Term
|
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 |
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Term
|
Definition
...a confluence of macules
...you will not feel this when you run your hand across it |
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Term
|
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 |
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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 |
|
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Term
|
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 |
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Term
|
Definition
| in psoriasis you will have bleeding points under scales when you pry them up |
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Term
|
Definition
| in urticaria pigmentosa rubbing the skin will make it edematous and erythramatous |
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Term
|
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 |
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Term
|
Definition
| it is a viral culture usually used to dx HSV |
|
|
Term
| what is a weak topical steroid? |
|
Definition
|
|
Term
| what is a weak topical steroid? |
|
Definition
|
|
Term
| what is a medium strength topical steriod? |
|
Definition
|
|
Term
| what is a strong topical steriod? |
|
Definition
|
|
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 |
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|
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
|
|
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 |
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|
Term
|
Definition
| a term specific to lichen planus where you don't see the nail folds |
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|
Term
|
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
|
|
Term
| on hand, 2 feet syndrome refers to what dermatophyte? |
|
Definition
|
|
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
|
Definition
| tinea capitis that is not treated correctly and becomes inflamed |
|
|
Term
|
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
|
|
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 |
|
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Term
|
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
|
Definition
| subungal debris of fungus |
|
|
Term
|
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
|
|
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
|
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
|
Definition
| a mole encircled by a halo of leukoderma or depigmentation (white) |
|
|
Term
| where do halo nevi usually occur? |
|
Definition
|
|
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
|
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
|
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
|
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
|
|
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
|
|
Term
| where are dysplastic nevi found? |
|
Definition
|
|
Term
|
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 |
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