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Dermatology for Studs
Dermatology Notes for the USMLE
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Acanthosis nigricans
Acanthosis nigricans --> Stomach adenocarcinoma
Actinic Keratosis
Risk of squamous cell carcinoma
Basal Cell Carcinoma
Begins as shiny papule and later develops umbilicated center which may ulcerate and develop peripheral telangiectasias
Basal Cell Carcinoma --> 'pearly' appearance
Treatment: excision
Contact Dermatitis
Contact to what?
E.g. nickel earrings most common form in women
Erysipelas
Fiery red rash, painful('St. Anthony's fire')
Cause: Streptococci
Tx: Pen G
Cause: Streptococci
Tx: Pen G
Herpes Zoster
Reactivation of latent varicella-zoster virus from dorsal root neurons when patient immunocompromised (cancer, steroids, fatigue, trauma etc.)
Impetigo
honey colored crusted lesions
Causes: Staph aureus or group A b-hemolytic Streptococcus
Tx: Mupirocin
Causes: Staph aureus or group A b-hemolytic Streptococcus
Tx: Mupirocin
Kaposi Sarcoma
Seen in AIDS patients commonly in upper body (remember Tom Hanks in 'Philadelphia')
Associated with herpesvirus 8
Malignant tumor of endothelial cells
Lice
Treatment: permethrin cream
Lichen Planus
Polygonal shaped violaceous plaques and papules
Lipoma
Treatment: surgical excision or liposuction
Malignant Melanoma
Neoplasm of melanocytes
Treatment: surgery, and if that fails, prognosis poor
Depth of invasion best prognostic factor --> <> 1.7 mm – potential for metastasis
Asymmetry, borders irregular, color changes, diameter increased
Pemphigus vulgaris
oral mucosa - how vulgar
Pediculosis (lice)
Tx: Pyrethrins > (OTC – over the counter)
Psoriasis
New Latin, from Greek psōriasis, from psōrian to have the itch, from psōra itch
Pruritus may or may not be present
Silvery scaly lesions > extensor surfaces: elbows, knees
Treatment: Phototherapy --> UVA, UVB or PUVA
Scabies
Caused by mite Sarcoptes scabei
Seborrheic Dermatitis (dandruff)
Tx: shampoo > Zinc, Selenium
Stasis Dermatitis
Lower extremities, hyperpigmentation, extravasated blood, hemosiderin in the tissue, varicose veins
Steven's Johnson Syndrome
Stevens – Johnson Syndrome (Erythema multiforme major) --> Hypersensitivity reaction to drugs --> mucous membrane involvement --> oral cavity , conjunctiva , respiratory tract
Toxic Shock Syndrome
Toxic Shock Syndrome --> staphylococcus attached to a foreign body (tampon use in female during menstruation)
Urticaria or Hives
Antihistaminic
Vitiligo
It is believed that Michael Jackson suffered from vitiligo
Depigmentation
Patients often have antibodies to melanin
Warts
Caused by human papillomavirus (HPV)
Hirsutism
Drugs: minoxidil
Impetigo
Cause:
Staphylococci>Streptococci
Squamous Cell Carcinoma
Develops in preexisting actinic (solar) keratosis lesions which follow sun exposure
Keloids
Do not excise, you might make it worse (remember 'Flowers of Hiroshima')
Moles
Treatment: Observe closely, biopsy/excise any suspicious lesion, avoid sun exposure/wear sun block
The...Tineas!
.
Tinea Capitis
Treatment
Oral antifungal
Tinea Versicolor
Multiple hypo- or hyper- pigmented macular lesions
Where?
Trunk, upper back, upper arm, neck, face
Cause: Malessezia furfur
Tinea Pedis (Athlete Foot)
Treatment: topical antifungal
Erythema Nodosum
Ulcerative colitis