermis (e.g. hang nail), trauma, nail biting, manicure, dishwashing, chemical |
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Definition
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Term
| Findings: Throbbing pain, erythema, swelling, pain, +/- abscess formation. Infection may extend deeper, forming a felon |
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Definition
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Term
|
Definition
Resolves spontaneously
Warm soaks (50% water/50% antibacterial soap 3-4xd)
Abscess needing I & D
PO antibiotics? |
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