Podcast
Questions and Answers
What percentage of total body surface area best estimates the extent of burns for the 52-year-old woman?
What percentage of total body surface area best estimates the extent of burns for the 52-year-old woman?
What is the recommended method of burn assessment in children?
What is the recommended method of burn assessment in children?
Lund-Browder chart
Which historical element is most likely to be obtained upon further questioning for the patient with a rash?
Which historical element is most likely to be obtained upon further questioning for the patient with a rash?
Is the rash of pityriasis rosea contagious?
Is the rash of pityriasis rosea contagious?
Signup and view all the answers
Which of the following is the most likely diagnosis for the patient with a solitary nodule in the axilla?
Which of the following is the most likely diagnosis for the patient with a solitary nodule in the axilla?
Signup and view all the answers
What is another name for hidradenitis suppurativa?
What is another name for hidradenitis suppurativa?
Signup and view all the answers
What is the most appropriate next step in management for a patient with thickened and discolored toenails?
What is the most appropriate next step in management for a patient with thickened and discolored toenails?
Signup and view all the answers
What is the most common etiology of onychomycosis?
What is the most common etiology of onychomycosis?
Signup and view all the answers
Which of the following is the most likely diagnosis for a patient with a diffuse papulosquamous rash following a herald patch?
Which of the following is the most likely diagnosis for a patient with a diffuse papulosquamous rash following a herald patch?
Signup and view all the answers
Which of the following presents with an annular plaque with central clearing?
Which of the following presents with an annular plaque with central clearing?
Signup and view all the answers
Which infection is most commonly associated with erythema multiforme?
Which infection is most commonly associated with erythema multiforme?
Signup and view all the answers
What is the treatment of choice in those who develop erythema multiforme?
What is the treatment of choice in those who develop erythema multiforme?
Signup and view all the answers
Which statement is true about the condition of recurrent skin infections along the axilla?
Which statement is true about the condition of recurrent skin infections along the axilla?
Signup and view all the answers
What medications may be used in the treatment of hidradenitis suppurativa?
What medications may be used in the treatment of hidradenitis suppurativa?
Signup and view all the answers
What is the best treatment for perioral dermatitis?
What is the best treatment for perioral dermatitis?
Signup and view all the answers
What is the recommended systemic treatment for perioral and periorbital dermatitis?
What is the recommended systemic treatment for perioral and periorbital dermatitis?
Signup and view all the answers
Which management represents the best course for herpetic whitlow?
Which management represents the best course for herpetic whitlow?
Signup and view all the answers
Which groups of patients are at increased risk of developing herpetic whitlow?
Which groups of patients are at increased risk of developing herpetic whitlow?
Signup and view all the answers
What is the indicated management for a 17-year-old male with a scaly rash and itch?
What is the indicated management for a 17-year-old male with a scaly rash and itch?
Signup and view all the answers
What is the most likely diagnosis for a 3-week-old term girl with a worsening rash that has been present since birth?
What is the most likely diagnosis for a 3-week-old term girl with a worsening rash that has been present since birth?
Signup and view all the answers
What is a known, transient complication of seborrheic dermatitis in dark-pigmented infants?
What is a known, transient complication of seborrheic dermatitis in dark-pigmented infants?
Signup and view all the answers
Which piece of patient education should be given for managing vesiculobullous hand eczema?
Which piece of patient education should be given for managing vesiculobullous hand eczema?
Signup and view all the answers
What is the most likely diagnosis for an 11-year-old girl with a scaly red patch that has spread outward?
What is the most likely diagnosis for an 11-year-old girl with a scaly red patch that has spread outward?
Signup and view all the answers
What kind of agar is used to grow dermatophytes in culture?
What kind of agar is used to grow dermatophytes in culture?
Signup and view all the answers
Which burn causes pressure and discomfort, extends into dermis, and may have thick-walled blisters?
Which burn causes pressure and discomfort, extends into dermis, and may have thick-walled blisters?
Signup and view all the answers
Can succinylcholine be used for rapid sequence intubation in an acute burn patient?
Can succinylcholine be used for rapid sequence intubation in an acute burn patient?
Signup and view all the answers
What represents the appropriate management of a 17-year-old girl with a fluctuant axillary swelling?
What represents the appropriate management of a 17-year-old girl with a fluctuant axillary swelling?
Signup and view all the answers
Why is trimethoprim-sulfamethoxazole (TMP-SMX) a poor choice for treating cellulitis?
Why is trimethoprim-sulfamethoxazole (TMP-SMX) a poor choice for treating cellulitis?
Signup and view all the answers
What is the most likely diagnosis for a rash on a 66-year-old woman that is painful and blistering?
What is the most likely diagnosis for a rash on a 66-year-old woman that is painful and blistering?
Signup and view all the answers
What finding is indicative of corneal ocular involvement in zoster ophthalmicus?
What finding is indicative of corneal ocular involvement in zoster ophthalmicus?
Signup and view all the answers
Which louse is responsible for lice infestation of the head and scalp?
Which louse is responsible for lice infestation of the head and scalp?
Signup and view all the answers
What medication is indicated for the treatment and prevention of head lice and scabies?
What medication is indicated for the treatment and prevention of head lice and scabies?
Signup and view all the answers
What is the most likely diagnosis for a 32-year-old man with a rash after yard work?
What is the most likely diagnosis for a 32-year-old man with a rash after yard work?
Signup and view all the answers
What is the recommended treatment for dyshidrotic eczematous dermatitis?
What is the recommended treatment for dyshidrotic eczematous dermatitis?
Signup and view all the answers
Why should fluorodinated corticosteroids not be applied to the face?
Why should fluorodinated corticosteroids not be applied to the face?
Signup and view all the answers
Which of the following is the most likely etiology of the disease in a woman with high fevers, severe headaches, and a rash?
Which of the following is the most likely etiology of the disease in a woman with high fevers, severe headaches, and a rash?
Signup and view all the answers
What is the treatment of choice for Rocky Mountain Spotted Fever in the pediatric population?
What is the treatment of choice for Rocky Mountain Spotted Fever in the pediatric population?
Signup and view all the answers
Which of the following diseases presents with small grouped vesicles on an erythematous base?
Which of the following diseases presents with small grouped vesicles on an erythematous base?
Signup and view all the answers
What is the treatment for herpes simplex?
What is the treatment for herpes simplex?
Signup and view all the answers
What management is indicated for a man with herpes zoster presenting with chest pain?
What management is indicated for a man with herpes zoster presenting with chest pain?
Signup and view all the answers
When are patients with herpes zoster considered to no longer be infectious?
When are patients with herpes zoster considered to no longer be infectious?
Signup and view all the answers
What is the most likely diagnosis for a woman with flesh-colored, non-tender, papillary growths in the genital area?
What is the most likely diagnosis for a woman with flesh-colored, non-tender, papillary growths in the genital area?
Signup and view all the answers
Which medications commonly used to treat condyloma acuminata should be avoided during pregnancy?
Which medications commonly used to treat condyloma acuminata should be avoided during pregnancy?
Signup and view all the answers
What is the cause of a rash consistent with shingles in a patient presenting with back pain, headache, and cough?
What is the cause of a rash consistent with shingles in a patient presenting with back pain, headache, and cough?
Signup and view all the answers
What is the most common location for zoster to occur in?
What is the most common location for zoster to occur in?
Signup and view all the answers
What treatment is indicated for a patient with tinea corporis?
What treatment is indicated for a patient with tinea corporis?
Signup and view all the answers
What is the most common serious side effect of treatment with oral ketoconazole?
What is the most common serious side effect of treatment with oral ketoconazole?
Signup and view all the answers
What is the next best step in managing a patient bitten by a stray cat?
What is the next best step in managing a patient bitten by a stray cat?
Signup and view all the answers
How is a previously vaccinated person who has had a potential rabies exposure treated?
How is a previously vaccinated person who has had a potential rabies exposure treated?
Signup and view all the answers
What is the most likely diagnosis for a man with purple-brownish plaques on his feet?
What is the most likely diagnosis for a man with purple-brownish plaques on his feet?
Signup and view all the answers
What is the appropriate treatment for Iatrogenic Immunosuppression-Associated Kaposi sarcoma?
What is the appropriate treatment for Iatrogenic Immunosuppression-Associated Kaposi sarcoma?
Signup and view all the answers
Which of the following sutures is absorbable?
Which of the following sutures is absorbable?
Signup and view all the answers
What has a greater risk of infection, cutaneous or subcutaneous sutures?
What has a greater risk of infection, cutaneous or subcutaneous sutures?
Signup and view all the answers
What is the most likely diagnosis for a woman with chronic, pruritic papulovesicular lesions and Celiac disease?
What is the most likely diagnosis for a woman with chronic, pruritic papulovesicular lesions and Celiac disease?
Signup and view all the answers
Which gender predominates in newly diagnosed cases of Celiac disease?
Which gender predominates in newly diagnosed cases of Celiac disease?
Signup and view all the answers
Which method is optimal for rewarming a frostbitten extremity?
Which method is optimal for rewarming a frostbitten extremity?
Signup and view all the answers
What is the phenomenon of 'core temperature after-drop' in frostbite management?
What is the phenomenon of 'core temperature after-drop' in frostbite management?
Signup and view all the answers
Which diagnostic test will confirm the suspected diagnosis of scabies?
Which diagnostic test will confirm the suspected diagnosis of scabies?
Signup and view all the answers
What is the first line medication for the treatment of scabies?
What is the first line medication for the treatment of scabies?
Signup and view all the answers
What is the expected finding on physical examination for a patient with Lyme disease after a tick bite?
What is the expected finding on physical examination for a patient with Lyme disease after a tick bite?
Signup and view all the answers
What is a common complication within 24 hours of initiation of antibiotic treatment of Lyme disease?
What is a common complication within 24 hours of initiation of antibiotic treatment of Lyme disease?
Signup and view all the answers
What is the most likely etiology of toenail discoloration in a 66-year-old man?
What is the most likely etiology of toenail discoloration in a 66-year-old man?
Signup and view all the answers
What structure does the fungi invade first to gain access to the nail bed?
What structure does the fungi invade first to gain access to the nail bed?
Signup and view all the answers
What is the likely diagnosis for an eight-year-old girl with itchy bumps on her legs after insect bites?
What is the likely diagnosis for an eight-year-old girl with itchy bumps on her legs after insect bites?
Signup and view all the answers
What is the family of mosquitoes that most commonly inflict insect bites?
What is the family of mosquitoes that most commonly inflict insect bites?
Signup and view all the answers
What baseline screening test is recommended prior to starting a patient on hydroxychloroquine for lupus?
What baseline screening test is recommended prior to starting a patient on hydroxychloroquine for lupus?
Signup and view all the answers
What is the most common complaint of patients with lupus?
What is the most common complaint of patients with lupus?
Signup and view all the answers
Which pathogen is most frequently implicated in erysipelas?
Which pathogen is most frequently implicated in erysipelas?
Signup and view all the answers
What bacteria has a gram stain showing gram-positive cocci in chains?
What bacteria has a gram stain showing gram-positive cocci in chains?
Signup and view all the answers
Which statement is true regarding a 16-year-old boy presenting with symptoms ofsecondary syphilis?
Which statement is true regarding a 16-year-old boy presenting with symptoms ofsecondary syphilis?
Signup and view all the answers
What are the manifestations of tertiary syphilis?
What are the manifestations of tertiary syphilis?
Signup and view all the answers
What is the maximum amount of 1% lidocaine without epinephrine that can be used for a child weighing 15 kg?
What is the maximum amount of 1% lidocaine without epinephrine that can be used for a child weighing 15 kg?
Signup and view all the answers
What are some methods to decrease pain associated with injection of lidocaine?
What are some methods to decrease pain associated with injection of lidocaine?
Signup and view all the answers
Which of the following is the most likely diagnosis?
Which of the following is the most likely diagnosis?
Signup and view all the answers
Which microbes would be necessary to empirically cover for in choosing an antibiotic treatment for uncomplicated cellulitis?
Which microbes would be necessary to empirically cover for in choosing an antibiotic treatment for uncomplicated cellulitis?
Signup and view all the answers
Which of the following anesthetics is a suitable alternative to lidocaine for a patient allergic to it?
Which of the following anesthetics is a suitable alternative to lidocaine for a patient allergic to it?
Signup and view all the answers
What is another name for procaine?
What is another name for procaine?
Signup and view all the answers
Which of the following is the most likely diagnosis for a 34-year-old woman with patches of pale skin?
Which of the following is the most likely diagnosis for a 34-year-old woman with patches of pale skin?
Signup and view all the answers
What tool may be helpful for identifying vitiligo in lightly pigmented individuals?
What tool may be helpful for identifying vitiligo in lightly pigmented individuals?
Signup and view all the answers
Which of the following is the most likely causative agent for hand-foot-and-mouth disease?
Which of the following is the most likely causative agent for hand-foot-and-mouth disease?
Signup and view all the answers
What is the classic dermatologic finding of tertiary syphilis?
What is the classic dermatologic finding of tertiary syphilis?
Signup and view all the answers
Which of the following is associated with an erythematous rash and caused by a bacterial infection?
Which of the following is associated with an erythematous rash and caused by a bacterial infection?
Signup and view all the answers
What is the name and causative agent of the fifth common childhood exanthemous disease?
What is the name and causative agent of the fifth common childhood exanthemous disease?
Signup and view all the answers
Which of the following lesion characteristics is most concerning for melanoma?
Which of the following lesion characteristics is most concerning for melanoma?
Signup and view all the answers
What are the most common sites of metastatic disease with melanoma?
What are the most common sites of metastatic disease with melanoma?
Signup and view all the answers
Which organism is most likely responsible for a bright red, painful, well-demarcated rash on the face?
Which organism is most likely responsible for a bright red, painful, well-demarcated rash on the face?
Signup and view all the answers
What is the treatment of choice for erysipelas caused by methicillin-resistant Staphylococcus aureus?
What is the treatment of choice for erysipelas caused by methicillin-resistant Staphylococcus aureus?
Signup and view all the answers
Which of the following is the first-line treatment for scabies?
Which of the following is the first-line treatment for scabies?
Signup and view all the answers
For non-crusted scabies, how should permethrin cream be applied?
For non-crusted scabies, how should permethrin cream be applied?
Signup and view all the answers
Which of the following is concerning for melanoma?
Which of the following is concerning for melanoma?
Signup and view all the answers
What is the prognostic indicator of a melanoma lesion?
What is the prognostic indicator of a melanoma lesion?
Signup and view all the answers
Which of the following oral antibiotics will cover community-acquired methicillin-resistant Staphylococcus aureus (MRSA)?
Which of the following oral antibiotics will cover community-acquired methicillin-resistant Staphylococcus aureus (MRSA)?
Signup and view all the answers
For what indication is oral vancomycin most useful?
For what indication is oral vancomycin most useful?
Signup and view all the answers
What is the most likely diagnosis of a small flesh-colored nodule with a pearly border?
What is the most likely diagnosis of a small flesh-colored nodule with a pearly border?
Signup and view all the answers
Does smoking increase the risk of basal cell carcinoma?
Does smoking increase the risk of basal cell carcinoma?
Signup and view all the answers
Study Notes
Pityriasis Rosea
- Presenting symptoms include a mildly pruritic rash on the back and trunk, spreading over a week.
- Characterized by a herald patch (2 to 5 cm erythematous oval plaque) preceding diffuse rash.
- Rash follows a "Christmas tree" pattern, adhering to skin cleavage lines.
- Self-limited course, typically lasting 4 to 7 weeks without treatment, though antihistamines may relieve itching.
- History of travel to Southeast USA raises concern for infectious etiologies like Rocky Mountain Spotted Fever.
Hidradenitis Suppurativa (HS)
- Chronic skin condition with recurrent painful nodules in intertriginous areas (e.g., axilla).
- Associated with scarring, keloids, and mechanical stress; more frequent in obese individuals and smokers.
- Initial presentation includes erythema; lesions can form sinus tracts and comedomes over time.
- Treatment includes a combination of medical management and surgical intervention for abscesses.
Onychomycosis
- A fungal nail infection with forms including distal subungual onychomycosis.
- Initial symptoms may cause pain and disfigurement; diagnosis confirmed by potassium hydroxide examination of nail scrapings.
- First-line treatment for confirmed cases is oral terbinafine, but liver function tests should be monitored due to hepatotoxic risks.
Erythema Multiforme (EM)
- Often triggered by herpes simplex virus (HSV), leading to lesion symptoms including macules and target-like formations.
- Characterized by symmetrical rash distribution and often affects palms and dorsal surfaces of hands/feet.
- Management typically involves supportive care, including antihistamines and pain relief.
Perioral Dermatitis
- Defined by erythematous micro-papules around the mouth with potential itching and burning.
- Best treated with metronidazole gel; topical steroids may exacerbate the condition.
- Recommended systemic treatment includes oral tetracyclines like doxycycline.
Herpetic Whitlow
- Localized herpes simplex virus infection presenting as painful, vesicular lesions on fingertips.
- Analysis and clean dressing provide initial care, with topical acyclovir potentially shortening illness duration.
Atopic Dermatitis (AD)
- Characterized by itchy, scaly rash with potential chronicity; most common in flexural areas of the body.
- Effective management includes topical corticosteroids to reduce inflammation and itching.
- Associated with a history of asthma and can be exacerbated by environmental factors.
Rocky Mountain Spotted Fever (RMSF)
- Tick-borne illness caused by Rickettsia rickettsii, prevalent in parts of North America.
- Characterized by high fever, headaches, and a maculopapular rash starting on wrists and ankles, progressing to trunk.
- Immediate antibiotic treatment is crucial, particularly with febrile presentations in endemic regions.### Rocky Mountain Spotted Fever (RMSF)
- RMSF presents with fever, petechial rash, and vomiting after tick exposure.
- Doxycycline is the first-line antibiotic therapy, initiated before laboratory confirmation.
- Doxycycline is effective against Lyme disease, ehrlichiosis, and relapsing fever.
- Treatment should start immediately to improve outcomes.
Tick-Borne Illnesses
- Babesiosis: Characterized by influenza-like symptoms, hemolytic anemia, jaundice, and renal failure.
- Ehrlichiosis: Presents with fever, chills, cough, malaise, and headache; rash is less common than in RMSF.
Herpes Simplex Virus
- Herpes simplex presents as small grouped vesicles on an erythematous base (dew drop on a rose petal).
- HSV-1 causes oral lesions; HSV-2 is primarily linked to genital lesions.
- Common treatments include acyclovir, valacyclovir, and famciclovir.
Herpes Zoster (Shingles)
- Caused by reactivation of the varicella-zoster virus; risks increase with age.
- Symptoms include burning pain, rash in a dermatomal distribution, and potential postherpetic neuralgia.
- Antiviral therapy is recommended to reduce pain and hasten recovery.
- Patients are non-infectious when zoster lesions are crusted over.
Condyloma Acuminata (Genital Warts)
- Caused by HPV types 6 and 11; presents as non-tender, flesh-colored, papillary growths.
- Often treated with trichloroacetic acid, cryotherapy, or surgical excision.
- Avoid podophyllin and imiquimod during pregnancy.
Tinea Corporis (Ringworm)
- Causes annular, erythematous lesions with central clearing; treated with topical antifungals like clotrimazole.
- Transmission occurs via person-to-person contact; the condition is often misdiagnosed.
Animal Bites
- Cat bites require irrigation, open drainage, and amoxicillin-clavulanate prophylaxis due to infection risks.
- Post-exposure rabies prophylaxis is required based on the exposure type.
Kaposi Sarcoma (KS)
- A systemic tumor associated with human herpesvirus 8, presenting with purplish skin lesions.
- Diagnosis confirmed through skin biopsy; treatment may include radiotherapy or chemotherapy.
Sutures in Surgery
- Vicryl is an absorbable suture; good for subcutaneous and mucosal closures.
- Nonabsorbable sutures include nylon, prolene, and silk, which are less reactive.
Dermatitis Herpetiformis
- Indicative of Celiac disease, manifests as pruritic, papulovesicular lesions primarily on extensor surfaces.
- Resolves with a gluten-free diet; diagnosis confirmed via immunofluorescence biopsy.
Celiac Disease
- Predominantly diagnosed in women, comprising 75% of new cases.
Histamine Fish Poisoning
- Symptoms arise from consuming improperly stored fish, leading to flushing, headache, and palpitations.
- Fast onset of symptoms typically occurs within one hour of eating the affected fish.
Seborrheic Dermatitis
- Common in infants, characterized by greasy, salmon-colored patches with yellow scales.
- Typically asymptomatic and self-limiting; may require topical corticosteroids for severe cases.### Erythema Toxicum
- Extremely common benign rash in neonates.
- Manifests as blotchy macules and papules, typically on face, trunk, and proximal extremities.
- Appearance described as "flea-bitten," not flaky.
- Lesions fade within 5-7 days but may recur for several weeks.
Seborrheic Dermatitis in Infants
- Transient complication includes postinflammatory hypopigmentation.
- Particularly noted in dark-pigmented infants.
Dyshidrotic Eczematous Dermatitis
- Presents as intensely itchy hands with tapioca-grain-like vesicles.
- Common in adults, often linked to a history of atopy.
- Treatment involves topical corticosteroids and educating patients to avoid prolonged water exposure.
- Patients may need to wear cotton-lined vinyl gloves and regularly apply moisturizers post-hand washing.
Tinea Corporis
- Diagnosis based on classic erythematous, raised, and scaly plaques that clear in the center.
- Exam of the entire body surface area is important for multiple lesions.
- First-line treatment is a topical azole antifungal.
- Confirmation can be achieved using KOH preparation of skin scrapings.
Burn Classification
- Second-degree deep partial thickness burns extend into the reticular dermis.
- Characterized by pressure, discomfort, leathery white appearance, and thick-walled blisters.
- Healing time varies; superficial partial thickness burns usually heal in 7-10 days, while deep partial thickness burns take 3-6 weeks.
Frostbite Management
- Gentle, active rewarming is essential using warm circulating water (37°C - 39°C).
- Signs of frostbite include erythema, blisters, and decreased sensation.
- Avoid hot water or passive warming methods as they may cause further injury.
Scabies Diagnosis and Treatment
- Confirmed via skin scraping and microscopy to visualize mites or feces.
- Permethrin 5% cream is the first-line treatment.
- Commonly presents with severe itching, particularly at night, and burrows in skin folds.
Lyme Disease
- Caused by Borrelia burgdorferi, transmitted by Ixodes dammini ticks.
- Early manifestation includes erythema migrans, characterized by an annular erythematous patch with central clearing.
- Empiric treatment includes doxycycline; alternatives for pregnant women or young children include amoxicillin.
- Common complication of antibiotic treatment is the Jarisch-Herxheimer reaction.
Onychomycosis
- Distal lateral subungual onychomycosis is primarily caused by Trichophyton rubrum.
- Symptoms often present as thickened, yellow-brown toenails.
Dermatophyte Culture
- Sabouraud's agar is the medium used for growing dermatophytes in culture.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge with these dermatology flashcards focusing on clinical case presentations. Each card presents a real-world scenario that requires you to identify historical elements and differential diagnoses related to dermatologic conditions. Perfect for medical students and professionals honing their skills in dermatology.
