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Dermatology – Awesom
Random derm questions
Question | Answer |
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Following cardiac catheterization, the patient developed pain and discoloration in the left toes, acute kidney injury, low-grade fever, elevated erythrocyte sedimentation rate, and leukocytosis with marked eosinophilia | cholesterol embolization |
a variation of impetigo, presenting at a deeper level of tissue. assoc w GAS, Superficial, saucer-shaped ulcers with overlying crusts, usu in AIDS or IVDU | Ecthyma |
appears in patients diagnosed with reactive arthritis, pustules or vesicles, waxy yellow brown hyperkeratotic lesions on soles and palms | Keratoderma Blennorrhagicum |
bacteria skin infection that can be caused by wearing tight or restricting footwear and excessive sweating. pits on the surface of the feet and toes, particularly weight bearing areas. tx topical antibiotics | Pitted keratolysis |
painless indurated plaque on the abdomen that is mildly pruritic, perivascular accumulations of lymphocytes in the dermis consistent with scleroderma skin; no pannicular inflammation is present - what is dx | morphea - histology similar to systemic sclerosis; however, it involves only the skin in the absence of other systemic manifestations of systemic sclerosis such as gastroesophageal reflux disease, lung disease, bowel dysmotility, or Raynaud phenomenon. |
skin thickening that involves areas proximal to the elbows and/or knees | Diffuse cutaneous systemic sclerosis |
skin disease that does not progress proximal to the elbows or knees | Limited cutaneous systemic sclerosis |
calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia | CREST a subset of limited cutaneous systemic sclerosis |
skin thickening that follows a dermatomal distribution on one side of the body | Linear scleroderma |
pt with fever and skin rash (intense neutrophilic inflammatory infiltrate and accompanying papillary dermal edema, the lesions often look “juicy", bright red plaques, well demarcated with a sharp cut-off separating nl & inflamed skin), h/o leukemia or MDS | Sweet Syndrome |
red-to-violaceous dermal papules and nodules. A biopsy would reveal atypical, leukemic cells infiltrating the dermis and dissecting through the collagen bundles | leukemia cutis |
small benign vascular papules with a collarette of scale, which can occur almost anywhere but tend to be seen on extremities around the nails and on the face. Patients on ART, acne medication, or pregnant | Pyogenic granulomas |
red papules on the chest, flanks, and back that may become pruritic with heat and sweating, papules may be topped by a fragile vesicle or fine scale; >50yo; path shows acantholysis characterized by dissociation of keratinocytes in the epidermis | Grover disease, also called acantholytic dermatosis; grover is hot and sweaty |
How to treat acantholytic dermatosis? | Treatment includes reassurance, cooling measures, and low- to mid-potency topical corticosteroids, but regardless of treatment, it tends to be recurrent. |
URI in spring or fall; begins w single, pink, 2- to 4-cm, thin, oval-shaped plaque with a thin collarette of scale at the periphery (herald patch). smaller plaques erupt within days to weeks on torso along skin cleavage lines, mild itch | Pityriasis rosea |
how to treat acne in pregnancy | topical clindamycin and azelaic acid, topical tretinoin can be ok category C, but don't use Tazarotene - category X |
paroxysmal bilateral erythema of the extremities with associated warmth and burning pain, episodic, precipitated by warmer external temperatures and febrile episodes and is aggravated by the dependent position | erysipelas |
abrupt onset of fever, arthralgia, myalgia, & cutaneous lesions. lesions are tender, nonpruritic, brightly erythematous, well-demarcated papules & plaques that appear on the neck, upper trunk, and typically, upper extremities, middle-aged women after URI | Sweet Syndrome |
white-reticulated network on the buccal mucosa; desquamative gingivitis; and chronic, painful erosions on the oral or vulvar mucosa. increased frequency in patients with liver disease, particularly hepatitis C | mucosal lichen planus |
cutaneous lesions typically occur as small polygonal violaceous papules, usually distributed symmetrically on the wrists, flexural aspects of the arms and legs, lower back, and genitals | cutaneous lichen planus |
how to dx and treat lichen planus | Diagnosis is confirmed with biopsy. Treatment consists of topical corticosteroids and calcineurin inhibitors. |
in patients with HIV infection that consists of wrinkled, white, adherent plaques with a corrugated appearance; these generally occur on the lateral aspects of the tongue. The plaques are adherent and are not easily removed by scraping. | oral hairy leukoplakia |
How to treat Grover disease | Treatment includes reassurance, cooling measures, and low- to mid-potency topical corticosteroids, but regardless of treatment, it tends to be recurrent. |
vesicles and bullae on sun-exposed skin, most commonly on the face, dorsal hands, and scalp, associated with HCV | porphyria cutanea tarda (PCT) |
discrete erythematous to hyperpigmented plaques with scale and erosion on the lower extremities in patients with hepatitis C, no systemic associations, +zinc deficiency | Necrolytic acral erythema |
itch without a rash; deep, crawling, or tingling sensation on the forearms, shoulders, and upper back | brachioradial pruritus |
itch without a rash; on the mid, medial back | notalgia paresthetica |
2-wk hx of rash on face and midchest. small, reddish “lumps” intensely itchy; they develop and begin to resolve with development of new lesions. recent diagnosis of HIV. 1- to 3-mm papules and pustules on the face and central chest. | Eosinophilic pustular folliculitis causes intensely pruritic papules on the face and chest and is most commonly seen in patients with HIV infection, generally with a CD4 cell count less than 300/µL. |