Term
Central pore with cheesy, foul smelling discharge is diagnostic
Origin is from the hair follicle |
|
Definition
|
|
Term
KEY POINTS
1. ____ nodule of uncertain origin
2. Suspect cancer for ____ dermal nodules
3. ___ & ____ are helpful distinguishing features. |
|
Definition
Biopsy
hard
Color and consistency |
|
|
Term
| Definition: cyst derived from the upper portion of the epithelial lining of a hair follicle, filled with macerated keratin. Also known as epidermoid cyst |
|
Definition
|
|
Term
| Epidermal Inclusion Cyst Incidence: |
|
Definition
| common, can occur at any age |
|
|
Term
| Epidermal Inclusion Cyst History: |
|
Definition
| usually asymptomatic and slow growing. May rupture or get infected causing inflammation, pain, and draining of purulent, foul smelling material |
|
|
Term
| Epidermal Inclusion Cyst Physical Examination: |
|
Definition
| flesh colored, firm, malleable, dome shaped nodule with central punctum (pore), location varies, usually on head or trunk |
|
|
Term
| A central pore is characteristic of a ___ |
|
Definition
|
|
Term
Epidermal Inclusion Cyst
Differential Diagnosis |
|
Definition
Pilar (tricholemma) cysts- arise from the middle third (isthmus) of the follicular canal. Occur most frequently on the scalp. Both Pilar and Epidermal Inclusion Cysts are benign.
Lipoma - tumor of fatty tissue, usually deeper in the skin and feels rubbery.
Malignant tumor must be considered if diagnosis is uncertain |
|
|
Term
Epidermal Inclusion Cyst
Laboratory and Biopsy |
|
Definition
Usually diagnosis can be made clinically.
Can incise and drain the lesion, will find cheesy, foul-smelling, keratinous contents.
Biopsy can confirm diagnosis, but is not necessary. |
|
|
Term
Epidermal Inclusion Cyst
Therapy |
|
Definition
Usually no therapy is requested or needed.
If it is, the entire cyst with its lining needs to be removed to prevent recurrence.
Elliptical excision is usually required for removal of cysts that have previously ruptured and scarred. |
|
|
Term
Epidermal Inclusion Cyst
Course and Complications |
|
Definition
Untreated, often stabilize in size between 1-3 cm.
Complications are rare but include rupture and infection. Treat as an abscess: Incision and drainage and occasionally oral antibiotics.
Gardner’s Syndrome: rare autosomal dominant disorder with multiple epidermal cysts, fibromas, osteomas, and intestinal polyps that often under go malignant degeneration |
|
|
Term
Epidermal Inclusion Cyst
Pathogenesis |
|
Definition
Epidermal inclusion cysts arise from the upper portion , the infundibulum of a hair follicle.
The lining of the cyst is identical to that of the surface epidermis and produces keratin, which having no place to shed, accumulates and forms the moist cystic mass. |
|
|
Term
Benign vascular tumor in infancy
Superficial and subcutaneous involvement
Most regress spontaneously |
|
Definition
|
|
Term
|
Definition
| benign proliferation of blood vessels in the dermis and subcutis |
|
|
Term
|
Definition
| most common soft tissue tumor of infancy, more common in female, premature, and Caucasian infants |
|
|
Term
|
Definition
| most arise in first few weeks of infancy and are usually asymptomatic |
|
|
Term
| Hemianginoma Physical Examination: |
|
Definition
superficial hemangiomas are bright red,
deep subcutaneous hemangiomas are bluish,
mixed hemangiomas are bright red, dome-shaped papules.
Blanchability is a diagnostic feature found in many hemangiomas. |
|
|
Term
| Hemianginoma Differential Diagnosis: |
|
Definition
| usually diagnosis is clinical, as vascular malformations are present at birth and do not spontaneously regress |
|
|
Term
| Hemangioma Laboratory and Biopsy: |
|
Definition
biopsy not needed, will show marked increase in number of blood vessels
Therapy:
None
Steroids, 3-5 mg/kg daily
Laser
Surgery |
|
|
Term
| Hemangioma Course and Complications |
|
Definition
By age 5, 50% will have spontaneously regressed
By age 9, 90% will have spontaneously regressed
20%of patients have residual changes including scarring and fibro-fatty tissue
Diffuse neonatal hemangiomatosis: in infants with numerous hemangiomas, internal organ involvement should be suspected as this rare syndrome occasionally leads to death from high output cardiac failure of vital organ compromise. |
|
|
Term
|
Definition
| Unknown- speculated result of angiogenic growth factors that encourage localized proliferation of endothelial cells and stroma resulting in a cellular mass with vasculature. |
|
|
Term
dermal fibrotic papule or small nodule
chronic, asymptomatic, and stable |
|
Definition
|
|
Term
| Dermatofibroma Definition: |
|
Definition
| area of focal dermal fibrosis, often accompanied by overlying epidermal thickening and hyperpigmentation. Appears clinically as a brown papule or small nodule, often more indurated than elevated |
|
|
Term
| Dermatofibroma Incidence: |
|
Definition
| common and often found incidentally |
|
|
Term
|
Definition
| asymptomatic, patient may wonder about chance of malignancy |
|
|
Term
| Dermatofibroma Physical Examination: |
|
Definition
| usually around 5 mm in size and slightly elevated, vary in color, best appreciated by palpation- “dimple sign” in where pinching the lesion results in central dimpling- not seen in other lesions. Commonly found on legs and thighs but can be located anywhere. |
|
|
Term
| Dermatofibroma Differential Diagnosis: |
|
Definition
| nevus, melanoma, dermatofibrosarcoma protuberans is a low-grade malignant fibrous tumor that grows slowly but persistently |
|
|
Term
| ___ or ___ ____ Dermatofibroma LESION SHOULD UNDERGO BIOPSY TO RULE OUT MALIGNANCY |
|
Definition
| ENLARGING OR ATYPICALLY COLORED |
|
|
Term
| Nevi are usually ___ than dermatofibromas and do not exhibit __ ___. Darker dermatofibromoas may look like ___ , if in doubt, biopsy the lesion. |
|
Definition
softer
dimple sign
melanoma |
|
|
Term
| Dermatofibroma Laboratory and Biopsy: |
|
Definition
| diagnosis is usually made clinically. Histology will show focal proliferation of densely packed collagen bands that are twisted and intertwined. Fibroblasts are interspersed and increased in number. Increased pigmentation of the slightly thickened overlying epidermis accounts for the frequently brown color of theses lesions. |
|
|
Term
Dermatofibroma Therapy
None
Excision |
|
Definition
|
|
Term
| Dermatofibroma Course and Complications: |
|
Definition
| chronic and stable and not associated with any complications |
|
|
Term
| Dermatofibroma Pathogenesis: |
|
Definition
| trauma, such as an insect bite, may be the culprit that initiates an exuberant healing response with proliferation of fibroblasts and subsequent fibrosis |
|
|
Term
Exuberant scar tissue
Treat cautiously because of high recurrence rate |
|
Definition
|
|
Term
|
Definition
| excessive proliferation of collagen (scar tissue) after trauma to the skin. |
|
|
Term
|
Definition
| common, occur most often in young African Americans |
|
|
Term
|
Definition
| ear piercing, surgical excision, wounds. Develop over weeks to months and may itch during growth phase |
|
|
Term
| Keloid Physical Examination: |
|
Definition
| protuberant, firm, scar tissue with irregular borders or claw-like extensions. Most commonly found on earlobes secondary to piercing, the shoulders, upper chest and back |
|
|
Term
| Keloid Differential Diagnosis |
|
Definition
Hypertrophic scars stay within original site of trauma, whereas keloids expand beyond, sometimes, far beyond the original border of the wound.
Dermatofibrosarcoma protuberans will not have a history of trauma and the lesion continues to enlarge- must biopsy if this is suspected. |
|
|
Term
| Keloid Laboratory and Biopsy: |
|
Definition
| usually not needed as can diagnosis can be made on clinical grounds. |
|
|
Term
|
Definition
whorls and nodules of highly compacted hyalinized bands of collagen,
an increased number of fibroblasts, and many
mast cells which may be the cause of the associated pruritus with the release of their histamine content. |
|
|
Term
|
Definition
None
Intralesional steroids: Kenalog-40
Surgery with intralesional steroids
Surgery should never be used alone in treating keloids |
|
|
Term
| Keloid Course and Complications: |
|
Definition
| untreated, will enlarge and then stabilize. Usually will not regress and if it occurs at all- will take years. Major problem is cosmetic disfigurement which may be profound. |
|
|
Term
|
Definition
increased fibroblast activity stimulated by tissue injury leads to increased collagen synthesis
Also there is an increase in dermal ground substance. |
|
|
Term
Benign subcutaneous fat tumor
Slow growing or stable
Biopsy rapidly growing tumors and if uncertain of the diagnosis |
|
Definition
|
|
Term
|
Definition
| Benign tumor of subcutaneous fat. Origin unknown. |
|
|
Term
|
Definition
| Common, most common in midlife. Patient may be concerned it is malignant. |
|
|
Term
|
Definition
| Asymptomatic, may grow slowly. |
|
|
Term
| Lipoma Physical Examination: |
|
Definition
| Flesh colored, may be elevated, rubbery and freely mobile nodule. Rarely larger than 10 cm, can be located anywhere, usually on trunk, neck and upper extremities. |
|
|
Term
| Lipoma Differential Diagnosis: |
|
Definition
Epidermal inclusion cyst- Lipoma is deeper, rubberier, and freely mobile underneath the skin.
Angiolipoma are often painful and have a prominent vascular component.
Malignant tumors of the skin can be deep, but are firm if not hard and also involve the dermis-skin can’t be freely moved over them.
Soft tissue sarcoma- harder to palpation. Lipomas are soft and fatty to palpation. |
|
|
Term
|
Definition
| Impinged on by encapsulated tumor of normal appearing fat cells. |
|
|
Term
| Lipoma Laboratory and Biopsy: |
|
Definition
| Diagnosis can be made clinically, but a deep elliptical excision is preferred and histology will show an encapsulated collection of normal fat cells. |
|
|
Term
|
Definition
|
|
Term
| Lipoma Course and Complications: |
|
Definition
| None, biopsy if acute in onset or appears to be growing. |
|
|
Term
Soft, “buttonhole”, papule or nodule
Keep neurofibromatosis type 1 in your differential if there is more than one neurofibroma |
|
Definition
|
|
Term
|
Definition
A focal proliferation of neural tissue within the dermis.
May appear as soft protruding papules and nodule and less often as deep firm subcutaneous nodule.
Multiple neurofibromas are a cutaneous expression of neurofibromatosis type 1, aka Von Recklinghausen’s disease, a dominantly inherited neurocutaneous disorder with prominent skin, skeletal, and nervous system abnormalities.
Neurofibromatosis 2 is characterized primarily by bilateral acoustic neuromas and usually lacks the cutaneous finds of neurofibromatosis 1. |
|
|
Term
|
Definition
Solitary neurofibromas are infrequent and inconsequential.
Neurofibromatosis type 1 is one of the more common genetic disorders, with an estimated birth incidence of 1 in 3000.
Multiple neurofibromas are a sign of neurofibromatosis type 1. |
|
|
Term
|
Definition
Neurofibromatosis type 1
develop skin tumors in late childhood, with rapid growth in puberty and pregnancy.
Inheritance is autosomal dominant, however spontaneous mutations are common and account for 50% of cases.
May also have signs and symptoms of skeletal and central nervous system involvement. |
|
|
Term
| Neurofibroma Physical Examination |
|
Definition
Soft, flesh colored protruding papule or nodule that characteristically on compression, can be invaginated into what feels like a defect in the skin- “button-hole” sign.
Large plexiform neurofibromas are deeper and firmer, may become extremely large and are occasionally tender. |
|
|
Term
| Neurofibromatosis Type 1 Criteria: must contain two or more of the following.....(7) |
|
Definition
1.) Six or more café-au-lait macules, 5mm or larger in children, and 15 mm or larger in adults
2.) Two or more neurofibromas of any type or one plexiform neurofibroma
3.) Axillary or inguinal freckling
4.) Optic nerve glioma
5.) Two or more Lisch nodules (iris hamartomas)
6.) Osseous lesions such as sphenoid wing dysplasia or long bone cortex thinning
7.) A first degree relative with neurofibromatosis type 1 |
|
|
Term
____ ____ are coffee-with milk-colored macules, 99% are present by age 1. >6 are diagnostic for _____.
Ophthalmologic evaluation is helpful because iris hamartomas, Lisch nodules, are found in 70% by age 10. |
|
Definition
Café-au-lait spots
NF (Neurofibromatosis) type 1 |
|
|
Term
| Ophthalmologic evaluation is helpful because iris hamartomas, Lisch nodules, are found in 70% of those w/ __________ by age 10. |
|
Definition
|
|
Term
| Neurofibroma Differential Diagnosis: |
|
Definition
|
|
Term
| Neurofibroma Laboratory and Biopsy: |
|
Definition
| Clinical diagnosis. MRI to detect brain hamartomas and acoustic neuromas in NF Type 2. Histology of biopsy specimen shows well circumscribed collection of fine, wavy fibers loosely packed in the dermis and stain positive for nerve fibers. |
|
|
Term
|
Definition
| None, excision, genetic counseling |
|
|
Term
| Neurofibromatosis Course and Complications |
|
Definition
Solitary neurofibromas are asymptomatic, stable, no complications
NF-1 is progressive- more lesions, larger lesions
Plexiform neurofibromas can rarely degenerate into malignant neurofibrosarcoma. Watch for enlargement and tenderness.
Central nervous system tumors
Mental retardation
Seizures
Skeletal abnormalities; kyphoscoliosis, pseudoarthrosis, localized gigantism
Precocious puberty and pheochromocytoma due to endocrine disorders.
Patients with neurofibromatosis and hypertension should be screened for pheochromocytoma |
|
|
Term
| Neurofibromatosis Pathogenesis |
|
Definition
Abnormal gene, NF-1, on chromosome 17, transmitted in an autosomal dominant manner in half of affected individuals, other half have spontaneous mutations.
Hint for remembering which chromosome: the word neurofibromatosis has 17 letters |
|
|
Term
Composed of lipid laden histiocytes
Skin sign of hyperlipidemia |
|
Definition
|
|
Term
|
Definition
Focal collection of lipid laden histiocytes in the dermis or tendons
Located in the upper dermis, they appear as yellowish papules, plaques, and nodules
Located deeper, xanthomas on the tendons are fleshy appearing and hard
Usually a skin manifestation of a hyperlipoproteinemic state
Xanthomas are yellow tumors in the skin |
|
|
Term
|
Definition
Flat xanthomas on the eyelids are the most common, called xanthelasmas
Familial hypertriglyceridemia and familial hypercholesterolemia patients who are homozygous for the disease are more likely to have xanthomas. |
|
|
Term
|
Definition
Positive family history may be elicited
Past medical history may include coronary artery disease and or diabetes
In addition to familial metabolic abnormality, patients may have increased alcohol use, obesity, glucose intolerance, hyperinsulinemia, and drugs including estrogens, corticosteroids, and isotretinoin.
Eruptive xanthomas appear quickly within weeks and disappear rapidly after lowering triglyceride levels. |
|
|
Term
| Yellowish plaques on the eyelids. The only type that is not associated with hyperlipidemia |
|
Definition
|
|
Term
| Reddish yellow papules and plaques in patient with hypertriglyceridemia, most commonly on extensor surfaces |
|
Definition
|
|
Term
| Potato like papules and nodules, usually on elbows and buttocks. Associated with elevated triglycerides or cholesterol |
|
Definition
|
|
Term
| Hard and stony nodules most often on the Achilles tendon and fingers. Deeper, so yellow color not appreciated. Associated with severe hypercholesterolemia |
|
Definition
|
|
Term
| Xanthoma Differential Diagnosis |
|
Definition
Sebaceous gland hyperplasia
Juvenile xanthogranuloma
Rheumatoid nodules |
|
|
Term
| Xanthoma Laboratory and Biopsy |
|
Definition
Clinical diagnosis
Screening fasting lipid profile
Biopsy shows infiltrate of numerous lipid laden histiocytes |
|
|
Term
|
Definition
Diet- low fat, exercise
Medications- cholesterol/triglyceride lowering
Surgery- removal for cosmetic reasons |
|
|
Term
| Xanthoma Course and Complications |
|
Definition
| Eruptive xanthomas usually resolve when triglyceride levels are lowered, other xanthomas are more persistent |
|
|
Term
|
Definition
Accumulation of lipid laden histiocytes
Patients with familial hypertriglyceridemia have high levels of VLDL, further increased with high fat diet, alcohol, obesity or diabetes. Xanthomas resolve quickly with treatment.
Patients with familial hypercholesterolemia have high levels of LDL (low density lipoproteins), xanthomas resistant to treatment. Patients at risk for early heart disease and atherosclerosis. |
|
|
Term
Malignant vascular tumor
Human herpes virus 8 may be pathogenetic
Sign of AIDS, test for HIV |
|
Definition
|
|
Term
| Kaposi’s Sarcoma Definition |
|
Definition
Malignant tumor derived from endothelial cells
Multiple vascular tumors appear as macules, plaques, or nodules |
|
|
Term
| Kaposi’s Sarcoma Incidence: Disease occurs in three settings |
|
Definition
Classic
Chronic cutaneous disorder in elderly men of eastern European descent. In USA, 0.05 per 100,000
Lymphadenopathic
Aggressive, rapidly fatal
Young men
Equatorial Africa, 9% of all cancers
AIDS associated
Most common neoplasm associated with AIDS
Frequently fatal
Incidence decreasing due to better antiretroviral medications
TEST FOR HIV IN PATIENTS NEWLY DIAGNOSED WITH KAPOSI’S SARCOMA |
|
|
Term
| Kaposi’s Sarcoma Physical Examination |
|
Definition
PURPLE macules, papules, plaques, or nodules
Classic type, lesions usually on lower legs
Other types, may be located anywhere and may have many lesions
May involve mucous membranes |
|
|
Term
| Kaposi’s Sarcoma Differential Diagnosis |
|
Definition
Bruise
Angiomas- usually redder in color
Bacillary angiomatosis- caused by bacteria and needs to be correctly diagnosed as it can be treated with erythromycin antibiotic |
|
|
Term
| Kaposi’s Sarcoma Laboratory and Biopsy |
|
Definition
Diagnosis confirmed with biopsy
Biopsy has proliferation of spindle cells in strands and small nodular aggregates. Spindle cells also attempt to form small blood vessels, resulting in slit like spaces filled with red blood cells.
Hemorrhage is common, lymphocytes and histiocytes may also be present |
|
|
Term
|
Definition
Local Radiation therapy for advance cutaneous disease
Excision if limited number of lesion
One or more chemotherapeutic agents for disseminated disease
Interferon alpha- intralesional or systemic therapy |
|
|
Term
| Kaposi’s Sarcoma Course and Complications |
|
Definition
Classic progresses slowly, patients often die from other causes. Increased frequency of lymphoma and leukemia.
Lymphadenopathic disseminates rapidly to internal organs and results in early death.
AIDs associated, also disseminates rapidly, but may respond to therapy. Patients often die of other causes like opportunistic infections. |
|
|
Term
| Kaposi’s Sarcoma Pathogenesis |
|
Definition
Malignant disease in which endothelial cells proliferate to form tumors
Multiple tumors from a multifocal rather than a metastatic process
In USA, most commonly found in immunosuppressed patients
Epidemic occurrences in Africa and finding in HIV-negative homosexuals suggest a transmissible infectious organism
Herpes virus type 8 detected in all forms- strongly implicated in pathogenetic process |
|
|
Term
| Rule out cancer for ___ dermal nodules -> Biopsy. |
|
Definition
|
|
Term
| Although uncommon, ___ ____ may be the first sign of internal cancer |
|
Definition
|
|
Term
| Patients with a known history of cancer, be suspicious of any new skin nodules. |
|
Definition
|
|
Term
|
Definition
|
|
Term
Other Malignant Dermal Tumors
History |
|
Definition
Patients with a known history of cancer be suspicious of any new skin nodule
Nodule itself may be asymptomatic, but may have other signs and symptoms
- Weight loss
- Lymphadenopathy
- Fatigue
- Night sweats |
|
|
Term
| Other Malignant Dermal Tumors Physical Examination |
|
Definition
Hard or extremely firm nodules
Flesh colored, pink, red, or purple nodules
Lymphoma and myeloma nodules often plum colored
Nodules may ulcerate
Look for lymphadenopathy or hepatosplenomegaly |
|
|
Term
Differential Diagnosis of skin metastases from internal malignancies |
|
Definition
Leukemia
- Acute myelomonocytic
- Chronic lymphocytic
- Acute lymphocytic
Lymphoma (not including mycosis fungoides)
- Non-Hodgkin’s
- Hodgkin’s
Multiple myeloma
Metastatic carcinoma |
|
|
Term
•Type of carcinoma responsible for skin metastases in men & women |
|
Definition
–Women
•Breast
•Melanoma
•Ovary
•Oral cavity
•Lung
–Men
•Melanoma
•Lung
•Large intestine
•Oral cavity
|
|
|
Term
| Other Malignant Dermal Tumors Laboratory and biopsy |
|
Definition
Biopsy is diagnostic, showing an infiltrate of malignant cells in nodular aggregates.
The histological features may be tumor specific- suggesting the primary source, e.g.. Lymphoma, myeloma |
|
|
Term
| Other Malignant Dermal Tumors Therapy |
|
Definition
Excision for primary tumors
Chemotherapy for metastases
Palliative radiation therapy for skin metastases
Treat the primary tumor |
|
|
Term
| Other Malignant Dermal Tumors Course and Complications |
|
Definition
For many diseases, the development of skin metastasis indicates a poor prognosis, e.g., acute myelomonocytic leukemia
Ulcerated nodules may become secondarily infected and lead to sepsis and death. Major complications usually related to the systemic disease. |
|
|
Term
| Other Malignant Dermal Tumors Pathogenesis |
|
Definition
Spread to the skin from an internal malignant disease usually by hematogenous route
Also can be spread via lymphatic pathways
Once in skin, malignant cells proliferate in a 3-D fashion leading to the formation of a nodule |
|
|
Term
Uncommon Dermal and Subcutaneous Growths
Infantile digital fibromatosis..... |
|
Definition
Rare
Benign, asymptomatic
Tumor of myofibroblasts
Occurs at birth or by age 1
Biopsy reveals spindle shaped cells with eosinophilic inclusion bodies
Usually affects finger and toes
High recurrence rate with surgical excision |
|
|
Term
Uncommon Dermal and Subcutaneous Growths
Granular cell tumor |
|
Definition
Benign, asymptomatic
Usually presents in middle age
Usually solitary, in skin or tongue
Biopsy reveals large polyhedral cells with a characteristic granular cytoplasm |
|
|
Term
Uncommon Dermal and Subcutaneous Growths
Leiomyoma |
|
Definition
Benign smooth muscle tumor
Painful
Solitary or grouped
Autosomal dominant familial form in women associated with uterine leiomyomas |
|
|
Term
Uncommon Dermal and Subcutaneous Growths
Lymphangioma circumscriptum... |
|
Definition
Benign
Lymphatic tumor
Usually occurs in infancy or early childhood
Irregularly grouped, vesicle like papules, looks like frog eggs- “frogspawn” appearance
Trauma results in weeping clear colorless lymphatic fluid
Treatment difficult as usually connected to deeper lymphatic system |
|
|
Term
Uncommon Dermal and Subcutaneous Growths
Myxoid cyst... |
|
Definition
Also known as digital mucous cyst
Solitary, opalescent or flesh colored nodule
Distal interphalangeal joint or proximal nail fold where it can cause a nail plate groove
Puncture release clear, viscous, sticky drainage
Treatment difficult due to connection with underlying joint space and joint fluid |
|
|
Term
| What is the origin of the epidermal inclusion cyst? |
|
Definition
|
|
Term
2. Which of the below is associated with dermatofibromas?
A. “frogspawn”
B. “dimple sign”
C. “claw like extensions”
D. “buttonhole sign”
E. “baboon sign” |
|
Definition
|
|
Term
3. What is the difference between a keloid and a hypertrophic scar?
A. A hypertrophic scar expands beyond the original trauma site while the keloid stays within the original area of trauma.
B. Both hypertrophic scar and keloid expand beyond the site of original trauma but the hypertrophic scar will regress.
C. A keloid expands beyond the original trauma site while the hypertrophic scar stays within the original area of trauma.
D. Both the hypertrophic scar and keloid stay within the site of original trauma but the hypertrophic scar will regress.
E. The term keloid can be interchanged with the term hypertrophic scar. |
|
Definition
| c. Keloid expands beyond original site of trauma. |
|
|
Term
4. All of the below are correct statement about lipomas except:
A. Lipomas are benign
B. Lipomas are slow growing or stable
C. Lipomas are freely movable beneath the skin
D. Lipomas have a hard consistency
E. Lipomas are composed of fatty tissue |
|
Definition
|
|
Term
5. A 30 year old male presents to your clinic with new onset of multiple purple macules and plaques. He admits to multiple partners and occasional use of condoms. You take a punch biopsy. What else should you do?
A. Draw blood for CBC
B. Draw blood for serologic HIV test
C. Send patient for a fasting lipid panel
D. Send patient for CT scan or MRI
E. Draw blood for metabolic panel |
|
Definition
|
|
