B OARD R EVIEW Dermatology
Psoriasis SILVERY SCALES COMMONLY HAVE THICKEND SKIN Found on extensor surfaces, scalp, butt AUSPITZ SIGN: when remove scale small pinpoint bleeding points
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
Koebner Pnenomenon Lesions seen at areas of trauma
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!
Pityriasis Alba Inflammation from atopic dermatitis – hypopigmented areas Most commonly seen on face or extremities Associated with other forms of atopy
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
Seborrhea “cradle cap” Greasy Scaly Seen in hear- bearing or intertriginous areas Tx: topical steroids, antiseborrheic shampoos Not that itchy.
P Thumb sucking eczema From repeated wetting and drying
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
Auspitz Sign of Psoriasis Bleeding after removal of scales
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
Rubber contact dermatitis T cell mediated immune reaction
Seborrhea of scalp
Tinea Corporis “Ringworm” Superficial fungal infection Annular lesion with central clearing. Vesicular border. Trichophyton tonsurans or Microsporum canis KOH
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
Diaper dermatitis Sparing intertirginous areas Treatment: barriers and moisturizer Watch for diaper rash that doesn’t go away!!
Tinea Pedis “Athlete’s foot” Commonly seen between toes and soles, but can spread Tx topical antifungals Onychomycosis- nail fungus - oral
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
Stevens-Johnson Erythema Multiforme major Involves mucus membranes and sloughing Monitor electrolytes
Candida diaper dermatitis Satellite lesions Bright red, sharp borders KOH – budding yeast Commonly seen with antibiotic use Tx; topical antifungal
Milia Rubra Sweat duct obstruction Commonly seen in infants – face and neck Worse in hot humid weather Tx: loose clothes, no greasy agents
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
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
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
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
Henoch-Schonlein Purpura Palpable purpura Usually LE Small vessel vasculitis skin, GI, kidneys, joints Rash, abd pain, arthritis Commonly seen after viral illness
Insect Bite Not to be confused with cellulitis Pruritc, nontender, and nonindurated.
Insect Bites Flea bites – red itchy with central puncta