Criado por Jessica Margaux Mercado
aproximadamente 9 anos atrás
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Questão | Responda |
papulosquamous, proliferative, inflamatory skin disease (common skin disorder) | PSORIASIS skin sheds every 5 days 2% of pop, peak: late 20s Koebner reaction extradermal: edema, liver damage, arthropathy, nail pitting, corneal nodules |
salmon pink plaque topped by silvery white scale on extensor surfaces (scalp, elbows, knees); can be round/gultate/ geographical/ circinate; (+) Auspitz (common skin disorder, be specific) | PLAQUE TYPE PSORIASIS |
pinkish, glazed, clearly demarcated, non-scaly; (groin, perianal, genital, inframammary folds); usually mistaken as dermatophytic or candida (type of psoriasis) | FLEXURAL PSORIASIS |
well-demarcated, scaling, erythematous, pustules are white/yellow/green/brown; common in palms and soles (type of psoriasis) | PUSTULAR PSORIASIS |
more complicated; life-threatening; can lead to death (type of psoriasis) | VON ZUMBUSCH PSORIASIS |
Psoriasis Management? | Reassurance, social support, emolients, salicylic acid, coal tar, UVB, calcipotriol, photochemotherapy (Psoralen w/ UVR), Acitretin, cytotoxic drugs (methotrexate, cyclosporine) |
Acute: vesicular, can rupture to leave a raw, weeping surface; Subacute: diffuse, irritating, pruritic, sometimes painful; Chronic: lichenification (common skin disorder) | ECZEMA/DERMATITIS |
presents at infancy, resolves by 12y/o; area of predilection: cheek; (+) Prick test to common allergens; itch rash cycle (type of eczema/dermatitis) | ATOPIC ECZEMA may be prevented by breastfeeding; family history of atopy |
age 2 and above; at flexural, antecubital, popliteal areas (type of eczema/dermatitis) | CHILDHOOD ATOPIC DERMATITIS |
Atopic Eczema Management? | Emolients, topical corticosteroids, antihistamines, immunosuppressants |
erythema, vesiculation, fissuring; commonly affects hands; can manifest even in 1st exposure (type of eczema/dermatitis) | IRRITANT CONTACT DERMATITIS occupational hazard detergents, bleach, soaps |
sharp cut-off where contact ends; previous sensitization, autosenzitation; most vulnerable: thin, moist skin; (+) Patch Test: marked prolonged response (type of eczema/dermatitis) | ALLERGIC CONTACT DERMATITIS dyes, nickel, chromates, lanolin, rubber, resins, topical antibiotics (Neomycin), antiseptics (Betadine) |
scaly, rusty, red, pruritic eruption on oily areas of skin (T-zone, flexures, scalp, nasolabial, eyebrows) (type of eczema/dermatitis) | SEBORRHEIC DERMATITIS unkown etiology; aggravated by stress; may be due to fungal infection |
papulopustular inflammatory condition affecting face and trunk; mild: comedo, open/closed; severe: pustular, scarring, cystic (common skin disorder) | ACNE VULGARIS 90% adolescents, hormonal overproduction of sebum = blockage = comedone (1˚ lesion); Proprionibacterium acnes |
Acne Vulgaris Management? | dispel myths, non-soap cleansers, benzoyl peroxide, eryhthromycin, tetracycline, clindamycin, isotretinoin |
chronic inflammatory eruption on cheeks, nose, chin; erythema, papules, pustules, cyst, telangectasia; complication: nose deformity (common skin disorder) | ACNE ROSACEA fair-skinned, middle-aged women; hot drinks, stress, sunlight, spicy food, cheese, alcohol, topical steroids |
Acne Rosacea Management? | Topical Metronidazole |
small, polygonal, flat-topped, violaceous papules; very pruritic; areas: wrist, lower extremities; Wickham striae; post-inflammatory hyperpigmentation (common skin disorder) | LICHEN PLANUS sulfonamides, sulfonylureas, methyldopa, thiazides, beta-blockers, antimalarials, gold salts, penicillamine |
Lichen Planus Management? | potent topical/systemic steroids and antihistamines |
self-limiting, non-recurrent, scaling reddish-brown discrete maculopaular eruption; Herald patch: shoulder or back; Christmas-tree like: trunk, upper thighs, arms; Colarette scaling (common skin disorder) | PITYRIASIS ROSEA unkown etiology, often mistaken for fungal infection; children & young adults, rainy months; clears w/in 6-8wks w/o treatment |
Pityriasis rosea Management? | Avoid precipitating factors (avoid too cold/hot baths, gold salts, penicillamine), antihistamines, topical steroids, emolients |
very pruritic, transient/evanescent, sharply defined, erythematous or white weals w/ erythematous rim (common skin disorder) | URTICARIA triggers: infection, drugs, food, parasites, physical exertion/stress, solar exposure, cold urticaria Treatment: antihistamine |
"burrows", excoriations; nocturnal pruritis or discomfort; Circle of Hebra; areas: fingerwebs, wrists, antecubital fossae, axilla, areola, abdomen, gentialia, areas w/ thin skin (common skin disorder) | SCABIES indigent communities, summer |
Scabies Management? | PERMETHRIN, precipitated sulfur; *Crotamiton (high failure rate, neurotoxic esp to children and pregnant) |
chronic, granulomatous; leonine facies, saddle nose (common skin disorder) | HANSEN'S DISEASE |
few, well-defined, hypopigmented, hypoesthetic macules/patches w/ raised erythematous/purple border enlarging peripherally (type of Hansen's) | TUBERCULOID LEPROSY milder, CMI is good Dapsone + Rifampicin, 1yr |
symmetric, skin-colored/slightly erythematous papules/nodules on nose, earlobes, face, arms, buttocks, trunk, and lower extremities; Leonine facies (type of Hansen's) | LEPROMATOUS LEPROSY severe, CMI is weak Dapsone + Rifampicin + Clofazimine, 2yr |
painful to touch, nodular lesions usually on anterior shins (systemic manifestations) | ERYTHEMA NODOSUM females, 20-50y/o |
Possible causes of Erythema Nodosum? | Sarcoidosis, Crohn's, ulcerative colitis, Behcet's, drugs (sulfonamides, OCP, dapsone), bacterial infection (Strep), fungal (histoplasma), viral, lepto |
Erythema Nodosum Management? | identify trigger, rest and elevation of affected extremity, Indomethacin, Potassium Iodide |
target lesions or circular w/ central blistering; usually on limbs, symmetric (systemic manifestations) | ERYTHEMA MULTIFORME |
Possible causes of Erythema Multiforme? | drugs (barbiturates, sulfonamides, PCN, salicylates), systemic infection (HSV), Vit deficiency (Niacin, A, C), Collagen disorders |
enlarging, coalescing macules w/ crinkled surface; sheet-like loss of epidermis; extensive necrosis; (+) Nikolsky (systemic manifestations) | SJS, TEN idiopathic, drug-induced; widespread apoptosis of keratinocytes (cell-mediated cytotoxicity) |
SJS Management? | early diagnosis and withdrawal of drug, ICU, IV fluids, systemic glucocorticoids, IV Ig |
evanescent pink rash/rings on trunk or proximal extremities (systemic manifestations) | ERYTHEMA MARGINATUM Rheumatic Fever |
starts as a papule, become vesicular and pustular; painful ulcers on back, thigh, buttocks w/ bluish edge (specific disease w/ skin manifestation) | PYODERMA GANGRENOSUM (Ulcerative Colitis, Crohn's, AML, Hodgkin's) |
hardened, raised, shiny area on shins, center has yellowish tint, surrounding: pink; telangectasia (lips, nose, eyes, fingers, oral cavities); gradual formation, slow healing (specific disease w/ skin manifestation) | NECROBIOSIS LIPOIDICA DIABETICORUM (DM) |
smooth, discolored, annular, pustular patches w/ intact skin surface; no ulceration, no damage to epidermis; usually on hands (specific disease w/ skin manifestation) | GRANULOMA ANNULARE (severe DM, HIV) |
pruritic, symmetrical clusters of urticarial lesions, evolve to vesicles & bullae; very itchy; found at gluteal area, extensor aspect of elbows, knees, and upper back (specific disease w/ skin manifestation) | DERMATITIS HERPETIFORMIS (Celiac Disease) Treatment: Dapsone, Gluten-free diet |
infiltrative dermopathy: erythematous, edematous swellings above lateral malleoli = thickened edema of legs & feet (specific disease w/ skin manifestation) | PRETIBIAL MYXEDEMA (Hyperthyroidism, Grave's) |
pigmented, rough, thickened skin in axilla or groin w/ warty lesions; velvety plaques on back in obese (specific disease w/ skin manifestation) | ACANTHOSIS NIGRICANS (Neoplasia: stomach CA) |
heliotrope inflamm changes, edema of eyelids & periorbital area; erythema of face, neck, upper trunk, usually sun-exposed areas; hands: Gottron's papule = flat-topped violacrous papules over knuckles (specific disease w/ skin manifestation) | DERMATOMYOSITIS (Neoplasia: stomach, breast, lung, ovarian, cervical; Rheuma: CT disease, paraneoplastic syndrome) |
dry, scaly skin; sparing of flexural areas e.g. popliteal (specific disease w/ skin manifestation) | ACQUIRED ICTHYOSIS (Neoplasia: lympoma) |
successive crops of tender nodules affecting blood vessels throughout the body (specific disease w/ skin manifestation) | THROMBOPHLEBITIS MIGRANS (Neoplasia: pancreatic carcinoma) |
painful groups of vesicles on an inflamed base, unilateral w/ dermatomal distribution (specific disease w/ skin manifestation) | HERPES ZOSTER |
reddening of skin on palmar aspect of hands, usually over hypothenar eminence (specific disease w/ skin manifestation) | PALMAR ERYTHEMA (liver disease) |
telangectasis found slightly beneath skin surface, often containing central red spot and reddish extension which radiate (specific disease w/ skin manifestation) | SPIDER NEVI (liver disease) |
diffuse bluish plaque w/ small papules w/in the swelling affecting the nose; sometimes spreads to cheek (specific disease w/ skin manifestation) | LUPUS PERNIO (Sarcoidosis) |
Café-au-lait macules, axillary freckling, violaceous dermal neurofibroma, subcutaneous nodules (specific disease w/ skin manifestation) | NEUROFIBROMATOSIS autosomal dominant; no treatment |
tense bullae & erosions on normal appearing skin; slowly heals to form pink atrophic scars, milia on dorsa of hands, feet, nose, forehead, scalp; hypertrichosis on face (specific disease w/ skin manifestation) | PORPHYRIA CUTANEA TARDA enzymatic defect in heme biosynthetic pathway; on sun exposed areas |
small, red papule; gradually enlarges to form ring w/ raised border (specific disease w/ skin manifestation) | ERYTHEMA CHRONICUM MIGRANS (Lyme Disease) |
Lyme Disease Treatment? | Tetracycline (Lymecycline), PCN, 3rd gen Cephalosporin (Cefotaxime) |
yellow plaque, commonly found on eyelids (specific disease w/ skin manifestation) | XANTHOMATOSIS (Hyperlipidemia) Tendon Xanthomata: familial hyperchol Eruptive Xanthomata: hyperlipidemia |
periorificial, acral eczematous and erosive dermatitis; may be some alopecia and diarrhea (specific disease w/ skin manifestation) | ACRODERMATITIS ENTEROHEPATICA autosomal recessive Zn deficiency; babies after weaning, elderly |
painful oral and genital ulcerations and eye and joint conditions; iritis, keratitis, hyopyon, retinal vein occlusion, arthritis, CNS, complications (specific disease w/ skin manifestation) | BECHET'S DISEASE wastebasket diagnosis recurrent progressive systemic disease of unknown etiology |
Bechet's Disease Management? | Steroids, Colchicine, Cytotoxic drugs (Azathioprine) |
initial: flesh-colored papule/plaque w/ superficial dilated blood vessels over surface; classic lesion: ulceration & central necrosis, pearly rolled border; "rodent ulcer": dirty-looking ulcerations | BASAL CELL CARCINOMA elderly, fair-skinned > 40y/o; face, nasal, periorbital; malignant but curable |
Basal Cell Carcinoma Management? | Surgical excision Cryotherapy Radiotherapy Moh's micrographic surgery |
hyperkeratotic, crusted, indurated, may ulcerate; may look like psoriatic lesion; from damaged/chronically irritated skin, sun exposure, HPV | SQUAMOUS CELL CARCINOMA fair-skinned >60y/o; HPV 6,11,16,18,30; grows more quickly, can be invasive, can metastasize |
Squamous Cell Carcinoma Management? | wide excision radiotherapy quadrivalent vaccine (9-26y/o) |
pigmented lesion with: rapid enlargement, bleeding, variegated pigmentation, ulceration, indistinct border, persistent itching, small satellite lesions around principal lesion | MALIGNANT MELANOMA fair-skinned w/ chronic UV exposure, may arise in pre-existing mole; prognosis: limbs>trunk>face |
Melanoma Management? | Interferon Wide excision w/ skin grafting |
Casal necklace: symmetric photosensitive eruption on face, neck and upper chest; Gauntlet: extensor arms, back of hands | PELLAGRA |
starts as erythema and swelling after sun exposure, accompanied by itching and burning or pain; skin becomes thickened, scaly, hyperpigmented w/ copper or mahogany hue | PELLAGRA |
dull erythema of bridge of nose w/ fine yellow, powdery scales over follicular orifices (sulfur scales) | PELLAGRA |
vesicular or bulous erruptions (type of pellagra) | WET PELLAGRA |
pustular and bullous dermatitis w/ acral and periorificial distribution; patchy, red, dry, scaling w/ exudation and crusting on face, groin, flexor areas | ACRODERMATITIS ENTEROHEPATICA autosomal recessive; mutation in SLC39A4 = Zn transporter ZIP4 |
periungual areas are erythematous and scaling, sometimes have superficial, flaccid pustules; angular chellitis, stomatitis; nail dystrophy, generalized alopecia; diarrhea, lethargy, irritibalitiy, whining, crying, Candidiasis, Staph | ACRODERMATITIS ENTEROHEPATICA |
hypopigmented on dark skin, erythematous/ purple on fair; first appear on friction areas (flexures, groin, buttocks, elbows); hyperpigmented patches w/ slightly raised edges, peeling, desquamation | KWASHIORKOR |
"crazy pavement", "crackled skin", "mosaic skin", "enamel paint", "flaky patient" | KWASHIORKOR |
hair: hypopigmented, reddish-yellow to gray or even white, dry, lusterless, crackled; (+) Flag Sign: alternating bands of pale and dark hair; nails are soft and thin; | KWASHIORKOR |
failure to thrive, edema, lethargy, irritability, apathy, abdominal distention, hypoglycemia, anemia, hypoprotenemia | KWASHIORKOR |
multiple, intensely pruritic, small papules and vesicles on thenar and hypothenar eminences of hands, soles, sides of fingers and toes | DYSHIDROTIC ECZEMA |
round or oblong, yellow fibrinous base ulcers; lower medial aspect of leg | VENOUS ULCERS |
early eruptions: symmetrical, more or less generalized, superficial, non-destructive, exanthematic, transient, macular later: maculopapular or papular, polymorphous | SECONDARY SYPHILIS; SYHPILID face, shoulders, flanks, palms and soles, anal or genital regions |
exanthemic erythema; round indistinct nonconfluent macules; appear first on sides of trunk, about the navel, and on inner surface of extremities | MACULAR ERUPTIONS (SECONDARY SYPHILIS; SYHPILID) |
raw ham or coppery shade and round; slightly raised; deep, firm, palpable; Ollendorf's sign: papule tender to touch of blunt probe; healing lesions leave hyperpigmented spots | PAPULAR ERUPTIONS (SECONDARY SYPHILIS; SYHPILID) |
adherent scales covering lesions more or less dominate (syphilid) | PAPULOSQUAMOUS SYPHILID (SECONDARY SYPHILIS; SYHPILID) |
minute scale-capped papules; at the ostia of hair follicles; conical, elsewhere domed (syhpilid) | FOLLICULAR/LICHENOID (SECONDARY SYPHILIS; SYHPILID) |
mimics sarcoidosis; usually in cheeks or angles of mouth; "nickels and dimes" | ANNULAR SYPHILID (SECONDARY SYPHILIS; SYHPILID) |
large central papule, group of minute satellite papules (syphilid) | CORYMBOSE SYMPHILID (SECONDARY SYPHILIS; SYHPILID) late in secondary stage |
widely scattered over trunk and extremities, involve face; arise from red infiltrated base (syphilid) | PUSTULAR SYPHILID (SECONDARY SYPHILIS; SYHPILID) rare |
papular lesions, relatively broad and flat; located on fold of moist skin, esp genitalia and anus (syphilid) | CONDYLOMATA LATA (SECONDARY SYPHILIS; SYHPILID) |
mucus patches; macerated, flat, grayish, roudned erosions covered by delicate, soggy membrane; occur on tonsils, tongue, pharynx, gums, lips, buccal areas, genitalia | SECONDARY SYPHILIS highly infectious |
butterfly rash over cheeks and bridge of nose; skin sores or flaky red spots on arms, hands, neck, head area; scaly red/purple raised rash; Raynaud's; temporary hair loss | SLE type II & III HSN; women 15-35 |
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