Logan Class of December 2011



*** Test: Open book and open notes. There will be multiple choice questions, matching, and several pictures to identify. ***

*** 50 questions….20 matching…30 Multiple choice ***

FINAL INFO

Lecture 1

1. Basal Cells = Lower level of epidermis (can lead to basal cell carcinoma)

2. Keratinocytes = Can transform to squamous cell carcinoma

3. Actinic Keratosis = Precancerous lesion that can lead to squamous cell carcinoma

4. Types of Lesions

a. Macule = Flat and small

b. Patches = Large and big

c. Papule = Raised and merge to form plaques

d. Plaques = Raised and palpable

d. Nodule = Round, solid and small

e. Tumor = Bigger nodule

f. Bulla = Blister

g. Wheal = Hive, transient and can last for less than 24 hours

h. Scales = Excess dead epidermal cells from shedding

f. Crust = Dried serum, scab

g. Erosion = Focal loss of epidermis

h. Ulcer = Loss of epidermis and dermis (heals with scarring)

i. Fissure = Linear loss of epidermis

j. Atrophy = Thinning of epidermis and dermis (less skin…decreased thickness)

k. Scar = Abnormal connective tissue

l . Burrow = Channel that is created from mite in the skin

5. Lichenification = Scratching and rubbing can accentuate the skin lines with thickened dermis.

6. Telangiectasia = Dilated superficial vessels

7. Eczema = Itchy lesions

8. Poison Ivy and Contact Dermatitis = Linear lines with blisters

9. Nickel Allergies = Allergic material in belts, watches, etc.

10. Lichen Simplex Chronicus = Chronic eczema from skin scratching

11. Asteatotic Eczema = Dries skin (dried river bed appearance)

12. Contact Dermatitis = Rubber, nickel, metal

13. Prurigo Nodularis = Bumps from repeated scratching

14. Stasis Dermatitis = PVD and poor circulation with swelling

15. Atopic Dermatitis = Hay fever and asthma are linked…Also has eczematous skin

16. Keratosis Pilaris = Follicularly oriented papules where skin doesn’t slough…Use moisturizer

17. Ptiyrisasis Alba = Eczema that is hypo-pigmented (ill defined white scaly areas)…Can occur on face, upper arms and thighs

18. Hives (urticaria) = Transient accumulation of dermal problems… Lasts less than 24 hours

19. Angioedema = Deeper and involves subcutaneous tissue (can involve windpipe)

20. Acne = Androgenic hormones and clogged pores along with bacteria. Whiteheads and blackheads

21. Rosacea = Red colored. Flushing and blushing, may occur with pimples, along with hyperplasia of glands of nose (rhinophyma), inflammation…Can also have telangiectasia associated with rosacea.

22. Hydro??? Supportiva = Groin area and armpits

Lecture 2

23. Psoriasis = Increased epidermal proliferation with scales (silver). Redness can be present. Condition is on lower back, knees and nails. Pitted nails can occur. Arthritis can occur with joint deformity and swelling. Nails won’t be in a straight orientation. The scale is adherent to the skin

24. Koebner’s Phenomenon = Injured skin due to trauma that erupts with new lesions Lichen planus, psoriasis and sarcodosis can get Koebner’s phenomenon.

25. Auspitz Sign = Prying off the scale/skin will show pinpoint bleeding (Auspitz Sign). The sign may occur in psoriasis.

26. Seborrheic Dermatitis = Scaling of the scalp and other hairy areas (mustache, chest, upper back and goin). Called cradle cap in babies.

27. Pityriasis Rosea = Harold Patch followed with generalized rash. Lesions are oval and align along skin wrinkles (Christmas Tree Sign). Important DDx is Secondary Syphilis.

28. Lichen Planus = 6 Ps (purple, planar, pruritis, polygonal, papules, penis). Check the mouth for white dots (Wickham’s striae). New lesions can occur in traumas (Koebner’s Phenomena).

29. Lichen Sclerosus = Chronic inflammatory condition that can occur in the vulva of females. White papules with plugged follicles. Wrinkled skin can occur

29. Pleva = Young children with dried up bumps.

30. Impetigo = Infection with staph aureus or strept pyogenes. Golden, honey colored crusts with pustules. Lesions can blister with erosions and scabs.

31. Bullous Impetigo

32. Cellulitis = Infection of dermis and subcutaneous tissue

33. Folliculitis = Inflammation of hair follicles (can be from tight clothing, staph or fungal).

34. Pseudo-folliculitis Barbae = Razor bumps from shaving.

35. Furuncles and Carbuncles = Pus pockets often due to staph aureus. Staph can be a “superbug” and methicillin resistant. Culture is the best way to determine sensitivity.

36. Pseudomonas Folliculitis = Hot tub folliculitis

37. Syphilis = Primary lesion is chancre. Secondary syphilis is more widespread leading to hair loss and lesions on palms. Tertiary can lead to granulomas on skin and in organs.

38. Chancroid = Painful ulceration with lymphadenopathy. Hemophilus Ducreyi is the organism.

39. Genital Warts = HPV is the cause. Little Bumps/lesions located near the genitals.

40. HSV = 1st episode is the worst. Recurrent lesions in the same spot (same DRG). Can become secondarily infected with impetigo. Eczema herpeticum can occur with eczema. Testing is via a culture. Multinucleated giant cells are the key to culture.

41. Pubic Lice = Very itchy…Check for scratch marks on patient. Nits are the eggs of lice that are stuck to the hair shaft. Nits can be seen in pubic area and hair on head.

42. Molluscum = Pox virus with pearly looking papules spread by direct contact (Very Contagious).

Lecture 3

43. Basal Cell Carcinoma = Malignant and most common skin cancer. Rarely metastasizes. Can have different looks to it.

44. Actinic Keratosis = Called Solar Keratosis. Easier to feel than to see. PRE-CANCEROUS and can lead to squamous cell carcinoma. Biopsy can be done to rule out carcinoma. Wear sunscreen and protect from sun.

45. Squamous Cell Carcinoma = Has potential to metastasize. Radiation, sunlight, chemicals and chronic injured areas, erosive conditions, osteomyelitis, and HPV area can get squamous cell carcinoma

46. Bowen’s Disease = Squamous cell carcinoma in situ

47. Intra-epidermal carcinoma of the breast = ???

48. Nevus = Moles…Can be removed

49. Becker’s Nevus = Harmless. A discoloration with hair in/near the lesion that is harmless. Mostly seen in males.

50. Halo Nevus = Immune system attacks pigment. IN adults, remove with surgery.

51. Atypical Mole Syndrome = Check the ABCD’s…Asymmetry, Border (irregular is bad), Color (non-uniform is bad) Diameter (greater than 6 mm is bad)

52. Melanoma = Superficial spreading is the most common manifestation. Man’s back and women’s legs are most common sites

53. Lentigo Malignant Melanoma = ???

54. Nodular Melanoma = Vertical Growth phase has poor prognosis.

55. Melanoma Prognosis= Depth of invasion determines prognosis. Incidence is on the rise in the US. Genetics, sunburns, and mole growth increases the risk and worsens the prognosis.

56. Hemangioma = Benign collection of blood vessels.

57. Cherry Angioma = Increases in number with age.

58. Pyogenic Granuloma = Can happen with pregnancy and trauma. Yellow, red glistening dome shaped papule. Can bleed easily.

59. Kaposi’s Sarcoma = Malignant vascular tumor from endothelial cells. Purple-brown colored lesions. Most commonly linked with AIDS. The condition can happen in people from the Mediterranean Sea and in Africa due to genetic immuno-suppression. For AIDS patients, have them stay on retroviral therapy to improve immune function. Other treatments include radiation, excise the lesions and interferon therapy. The pathogenesis may include human herpes virus 8.

Lecture 4

60. HPV = Causes genital warts…blacks does due to thrombosed areas.

61. Corn’s and Calluses = To area of trauma

62. Mulloscum Contagiosum= Contagious condition linked with a pox virus

63. Varicella Chicken Pox = can lead to shingles later in life. The patient is contagious several days before the rash until all the blisters are dried up. Dermatomal collection of blisters that itch/irritate is the chief complaint.

64. Herpes Zoster (Shingles) = Tzanck smears can be done to help the patient.

65. Hand, Foot and Mouth Disease = Coxsackie virus A-16…Blisters and erosions on multiple areas.

66. Candidiasis = Yeast infection or called thrush (in mouth). Beefy red areas with satellite papules and pustules. All ages can get it. Infants, moisture, pregnancy, oral contraceptives, systemic antibiotic therapy, diabetes are all at risk.

67. Candida Balanitis = Located on male genitalia.

68. Candida Intertrigo = Moist skin folds (satellite papules, macules and pustules).

69. Thrush = Oral candidiasis. Thrush can be scraped off. Lesions are white, curd/cottage cheese like lesions in the mouth. Thrush lesions are common to newborns, denture wearers, and immuno-suppressed.

70. Tinea Versicolor = Yeast infection…pink, tan or brown white scaly patches. Lesions are scraped for hyphae (spaghetti like lesions) and spores (meatball looking lesions).

71. Tinea

a. Tinea Corporis = Body…Rings on skin that grow outward.

b. Capitis = On Scalp…Can lead to alopecia (hair loss). The fungus eats away at the hair. We can see broken off hair with black dots.

72. Rash = Reaction to viruses or medications

73. Erythema Multiforme = Symmetrical lesions of the extremity located on the palms and feet mostly that appear target shaped.

74. Steven’s Johnson Syndrome = Severe blistering disease

75. Toxic Epidermal Necrolysis = DERM EMERGENCY due to toxins, infections, etc. Skin sloughs off. Separation of the skin causing loss of skin to pressure.

a. Nikolski’s Sign = Loss of skin when rubbed with gentle pressure.

76. Erythema Nodosum = ???

77. Vasculitis = Palpable purpura due to inflamed vessel with RBC leakage. Lesions can be bumpy (papule - like). Causes can be drugs, connective tissue disease or vial infections.

78. Scabies = Itchy condition (especially at night) that affects multiple family members. Caused by a mite (feces of mite). Scrape the burrows and examine under the microscope to ID.

79. Lice (pediculosis) = Nit is the egg cemented to the hair…Can happen on scalp and pubic area.

80. Bee stings = Can be deadly. Need Epipen for severe allergies (epinephrine injection).

81. Bedbug = ???

82 Brown Recluse Spiders = Fiddle looking, violin shaped.

83. Tick Bites = Deer tick is very small in size. Bites can lead to lyme disease (erythema migrans).

84. Lupus = atrophy, scaling, redness, follicular plugging (carpet tack appearance), trauma and UV light makes worse, women greater than men, butterfly rash.

85. Dermatomyositis = Connective tissue problem based disease that leads to muscle weakens, heliotrope rash (around eyelids), Gottron’s papules (over bony areas), and Shawl sign (erythema over neck and shoulders).

86. Scleroderma = Tapering of fingers and sclerodactyly are signs.

87. Morphea (???) = Collection of excess collagen

88. Polymorphous Light eruption = “Allergic reaction” to sunlight

89. Porphyria Cutaneosum (???) = Due to liver trouble/bad livers (???)

90. Vitiligo = Acquired condition where melanocytes disappear.

91. Seborrheic Keratosis = Benign stuck on plaques

92. Lesser Trelat Sign = ???

93. Skin Tags = Benign and common condition

94. Dermatofibroma = Harmless dimpling of skin

95. Kollonychia = Spoon nails…Can be linked with iron deficiency.

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