Card Set Information
Macule v. papule
Both under 1 cm
A macule is flat
A papule is raised
Patch v. plaque
Both over 1 cm
A patch is flat
A plaque is raised
Vesicle v. bulla
Both are elevated, fluid filled lesions
A vesicle is under 5 mm
A bulla is over 5 mm
What is vitiligo?
Skin depigmentation, associated with AI diseases such as Addison's, pernicious anemia, type I DM, and hypothyroidism
Chronic, allergic-type condition
Begins in first year of life
Red, itchy skin on head, arms, and trunk
Family hx of allergies or asthma
Tx with antihistamines and topical steroids
Scaling skin on hair areas of the head (scalp, eyebrows, beard), forehead, nasolabial folds, and ears
Tx with dandruff shampoo, topical steroids, and/or ketoconazole cream
Annular lesion on body or trunk with well-defined, scaly margins and healing centers
Tinea corporis (dermatophytosis)
Superficial skin infection that fluoresces under Wood's lamp
Microsporum sp (trichophyton sp do not fluoresce)
How are fungal infections diagnosed and treated?
Dx with KOH prep of skin scraping
Treat tinea capitis and onychomycosis with oral antifungals
Treat all other fungal infections with topical antifungals (azoles, griseofulvin for severe infections)
How is candidiasis treated?
Topical nystatin or azoles
Oral nystatin or ketoconazole for severe infection
Visible burrows in the skin in the finger web spaces and flexor surfaces of the wrists
Scabies (sarcoptes scabei)
Treat with whole body permethrin cream
Treat patient + family
Multiple patches of various size and color, typically on the torso, that do not tan with the rest of the skin
Tinea versicolor, aka pityriasis versicolor (malassezia furfur)
Treat with selenium sulfide or topical azoles
Why is permethrin preferable to lindane for tx of scabies and lice?
Lidane is neurotoxic
What do HPV serotypes 6 and 11 cause?
Can treat with salicylic acid, liquid nitro, and curettage
(serotypes 16 and 18 are carcinogenic)
Treatment options for acne
First line--topical benzoyl
If that doesn't work, try topical clinda or oral tetracyclin (to tx propionibacterium)
If that doesn't work, try topical tretinoin
Oral tretinoin is a last resort (effective but side effects include myalgias, elevated LFTs, and teratogenicity)
What is rosacea?
Looks like acne, begins in middle age
Associated with rhinophyma (bulbous, red nose) and blepharitis
Treat with topical metro or oral tetracyclins
Describe the typical psoriatic lesions
Dry, scaly, well-circumscribed, silvery, scaling papules and plaques
Found on scalp and extensor surfaces
What is pityriasis rosea?
Benign skin rash
Begins with a scaly, oval, erythematous lesion called a "herald patch"
Herald patch is followed by many similar lesions that spread out across the torso in a "christmas tree" pattern, and itch
Remits within about a month
Need to r/o herpes
Pruritic, purple, polygonal papules, found on wrists and lower legs
May be associated with whitish, lacy lesions on the oral mucosa
What drugs classically cause photosensitivity?
What does erythema multiforme look like, and what are some possible etiologies?
Target lesions (round, erythematous, with central clearing)
Caused by IgM immune complex deposition in superficial vasculature
Drugs (sulfa drugs, penicillin)
What is erythema nodosum?
Inflammation of subQ, usually in the pretibial region
Associated with sarcoidosis, coccidioidomycosis, and UC
AI disease, associated with anti-desmoglein antibodies
Presents in middle age with extensive blistering that starts in the oral mucosa and spreads all over the body
Positive Nikolsky sign
Dx on punch biopsy
Tx with oral steroids
AI skin disease, associated with IgG autoantibodies against hemidesmosomes
Tense bullae, all over skin (rarely in oral mucosa)
Linear staining on immunofluorescence
What disease is associated with dermatitis herpetiformis?
Celiac (lots of IgA deposits in skin)
Flesh-colored lesion with a central crater, containing keratin
Typically on face
Rapid onset, grows to full size within 2 months, and then spontaneously involutes
No tx needed
Easy to confuse with skin cancer
What does the classic lesion of basal cell carcinoma look like?
Shiny papule in sun-exposed are that slowly enlarges and develops an umbilicated center and peripheral telangiectasias
Rarely metastasizes, but can be locally invasive
What does actinic keratosis look like, and what is it associated with?
Thick, scaly lesion in sun-exposed area (scalp, shoulders, back)
Can develop into squamous cell carcinoma
What is Bowen's disease?
Squamous cell carcinoma in situ
What is stomatitis, and what is it associated with?
Inflammation of the oral mucus membranes
(angular stomatitis--fissuring of the corners of the mouth)
Associated with vit B deficiencies (riboflavin, niacin, pyridoxine) or vit C deficiency