Dermatology

Question 1

Excoriations?

Fissures?

Answer 1

Linear erosions into the epidermis cause by scratching

Linear cracks into the dermis

Question 2

Primary irritant contact dermatitis – caused by? Most common? Secondary infection with what organism? Crease involvement suggests? Management?

Answer 2

Caustic substances that irritate the skin; diaper dermatitis

Secondary infection with Candida

Dermatitis does not involve inguinal creases; secondary infection involves inguinal creases

Zinc oxide

Question 3

Seborrheic dermatitis – potential cause? Clinical features? Type in infants? Management?

Answer 3

Yeast (pityrosporum ovale)

Red scale/crust in areas with high sebaceous glands

Infants – limited to the scalp, called seborrheic capitis

Steroids, sulfur/zinc, antifungals

Question 4

Pityriasis rosacea – age? Cause? Clinical features? Management?

Answer 4

Older than five; unknown – possibly hypersensitivity to a virus

1. Papulosquamous “Herald patch”
2. Two weeks later – pruritic erythematous macules/papules forming “Christmas tree” distribution

Antihistamines, ultraviolet light

Question 5

Psoriasis – Koebner phenomenon? Nail involvement? Extracutaneous finding in children?

Answer 5

New lesions develop at sites of skin trauma

Pits, distal thickening, lifting of the nail bed

Arthritis

Question 6

Miliaria rubra – A.k.a.? Caused by?, Location? Treatment?

Answer 6

Heat rash; sweat produces inflammatory response

Areas of occlusion – inguinal region, axilla, chest, neck

Decrease sweating

Question 7

Symptoms of serum sickness? Cause?

Answer 7

Urticaria, fever, arthralgias, adenopathy

Cephalosporins

Question 8

Fungal infections of the scalp:

1. Acquired from human to human contact
2. Acquired from cats and dogs
3. Hair loss with hair breaking off at scalp
4. Hair loss with broken hairs thickened and white
5. Kerion
6. Occipital/posterior cervical lymphadenopathy
7. Wood’s Light

Answer 8

1. Trichophyton tonsurans
2. Microsporum canis
3. Black dot ringworm
4. Microsporum canis
5. Large red boggy nodule that is a hypersensitivity reaction to dermatophyte
6. Tina Capitis
7. Identify Microsporum canis

Question 9

Erythema multiforme minor:

1. Major cause?
2. skin findings
3. Mucus membrane findings
4. Systemic findings
5. Management
6. prognosis

Answer 9

1. Herpes Symplex virus
2. Symmetric target lesions
3. Only one surface – the help
4. Prodrome of fever, arthralgias, myalgias
5. Supportive, acyclovir
6. Possible recurrence

Question 10

Erythema multiforme major:

1. Major cause?
2. skin findings
3. Mucus membrane findings
4. Systemic findings
5. Management
6. prognosis

Answer 10

1. Mycoplasma, drugs
2. Symmetric target lesions acral and truncal
3. Two mucosal surfaces involved – mouth and eyes
4. Prodrome a fever, arthralgias, myalgias,
5. Supportive,
6. Good

Question 11

SJS:

1. Major cause?
2. skin findings
3. Mucus membrane findings
4. Systemic findings
5. Management
6. prognosis

Answer 11

1. Drugs
2. Atypical asymmetric target lesions, blisters, the closest
3. At least two mucosal surfaces involved
4. Prodrome of high fever, cough, malaise, headache, arthralgias
5. Steroids, IVIG, burn unit
6. 5% mortality

Question 12

1. Circular scaly erythematous patches with partial central clearing
2. Scaling and erythema between the toes
3. Scaling and erythema in groin/inguinal creases
4. Thickening and yellow discoloration of nails

Diagnose with?

Answer 12

1. Tinea corporis – “ringworm”
2. Tinea pedis
3. Tinea cruris
4. Tinea unguium

KOH

Question 13

Tinea versicolor – causal organism? Invades what skin layer? Microscopic examination will show? Wood’s light evaluation shows?

Answer 13

Pityrosporum orbiculare

Stratum corneum

“Spaghetti and meatballs” appearance; yellow/orange fluorescence

Question 14

Morbilliform versus scarlatiniform?

Answer 14

Measles-like versus scarlet fever-like (papular, Vesicular, petechial)

Question 15

Erythema infectiosum – Causal organism? Description of the rash? No longer contagious when?

Answer 15

Parvovirus; lacy, reticular; when rash appears

Question 16

Roseola infantum – causal organism? Page? Clinical features?

Answer 16

HHV 6/7, adenovirus, echovirus; less than two years old

Few days of high fever followed by pink papillae rash on trunk

Question 17

Gianotti-Crosti syndrome– AKA? Age? Associated with what viruses? Clinical features? Maybe preceded by?

Answer 17

Papular acrodermatitis; Younger than three years

Hepatitis B, EBV, CMV, Coxsackie

Red papules in acral areas (extremities, but, cheeks) lasting for weeks

URI

Question 18

Most common HSV infection during infancy/childhood?

Answer 18

Gingivostomatitis – Grouped vesicles and ulcers on lips, and corners of mouth, tongue

Question 19

Complications of Varicella infection?

Answer 19

1. Skin – bacterial superinfection, scarring, necrotizing fasciitis
2. CMS – encephalitis, acute cerebellar ataxia
3. Lung – pneumonia

Question 20

Teratogenic effects of varicella?

Answer 20

1. Skin – zigzag scarring
2. CNS – damage
3. Extremities – shortened or malformed
4. Eye – cataracts or chorioretinitis

Question 21

1. Neonatal HSV?

2. Herpetic Whitlow

Answer 21

1. Vesicles on the scalp, apnea, lethargy, meningioencephalitis
2. HSV infection of them/fingers due to finger sucking

Question 22

Herpangina

Answer 22

Hand-foot-mouth disease, but only oral ulcers are present

Question 23

Condylomata acuminata – causal organism? Management?

Answer 23

HPV; liquid nitrogen, podophyllin, salicylic acid

Question 24

Flesh colored papules with central umbilication? Associated with what virus? Tx?

Answer 24

Molluscum contagiosum; poxvirus;

podophyllin, trichloroacetic acid, liquid nitrogen, salicylic acid, cantharidin

Question 25

Six Legged insect that attaches to skin and ingests blood? Unique finding in pubic variety? Tx?

Answer 25

Pediculus humanus; phthirus pubis Black crusted papules or blue macules 1. Head lice - 1% permethrin shampoo 2. Body/pubic lice – 1% gamma-benzene hexachlorophene lotion

Question 26

Scabies – treatment? Who should be treated? How long does the itching last?

Answer 26

Permethrin lotion or lindane (In adolescents and above) All household contacts Up to 30 days after treatment

Question 27

Causes of hypopigmentation?

Answer 27

1. Postinflammatory hypopigmentation 2. Pityriasis alba – hypopigmented, dry, scaly patches found on cheeks. Related to atopic dermatitis 3. Vitiligo 4. Oculocutaneous Albinism – genetic defect in melanin synthesis

Question 28

Tuberous sclerosis?

Answer 28

``` HAMARTOMAS Adenoma Sebaceum Mitral regurgitation Ash-leaf spots Cardiac rhabdomyoma Tubers (Cortical or subependymoma) Autosomal dominant Mental retardation Renal angiomyolipoma Seizures/Shagreen patch (Thickened orange peel appearance) ```

Question 29

Iris hamartoma – disease?

Answer 29

Lisch nodules – neurofibromatosis

Question 30

Diagnostic criteria for neurofibromatosis type one?

Answer 30

Two or more: 1. 6+ café au lait spots 2. 2+ neurofibromas 3. Freckling in axilla or grind 4. optic glioma 5. 2+ Iris hamartomas (Lisch) 6. Osseous lesion (scoliosis, sphenoid dysplasia) 7. Family history

Question 31

Increased risk of malignancy with what type of nevi?

Answer 31

Giant nevi> Congenital nevi | > Acquired nevi

Question 32

Alopecia – treatment?

Answer 32

Most patients and regrow hair within one year Accelerate with corticosteroids or topical Minoxidil

Question 33

Causes of hair loss?

Answer 33

1. Alopecia areata 2. Tinea capitis 3. Traumatic alopecia

Question 34

Types of traumatic alopecia?

Answer 34

1. Trichotillomania - hair loss as a result of unconscious or conscious pulling/twisting 2. Hair loss caused by constant traction or friction (braids, curling, rubbing)

Question 35

Telogen effluvium?

Answer 35

Hair loss called by acute stress event

Question 36

Allergic Contact dermatitis – cell responsible? Management?

Answer 36

T cell mediated; corticosteroids