4。Derm

27 flashcards · Other · by Wanying Koh

1. pityriasis rosea 特徵

   herald paper reported 6-7 roses on christmas tree begins w herald patches lasting for 1 to 2 weeks before widespread rash develops (christmas tree branches style) lasting 6-8 weeks possibly related to HHV6 / HHV7 *need to also r/o syphillis - possible mimicker

2. 52 y/o F, enjoyed wearing high heels when young R ant. sole lesion appeared half-year ago Dx

   plantar wart painful + black pinpoints (small bv) appear at the heels (後) and balls (前) of feet, where pressure is highest (weight-bearing) [This pressure may also cause a wart to grow inward beneath a hard, thick layer of skin (callus).] Corns - inflammed and painful Callus - not painful Corns and calluses are caused by response to friction and pressure

3. syphilis timelines infection to first s/s: 1' hard chancre 2' condyloma lata 3' gumma neuro/cardiac syphilis

   10-90d 1' hard chancre (4-6wk) 6-8wk after, 2' condyloma lata appear (2-6wk) latent phase 3-7y after, 3' gumma appear 10-30y after first infection, 10% 病發 neurosyphilis/cardio syphilis

4. drug-induced pemphigus prognosis better or worse than the usual pemphigus pts

   better prognosis

5. pt w Raynaud's phenomenon + anti-U1 RNP increase Dx

   mixed connective tissue disease anti-U1 RNP specific for MCTD

6. Dx? what kind of dermatitis? 2 days after dyeing hair had similar experience before

   allergic dermatitis to hair dye

7. perioral dermatitis 好發族群 causes tx - can use steroids?

   females, immunocompromised use of topical steroids, organisms S aureus, Candida no steroids - worsen condition use doxycycline (注意 photosensitivity) tetracycline

8. 5yo M Dx tinea pedis juvenile plantar dermatosis ichthyosis asteatotic eczema

   juvenile plantar dermatosis 好發 eczema 族群 due to friction + sweat => 脫皮 wetting of skin in the day and drying at night during summer especially at weight-bearing areas ichthyosis - 比較嚴重的層狀剝裂 asteatotic eczema - in middle-aged/old people ant. tibia tinea pedis - 泛紅，爛 between toes，變白，潮濕

9. tx for atopic dermatitis

   topical steroids moisturize 照光治療 止癢 calcineurin inhibitors - e.g. tacrolimus NO vit B3 - for psoriasis

10. associated HLA-B genes carbamazepine allopurinol

    HLA-B 1502 HLA-B 1501

11. nikolsky sign present in which diseases

    SJS TEN pemphigus vulgaris pemphigus foliaceus

12. KOH negative Dx most common in what organs

    psoriasis joints

13. suspected dx what diagnostic tools to use for DD

    suspect vitiligo 白斑 r/o tinea versicolor 汗斑 Wood's lamp - 讓 vitiligo spots 更明顯 KOH - 有無菌絲 can r/o tinea versicolor skin biopsy DOPA dye - DOPA 染 melanocytes tyrosinase (not present in vitiligo as melanocytes destroyed so produce negative results)

14. Dx

    actinic keratosis

15. Dx subungual hematoma subungual melanoma subungual pigmented nevus friction induced melanonychia

    subungual melanoma hutchinson's sign present periungual pigmentation of the nail folds and hyponychium DD subungual melanonychia regularity of pigmented lines laid on the background; regular lines occur in nevus and irregular lines in melanoma

16. Dx

    Basal cell ca irregular borders globules at top of lesion (pearly edges) partial superficial erosion telangiectasia at top left (defining feature of BCC)

17. Dx

    Basal cell ca scaly, eczema like may be pink, blue or black

18. 26yo F, itchy keratinized papules on neck since 10yo, worsen w sweat during summer nails w red-white banding and V shaped 凹陷 Dx

    Darier's dz genetic disorder - AD mutation in ATP2A2 gene finger-nails w red and white streaks, V-shaped 裂痕 seborrheic areas 出現 warty papules, 日照/熱/流汗 worsens tx - topical: retinoic A, steroids, moisturizer oral: retinoic A (steroids NOT oral!)

19. malignant acanthosis nigricans associated w what dz what meds

    GI, endocrine dz obesity insulin resistance hyperandrogen/testosterone meds insulin steroids androgens OCPs GH

20. mechanoreceptors meissner merkel pacinian ruffini

21. koebner's phenomenon in what dz

    NON-specific sign psoriasis vitiligo lichen planus pityriasis rubra lichen sclerosis

22. lesions on scalp, back, elbows, knees dx

    psoriasis vulgaris also present on extensor sites *silvery-scales - 非常厚 (patho - increased proliferation of keratinocytes)

23. vitiligo repigmentation mechanisms after UVB tx

    dermis melanocyte 移行到表皮 follicular pattern repigmentation: hair follicles outer root sheath 的 melanoblast [a] and 移行到表皮 表皮殘餘的 melanocytes

24. griseofulvin treats

    dermatophyte (tinea)

25. pityriasis versicolor 菌 tx

    Malassezia -- yeast itraconazole

26. chemical vitiligo

    phenol catechol rhododendrol - makeup PPD p-Phenylenediamine - hair dye

27. nevus of Ota nevus of Ito nevus of Hori

    Nevus of hori Nevus of Ito Nevus of Ota