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DERMATOLOGY EXAM QUESTIONS AND ANSWERS, Exams of Nursing

DERMATOLOGY EXAM QUESTIONS AND ANSWERS

Typology: Exams

2024/2025

Available from 01/14/2025

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DERMATOLOGY EXAM WITH ALL

QUESTIONS AND VERIFIED ANSWERS

Terminology - ANSWER Terminology - ANSWER Know Teleangiectasia, Papule, Plaque, Vesicle, Macule, Nodule, Petechiae. Know the picture of each one. Terminology - ANSWER Terminology - ANSWER "*" Means it's important to know. Good Luck!! - ANSWER ... Cutaneous Membrane consist of all the following, except? A. Epidermis B. Dermis C. Hypodermis - ANSWER C. Hypodermis What is considered the largest organ of the body? - ANSWER Skin Accessory Structures includes: - ANSWER Hair, exocrine glands, sensory , receptors, and nail What connects the epidermis to the dermis layer? - ANSWER Hemi- Desmosomes Layers "Strata" of the Skin - ANSWER Come, Lets Get Sun Burned

  • Corneum
  • Lucidum* (Only found in thick skin: palm, sole of foot)
  • Granulosum
  • Spinosum
  • Basal Layer (aka Germinativum)

Epidermis is composed of: - ANSWER - Stratified Squamous Epithelium (Multi-layer)

  • Provide mechanical protection from pathogens.
  • Dominated by Keratinocytes that secrete keratin
  • Dead cell (No nuclei) Basal Layer is composed of: - ANSWER ALIVE!!!
  • Have Nuclei
  • Melanocytes and Basal cells are found here
  • When division melanocytes goes awry>melanoma is formed Melanocytes helps protect - ANSWER the rapidly dividing basal cells from damage due to the UV radiation. Dead cells are helds together by - ANSWER desomosomes What gives the skin it's protective capabilities? - ANSWER Keratin, which is secrete by keratinocytes. It also makes the skin water proof. Hyperkeratosis is a common pathological phenomenon - ANSWER - Actinic Keratosis (AK)
  • Squamous Cell Carcinoma (SCC)
  • Keratoacanthoma (KAs) Looks like a volcano What gives the skin it's color? - ANSWER Melanocytes that secrete melanin. Remember that skin under mitosis. Mutant "daughter cell" can happen that can lead to melanoma Where is merkel cells located? A. Thin Skin B. Thick Skin - ANSWER A. Thick skin Located in skin that lack hair. Ex. Palms of hand and sole of feet. What are merkel cells? - ANSWER Sensory Receptors. (Sensitive Touch) Merkel Cells carcinoma - ANSWER Rare and highly agressive skin cancer, in most cased caused by a virus (Merkel cell polyomavirus)

What are the two components of the dermis? - ANSWER 1. Superficial Papillary

  1. Deep Reticular Layer Tissue found in the dermis layer - ANSWER Areolar Tissue What is found in areolar tissue? - ANSWER Collagen (Give skin its bulk) and elastic fibers (Give the skin the ability to stretch and recoil) Collagen and elastic fibers are secreted by - ANSWER fibroblasts (Make less of this as you ages: Wrinkles) Immune cells, blood vessels, lymphatic, and sensory neurons are found in which layer? A. Superficial Papillary B. Deep Reticular Layer C. Corneum D. Subcutaneous Layer - ANSWER B. Deep Reticular Layer Exocrine glands includes - ANSWER Eccrine sweat glands and Sebaceous oil glands Function of the Skin - ANSWER - Protection (against organism, UV, chemicals)
  • Body Temp. Regulation
  • Melanin (Skin color)
  • Syn.of Vit D
  • Storage of lipids
  • Salt and Water excretion
  • Immune Function
  • Wound Healing What is a PPTT? - ANSWER Another function of the skin. Pain, Pressure, Temperature, Touch (PPTT) If you lack Vit D2? - ANSWER Body can't absorb Calcium and phosphorus in the small intestine

Where is Eccrine Sweat gland found? - ANSWER All over the body

  • Help cool body
  • Salt and water excretion
  • Location: Upper lip, forehead , palms, soles Where is apocrine sweat gland? - ANSWER Axillary and inguinal What provides the our unique scent? - ANSWER Apocrine sweat gland Pilosebaceous oil gland - ANSWER Duct open in to hair follicles
  • When clogged may cause acne How do you make Vit D3? - ANSWER The skin convert a steroid (7- dehydrocholesterol) to Vit D What convert Vit D3 to Vit D2? - ANSWER the liver What is calcium used for? - ANSWER - Nerve tranmission
  • Heart function
  • Blood clotting
  • Bone growth and repair Inadequate supply of Vit D2 can result in: - ANSWER Osteoporosis Type of sensory receptors Prof. Best stated "Just read through this..." I doubt it's test material - ANSWER
  • Free nerve ending: Nociceptors detects PPTT (penetrate into the epidermis)
  • Merkel Cells (Sensitive Touch) Migrate into the epidermis
  • Meissner's Corpuscles: detect touch and pressure. Found in the dermal papillae
  • Pacinian Corpuscles (Detects deep pressure and vibration. Located in the deep reticular layer) Hypersensitivity Reactions Type 1 - ANSWER Remember Triple A: Anaphylaxis, Asthma, Atopic reaction *Has 1 antigen-IgE linking Usually happens with an allergic rxn. Pre-senstized mast cells and basophils, trigger release or histamines.

What is Anaphylaxis? - ANSWER a severe response to an allergen in which the symptoms develop quickly, and without help, the patient can die within a few minutes. Hypersensitivity Reactions Type 2 - ANSWER Think 2 (Cy- 2 - toxic): IgM and IgG binds to antigen on an "enemy" cell, which leads to complement or phagocytosis.

  • Resemble Autoimmune diseases
  • Rheumatic fever
  • Goodpastures Example of Hypersensitivity Reactions Type 2 - ANSWER - Autoimmune hemolytic anemia, Rh disease of the newborn
  • Rheumatic fever
  • Goodpasture syndrome
  • Blood Transfusion (Receiving the wrong blood type) FYI: Goodpasture means... - ANSWER anti-basement membrane antibody mediated destruction of glomerular and pulmonary basement membranes leading to a rapidly progressive glomerulonephritis and a necrotizing, hemorrhagic pneumonia Hypersensitivity Reactions Type 3 "3A" - ANSWER occurs when there is little antigen and an excess of antibody. The complex of "Antibody-Antigen Activate complement, which damages tissue. Think!! 3 entitles stuck together. Antibody, Antibody, and antibody-antigen complex Example of Hypersensitivity Reactions Type 3 - ANSWER - Post Strep Glomerulonephritis
  • Systemic lupus erythematosus (SLE) Hypersensitivity Reactions Type 4 - ANSWER Often called delayed type hypersensitivity.
  • Cell mediated
  • T lymphocyte release immune mediators when they are exposed to an antigen.

FYI: What is Cell-mediated immunity? - ANSWER is an immune response that does not involve antibodies but rather involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. Example of Hypersensitivity Reactions Type 4 - ANSWER TB skin test, transplant rejection, contact dermatitis, Poison Ivy Epidermal Pigmentation - ANSWER 1. Carotene (Overeating food with carotene: orange-yellow

  1. Melanin: Brown, yellow pigment Dermal Circulation - ANSWER 1. Blood vesseldilate: Appear Red (Usually when a person is hot)
  2. Blood constrict: Appear blue (Cyanosis) due to cold temp. Jaundice - ANSWER - Yellowish-green
  • Build of bilirubin in the blood>skin Cause by liver disease, gallbladder disease, certain type of anemia Cancer - ANSWER Ex. Tumor secrete Melanocyte-stimulating hormone. Skin will show hyperpigmentation Vitilgo - ANSWER Pt. loose melanocytes Skin have large area of hypopigmentation Best Stated: Know the difference bt. Primary Skin and Secondary Skin Lesions
  • ANSWER For 2nd Skin lession Remember "Classee U" Crust, Lichenification, atrophy, scar, scale, erosion, excoriation, ulcer. PANCE / PANRE Blueprint - ANSWER ... Two Type of Dermatitis - ANSWER 1. Atopic-Eczema
  1. Contact Dyshidrosis - ANSWER Dishydrotic eczema Vesiculobullous hand eczema

Lichen Simplex Chronicus - ANSWER Neurodermatitis Atopic Dermatitis (Eczema) - ANSWER The skin of a patient with atopic dermatitis reacts abnormally and easily to irritants, food, stress and environmental allergens and becomes very itchy, which leads to scratching, redness, and flaky skin. Atopic Dermatitis (Eczema) "The itch that rashes" - ANSWER Pruritis (Itching) ---> lichenification Type 1 Hypersensitivity Atopic Dermatitis Presentation depends on age. - ANSWER Infants: erythematous, weeping, pruritic patches on the face, scalp, and diaper area. Children: dry, scaly, pruritic patches on face, scalp, diaper , and in ****flexor area****. Adults: dry, fissured skin, in hands, nape of neck, knee in ****extensor area**** Atopic Dermatitis - ANSWER Atopic Dermatitis - ANSWER Often occurs together with other atopic diseases like (Triad): Eczema, asthma, allergic rhinitis. Atopy - ANSWER refers to the genetic predisposition for the pt to make IgE antibodies in response to allergen exposure. Diagnosis of Atopic Dermatitis: - ANSWER Eosinophilia, elevated IgE antibodies R/o (Rule out): Seborrheic dermatitis, contact dermatitis, drug sensitivity rxn. Treatment for Atopic Dermatitis - ANSWER Corticosteroid Cream: Triamcinolone 0.1% cream (low potency) Nummular Dermatitis Coin shaped or annular shape - ANSWER Is a form of eczema. Characterized by Round to oval erythematous plaque found on arms and legs

Nummular Dermatitis - ANSWER Lesion start as papules then into plaques with scales. Early Nummular Dermatitis may be studded with vesicles containing serous exudate. Lesion are usually very pruritic. Tx: Corticosteroid Cream Nummular Dermatitis - ANSWER A rash involving flexor surfaces - ANSWER Think!! Atopic Dermatitis (Mostly in children) A rash involving extensor surfaces - ANSWER Think!!! Psoriasis (Mostly in adults) Contact Dermatitis - ANSWER Contact Dermatitis - ANSWER - Type 4 Hypersensitivity rxn.

  • Common in adult
  • Present with pruritic rash, may have fever, lymphadenopathy, edema
  • Ezcema Contact Dermatitis Treatment - ANSWER Corticosteriods Pompholyx (Greek=bubbles) - ANSWER Formerly known as: Dyshidrosis / Dyshidrotic Eczema Pompholyx - ANSWER Looks a like "Tapicoa" vesicles 1-2cm on palms, soles, and sides of finger, associated with pruritus. Dyshidrotic Eczema - ANSWER Have vesicles may coalesce to form multioculated blisters Dyshidrotic Eczema confirm with Biopsy - ANSWER In addition, Dx: clinical exam. KOH prep: unroofing vesicles and examining under microscopy w/ KOH prep slide will reveal hyphae in cases of bullous tinea. Can Confirm Candidasis

Dyshidrotic Eczema treatment - ANSWER Corticosteroid: Clobetasol (high potency) Lichen Simplex Chronicus - ANSWER Presentation: Lichenification (thickening) of the skin w/ scaling as a result of repetitive scratching or rubbing. Atopic dermatitis may be underlying cause. Lichen Simplex Chronicus - ANSWER Hyperkeratotic processes, may grow a horn. Common sites: Scalp Nape of neck Extensor forearms and elbows Vulva and scrotum Upper medial thighs, knees, lower legs, and ankles Lichen Simplex Chronicus Treatment - ANSWER Corticosteroid: Triamcinolone 0.1% (Alway start off with low potency then move if it gets worst) Drug Eruption-Dermatitis Medicamentosa - ANSWER Allergic rxn to drugs Drug Eruption-Dermatitis Medicamentosa - ANSWER Examples: Erythema Multiforme (EM) Stevens-Johnson Syndrome (SJS) Toxic epidermal necrolysis (TEN) Drug Eruption Know difference bt Morbilliform vs Exanthematous Rash - ANSWER - Morbilliform (Left) erythematous wheal (Clearing center) from (Augmentin)

  • Exanthematous Rash (Right) coalescing erythematous (Ampicillin) Drug Eruption-Dermatitis Medicamentosa Classification - ANSWER Simple Exanthems appears in 2nd week of drug therapy Drug Eruption-Dermatitis Medicamentosa Classification - ANSWER Complex (drug induced hypersensitivity rxns) DRESS DRug Eruptions Eosinophilia and Systemic Symptoms

Most common: sulfonamides, allopurinol, and anticonvulsants Drug Eruption-Dermatitis Medicamentosa Treatment - ANSWER Withdrawal drug. May consider benadryl Anaphylaxis Tx: ABCD A: Airway B: Blood access C:Cardiac Monitoring D: Drug {Epinephrine (1:1,000) solution 0.1-0.25mg IM} Toxic Erythema: Can be caused by Antibiotic (Ampicillin, TMP-SMZ(bactrim); also thiazide diuretics, furosemide, and sulfonylureas.) - ANSWER Morbiliform (Left), maculopapular (Middle), exanthematous reaction (Right) Stevens-Johnson Syndrome (SJS) Toxic epidermal necrolysis (TEN) - ANSWER Target like lesions, bullae, mucosal involvement. Desquamation. Caused by: Sulfonamides, anticonvulsants, allopurinol, NSAIDS Erythema Nodosum - ANSWER Erythema Nodosum - ANSWER - Inflammatory process of the subcutaneous adipose tissue.

  • Erythematous plaques and nodules commonly located on pretibial areas.
  • Lesions are painful and indurated but heal spontaneously without ulceration.
  • Drug rxn: Sulfonamides, various antibiotics, OCPs.
  • Other causes: TB, Strep infection; Crohn's Dz and Ulcerative Colitis Allergic Vasculitis - ANSWER Bleeding under the skin Allergic Vasculitis - ANSWER Urticaria lasting > 24 hrs Hemorrhagic papules ("palpable purpura") Vesicles, bullae, or necrotic ulcers Photosensitivity - ANSWER Photosensitivity - ANSWER Increased sensitivity to light, often UVA, but may be due to UVB or visible light.

Photosensitivity Drug like rxn - ANSWER Sulfonamides and sulfonamide related compounds (thiazide diuretics, furosemide, sulfonylureas), *TCAs, amiodarone, and NSAIDs, etc.. Anything with sulfur Lichenoid and Lichen Planus-like Eruptions - ANSWER Remember 5 Ps. Pruritic, erythematous to violaceous (Purple) Polygonal, Papules and Plaques. Fixed Drug Eruption - ANSWER Single or multiple demarcated, round, erythematous plaques that often become hyperpigmentated. Has clear border. Urticaria (hives) - ANSWER Urticaria - ANSWER - Red, itchy, wheals that very in size from < 1 cm to many cm

  • Accompanied by angioedema
  • Cause by antibiotic (Penicillin) and more Urticaria (hives) - ANSWER Picture found online. Lichan Planus - ANSWER Lesions may have Wickham's striae (white stripes), especially on the mucous membranes and Koebner's phenomena (lesions that appear at the site of trauma).
  • Lesions often develop in flexural surfaces of the limbs. Lichan Planus - ANSWER Lichen planus is the "P" disease: Planar, Purple, Pruritic, Persistent, Polygonal, Penile, Perioral, Puzzling, and Koebner's Phenomenon Lichan Planus Treatment - ANSWER Topical corticosteroids Lichan Planus Diagnosis - ANSWER Clinical confirm w/ Biopsy Lichan Planus - ANSWER Taken from American Academy of Dermatology website Pityriasis Rosea - ANSWER Pathogenesis:

Herald patch (Happens 1st): An solitary round or oval, pink plaque with raised borders and fine adherent scales appears first.

  • The long axis of the lesions typically follow the natural skin lines, forming the classic "Christmas-Tree" pattern. Pityriasis Rosea - ANSWER No treatment required; rash usually disappears spontaneously in 3-4 wks. Psoriasis - ANSWER Erythematous Plaques with Silvery Scales Found in the extensor surface of the elbow, knee, lumbosacral regions. Psoriasis - ANSWER inflammatory disease that involves hyperproliferation of the keratinocytes in the epidermis, with an increase in the epidermal cell turnover rate. Psoriasis - ANSWER Steroids & PUVA: psoralen + UVA treatment psoriasis. Bullous Pemphigoid - ANSWER Bullous Pemphigoid (Appear Spontaneously) - ANSWER - An uncommon intraepidermal blistering disease that occurs on skin and mucous membranes.
  • They are tender and painful when they rupture. Bullous Pemphigoid Diagnosis - ANSWER Labs: Auto-antibodies against hemidesmosomes can be detected with ELISA assays. Key thing here is the BIOPSY!! Bullous Pemphigoid Treatment - ANSWER - Local:topical corticosteroids / High dose of clobetasol cream.
  • Systemic dz: hospitalization to provide antibiotics, IV feedings, anesthetic troches used before eating to help with oral lesions. Nikolsky sign: superficial detachment of skin after pressure or trauma - ANSWER Biopsy reveals: Acantholysis Bullous Pemphigoid - ANSWER

Nikolsky sign is present in which of the following? A. Bullous Pemphigoid B. Pemhigus Vulgaris - ANSWER B. Pemphigus Vulgaris Also found in Toxic epidermal necrolysis (TEN) & Stevens Johnson Syndrome (SJS) Pemphigus Vulgaris - ANSWER "Pimp that let the girl go for Nickel"...now thats Vulgar

  • has a flat bullous involving skin and mucous membrane
  • Flaccid (Loose) blister rapidly progressing to erosions.
  • Autoimmune against desomosomes
  • Lesion often begin in the oral mucosa Pemphigus Vulgaris Diagnosis - ANSWER Biopsy; serum antibodies Pemphigus Vulgaris Treatment - ANSWER Prednisone 1mg/kg/day Dermatology Part 2 - ANSWER ... Acne Vulgaris - ANSWER Bacterial: Propionibacterium acnes within follicles Has three stages
  1. Comedo: open "blackheads" or closed "whiteheads"
  2. Inflammatory: comedo ruptures
  3. Scarring: as inflammation heals, scars may develop Acne Vulgaris Treatment Step 1 - ANSWER Step one (comedonal acne): Tx:OTC salcyclic acid topical and benzoyl peroxide Rx: clinamycin/benzoyl peroxide (BenzaClin) 1%/5% gel; apply bid Rx: Tretinoin topical (Retin A, etc..) / tazarotene topical (tazorac) Acne Vulgaris Treatment Step 2 - ANSWER Step two (inflammatory acne):
  • Add topical antibiotics: erythromycin/ clindamycin
  • Systemic antibiotics is refractory to topical: Doxyclycline* 100 mg qd, minocycline ER, 1 mg/kg PO qd, OR minocycline 50 mg PO qd to tid (for severe dz)
  • Note: photosensivity reactions may result

Acne Vulgaris Treatment Step 3 - ANSWER Step Three (severe cystic acne) Isotretinoin (Absorica; Accutane brand dc in US): 0.5-1 mg/kg/d div bid x 15- 20 wks. Check cholesterol, triglycerides, and LFTs at baseline and thereafter q 1 - 2 wks until stable. Also, do NOT give to women of child-bearing age. Cat X Acne Vulgaris - ANSWER Rosacea - ANSWER Rosacea - ANSWER Central facial erythema with telangiectasias; later papules and pustules may develop. Abnormal flushing. Associated w/ drinking Alcohol Typical onset is middle age; Fair skin; female predominance. Rosacea Treatment - ANSWER Rx: metronidazole topical 0.75% cream/ gel/ lotion; apply bid to affected area. Also comes in a 1% gel (MetroGel) that can be used qd. Rx. Severe disease: metronidazole PO 500mg Bid x2 wks, then topical cream to follow Actinic Keratosis - ANSWER Firm, rough, indurated, well circumscribed lesions with indistinct margins, pinpoint* to plaque-like nodules of varying colors, adherent to underlying dermis. Lesions are found on sun-exposed areas. White top Actinic Keratosis - ANSWER - UV-induced mutations

  • Hyperkeratosis: hyper-proliferation of keratinocytes Precursor of squamous cell carcinoma (SCC)
  • Occur in sun-exposed areas, face, forearms, dorsal surface of the hands. Often in elderly. Actinic Keratosis Diagnosis - ANSWER Clinical; Confirm with biopsy (if unsure) Actinic Keratosis Treatment - ANSWER Cryosurgery with liquid nitrogen x 6 sec; repeated visits 4 wks Fluorouracil topical (5FU, Efudex); apply bid x 4 wks

Imiquimod topical (Aldara); apply 2x/wk at bedtime x 16 wks Can lead to Squamous Cell carcinoma Seborrheic Keratosis - ANSWER Hyperkeratosis: hyper-proliferation of keratinocytes Some lesions may become "irritated" either spontaneously or by external trauma, esp in the groin, breast, and axilla regions. Seborrheic Keratosis Presentation - ANSWER Sharply demarcated brown/ black/ tan verrucal, warty, raised lesions, with a waxy, "stuck-on" appearance, typically found on face, neck, trunk, sizes vary from few mm to cm. Seborrheic Keratosis Treatment - ANSWER Cryosurgery Keratoacanthoma (KA) - ANSWER - low grade tumor that originates in the pilosebaceous glands.

  • dermatopathologists refer to the lesion as "squamous cell carcinoma, keratoacanthoma-type."
  • Round, firm, flesh-colored nodule with a central necrotic crater. Rapidly growing; resembles a "volcano" in appearance. Keratoacanthoma Diagnosis / Treatment - ANSWER - Excisional or deep incisional biopsy
  • Education, periodic FU-exams Keratoacanthoma - ANSWER Lice-Pediculosis - ANSWER Lice-Pediculosis Treatment - ANSWER - Head Lice: pyrethrum/piperonyl butoxide topical shampoo (RID) OTC.
  • Body Lice: most impt to wash all clothes and bedding is hot-hot water. May treat with permethrin top lotion 1%. Sig: apply from neck down. Leave on x 8- 14 hrs. Repeat 2x in 7d and in 14d.
  • Pubic Lice: permethrin topical lotion 1% or RID shampoo. Sig: same as above. Lice-Pediculosis - ANSWER

Scabies - ANSWER Pathogenesis: Sarcoptes scabiei, an arthropod that burrows into the epidermis, which leads to intense pruritus.

  • Common sites affected: web-spaces between fingers, wrist creases, intertrigo creases. Scabies Diagnosis & Presentation - ANSWER Confirm with Biopsy Presentation: Erthematous, pimple-like papules with linear tracks that represent mite burrowing. Scabies Treatment - ANSWER Permethrin topical Scabies Pictures - ANSWER Erythematous, pimple-like papules with linear tracks that represent mite burrowing. Typical areas: web spaces between fingers, creases in wrist, folds of the skin. Brown Recluse Spider Bite - ANSWER A single bite accompanied by an infarct of skin.
  • large area of asymmetric erythema leads to the typical "red, white, and blue" sign. Brown Recluse Spider Bite Treatment - ANSWER - May offer a conservative approach using cold compresses, simple analgesics, elevation of an affected extremity, and cleansing of the bite site. < 10% will progress and need surgical debridement, excision, drainage of the spider toxins from the wound, and IV antibiotics. Dapsone* is bacteriostatic Tick Bites-Lyme Disease - ANSWER Pathogenesis:
  • Caused by the spirochete Borrelia burgdorferi
  • Endemic to the Northeast US.
  • Erythema migrans: "bulls-eye rash" It expands slowly over days to weeks to a central erythematous ring, surrounded by a clearing, which is surrounded by another erythematous ring.

Tick Bites-Lyme Disease Treatment - ANSWER - Doxycycline* 100 mg. Sig: 1 tab PO bid x 21d

  • Children < 8 y/o and pregnant moms: Amoxicillin 500 mg. Sig: 1 tab PO bid x 21d.
  • PCN allergy: cefuroxime axetil (Ceftin) 500 mg. Sig: 1 tab PO bid x 21d. Tick Bites-Lyme Disease Diagnosis - ANSWER ELISA screen followed by Western blot Tick Bites Rocky Mountain Spotted Fever - ANSWER A petechial-purpuric rash begins on the wrists and ankle and spreads centrally. Tick Bites Rocky Mountain Spotted Fever Pathogenesis - ANSWER A disease caused by Rickettsia Rickettsii, carried by the American dog tick Tick Bites Rocky Mountain Spotted Fever Diagnosis - ANSWER Confirmed with biopsy Tick Bites Rocky Mountain Spotted Fever Treatment - ANSWER Doxycycline Basal Cell Carcinoma - ANSWER - Most common skin cancer
  • Raised nodular lesion with central ulceration, pearly thready boarders with telangiectasias. Caused by; Chronic UV light Basal Cell Carcinoma Diagnosis - ANSWER Confirm by biopsy Basal Cell Carcinoma Treatment - ANSWER ED&C (electrodesiccation & cautery), excision, superficial radiation, and Mohs' surgery. Squamous Cell Carcinoma (SCC) - ANSWER Pathogenesis: The second most common skin cancer, with locally destructive effects.
  • Etiology : UV light is most common
  • Bowen's Disease: is a form of SCC in situ.
  • SCC may arise from AK (Actinic Keratosis) Squamous Cell Carcinoma (SCC) Diagnosis / Treatment - ANSWER - Confirm by biopsy
  • Surgical excision, Mohs' surgery Squamous Cell Carcinoma - ANSWER Melanoma - ANSWER Epidermal basal layer, where melanocytes are found. 4 Types of MeLANoma - ANSWER (LANS)
  • Lentigo maligna melanoma
  • Acral lentiginous melanoma
  • Nodular melanoma
  • Superficial spreading melanoma Superficial spreading melanoma - ANSWER Most common Appox. 70% of melanomas Nodular melanoma - ANSWER Are blue-black but some may lack pigment. May metastasize by vertical growth into the dermis with minimal radial component. Lentigo maligna melanoma - ANSWER Lesions are often than 3 cm, flat, tan, and beginas small, freckles Acral lentiginous melanoma - ANSWER Acral-means toes and fingers
  • Occur on the palms of the hands, beneath the nail beds, on the soles of the feet, and under the tongue.
  • Lesions are often flat, tan, or brown with irregular borders. Melanoma Level 1 - ANSWER Level I - Involves only epidermis (in situ melanoma); no invasion Melanoma Level 2 - ANSWER Level II - Invades papillary dermis but not papillary-reticular dermal interface Melanoma Level 3 - ANSWER Level III - Invades and expands papillary dermis up to the interface with, but still does NOT invade the reticular dermis. Melanoma Level 4 - ANSWER Level IV - Invades reticular dermis but NOT into subcutaneous tissue

Melanoma Level 5 - ANSWER Level V - Invades into subcutaneous tissue and metastasizes to other organs and tissues Melanoma ABCDE Rule - ANSWER Melanoma - ANSWER Kaposi Sarcoma (KS) Diagnosis / Treatment - ANSWER She focus on palliative. Kaposi Sarcoma (KS) - ANSWER Kaposi Sarcoma (KS) - ANSWER Answer: D - ANSWER ... - ANSWER Lipoma - ANSWER Benign Fatty soft-tissue tumors. Lobulated mass (Lump) Dx: Clinically Tx: Reassurance; Surgical Excision Answer: E - ANSWER ... - ANSWER Squamous Cell Carcinoma (2nd Most common skin cancer) - ANSWER Present: Plaque-like to nodular lesion, varie in color, ulcerated and scale. Etiology: UV Light Dx: Clinically Tx: Surgical Excision Answer: B - ANSWER ... - ANSWER

Decubitus Ulcer - ANSWER Occurs mostly in elderly pt confined to hospital Bed Stages I. Erythema II. Induration and blister III. Shallow Ulcer IV. Deep necrosis of fat and muscle V. Bone destruction Tx: Turn pt regularly Answer: C - ANSWER ... - ANSWER Vitiligo - ANSWER Disease of Depigmentation. Present sharply demarcated, depigmented macules or patches hands, face, or genitalia. Tx: PUVA (w/ 8-methoxypsoralen, 5-methoxypsoralen, and trimethylporalen Adult is mostly asked: If an adult is burnt on the on both legs, chest, and abdominal area? 18% + 9% + 9%= 36% is burnt - ANSWER Melasma - ANSWER Pathogenesis: increase melanosome production Dx: Clinical Tx: Sunscreen; Hydroquinone Present: Brownish, hyperpigmented Pilonidal Disease - ANSWER Caused by hair and cellular debris Cystic cavity containing keratin and hair in the subcutaneous tissue of the natal cleft (Butt crack) Tx: Incision and Drainage) Candidiasis - ANSWER A fungal infection caused by yeast. Types:

  1. Cutaneous candidiasis/ intertrigo
  2. Angular chelitis (corners of the mouth)
  3. Oorpharyngeal candidiasis
  4. Vulvovaginal candidiasis
  5. Candida balantitis
  1. Esophageal candidiasis Candidiasis - ANSWER Angular chelitis Candidiasis - ANSWER Oorpharyngeal Candidiasis - ANSWER Vulvovaginal candidiasis: thick, cottage-cheese Candidiasis - ANSWER Intertrigo (Satellite lesions) Candidiasis - ANSWER Candida balantitis Candidiasis - ANSWER Tx: Oral or topical azoles Ex, Fluconazole Dermatophyte Infection - ANSWER D for Dead Fungi that invade the dead keratin of skin, hair, nails Dead Go Rise!! Tx: Griseofulvin Tinea Capitis (form kerion on scalp): Griseofulvin Tinea Barbae (On beard): Griseofulvin Tinea Corporis (ringworm of the body): Ketoconazole Tinea Cruris (jock itch): Ketoconazole Acanthosis Nigricans - ANSWER Brown to black hyperpigmentation of the skin in body folds, neck, axilla, groin. Associated w/ DM, hyperinsulinemia Tx: Keratolytics: Tretinoin (Tren the color down) Bleaching cream: hydroquinone Hidradenitis Suppurative - ANSWER Inflammation of the hair follicle associated with with Apocrine glands. Hide under your arm and groin. Tx: Clindamycin Present: Painful, Prutitus, erythematous to nodules with local hyperhidrosis. Hyperhidrosis - ANSWER is the condition characterized by abnormally increased sweating/perspiration

"Come, Lets Get Sun Burned"

  • Corneum
  • Lucidum* (Only found in thick skin: palm, sole of foot)
  • Granulosum
  • Spinosum
  • Basal Layer (aka Germinativum) - ANSWER Layers "Strata" of the Skin Answer: B. Deep Reticular Layer - ANSWER Immune cells, blood vessels, lymphatic, and sensory neurons are found in which layer? A. Superficial Papillary B. Deep Reticular Layer C. Corneum D. Subcutaneous Layer All over the body
  • Help cool body
  • Salt and water excretion
  • Location: Upper lip, forehead , palms, soles - ANSWER Where is Eccrine Sweat gland found?
  • Axillary and inguinal
  • Provides our unique scent? - ANSWER Where is apocrine sweat gland and what does it provide? Answer: E - ANSWER ... - ANSWER Varicella Zoster Virus - ANSWER Varicella (Chicken Pox) and Herpes Zoster (Shingles)
  • Pneumonia is a serious complication in children with leukemia. Dormant in the dorsal root ganglion for life. Tx: Vaccine
  • Acyclovir 800mg(Shorten course)
  • Valacyclovir 1000mg Grouped Blisters on an erythematous base, appearing along a dermatome distribution

Answer: E - ANSWER ... - ANSWER Answer:B - ANSWER Not on Prof. Best Test ... - ANSWER Alopecia Areata - ANSWER Auto-immune process. May be associated with meds (Ex. PTU, Lithium, heparin, birth control pills, beta blocker) Due to the Lack of Vitamin A Kenolog Corticosteroid injection Mainly: Minoxidil (Rogaine) "Just for Men" - ANSWER Treatment for Alopecia Areata?

  • Hair falling out
  • Biotin ""Tell & go get Biotin" - ANSWER What is Alopecia- Telegon Effluvium? What do you treat it with? at the nail root - ANSWER Where does nail production occurs? a portion of the stratum corneum that extends over the exposed nail. - ANSWER Eponychium Onychomycosis - ANSWER Fungal infection of the toenail or fingernail - ANSWER Onychomycosis
  • Terbinafine (79% effective)
  • Itraconazole - ANSWER How would you treat Onychomycosis? Ciclopirox topical 8% solution - ANSWER New treatment for Onychomycosis?

Paronychia - ANSWER Infection of the epithelium laternal to the nail plate Acute: Drainage procedure Chronic: Acyclovir - ANSWER How would you treat Paronychia? Clotrimazole Remember "Azole" - ANSWER Paronychia. If hands in water for prolong periods of time (Dishwasher dermatitis) suspect Candida infection. Treatment would be? Answer: A - ANSWER ... - ANSWER inflammatory disease that involves hyperproliferation of the keratinocytes in the epidermis, with an increase in the epidermal cell turnover rate. Key Point: Erythematous Plaque with silvery scales* - ANSWER Psoriasis Psoriasis PUVA: psoralen + UVA treatment psoriasis. - ANSWER What do you treat psoriasis with? Psoriasis (Found in adults) - ANSWER A rash involving extensor surface ---- Think What!!! Answer: A - ANSWER ... - ANSWER Verrucae (Warts) - ANSWER Caused by HPV 16 and 18 Tx: Cryosurgery Dx: Acetowhitening maybe helpful to visualize on mucosa/cervix - ANSWER Verrucae Appear pearly , filiform, fungating, cauliflower, or plaquelike - ANSWER Verrucae Genital Warts

Hyperkeratotic papules with a rough irregular surface. - ANSWER Verrucae Non-Genital Warts Condyloma Acuminatum - ANSWER Related to HPV Type 6 and 11 cryosurgery - ANSWER Condyloma Acuminatum Acetowhitening maybe helpful to visualize on mucosa/cervix treatment would be?

  • Acetowhitening maybe helpful to visualize on mucosa/cervix - ANSWER Dx. of Condyloma Acuminatum Molluscum Contagiousm - ANSWER Caused by Poxvirus Present: trunk, extremities, face. Tiny, flesh-colored, pearl waxy papules with central umbilication.
  • Spread by physical contact - ANSWER Molluscum Contagiousm
  • Cryosurgery
  • Trichloroacetic Acid (TCA) Topical - ANSWER Molluscum Contagiousm Treatment with? Answer: A - ANSWER ... - ANSWER Lichen Simplex Chronicus - ANSWER Tx: Corticosteroids (Triamcinolone topical cream 0.1%) Present: Lichenification (Thickening of the skin w/ scaling asa results of repetitive scratching or rubbing. - ANSWER Lichen Simplex Chronicus Scalp Nape of neck Extensor forearms and elbows Vulva and scrotum