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MED: Common Skin Disorders & Manifestations of Systemic Disorders

Jessica Margaux Mercado Medicine I MD English 85 cards

Cards in this deck (85)

  1. 1papulosquamous, proliferative, inflamatory skin disease (common skin disorder)PSORIASIS
    skin sheds every 5 days
    2% of pop, peak: late 20s
    Koebner reaction
    extradermal: edema, liver damage, arthropathy, nail pitting, corneal nodules
  2. 2salmon pink plaque topped by silvery white scale on extensor surfaces (scalp, elbows, knees); can be round/gultate/ geographical/ circinate; (+) Auspitz (common skin disorder, be specific)PLAQUE TYPE PSORIASIS
  3. 3pinkish, glazed, clearly demarcated, non-scaly; (groin, perianal, genital, inframammary folds); usually mistaken as dermatophytic or candida (type of psoriasis)FLEXURAL PSORIASIS
  4. 4well-demarcated, scaling, erythematous, pustules are white/yellow/green/brown; common in palms and soles (type of psoriasis)PUSTULAR PSORIASIS
  5. 5more complicated; life-threatening; can lead to death (type of psoriasis)VON ZUMBUSCH PSORIASIS
  6. 6Psoriasis Management?Reassurance, social support, emolients, salicylic acid, coal tar, UVB, calcipotriol, photochemotherapy (Psoralen w/ UVR), Acitretin, cytotoxic drugs (methotrexate, cyclosporine)
  7. 7Acute: vesicular, can rupture to leave a raw, weeping surface; Subacute: diffuse, irritating, pruritic, sometimes painful; Chronic: lichenification (common skin disorder)ECZEMA/DERMATITIS
  8. 8presents at infancy, resolves by 12y/o; area of predilection: cheek; (+) Prick test to common allergens; itch rash cycle (type of eczema/dermatitis)ATOPIC ECZEMA
    may be prevented by breastfeeding;
    family history of atopy
  9. 9age 2 and above; at flexural, antecubital, popliteal areas (type of eczema/dermatitis)CHILDHOOD ATOPIC DERMATITIS
  10. 10Atopic Eczema Management?Emolients, topical corticosteroids, antihistamines, immunosuppressants
  11. 11erythema, vesiculation, fissuring; commonly affects hands; can manifest even in 1st exposure (type of eczema/dermatitis)IRRITANT CONTACT DERMATITIS
    occupational hazard
    detergents, bleach, soaps
  12. 12sharp cut-off where contact ends; previous sensitization, autosenzitation; most vulnerable: thin, moist skin; (+) Patch Test: marked prolonged response (type of eczema/dermatitis)ALLERGIC CONTACT DERMATITIS
    dyes, nickel, chromates, lanolin, rubber, resins, topical antibiotics (Neomycin), antiseptics (Betadine)
  13. 13scaly, rusty, red, pruritic eruption on oily areas of skin (T-zone, flexures, scalp, nasolabial, eyebrows) (type of eczema/dermatitis)SEBORRHEIC DERMATITIS
    unkown etiology; aggravated by stress; may be due to fungal infection
  14. 14papulopustular inflammatory condition affecting face and trunk; mild: comedo, open/closed; severe: pustular, scarring, cystic (common skin disorder)ACNE VULGARIS
    90% adolescents, hormonal
    overproduction of sebum = blockage = comedone (1˚ lesion);
    Proprionibacterium acnes
  15. 15Acne Vulgaris Management?dispel myths, non-soap cleansers, benzoyl peroxide, eryhthromycin, tetracycline, clindamycin, isotretinoin
  16. 16chronic inflammatory eruption on cheeks, nose, chin; erythema, papules, pustules, cyst, telangectasia; complication: nose deformity (common skin disorder)ACNE ROSACEA
    fair-skinned, middle-aged women;
    hot drinks, stress, sunlight, spicy food, cheese, alcohol, topical steroids
  17. 17Acne Rosacea Management?Topical Metronidazole
  18. 18small, polygonal, flat-topped, violaceous papules; very pruritic; areas: wrist, lower extremities; Wickham striae; post-inflammatory hyperpigmentation (common skin disorder)LICHEN PLANUS
    sulfonamides, sulfonylureas, methyldopa, thiazides, beta-blockers, antimalarials, gold salts, penicillamine
  19. 19Lichen Planus Management?potent topical/systemic steroids and antihistamines
  20. 20self-limiting, non-recurrent, scaling reddish-brown discrete maculopaular eruption; Herald patch: shoulder or back; Christmas-tree like: trunk, upper thighs, arms; Colarette scaling (common skin disorder)PITYRIASIS ROSEA
    unkown etiology, often mistaken for fungal infection;
    children & young adults, rainy months;
    clears w/in 6-8wks w/o treatment
  21. 21Pityriasis rosea Management?Avoid precipitating factors (avoid too cold/hot baths, gold salts, penicillamine), antihistamines, topical steroids, emolients
  22. 22very pruritic, transient/evanescent, sharply defined, erythematous or white weals w/ erythematous rim (common skin disorder)URTICARIA
    triggers: infection, drugs, food, parasites, physical exertion/stress, solar exposure, cold urticaria
    Treatment: antihistamine
  23. 23"burrows", excoriations; nocturnal pruritis or discomfort; Circle of Hebra; areas: fingerwebs, wrists, antecubital fossae, axilla, areola, abdomen, gentialia, areas w/ thin skin (common skin disorder)SCABIES
    indigent communities, summer
  24. 24Scabies Management?PERMETHRIN, precipitated sulfur;
    *Crotamiton (high failure rate, neurotoxic esp to children and pregnant)
  25. 25chronic, granulomatous; leonine facies, saddle nose (common skin disorder)HANSEN'S DISEASE
  26. 26few, well-defined, hypopigmented, hypoesthetic macules/patches w/ raised erythematous/purple border enlarging peripherally (type of Hansen's)TUBERCULOID LEPROSY
    milder, CMI is good
    Dapsone + Rifampicin, 1yr
  27. 27symmetric, skin-colored/slightly erythematous papules/nodules on nose, earlobes, face, arms, buttocks, trunk, and lower extremities; Leonine facies (type of Hansen's)LEPROMATOUS LEPROSY
    severe, CMI is weak
    Dapsone + Rifampicin + Clofazimine, 2yr
  28. 28painful to touch, nodular lesions usually on anterior shins (systemic manifestations)ERYTHEMA NODOSUM
    females, 20-50y/o
  29. 29Possible causes of Erythema Nodosum?Sarcoidosis, Crohn's, ulcerative colitis, Behcet's, drugs (sulfonamides, OCP, dapsone), bacterial infection (Strep), fungal (histoplasma), viral, lepto
  30. 30Erythema Nodosum Management?identify trigger,
    rest and elevation of affected extremity,
    Indomethacin,
    Potassium Iodide
  31. 31target lesions or circular w/ central blistering; usually on limbs, symmetric (systemic manifestations)ERYTHEMA MULTIFORME
  32. 32Possible causes of Erythema Multiforme?drugs (barbiturates, sulfonamides, PCN, salicylates), systemic infection (HSV), Vit deficiency (Niacin, A, C), Collagen disorders
  33. 33enlarging, coalescing macules w/ crinkled surface; sheet-like loss of epidermis; extensive necrosis; (+) Nikolsky (systemic manifestations)SJS, TEN
    idiopathic, drug-induced;
    widespread apoptosis of keratinocytes (cell-mediated cytotoxicity)
  34. 34SJS Management?early diagnosis and withdrawal of drug, ICU, IV fluids, systemic glucocorticoids, IV Ig
  35. 35evanescent pink rash/rings on trunk or proximal extremities (systemic manifestations)ERYTHEMA MARGINATUM
    Rheumatic Fever
  36. 36starts as a papule, become vesicular and pustular; painful ulcers on back, thigh, buttocks w/ bluish edge (specific disease w/ skin manifestation)PYODERMA GANGRENOSUM
    (Ulcerative Colitis, Crohn's, AML, Hodgkin's)
  37. 37hardened, raised, shiny area on shins, center has yellowish tint, surrounding: pink; telangectasia (lips, nose, eyes, fingers, oral cavities); gradual formation, slow healing (specific disease w/ skin manifestation)NECROBIOSIS LIPOIDICA DIABETICORUM
    (DM)
  38. 38smooth, discolored, annular, pustular patches w/ intact skin surface; no ulceration, no damage to epidermis; usually on hands (specific disease w/ skin manifestation)GRANULOMA ANNULARE
    (severe DM, HIV)
  39. 39pruritic, symmetrical clusters of urticarial lesions, evolve to vesicles & bullae; very itchy; found at gluteal area, extensor aspect of elbows, knees, and upper back (specific disease w/ skin manifestation)DERMATITIS HERPETIFORMIS
    (Celiac Disease)
    Treatment: Dapsone, Gluten-free diet
  40. 40infiltrative dermopathy: erythematous, edematous swellings above lateral malleoli = thickened edema of legs & feet (specific disease w/ skin manifestation)PRETIBIAL MYXEDEMA
    (Hyperthyroidism, Grave's)
  41. 41pigmented, rough, thickened skin in axilla or groin w/ warty lesions; velvety plaques on back in obese (specific disease w/ skin manifestation)ACANTHOSIS NIGRICANS
    (Neoplasia: stomach CA)
  42. 42heliotrope inflamm changes, edema of eyelids & periorbital area; erythema of face, neck, upper trunk, usually sun-exposed areas; hands: Gottron's papule = flat-topped violacrous papules over knuckles (specific disease w/ skin manifestation)DERMATOMYOSITIS
    (Neoplasia: stomach, breast, lung, ovarian, cervical; Rheuma: CT disease, paraneoplastic syndrome)
  43. 43dry, scaly skin; sparing of flexural areas e.g. popliteal (specific disease w/ skin manifestation)ACQUIRED ICTHYOSIS
    (Neoplasia: lympoma)
  44. 44successive crops of tender nodules affecting blood vessels throughout the body (specific disease w/ skin manifestation)THROMBOPHLEBITIS MIGRANS
    (Neoplasia: pancreatic carcinoma)
  45. 45painful groups of vesicles on an inflamed base, unilateral w/ dermatomal distribution (specific disease w/ skin manifestation)HERPES ZOSTER
  46. 46reddening of skin on palmar aspect of hands, usually over hypothenar eminence (specific disease w/ skin manifestation)PALMAR ERYTHEMA
    (liver disease)
  47. 47telangectasis found slightly beneath skin surface, often containing central red spot and reddish extension which radiate (specific disease w/ skin manifestation)SPIDER NEVI
    (liver disease)
  48. 48diffuse bluish plaque w/ small papules w/in the swelling affecting the nose; sometimes spreads to cheek (specific disease w/ skin manifestation)LUPUS PERNIO
    (Sarcoidosis)
  49. 49Café-au-lait macules, axillary freckling, violaceous dermal neurofibroma, subcutaneous nodules (specific disease w/ skin manifestation)NEUROFIBROMATOSIS
    autosomal dominant;
    no treatment
  50. 50tense bullae & erosions on normal appearing skin; slowly heals to form pink atrophic scars, milia on dorsa of hands, feet, nose, forehead, scalp; hypertrichosis on face (specific disease w/ skin manifestation)PORPHYRIA CUTANEA TARDA
    enzymatic defect in heme biosynthetic pathway; on sun exposed areas
  51. 51small, red papule; gradually enlarges to form ring w/ raised border (specific disease w/ skin manifestation)ERYTHEMA CHRONICUM MIGRANS
    (Lyme Disease)
  52. 52Lyme Disease Treatment?Tetracycline (Lymecycline),
    PCN, 3rd gen Cephalosporin (Cefotaxime)
  53. 53yellow plaque, commonly found on eyelids (specific disease w/ skin manifestation)XANTHOMATOSIS
    (Hyperlipidemia)
    Tendon Xanthomata: familial hyperchol
    Eruptive Xanthomata: hyperlipidemia
  54. 54periorificial, acral eczematous and erosive dermatitis; may be some alopecia and diarrhea (specific disease w/ skin manifestation)ACRODERMATITIS ENTEROHEPATICA
    autosomal recessive Zn deficiency;
    babies after weaning, elderly
  55. 55painful oral and genital ulcerations and eye and joint conditions; iritis, keratitis, hyopyon, retinal vein occlusion, arthritis, CNS, complications (specific disease w/ skin manifestation)BECHET'S DISEASE
    wastebasket diagnosis
    recurrent progressive systemic disease of unknown etiology
  56. 56Bechet's Disease Management?Steroids, Colchicine, Cytotoxic drugs (Azathioprine)
  57. 57initial: flesh-colored papule/plaque w/ superficial dilated blood vessels over surface; classic lesion: ulceration & central necrosis, pearly rolled border; "rodent ulcer": dirty-looking ulcerationsBASAL CELL CARCINOMA
    elderly, fair-skinned > 40y/o;
    face, nasal, periorbital;
    malignant but curable
  58. 58Basal Cell Carcinoma Management?Surgical excision
    Cryotherapy
    Radiotherapy
    Moh's micrographic surgery
  59. 59hyperkeratotic, crusted, indurated, may ulcerate; may look like psoriatic lesion; from damaged/chronically irritated skin, sun exposure, HPVSQUAMOUS CELL CARCINOMA
    fair-skinned >60y/o;
    HPV 6,11,16,18,30;
    grows more quickly, can be invasive, can metastasize
  60. 60Squamous Cell Carcinoma Management?wide excision
    radiotherapy
    quadrivalent vaccine (9-26y/o)
  61. 61pigmented lesion with: rapid enlargement, bleeding, variegated pigmentation, ulceration, indistinct border, persistent itching, small satellite lesions around principal lesionMALIGNANT MELANOMA
    fair-skinned w/ chronic UV exposure, may arise in pre-existing mole;
    prognosis: limbs>trunk>face
  62. 62Melanoma Management?Interferon
    Wide excision w/ skin grafting
  63. 63Casal necklace: symmetric photosensitive eruption on face, neck and upper chest; Gauntlet: extensor arms, back of handsPELLAGRA
  64. 64starts as erythema and swelling after sun exposure, accompanied by itching and burning or pain; skin becomes thickened, scaly, hyperpigmented w/ copper or mahogany huePELLAGRA
  65. 65dull erythema of bridge of nose w/ fine yellow, powdery scales over follicular orifices (sulfur scales)PELLAGRA
  66. 66vesicular or bulous erruptions (type of pellagra)WET PELLAGRA
  67. 67pustular and bullous dermatitis w/ acral and periorificial distribution; patchy, red, dry, scaling w/ exudation and crusting on face, groin, flexor areasACRODERMATITIS ENTEROHEPATICA
    autosomal recessive; mutation in SLC39A4 = Zn transporter ZIP4
  68. 68periungual areas are erythematous and scaling, sometimes have superficial, flaccid pustules; angular chellitis, stomatitis; nail dystrophy, generalized alopecia; diarrhea, lethargy, irritibalitiy, whining, crying, Candidiasis, StaphACRODERMATITIS ENTEROHEPATICA
  69. 69hypopigmented on dark skin, erythematous/ purple on fair; first appear on friction areas (flexures, groin, buttocks, elbows); hyperpigmented patches w/ slightly raised edges, peeling, desquamationKWASHIORKOR
  70. 70"crazy pavement", "crackled skin", "mosaic skin", "enamel paint", "flaky patient"KWASHIORKOR
  71. 71hair: hypopigmented, reddish-yellow to gray or even white, dry, lusterless, crackled; (+) Flag Sign: alternating bands of pale and dark hair; nails are soft and thin;KWASHIORKOR
  72. 72failure to thrive, edema, lethargy, irritability, apathy, abdominal distention, hypoglycemia, anemia, hypoprotenemiaKWASHIORKOR
  73. 73multiple, intensely pruritic, small papules and vesicles on thenar and hypothenar eminences of hands, soles, sides of fingers and toesDYSHIDROTIC ECZEMA
  74. 74round or oblong, yellow fibrinous base ulcers; lower medial aspect of legVENOUS ULCERS
  75. 75early eruptions: symmetrical, more or less generalized, superficial, non-destructive, exanthematic, transient, macular later: maculopapular or papular, polymorphousSECONDARY SYPHILIS; SYHPILID
    face, shoulders, flanks, palms and soles, anal or genital regions
  76. 76exanthemic erythema; round indistinct nonconfluent macules; appear first on sides of trunk, about the navel, and on inner surface of extremitiesMACULAR ERUPTIONS
    (SECONDARY SYPHILIS; SYHPILID)
  77. 77raw ham or coppery shade and round; slightly raised; deep, firm, palpable; Ollendorf's sign: papule tender to touch of blunt probe; healing lesions leave hyperpigmented spotsPAPULAR ERUPTIONS
    (SECONDARY SYPHILIS; SYHPILID)
  78. 78adherent scales covering lesions more or less dominate (syphilid)PAPULOSQUAMOUS SYPHILID
    (SECONDARY SYPHILIS; SYHPILID)
  79. 79minute scale-capped papules; at the ostia of hair follicles; conical, elsewhere domed (syhpilid)FOLLICULAR/LICHENOID
    (SECONDARY SYPHILIS; SYHPILID)
  80. 80mimics sarcoidosis; usually in cheeks or angles of mouth; "nickels and dimes"ANNULAR SYPHILID
    (SECONDARY SYPHILIS; SYHPILID)
  81. 81large central papule, group of minute satellite papules (syphilid)CORYMBOSE SYMPHILID
    (SECONDARY SYPHILIS; SYHPILID)
    late in secondary stage
  82. 82widely scattered over trunk and extremities, involve face; arise from red infiltrated base (syphilid)PUSTULAR SYPHILID
    (SECONDARY SYPHILIS; SYHPILID)
    rare
  83. 83papular lesions, relatively broad and flat; located on fold of moist skin, esp genitalia and anus (syphilid)CONDYLOMATA LATA
    (SECONDARY SYPHILIS; SYHPILID)
  84. 84mucus patches; macerated, flat, grayish, roudned erosions covered by delicate, soggy membrane; occur on tonsils, tongue, pharynx, gums, lips, buccal areas, genitaliaSECONDARY SYPHILIS
    highly infectious
  85. 85butterfly rash over cheeks and bridge of nose; skin sores or flaky red spots on arms, hands, neck, head area; scaly red/purple raised rash; Raynaud's; temporary hair lossSLE
    type II & III HSN; women 15-35

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Common Skin Disorders & Manifestations of Systemic Disorders
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