22 Questions
What is the primary function of the skin in terms of thermoregulation?
Regulation of body temperature through sweating
A patient presents with a round-to-oval crusted or scaly erythematous plaque on their arm. What is the most likely diagnosis?
Nummular dermatitis
What is the primary mode of transmission of MRSA?
Direct skin-to-skin contact
A patient is diagnosed with folliculitis and is prescribed antibiotics. What is the primary goal of antibiotic treatment in this case?
To eliminate the bacterial infection
A patient presents with a papule that is studded with vesicles containing serous exudate. What is the most likely diagnosis?
Nummular dermatitis
What is the primary difference between an erosion and an ulcer?
Depth of the lesion
What is the primary trigger for Bullous Pemphigoid?
Pharmacologic agents
What is the most common topical steroid used to treat Stasis Dermatitis?
Triamcinolone
What is the primary risk factor for developing skin ulcers in Stasis Dermatitis?
Venous insufficiency
What is the differential diagnosis for Stasis Dermatitis that is never bilateral?
Cellulitis
What is the recommended treatment for Bullous Pemphigoid to promote healing and reduce itching?
Topical steroids
What is the primary consideration when suspecting DVT in Stasis Dermatitis?
Ordering a STAT doppler
What is the estimated percentage of patients with chronic urticaria whose causes are unknown?
80-90%
Which of the following is a characteristic of urticarial vasculitis?
Lesions that leave residual hyperpigmentation
What is the primary treatment for chronic urticaria?
H1 antihistamines
What is the underlying defect in mastocytosis?
Defect in the KIT gene
What is the characteristic distribution of lesions in seborrheic dermatitis?
T-zone of the face, scalp, and central chest
What is the estimated percentage of psoriasis patients who have psoriatic arthritis?
10%
What is Koebner's phenomenon?
A phenomenon where non-specific trauma can lead to formation of psoriasis in the area of irritation
What is the primary treatment for inverse psoriasis?
Topical calcineurin inhibitors
What is the characteristic distribution of lesions in tinea pedis?
Moccasin distribution
What is the primary diagnostic test for tinea pedis?
KOH prep
Study Notes
Structure and Function of Skin
- Barrier against fluid loss
- Protection from ultraviolet radiation
- Thermoregulation
- Cushioning
- Immunologic protection
- Appearance
Dermatologic Terminology
- Macule: flat (nonpalpable), < 1cm in size
- Patch: flat (nonpalpable), > 1cm in size
- Papule: raised, < 1cm in size
- Plaque: raised (a broad papule), > 1cm in size
- Nodule: similar to a papule but > 1cm and located in the dermis or subcutaneous fat
- Vesicle: fluid-filled, < 1cm in size
- Bulla: fluid-filled, > 1cm in size
- Wheal (hive): edematous papule or plaque that usually lasts < 24 hours
- Scale: dry or greasy laminated masses of keratin
- Crust: dried serum, pus, or blood
- Fissure: a linear cleft through the epidermis or into the dermis
- Erosion: loss of all or portions of the epidermis alone, heals without scarring
- Ulcer: complete loss of the epidermis and some portion of the dermis, heals with scarring
Common Skin Disorders
Nummular Dermatitis
- Etiology: unknown
- 2 peaks of age distribution: 2nd to 3rd decade and 6th to 7th decade of life
- Presentation: round-to-oval crusted or scaly erythematous plaques on arms and legs
- Lesions often symmetrically distributed
- Treatment: topical steroids, moisturization
Contact Dermatitis
- Etiology: allergic or irritant reactions
- Presentation: erythema, pruritus, burning, and vesiculation
- Treatment: topical steroids, moisturization
Urticaria
- Etiology: unknown in > 60% of cases
- Known causes include: infections, foods, drugs, environmental factors, and emotional stress
- Presentation: blanching, raised, palpable wheals
- Treatment: H1 antihistamines, H2 antihistamines for severe or persistent urticaria
Seborrheic Dermatitis
- Etiology: related to a pathologic overproduction of sebum
- Presentation: erythema with greasy yellowish scale on the “T-zone” of the face, scalp, and chest
- Treatment: shampooing, topical corticosteroids, antifungal agents
Psoriasis
- Etiology: multifactorial disease influenced by genetic and immune-mediated components
- Presentation: red papules and plaques with adherent silvery scale
- Triggers: physical trauma, stress, infection, pregnancy, medications
- Treatment: topical corticosteroids, vitamin D analogs, topical calcineurin inhibitors
Tinea Pedis
- Etiology: dermatophyte infection of the soles of the feet and interdigital spaces
- Presentation: pruritic, scaling in a moccasin distribution, often with painful fissures between the toes
- Treatment: topical Azoles, topical Allylamines, Castellani’s paint
Test your knowledge on the structure and function of skin in older adults, including its role in barrier protection, thermoregulation, and immunologic protection. Learn key dermatologic terminology, such as macule, patch, papule, and plaque, and recognize common skin disorders affecting older adults.
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