Dermatology Disorders and Hormonal Impacts

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Questions and Answers

What is vitiligo primarily characterized by?

Appearance of tan or brown patches during pregnancy.

Visible veins under the skin due to inflammation.

Loss of pigment cells leading to discolored patches. (correct)

The skin produces excess pigment cells.

Which condition is commonly referred to as the 'pregnancy mask'?

Vitiligo.

Melasma. (correct)

Clubbing of the fingers.

Petechiae.

What might the presence of petechiae or ecchymosis indicate?

Vitamin deficiency.

Potential bleeding problems or blood thinner use. (correct)

Growth of tumors.

Skin infection or trauma.

What can be a possible sign of heart or respiratory problems?

Clubbing of the fingers. Signup and view all the answers

What factor can contribute to pigmentation alteration?

Recent skin infections or trauma. Signup and view all the answers

When might yellowing of the skin and whites of the eyes be a concern?

Infant jaundice after birth. Signup and view all the answers

Which of the following is NOT a common cause of pigmentation change?

Engaging in sports. Signup and view all the answers

How does melasma typically respond after pregnancy?

It frequently disappears. Signup and view all the answers

What is the primary hormone involved in causing moon facies?

Cortisol Signup and view all the answers

Which of the following conditions could contribute to elevated cortisol levels?

Nonpituitary tumors Signup and view all the answers

What facial feature is commonly associated with moon facies?

A round and puffy appearance Signup and view all the answers

Which diagnostic tests help confirm the presence of abnormal cortisol levels related to moon facies?

Blood and urine tests Signup and view all the answers

What is the link between long-term steroid use and moon facies?

Steroids can mimic symptoms of Cushing's syndrome Signup and view all the answers

Which hormone released by the pituitary gland prompts cortisol production?

ACTH Signup and view all the answers

Why can diagnosing Cushing's syndrome be challenging?

Sign and symptoms can overlap with other conditions Signup and view all the answers

Which of the following is NOT commonly associated with moon facies?

Reduced fat on the face Signup and view all the answers

What factor primarily influences the risk of developing Cushing's signs and symptoms?

Dose and duration of medication Signup and view all the answers

Which facial feature may indicate muscle weakness in children using steroids?

Lack of expressiveness Signup and view all the answers

What characteristic of the nose is described in relation to children with certain steroid effects?

Bulbous with a prominent bridge Signup and view all the answers

Which feature is common among the eyes of children showing signs related to steroid use?

Small and almond-shaped Signup and view all the answers

What is the term used to describe flattened cheekbones in children affected by steroid use?

Malar flatness Signup and view all the answers

What condition is indicated by a yellow coloration of the skin and eyes due to high levels of bilirubin?

Jaundice Signup and view all the answers

What can pale skin indicate in a patient?

Anemia Signup and view all the answers

What causes brown spots on the skin?

Overproduction of melanin Signup and view all the answers

What skin discoloration occurs when the kidneys fail to excrete toxins properly?

Uremic frost Signup and view all the answers

Which skin abnormality is characterized by localized benign proliferations of melanocytes?

Blue nevi Signup and view all the answers

What is the term for the rounded, swollen facial appearance often seen in patients with obesity or Cushing's syndrome?

Moon facies Signup and view all the answers

Which of the following can cause skin discoloration due to the retention of urochromes?

Kidney dysfunction Signup and view all the answers

What type of blue nevi is more than 1 cm and may resemble nodular melanoma?

Cellular blue nevi Signup and view all the answers

What aspect of the patient's appearance should be noted during the general examination?

General appearance, symmetry, gait, and mobility Signup and view all the answers

What is a possible impact of observing a patient in a wheelchair during the examination?

It could affect oral hygiene and dental treatment procedures. Signup and view all the answers

How should significant asymmetries be assessed in a patient?

By comparing one side of the head and neck to the other while standing in front of the patient Signup and view all the answers

What might decreased mobility of the head and neck indicate during the examination?

Potential difficulty in performing dental procedures. Signup and view all the answers

Which of the following is NOT a key area of examination in the extraoral assessment?

Patient's dietary habits Signup and view all the answers

What should a clinician do if they notice facial asymmetries during the examination?

Inquire if the patient knows the cause of the asymmetry. Signup and view all the answers

Why is it important to consider a patient’s medical history during a dental examination?

It may influence necessary adjustments for dental procedures. Signup and view all the answers

What is the primary focus of the extraoral head and neck soft tissue examination?

To determine if soft tissue is within normal limits Signup and view all the answers

What is a characteristic facial appearance of individuals with Down syndrome?

Flattened face and upslanting palpebral fissures Signup and view all the answers

Which of the following features is NOT found in nearly every person with Down syndrome?

High cheekbones Signup and view all the answers

What distinguishes kwashiorkor from marasmus?

Presence of edema in kwashiorkor Signup and view all the answers

Malar rash is characterized by a pattern that covers which areas?

Cheeks and bridge of the nose Signup and view all the answers

Scaly skin can result from various environmental factors; which factor is NOT commonly associated with skin desquamation?

Nutritional deficiency Signup and view all the answers

What common condition can lead to skin desquamation accompanied by itching?

Allergic reaction Signup and view all the answers

Red spots or rash can be caused by numerous dermatological issues; which of the following is not a cause listed?

High blood pressure Signup and view all the answers

Which feature is characteristic of face malnutrition, particularly in acute forms?

Cold and relaxed lips Signup and view all the answers

Study Notes

Oral Examination of the Patient

A complete examination covers the head and neck, the general appearance, and extraoral head and neck soft tissue examination.

General Examination

Observe the patient's general appearance, symmetry, gait, and mobility as they enter the operatory and during the history taking.
Note any facial asymmetries, lesions, or scars.
A patient's wheelchair use, stroke history, or medications can affect treatment and need to be noted for proper dental care.
Assess for adequate oral hygiene and mobility of the head and neck for patient tolerance of dental procedures.

Extraoral Head and Neck Soft Tissue Examination

Focuses on the head and neck.
Determines if soft tissue is within normal limits (WNL).

Intraoral Soft Tissue Examination

Determines if the intraoral soft tissue is within normal limits (WNL).

Asymmetries

Observe the head and neck for asymmetries by standing in front of the patient.
Compare one side of the head and neck to the other.
Note any significant asymmetries, such as previous surgeries, nerve paralysis (e.g., CVA/stroke), tumors, or infections.

Abnormal Facial Color

Examine the patient's exposed skin, including the face.
Look for petechiae, ecchymosis, or hematomas, which may indicate bleeding disorders.
Yellowish skin may suggest jaundice or liver problems, while clubbing of the fingers may indicate heart or respiratory issues.
Other skin conditions like vitiligo, melasma (chloasma), or pigmentation alteration (post-inflammatory hyper- or hyperpigmentation) should be noted.
Consider the patient's medical history for possible causes of discoloration.

Facial Features - Moon Facies

Swollen rounded face shape, extra fat on the sides.
Often related to Cushing's syndrome (high cortisol levels).
Can be caused by increased hormone release (cortisol), specifically from the adrenal glands.
Associated conditions include pituitary gland problems and tumors of the lung, pancreas, or thymus; or benign tumors/cancers in the adrenal glands.

Moon Facies and Steroid Treatment

Long-term steroid use (like prednisone) can lead to similar symptoms as Cushing's Syndrome, including moon face due to weight gain and redistribution of fat.
Should consult regarding steroid use, dose, and duration.

Facial Features - Additional Aspects

Assess and note features such as:
- Scaly skin (desquamation) from environmental factors, allergies, infections, or other medical conditions.
- Red spots/rash that can stem from infections, allergens, immune system disorders, or medications.
- Skin moles, especially if changes in size, shape, or color are noted, could be abnormal.
- Note presence of edema, and any other unusual characteristics of the skin for possible issues.
Assess other facial features like eyes (size, shape, and placement), mouth (lip shape, and philtrum), nose (size, and shape).
- Down syndrome characteristics such as flattened face with epicanthic folds, upslanting palpebral fissures and a brachycephalic (smaller) head.
- Malar rash (butterfly rash) on the cheeks and nose.
Assess for any signs of malnutrition, such as a face of malnourishment which has specific observable facial characteristics

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Description

This quiz covers key concepts related to dermatological conditions such as vitiligo and melasma, along with hormonal influences like cortisol levels and moon facies. Test your knowledge on the diagnosis and characteristics of these conditions, their treatments, and the factors affecting pigmentation changes.