Transcript PowerPoint Template

Itchy Rash
D. Erichsen MD
Case
• 2 siblings, 16 and 13
y. o present with rash
• Trunk > extremities,
face spared
• Itch started
immediately after
swimming
• Rash after 1 day
• ROS negative
Case
•
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Pmhx: none
Meds: benadryl prn. only
No previous episodes
No other sick contacts
Case presentation
• Nomenclature
• Differential
• Case discussion
Nomenclature
• Lesion
– A lesion is any single area of altered skin.
It may be solitary or multiple.
• Rash
– A rash is a widespread eruption of lesions.
• The rules
– A description and picture of an example of
a dermatological term will be provided
– You have one guess
– Each participant has 2 lifelines
• You may ask anyone in the room once
excluding myself and the chief resident
• You may ask for a clue once
Descriptive term?
• Round (coinshaped) lesions.
Also known as
discoid.
Nummular lesion
• Round (coinshaped) lesions.
Also known as
discoid.
Descriptive term?
• A straight shape
to a lesion often
occurs for some
external reason
such as
scratching. Also
striate.
Linear lesion
• A straight shape
to a lesion often
occurs for some
external reason
such as
scratching. Also
striate.
Descriptive term?
• Concentric rings
like a dartboard.
Also known as iris
lesion.
Target lesion
• Concentric rings
like a dartboard.
Also known as iris
lesion.
Descriptive term?
• Lesions grouped
in a circle.
Annular lesion
• Lesions grouped
in a circle.
Dermatological term?
• An area of color
change less than
1.5 cm diameter.
• The surface is
smooth.
Macule
• A macule is an
area of color
change less than
1.5 cm diameter.
• The surface is
smooth.
Dermatological term?
• A large area of color change, with smooth
surface.
Patch
• A patch is a large area of color change,
with smooth surface.
Dermatological term?
• Small palpable lesions. Less than 0.5 cm
diameter, although some authors allow
up to 1.5 cm. Raised above the skin
surface, and may be solitary or multiple.
Papule
• Small palpable lesions. Less than 0.5 cm
diameter, although some authors allow
up to 1.5 cm. Raised above the skin
surface, and may be solitary or multiple.
Dermatological term?
• An enlargement of a papule in three
dimensions (height, width, length). It is a
solid lesion.
Nodule
• An enlargement of a papule in three
dimensions (height, width, length). It is a
solid lesion.
Dermatological term?
• A purulent vesicle. It is filled with
neutrophils, and may be white, or yellow.
Not all are infected.
Pustule
• A purulent vesicle. It is filled with
neutrophils, and may be white, or yellow.
Not all are infected.
Dermatological term?
• A large fluid-filled blister. It may be a
single compartment or multiloculated.
Bulla(e)
• A large fluid-filled blister. It may be a
single compartment or multiloculated.
Dermatological term?
• A localised collection of pus.
Abscess
• A localised collection of pus.
Dermatological term?
• An oedematous papule or plaque caused
by swelling in the dermis. Often indicates
urticaria.
Weal
• An oedematous papule or plaque caused
by swelling in the dermis. Often indicates
urticaria.
Dermatological term?
• Change in skin caused by chronic
rubbing, which results in palpably
thickened skin with increased skin
markings.
Lichenification
• Change in skin caused by chronic
rubbing, which results in palpably
thickened skin with increased skin
markings.
Dermatological term?
• Occurs when plasma exudes through an
eroded epidermis. It is rough on the
surface and is yellow or brown in colour.
Crust
• Occurs when plasma exudes through an
eroded epidermis. It is rough on the
surface and is yellow or brown in colour.
Dermatological term?
• A scratch mark. It may be linear or a
picked scratch (prurigo). May occur in the
absence of a primary dermatosis.
Excoriation
• A scratch mark. It may be linear or a
picked scratch (prurigo). May occur in the
absence of a primary dermatosis.
Differential
• Skeeter syndrome
• Insect bites
• Scabies
Skeeter Syndrome
• IgE mediated allergic skin reaction to
mosquito saliva.
• Young children, immuno-compromised
and visitors at increased risk.
• Difficult to distinguish from cellulitis.
– Develops within hours
• Benign
– Topical hydrocortisone
– Bacitracin
– Benadryl
Insect bites
• Can cause similar local reactions
• Diagnosis of exclusion
• Treatment similar to Skeeter Syndrome
Scabies