Transcript Board Review - LSU School of Medicine

BOARD REVIEW
Dermatology
Psoriasis
SILVERY
SCALES
COMMONLY
HAVE
THICKEND SKIN
Found on extensor
surfaces, scalp,
butt
AUSPITZ SIGN:
when remove scale
small pinpoint
bleeding points
Staph diaper
dermatitis
Complication of
diaper dermatitis
Thin walled
pustules with
erythematous
base- rupture and
leave a denuded
area
Cx: gram pos cocci
Tx: oral and
topical antibiotics
Koebner
Pnenomenon
Lesions seen at
areas of trauma
Nummular
excema
Pruritic, round to
oval shape red
scaly patch
Usually found on
extensor thigh or
abdomen.
Commonly seen in
children with
atopic derm or
keratosis pilaris
Lack of central
clearing!
Pityriasis Alba
Inflammation
from atopic
dermatitis –
hypopigmented
areas
Most commonly
seen on face or
extremities
Associated with
other forms of
atopy
Pityriasis Rosea
Herald Patch –
oval pink lesion
5-10 days later
the other lesion
appear all over the
body.
Commonly seen on
the trunk.
Small round
papules with scale
“Christmas tree”
Usually resolves
in 4-6 weeks
Seborrhea
“cradle cap”
Greasy
Scaly
Seen in hearbearing or
intertriginous
areas
Tx: topical
steroids,
antiseborrheic
shampoos
Not that itchy.
P
Thumb sucking
eczema
From repeated
wetting and
drying
Epidrmolytic
Hyperkartosis
Rare
AD
Form of ichthyosis
Generalized thick,
warty scales with
intermittant
blisters.
Worse at extensor
surfaces
Histiologicallyballooning of
squamous cells
and microvesicles
Auspitz Sign of
Psoriasis
Bleeding after
removal of scales
Atopic Dermatitis
A: infantile
Red, ITCHY,
papules that ooze
and crust
Childhood – dry
and very itchy
Wrist, ankles,
anticubital fossa,
Popliteal fossa
Can see with
hyper or hypo
pigmentation
Rubber contact
dermatitis
T cell mediated
immune reaction
Seborrhea of scalp
Tinea Corporis
“Ringworm”
Superficial fungal
infection
Annular lesion
with central
clearing.
Vesicular border.
Trichophyton
tonsurans or
Microsporum
canis
KOH
Tinea Versicolor
Multiple small
oval scaly patches
Commonly on
upper back, trunk
and upper ext.
Pityrosporum org.
Dark than other
skin in non sun
exposed areas and
lighter in areas
that are exposed.
KOH – spaghetti
and meatballs
Tx; topical
antifungals
Discoloration may
remain for months
Diaper dermatitis
Sparing
intertirginous
areas
Treatment:
barriers and
moisturizer
Watch for diaper
rash that doesn’t
go away!!
Tinea Pedis
“Athlete’s foot”
Commonly seen
between toes and
soles, but can
spread
Tx topical
antifungals
Onychomycosisnail fungus - oral
Erythema
Multiforme
Target Lesions
Hypersensitivity
reaction
Symmetrical, any
part of the body
Can develop to
bullae
Causes: drugs,
foods,
immunizations
Typically not that
itchy
Resolves 1-3
weeks
Stevens-Johnson
Erythema
Multiforme major
Involves mucus
membranes and
sloughing
Monitor
electrolytes
Candida diaper
dermatitis
Satellite lesions
Bright red, sharp
borders
KOH – budding
yeast
Commonly seen
with antibiotic use
Tx; topical
antifungal
Milia Rubra
Sweat duct
obstruction
Commonly seen in
infants – face and
neck
Worse in hot
humid weather
Tx: loose clothes,
no greasy agents
Infantile
Acropustulosis
Starts as papules
and then
progesses to
pustules of
vesiculopustules
Common in AA
males
Seen on hands and
feet
Last 10 days then
disappear, but will
reappear a few
weeks later.
Resolves 2-3 yrs
Unknown etiology
Urticaria
“Hives”
Wheals
VERY ITCHY
IgE mediated
Usually resolves
within 24 hours
Can progress to
look like EM, or
can spread to
subcut tissues angioedema
Serum Sicknesslike reaction
1.
Urticarial
lesions
2.
Periarticular
swelling
3.
Extremity
swelling
Seen with URI or
sulfa
containing
drugs
Stocking glove
angioedema
Painful migratory
periarticular
swelling
Morbilliform drug
eruption
Can look like viral
exathem
Macules and
papules that
usually starts on
trunk or face
Can see 5-14 days
after starting the
medication
Henoch-Schonlein
Purpura
Palpable purpura
Usually LE
Small vessel
vasculitis
skin, GI, kidneys,
joints
Rash, abd pain,
arthritis
Commonly seen
after viral illness
Insect Bite
Not to be confused
with cellulitis
Pruritc,
nontender, and
nonindurated.
Insect Bites
Flea bites – red
itchy with central
puncta