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Terms in this set (27)
Basal cell carcinoma
low metastatic potential. risk factors: actinic keratosis, chronic sunlight and pale skin. VERY common. 4 types: nodular, pigemented, superficial and scarring. coudl describe as pearly nodule with central depression w/telangiectasia. death is RARE. refer to dermatologist
From herpes virus 8 infection. malignant tumor commonly found in immunocomrpmised HIV/AIDS edlerly men. mucous membranes common spot to start and appears as round oval papules or plaques with LAD. increased risk of lymphoma and leukemia but progresses slowly and these people usually die of other causes. refer to derm to determine appropriate treatments.
DEADLY unless removed early. SSX: asymmetrical, irregular border, multiple colors, elevated, larger than 6 mm. DDX: pigmented BCC, SK, dysplastic nevi. excisional biopsy required since punch and shave biopsies are contraindicated. Skin exams every 3-6 months for 2 years then 6-12 months depending on thickness. check liver spleen and lymph nodes. REFER FOR EXCISION
Squamous Cell Carinoma
keratinocyte malignancy with low metastatic potential. Second MC skin cancer. AK is risk factor as well as skin exposure and fair skin. 3x more common in men. 50% are near head and neck but just any exposed area. indurated hyperkeratotic ulcerated or crusted and erythematous. may bleed easily. DDX: keratoacanthoma, wart, BCC, SK. LOCALLY INVASIVE
furnicle vs carbuncle
poor hygeine RF. DDX folliculitis, acne. may resolve may become chronic or cause destruction. Can incise and drain.
infection of the periungal region that presents as a tender inflamed pustule near margin of nail. RF: trauma irritation, immunocompromised. insidious onset and often worsens without antifungal tx. if effects tendon sheaths and does not improve refer to hand surgeon for I and D
idiopathic hypopigemented condition with bran like scales. often effects children and blacks. atopic hx common. face or upper arm mild pruritus. negative skin scraping and re-pigementation takes months to years.
dermatosis unknown etiology with tree shaped pattern. older children least common in summer. may have viral trigger. mild to moderate pruritus. HERALD PATCH. looks similar to ringworm. KOH scrape negative (due to rule out fungal) self resolves over months. (2 weeks to 2 months).
benign plaque with stuck on appearance. greasy dark plaques. genetic and more common over 30 in males. DDX: melanoma, BCC wart or actinic keratosis. IF they occur and increase in size and number quickly must consider LESER TRELAT=internal malignancy. DX via biopsy. do not resolve but are benign. REFER to REMOVE.
more common in females. risk of rhinopehyma and disfigurement. exacerbated by stress, alcohol and vasodilators
Propionbacterium acnes in pilosebaceous glands
skin tags. does not resolve on its own. becomes larger and more numerous. RF: large obese women with DM or pregnant
contact dermatitis types
irritant is immediate and less vesicle with scaling and edema. allergic type has crusting. clears in 3-4 weeks. monitor for secondary bacterial infection.
DDX of alopecia
alopecia areata, female patter, male pattern, tine capitis (pruritic), scarring alopecia, toxic alopecia, trichotillomania.
anaphylaxis of skin caused by cold, pressure, sunlight. possible NSAID or aspirin. more than 24 hours is chronic and less is acute. if chronic biopsy if suspect vasculitis. challenge tests. usually sealers several days after d/c drug but consider liver function tests and monitor.
extensor surfaces and face in infants and children but may be flexor creases in adults. most children outgrow it but may take months to years to resolve.
life threatening hypersensitivity. recent viral illness, vaccination or drug. target lesions with fever, fatigue, arthralgia. Stevens-Johnson syndrome is the sever form (ulcerative stomatitis, mucosal involvement, bull, cough with mucopurulent sputum, burning sensation in mouth and eyes REFER). 2-3 weeks for mild and 6 weeks for severe.
uncommon emergent AI condition with intra-epidermal bullae. Nikolsky's sign and Tzank smear. usually on upper back and trunk. DEATH possible. advanced age and high dose steroids are bad signs but hard to predict this condition.
chronic benign AI condition mainly in elderly. negative Nikolsky. more intact lesions than erosions. DDX: pemphigus, bullous erythema multiforme, drug reaction. Benign. DX with skin biopsy showing sub-epidermal blisters and anti basement membrane AB.
astringents (aluminum sulfate/calcium acetate)
Bacitracin, neomycinm, lidocaine, polymyxin B
superficial topical infections
skin irritation chapped skin or diaper rash
SD, psoriasis, acne, warts
itching, scalp irritation, dandruff, seborrheic derm.
herbs to avoid over broken skin
arnica montana, gaultheria procumbens, melaleuca alternifolia, larrea tridentata, tussilago farfara, symphytum officinale
synthetic retinoids. reduces sebum production. USE: severe acne or rosacea. should have failed oral and topical ABX before considering. must order CBC ESR, CPK, LFTs. can elevated liver enzymes cause h/a, photosensitivity, dryness. PREG X. caution with depression. AVOID steroids, alcohol, micro dose progesterone OCP effected. Depletes acetyl l carnitine and L carnitine. ORAL WITH FOOD.
inhibits bacterial protein synthesis. used topically for acne, rosacea, BV. orally for osteomyelitis, bacterial skin infection and PID, sinusitis and strep throat. caution with septic impairment and previous colitis.
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