Term
| Examples of adnexal structures |
|
Definition
| Hair follicles, sebaceous glands |
|
|
Term
| Difference between apocrine and ecrine glands |
|
Definition
Apocrine gland - opens into hair follicle
Ecrine gland - opens into the skin |
|
|
Term
| Type of epithelium that makes up epidermis? |
|
Definition
| Keratinized stratified squamous epithelium |
|
|
Term
| What are the 4 layers of the epidermis? |
|
Definition
Corneum
Granulosum
Spinosum
Basalis
"Come Get Sun Burned" |
|
|
Term
| What layer of the epidermis are MELANOCYTES located within? |
|
Definition
| Located in the stratum basalis (deepest layer) |
|
|
Term
| Function of Langerhans cells in the epidermis? |
|
Definition
|
|
Term
| What two areas of skin is the stratum corneum thickest in? What surfaces have NO stratum corneum? |
|
Definition
The PALM and SOLE have thickest corneum
MUCOSA has no corneum |
|
|
Term
| Melanin is produced by melanocytes from ________ precursors in the body |
|
Definition
|
|
Term
| What causes differences in skin colour between people? |
|
Definition
The number of MELANOSOMES in their skin cells
**NOT due to number of melanocytes themselves; only concerns the # of melanosomes within melanocytes
# of melanocytes per unit skin is constant between races |
|
|
Term
| What are the two parts of the dermis? |
|
Definition
Papillary = superficial
Reticular = deep |
|
|
Term
| What is located within DERMIS of skin? |
|
Definition
| Elastic fibers, ground substance, BVs and nerves; this is where thermal regulation of skin occurs via BV vasoconstriction/dilation |
|
|
Term
| What makes up the pilo-sebaceous unit? |
|
Definition
| Hair follicle + sebaceous gland |
|
|
Term
|
Definition
Open = open mouth of dilated follicle; BLACK HEAD
Closed = closed mouth of follicle; WHITE HEAD |
|
|
Term
| Function of desmosomes in the skin... |
|
Definition
| Link keratinocytes together |
|
|
Term
|
Definition
| Intercellular edema; form microvesicles in epidermis in between cells; e.g. acute dermatitis |
|
|
Term
| Where does cell division occur in the epidermis? |
|
Definition
| In the Stratum Basalis (basal cell layer), differentiation occurs in the layers above it |
|
|
Term
| Renewal rate of epidermis is approximately? |
|
Definition
|
|
Term
|
Definition
Thickening of stratum corneum (most keratinized layer)
Usually in chronic disease; any SCALY condition |
|
|
Term
| Difference between Orthokeratosis and Parakeratosis |
|
Definition
Ortho = no nuclei in stratum corneum
Para = nuclei are present in stratum corneum
Both are subtypes of HYPERKERATOSIS |
|
|
Term
|
Definition
Loss of attachments between keratinocytes due to desmosome dysfunction
E.g. Pemphigus vulgaris |
|
|
Term
| Which sweat glands are the most important in thermoregulation? |
|
Definition
| ECCRINE - responsible for excreting sweat onto skin surface to regulate body temperature |
|
|
Term
| Which sweat glands are responsible for body odour? |
|
Definition
|
|
Term
| What does SCALDA stand for? |
|
Definition
Size
Colour
Arrangement
Lesion Morphology
Distribution
ALWAYS CHECK HAIR, NAILS |
|
|
Term
| Difference between macule and patch |
|
Definition
Macule < 1 cm, flat
Patch > 1 cm, flat |
|
|
Term
| Difference between papule and plaque |
|
Definition
Papule = raised, < 1 cm
Plaque = raised, > 1 cm |
|
|
Term
| What is the atopic triad? |
|
Definition
| Atopic dermatitis + asthma + allergic rhinitis |
|
|
Term
| Phases of atopic dermatitis... |
|
Definition
Infantile (0-2)
Childhood (2-puberty)
Adult (puberty onwards) |
|
|
Term
| What is pathognomonic of chronic atopic dermatitis? |
|
Definition
| LICHENIFICATION - lichenification only seen in chronic atopic dermatitis |
|
|
Term
| Lichenification is pathognomonic of... |
|
Definition
| Chronic atopic dermatitis |
|
|
Term
| Characteristics of Infantile Phase of Atopic Dermatitis |
|
Definition
| Red plaques on EXTENSOR surfaces |
|
|
Term
| Location of atopic dermatitis lesions in infantile vs. childhood phases? |
|
Definition
Infant = extensor surfaces
Child = flexural surfaces |
|
|
Term
| What symptom is present in 100% of atopic dermatitis cases? |
|
Definition
PRURITIS
Leads to excorations as secondary lesions |
|
|
Term
| Aside from pruritis, what is the other cardinal feature of atopic dermatitis? |
|
Definition
|
|
Term
|
Definition
| Excessive scaling seen in 50% of atopic derm patients |
|
|
Term
| What is the Outside In Hypothesis? |
|
Definition
Describe pathophys of atopic dermatitis
AD is genetic condition w/ abnormal skin barrier, exacerbated by environment; defective skin barrier causes water loss (xerosis), Th2 shift to increase allergic reactions |
|
|
Term
| Complications of Atopic Dermatitis? |
|
Definition
Secondary impetignization - crusting in areas of eczema; often S. aureus
Eczema herpeticum -- MEDICAL EMERGENCY; monomorphic erosions; NEED OPHTHO CONSULT IF EYE INVOLVED |
|
|
Term
| What is the most serious and emergent complication of Atopic Dermatitis? |
|
Definition
| Eczema herpeticum - medical emergency, need immediate anti-virals and ophtho consult if eyelid involved |
|
|
Term
| What are the topical treatments for atopic dermatitis? |
|
Definition
1st = topical corticosteroids
2nd = topical calcineurin inhibitors (tacrolimus) |
|
|
Term
|
Definition
| Wide-spread rash occurring as a symptom of general disease |
|
|
Term
| What are 3 specific childhood viral exanthems? |
|
Definition
Parvovirus B19 infection - 5th disease/erythema infectiosum
Varicella infection - chicken pox
HHV6 infection - roseola |
|
|
Term
| What are the MAJORITY of childhood exanthems and how do you treat them? |
|
Definition
| NON-specific viral exanthems, blanchable erythematous maculopapular rash; often spontaneous resolution in 1 week |
|
|
Term
| Scarlet fever occurs after infection from? |
|
Definition
|
|
Term
| What are the skin manifestations of Scarlet Fever? |
|
Definition
Strawberry tongue (mucosal)
Blanchable, erythematous maculopapular rash, with SANDPAPER like texture; Pastia's lines |
|
|
Term
| Pastia's lines are commonly seen in .... |
|
Definition
| Scarlet fever - seen in skin folds, small petechiae |
|
|
Term
| Julie is a 4 yo child w/ lichenified erythematous pruritic plaques in the antecubital fossa that come and go, most likely dx... |
|
Definition
| ATOPIC DERMATITIS (flexural eruptions, lichenification) |
|
|
Term
| Anxious med student presents with a flesh covered firm papule on lower leg, hasn't changed in several years post-mosquito bite; most likely dx... |
|
Definition
|
|
Term
| Describe pathogenesis of acne... |
|
Definition
4 factors:
1) Release of inflammatory mediators
2) P. acnes follicular colonization
3) Altered keratinization (hyperkeratinization)
4) Excess sebum production by sebaceous gland |
|
|
Term
| 3 lesions that can be seen in acne... |
|
Definition
| Comedones (open = black, closed = white), papules/pustules, cysts |
|
|
Term
| 5 Cleansing Tips for Acne Vulgaris... |
|
Definition
Wash w/ lukewarm water
Mild cleanser
NO abrasives
NO scrubbing
Don't squeeze |
|
|
Term
| What are 4 effects of taking isoretinoin? |
|
Definition
Decreased sebum production
Correct hyperkeratinization
Decreased P. acnes growth
Decreased inflammation
Targets ALL 4 factors of pathogenesis of acne |
|
|
Term
| What is the only absolute contraindication of Isoretinoin/Acutane? |
|
Definition
|
|
Term
| 3 relative contraindications of Isoretinoin/Acutane? |
|
Definition
Depression
History of hypercholesterolemia
Pre-existing liver disease |
|
|
Term
| What are the two top adverse effects of isoretinoin? |
|
Definition
Cheilitis (inflammation of lips)
Dermatitis |
|
|
Term
| What is the typical pattern of onset of rosacea? |
|
Definition
| Usually after age of 30 (peak incidence in 4th to 7th decade of life) |
|
|
Term
| Difference in onset between acne and rosacea? |
|
Definition
Acne = onset at puberty
Rosacea = onset after age of 30; usually 40-70 |
|
|
Term
| What is the main difference in skin lesions between acne and rosacea? |
|
Definition
| In rosacea have NO COMEDONES***** |
|
|
Term
| What are 4 subtypes of rosacea? |
|
Definition
Erythematotelangiectasic
Papulopustular
Phymatous (big nose)
Ocular |
|
|
Term
| What is the most common subtype of rosacea? |
|
Definition
|
|
Term
| Oral treatments for rosacea? |
|
Definition
Antibiotics target SKIN and EYE
Tetracyclines
Erythromycin, Clarithromycin, Azithromycin
Metronidazole
Can also use isoretinoin |
|
|
Term
| What is the age range for psoriasis onset? |
|
Definition
0-108 yrs
ANYTIME MOTHERFUCKER, ALWAYS GOTTA BE READY |
|
|
Term
| What are the 2 peaks in psoriasis onset? |
|
Definition
Type I - age 20 to 30 (familial linked)
Type II - age 60 (non familial) |
|
|
Term
|
Definition
Autoimmune mediated with activated T cells
Get inflammation, keratinocyte hyperplasia, neovascularization
**Excess cell proliferation and lack of differentiation; elevated transit rate of psoriatic cells |
|
|
Term
| What is the most common type of psoriasis? |
|
Definition
| Psoriasis Vulgaris (aka Plaque Psoriasis) |
|
|
Term
| What condition is the Auspitz sign seen in? |
|
Definition
| Plaque Psoriasis (Vulgaris) - occurs when silvery-white scales are removed, causing small bleeding points to arise where suprapapillary epithelium is torn off |
|
|
Term
| Describe the locations and characteristics of the plaques in psoriasis vulgaris? |
|
Definition
Seen elbows, knees, lumbosacral, scalp
Silvery-white scales with underlying erythematous lesions |
|
|
Term
| Main difference in distribution between plaque vs. guttate psoriasis? |
|
Definition
Plaque = face is spared
Guttate = face commonly affected |
|
|
Term
| What infection is guttate psoriasis usually associated with? |
|
Definition
| Acute Streptococcal infections |
|
|
Term
| Describe the lesions seen in guttate psoriasis? |
|
Definition
| Small, drop-like gouttes develop SUDDENLY |
|
|
Term
| In what type of psoriasis is the typical scaling often absent? |
|
Definition
| Inverse (flexural) psoriasis |
|
|
Term
| What type of psoriasis is often mistaken for a yeast infection? |
|
Definition
Intertriginal (flexural/inverse)
**Borders in psoriasis lesions are well demarcated |
|
|
Term
| What is Generalized Von Zumbusch Pustular Psoriasis? |
|
Definition
Unstable, reactive form
Tender skin w/ pinpoint pustules, often affects genitals and flexures
Fever, malaise, leukocytosis; acutely sick and can be fatal
Remission can occur but relapse is common |
|
|
Term
| What are some nail changes associated with psoriasis? |
|
Definition
Pitting
Oncholysis (detachment of nail)
Oil drop changes
Splinter hemorrhage
Occur in 25-50% of patients |
|
|
Term
| What are nail changes in psoriasis often associated with? |
|
Definition
|
|
Term
| Psoriatic arthritis is most common in... |
|
Definition
|
|
Term
| Most common form of psoriatic arthritis is... |
|
Definition
| Asymmetric oligoarthritis - most often affects knees |
|
|
Term
| What are 5 common co-morbidities in psoriasis patients? |
|
Definition
Metabolic syndrome
DM
HTN
Hyperlipidemia
Smoking
Obesity |
|
|
Term
| When does psoriatic arthritis onset? |
|
Definition
| 10 yrs after skin manifestations begin |
|
|
Term
| 4 levels of Rx for Psoriasis |
|
Definition
OTC - emollients
Topical - steroids, retinoids, calcineurin inhibitors
Phototherapy - UVB, PUVA
Systemic - cyclosporine, methotrexate |
|
|
Term
| What can be used to lower the MI risk by 50% in psoriasis? |
|
Definition
|
|
Term
| Rx of mild localized disease vs. moderate-to-severe psoriasis? |
|
Definition
Localized = topical (CNI, steroids)
Mild-Severe = phototherapy, systemic, biologics |
|
|
Term
| What condition is the "Herald Patch" seen in the majority of cases? |
|
Definition
PITYRIASIS ROSEA
Herald patch = 50% on trunk, about 2 wks pre-onset |
|
|
Term
| What is the distribution of pityriasis rosea? |
|
Definition
Christmas tree (face, palms, soles are spared)
Associated with HHV 6,7,8 |
|
|
Term
| What are the 5 P's of Lichen Planus? |
|
Definition
Purple
Pruritic
Planar
Polygonal
Papules |
|
|
Term
| In what self-limiting eruption are Wickham's striae typically seen? |
|
Definition
| In LICHEN PLANUS (Wickham's striae = lacy, reticulated pattern) |
|
|
Term
| Where is hypertrophic lichen planus most commonly seen? |
|
Definition
|
|
Term
| Lichen _______ can progress to scarring _________ |
|
Definition
Lichen PLANOPILARIS
Scarring ALOPECIA |
|
|
Term
| What is the treatment regimen of lichen planus? |
|
Definition
Usually self limiting, lasts average of 8 months
Localized disease may require topical steroids or calcineurin inhibitors; systemic disease can be treated with systemic prednisone, UVB or PUVA therapy |
|
|
Term
| Lichen planus can occur/be brought on following use of which 4 drugs? |
|
Definition
Thiazides
Anti-malarials
Captopril (ACEI)
B-blockers |
|
|
Term
| 2/3 patients with lichen planus will present with lesions in their ______; these lesions may progress to ________ |
|
Definition
Present w/ lesions in MOUTH
Can progress to SCC |
|
|
Term
| What are the 2 types of contact dermatitis? |
|
Definition
Allergic (Hypersensitivity)
Irritant |
|
|
Term
| Which form of contact dermatitis is more common? |
|
Definition
|
|
Term
| What is the most common irritant leading to irritant contact dermatitis? |
|
Definition
|
|
Term
| Allergic contact dermatitis is due to a __________ hypersensitivity reacion |
|
Definition
|
|
Term
| Suspect allergic dermatitis based on a __________ pattern |
|
Definition
|
|
Term
| Characteristic locations of seborrheic dermatitis? |
|
Definition
| Greasy scales on nose, glabella (in between eyebrows), perioral, scalp, ears, chest |
|
|
Term
| Seborrheic dermatitis is due to ___________ |
|
Definition
| ...overgrowth of commensal yeast Pityrosporum ovale |
|
|
Term
| Main two treatment adjuvants for seborrheic dermatitis on the body? |
|
Definition
Topical steroid
Imidazole (antifungal) or antimicrobial |
|
|
Term
| Nummular eczema presents with distinct..... |
|
Definition
| Pruritic coin-shaped macules/patches |
|
|
Term
| Xerotic dermatitis is seen mainly in the _______ |
|
Definition
Elderly
Typically due to lack of bathing from being old as fuck |
|
|
Term
| What other 2 skin findings are seen in venous stasis eczema? |
|
Definition
| Edema + hyperpigmentation, usually in lower legs + ankles |
|
|
Term
| Difference between vesicle and bulla |
|
Definition
Both are clear fluid filled lesions
Vesicle < 1 cm
Bulla > 1 cm |
|
|
Term
| If a blistering disorder is suspected, what 2 types of biopsies should be done? |
|
Definition
Biopsy for histopathology
Biopsy for immunofluorescence |
|
|
Term
Impetigo is a superficial skin infection characterized by _________
Usually caused by (2 main organisms) |
|
Definition
Characterized by GOLDEN CRUST
Caused by S. aureus or Strep. pyogenes |
|
|
Term
| Autoimmune blistering diseases are characterized by blistering ______________ the epidermis |
|
Definition
| Blistering WITHIN AND BENEATH the epidermis |
|
|
Term
| In what age group does bullous pemphigoid typically present and what is its disease course? |
|
Definition
Typically presents in > 60 yrs of age (in elderly)
Usually self-limiting, remission after 5-6 yrs |
|
|
Term
| What is seen on immunofluorescence in Bullous Pemphigoid? |
|
Definition
| IgG deposition along basement membrane |
|
|
Term
| Treatment for Mild vs. Moderate vs. Severe Bullous Pemphigoid |
|
Definition
Mild = topical steroids
Moderate = steroids + oral tetracycline
Severe = oral immunosuppressants |
|
|
Term
| When does pemphigus present and what are its characteristics on biopsy? |
|
Definition
Pemphigus presents at mean age of 50-60
On histopathology - fragility due to loss of intraepidermal cohesion
On immunofluorescence - loss of cohesion due to intrercellular IgG deposition |
|
|
Term
| Main cause of death in Pemphigus? |
|
Definition
| INFECTION - high mortality rate (6%) |
|
|
Term
| What is seen in immunofluorescence in bulllous pemphigoid vs. dermatitis herpetiformis? |
|
Definition
BP = IgG deposition along basement membrane
DH = IgA present at basement membrane and dermal papillae |
|
|
Term
| What disease is dermatitis herpetiformis typically associated with? |
|
Definition
Celiac Disease
DH has NOTHING to do with HHV infection |
|
|
Term
| What is the most common cutaneous drug reaction morphology? |
|
Definition
Exanthematous eruptions
Usually due to - penicillins, sulfonamides, barbiturates |
|
|
Term
| Hypersensitivity Syndrome is a triad of... |
|
Definition
Fever
Skin Eruption
Internal Organ Involvement
DRESS = Drug rxn with eosinophilia and systemic symptoms = Hypersensitivty Syndrome |
|
|
Term
| 2 causes of urticarial mast cell degranulation: |
|
Definition
1) Type I Hypersensitivity (IgE mediated)
2) Non-immunologic Activation (IgE independent) |
|
|
Term
| If a red spot is not blanchable, it likely (IS/IS NOT) vasculitis |
|
Definition
| Non blanching = vasculitis |
|
|
Term
| Cutaneous features of SLE: |
|
Definition
Malar rash (butterfly rash on face)
Discoid and psoriaform lesions
Plaques + Photosensitivity |
|
|
Term
| What two features of DERMATOMYOSITIS are pathognomonic? |
|
Definition
Heliotrope (Purple) Erythema - over eyelids
Gottron's Papules - pink patches on extensor surfaces |
|
|
Term
| What are cutaneous findings on vasculitis w/ small vessels vs. medium sized vessels? |
|
Definition
Small vessel = palpable purpura, petechiae
Medium vessel = livedo reticularis, ulcers, nodules |
|
|
Term
| What is Henoch-Schonlein Purpura and what does it typically follow? |
|
Definition
Vasculitis in children w/ arthritis, abdominal pain and heamturia
Typically post-Strep infection |
|
|
Term
| What are 2 cutaneous features of diabetes? |
|
Definition
Acanthosis nigricans - brown, velvety patches in fold areas, neck and axillae
Necrobiosis lipoidica - atrophic patches w/ enlarging erythematous borders |
|
|
Term
| Most common skin cancer in humans is .... |
|
Definition
| Basal cell carcinoma = BCC |
|
|
Term
| What is the least aggressive form of skin cancer? |
|
Definition
|
|
Term
| What is the description of the typical lesion seen with BCC? |
|
Definition
| Pearly white nodule w/ telangiectasia |
|
|
Term
| What are the ABCDE criteria of melanoma? |
|
Definition
Asymmetry - less symmetric is bad
Border - poorly defined borders are bad
Color - multiple colours is bad
Diameter - if greater than 1/4 inch is bad (> 6 mm)
Evolving |
|
|
Term
| Where should you biopsy a suspected lesion of malignant melanoma? |
|
Definition
| Where it is DARKEST or where nodule is located |
|
|
Term
| Which type of UV radiation is more carcinogenic? |
|
Definition
|
|
Term
| Histology of BCC vs. SCC vs. melanoma? |
|
Definition
BCC = nests of basaloid (blue) cells with peripheral palisading of nuclei
SCC = cells pink in colour from keratinization
Melanoma = melanin pigment in cytoplasm |
|
|
Term
| What is seborrheic keratosis caused by and what is its appearance? |
|
Definition
Caused by benign epidermal proliferation of keratin
Appears as brown & scaly papules/plaques with a stuck on appearance |
|
|
Term
| A ___________ is a soft, pedunculated papule/nodule as a pull out of epidermis and dermis |
|
Definition
|
|
Term
| Difference between a wart vs. molluscum contagiosum? |
|
Definition
Wart - scaly, flesh covered papule caused by HPV
Molluscum - umbilicated skin papules from pox virus (see UMBILICATION - have dot in centre of papule) |
|
|
Term
| Solar keratosis/actinic keratosis is a ____________ lesion |
|
Definition
| PRE MALIGNANT (dysplasia in dermis, have atypical keratinocytes in epidermis) |
|
|
Term
| What can be used to diagnose a dermatofibroma? |
|
Definition
| Dimple Sign/Fitzpatrick Sign - when lesion is pinched, forms a dimple; due to proliferation of fibroblasts |
|
|
Term
| What genetic syndrome puts patients at a high risk of developing melanoma? |
|
Definition
| DYSPLASTIC NEVUS SYNDROME - autosomal dominant inheritance |
|
|
Term
| Best treatments for removal of Sebb Keratoses? |
|
Definition
|
|
Term
| _________ is considered by some to be a variant of SCC, looks like a small volcano |
|
Definition
| Keratoacanthoma - should be biopsied and treated |
|
|
Term
| Most important factor in the development of BCC is exposure to....... |
|
Definition
| UV radiation (UVB is worse than UVA) |
|
|
Term
| Most aggressive subtype of BCC is ... |
|
Definition
| Morpheic Sclerosing - flat, yellow-white waxy plaques |
|
|
Term
| What lesions caused by prolonged sun exposure are considered as early precursors of SCC? |
|
Definition
Actinic keratoses
***10% of AKs transform into SCC in 10 yrs if untreated*** |
|
|
Term
| What is the most common subtype of melanoma? |
|
Definition
| Superficial Spreading Melanoma (75%) |
|
|
Term
| Name 3 types of benign nevi? |
|
Definition
Junctional
Compound
Intradermal |
|
|
Term
| What are the 5 important prognostic factors of melanoma and its staging? |
|
Definition
Breslow Thickness - depth of invasion from top granular layer to deepest melanoma cell in dermis
Presence of mitosis
Ulceration
Sentinel lymph node
Satellite nodule |
|
|
Term
| What type of skin lesion typically has an umbilicated centre? |
|
Definition
| Molluscum contagiosum, caused by pox virus |
|
|
Term
|
Definition
SCC in situ; slowly enlarging, sharply demarcated red scaly macule/patch
Malignant SCC confined to epidermis only, NO dermal invasion yet (b/c in situ) |
|
|
Term
| What single feature distinguishes chronic and acute dermatitis? |
|
Definition
| LICHENIFICATION - always chronic |
|
|
Term
| What is Koebner's phenomenon? |
|
Definition
Skin lesions appearing regularly at site of repeated trauma
Seen in psoriasis vulgaris |
|
|
Term
| Which type of BCC often needs to be biopsied and why? |
|
Definition
| PIGMENTED - need to rule out melanoma in DDx |
|
|
Term
| What are pigmented lentignes? |
|
Definition
Benign condition (also called solar letignes)
Secondary to sun exposure, usually caused by UVA radiation |
|
|
Term
| In terms of melanoma prognosis, which type of growth is worse, radial or vertical? |
|
Definition
| VERTICAL is worse because it involves invasion into dermis and potential systemic mets |
|
|
Term
| Are all melanomas curable? |
|
Definition
YES - only if diagnosed early enough though
Overall (for all stages, I-IV) have 92% survival rate |
|
|
Term
| What are the recommended margins for melanoma excision? |
|
Definition
If < 1 mm - 1 cm margin
If 1-4 mm - 2 cm margin
If > 4 mm - 3 cm margin (but in literature, says can stick with 2 cm, makes no difference) |
|
|
Term
| KOH Examination is done for diagnosis of what types of lesions? |
|
Definition
|
|
Term
| Tzanck preparation is used to diagnose which kind of lesions? |
|
Definition
| Confirm Herpes infections (simplex, varicella, etc.) |
|
|
Term
| Oil Preparation is done to diagnose and rule out which condition? |
|
Definition
|
|
Term
| What is the typical appearance of the skin lesions in Chicken Pox? |
|
Definition
| Vesicles on top of erythematous papules (dew drop on rose petal); see ALL stages simultaneously (macules, papules, crusts, vesicles) |
|
|
Term
| Roseola is believed to be caused by which virus? |
|
Definition
HHV6
Typically present w/ high fever for 3 days, then immediate resolution + rash onset (rose, maculopapular) |
|
|
Term
| Which childhood exanthem has a "slapped cheek appearance" which spares the bridge of the nose? |
|
Definition
Erythema Infectiosum (5th Disease)
Caused by parvovirus B19 |
|
|
Term
| What are the 3 phases of wound healing and their lengths? |
|
Definition
Inflammatory - day 1 to 4; neutrophils, edema
Proliferative - day 4 to 42; body attempts to mend itself by laying down scar tissue
Remodeling - 3 weeks onwards |
|
|
Term
| General rule of thumb for the healing time of any wound? |
|
Definition
|
|
Term
| What is the difference between primary and secondary and tertiary wound healing? |
|
Definition
Primary - wound closed by direct approximation via sutures, skin graft, staples
Secondary - wound is left to granulate and heal on its own; causes a broader scar to form and longer healing process
Tertiary - "secondary suture", wound purposely left open due to contamination or infection, then approximate w/ sutures after several days |
|
|
Term
| Two most common locations to get keloid scars? |
|
Definition
|
|
Term
| When does remodeling/maturation begin in the wound healing process? |
|
Definition
| Approximately 21 days post-injury - this is when net collagen content is finally stable |
|
|
Term
| Suture removal time for face vs. elsewhere? |
|
Definition
Face = 4-6 days
Elsewhere = 7-10 days |
|
|
Term
| What causes keloid/hypertrophic scar formation? |
|
Definition
| Imbalance between anabolic + catabolic phases of healing; make more collagen than is degraded |
|
|
Term
| What is the difference between a Hypertrophic vs. Keloid scar? |
|
Definition
Hypertrophic - elevated over skin, but limited to boundaries of initial injury; generally regress, responsive to treatment
Keloid - overgrowth of dense fibrous tissue that extends BEYOND borders of original scar; does not regress spontaneously |
|
|
Term
| What is the rule of 9s for burn injury? |
|
Definition
Used when estimating % body surface area burned
For adult:
Head is 9%, each arm is 9%
Front of torso is 18%, Back is 18%, each Leg = 18% |
|
|
Term
| What is the difference between a superficial and a deep partial thickness burn? |
|
Definition
Superficial = in the superficial dermis (papillary dermis)
Deep = in deep dermis (reticular dermis) |
|
|
Term
First degree burn = Superficial Burn
Second degree burn = Superficial or Deep Partial Thickness Burn
Third degree/fourth degree = Full Thickness Burn |
|
Definition
|
|
Term
| Clinically, how can you differentiate between superficial burns and partial thickness burns? |
|
Definition
Superficial burns HAVE NO BLISTERS
Partial thickness burns (2nd degree) have blisters |
|
|
Term
| How can burns lead to rapid hypovolemia? |
|
Definition
Fluid enters burn wound, necrotic tissue attracts more fluid from intravascular space - rapidly enter hypovolemic shock
Be ready for fluid resuscitation w/ larger burns |
|
|
Term
|
Definition
| Procedure used to treat full thickness circumferential burns - cut through thick eschar of burn to prevent compartment syndrome |
|
|
Term
| Arc Injury vs. True Electrical Burn |
|
Definition
Arc injury - short circuit causing almost a heat-like burn
True electric burn - e.g. struck by lightning, person acts as a part of the circuit, electricity flowing THROUGH them; leads to current flow injury as electricity flows through the body |
|
|
Term
| Difference between Venous Stasis Ulcer and Ischemic Ulcer? |
|
Definition
VS Ulcer - swollen feet, brown skin, medial malleolus, painless
Ischemic Ulcer - cold feet, lateral malleolus, white or bluish, no edema, painful |
|
|
Term
| Impetigo - appearance and cause? |
|
Definition
Appear like honey crusts
Step. pyogenes infection (may be mistaken as cold sores from HHV infection); differentiate as impetigo will not cross vermillion border of the lips |
|
|
Term
| Bullous impetigo typically caused by .... |
|
Definition
|
|
Term
| Causative organism of Erysipelas and typical appearance? |
|
Definition
Caused by S. pyogenes
Usually have fiery red, well demarcated area of involvement (peau d'orange skin) |
|
|
Term
| Cellulitis is most often caused by ... |
|
Definition
|
|
Term
| What are the 3 likely causes of necrotizing fasciitis? |
|
Definition
Mixed etiology - anaerobes + aerobes; see gas bubbles in tissues
S. pyogenes - NO gas in tissues
Vibrio vulnificus - monster of the deep; Hx of seawater exposure |
|
|
Term
| If a person presents w/ necrotizing fasciitis post seawater exposure, the most likely cause is... |
|
Definition
|
|
