BOARD REVIEWDermatology

Click icon to add picture Psoriasis

SILVERY SCALES

COMMONLY HAVE THICKEND SKIN

Found on extensor surfaces, scalp, butt

AUSPITZ SIGN: when remove scale small pinpoint bleeding points

Click icon to add picture 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

Click icon to add picture Koebner Pnenomenon

Lesions seen at areas of trauma

Click icon to add picture 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!

Click icon to add picture Pityriasis Alba

Inflammation from atopic dermatitis – hypopigmented areas

Most commonly seen on face or extremities

Associated with other forms of atopy

Click icon to add picture 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

Click icon to add picture Seborrhea

“cradle cap”

Greasy

Scaly

Seen in hear-bearing or intertriginous areas

Tx: topical steroids, antiseborrheic shampoos

Not that itchy.

PClick icon to add picture Thumb sucking eczema

From repeated wetting and drying

Click icon to add picture Epidrmolytic Hyperkartosis

Rare

AD

Form of ichthyosis

Generalized thick, warty scales with intermittant blisters.

Worse at extensor surfaces

Histiologically- ballooning of squamous cells and microvesicles

Click icon to add picture Auspitz Sign of Psoriasis

Bleeding after removal of scales

Click icon to add picture 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

Click icon to add picture Rubber contact dermatitis

T cell mediated immune reaction

Click icon to add picture Seborrhea of scalp

Click icon to add picture Tinea Corporis

“Ringworm”

Superficial fungal infection

Annular lesion with central clearing. Vesicular border.

Trichophyton tonsurans or Microsporum canis

KOH

Click icon to add picture 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

Click icon to add picture Diaper dermatitis

Sparing intertirginous areas

Treatment: barriers and moisturizer

Watch for diaper rash that doesn’t go away!!

Click icon to add picture Tinea Pedis

“Athlete’s foot”

Commonly seen between toes and soles, but can spread

Tx topical antifungals

Onychomycosis- nail fungus - oral

Click icon to add picture 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

Click icon to add picture Stevens-Johnson

Erythema Multiforme major

Involves mucus membranes and sloughing

Monitor electrolytes

Click icon to add picture Candida diaper dermatitis

Satellite lesions

Bright red, sharp borders

KOH – budding yeast

Commonly seen with antibiotic use

Tx; topical antifungal

Click icon to add picture Milia Rubra

Sweat duct obstruction

Commonly seen in infants – face and neck

Worse in hot humid weather

Tx: loose clothes, no greasy agents

Click icon to add picture 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

Click icon to add picture 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

Click icon to add picture Serum Sickness-like reaction

1. Urticarial lesions

2. Periarticular swelling

3. Extremity swelling

Seen with URI or sulfa containing drugs

Stocking glove angioedema

Painful migratory periarticular swelling

Click icon to add picture 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

Click icon to add picture Henoch-Schonlein Purpura

Palpable purpura

Usually LE

Small vessel vasculitis

skin, GI, kidneys, joints

Rash, abd pain, arthritis

Commonly seen after viral illness

Click icon to add picture Insect Bite

Not to be confused with cellulitis

Pruritc, nontender, and nonindurated.

Click icon to add picture Insect Bites

Flea bites – red itchy with central puncta