Derm1

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary method of transmission for scabies?

Contaminated food or water

Direct physical contact (correct)

Vector-borne transmission

Airborne respiratory droplets

Which of the following is NOT a symptom of scabies?

Burrows in the skin

Pimple-like rash

Intense itching, especially at night

High fever (correct)

What is the preferred first-line treatment for scabies in adults?

Systemic antifungal medication

Topical permethrin 5% lotion (correct)

Topical hydrocortisone cream

Oral antibiotics

Which area of the body is most commonly affected by scabies burrows?

Interdigital folds Signup and view all the answers

When diagnosing scabies, which of the following methods is essential?

Direct visualization of mites or their feces Signup and view all the answers

What specific precaution should be taken following a diagnosis of scabies in a household?

All household contacts should be treated even if asymptomatic Signup and view all the answers

Which symptom is pathognomonic for measles?

Koplik spots Signup and view all the answers

What is the gold standard for diagnosing measles?

Detection of Measles-specific IgM antibodies Signup and view all the answers

What role does Vitamin A supplementation play in measles treatment?

Reduces morbidity and mortality Signup and view all the answers

For how long should a patient with measles be isolated from the onset of rash?

4 days Signup and view all the answers

Which of the following is NOT a common symptom of measles?

Excessive sweating Signup and view all the answers

In a patient with measles, which precaution should be initiated if they are hospitalized?

Airborne precautions Signup and view all the answers

What is a potential complication of measles that Vitamin A supplementation helps mitigate?

Pneumonia Signup and view all the answers

What is the primary method used for confirming the diagnosis of Tinea Versicolor in the mentioned case?

Potassium hydroxide preparation Signup and view all the answers

Which statement regarding measles vaccination is accurate?

Live attenuated vaccines are used for prevention Signup and view all the answers

What characteristic feature of the lesions observed in the 13-year-old boy is indicative of Tinea Versicolor?

Fine scaling upon scraping Signup and view all the answers

Which treatment option is NOT typically indicated for Tinea Versicolor?

Topical corticosteroids Signup and view all the answers

In the case of the 10-year-old girl, what additional symptom prior to the rash could be a significant indicator of a viral etiology?

Malaise Signup and view all the answers

Which of the following findings would support the diagnosis of Pityriasis Rosea rather than Tinea Versicolor?

Presence of a herald patch Signup and view all the answers

During the examination of the 13-year-old boy, if the lesions were described as oval and arranged in a Christmas tree pattern, which diagnosis would be more appropriate?

Pityriasis Rosea Signup and view all the answers

What is a significant complication associated with measles in infants and young children?

Increased risk for encephalitis Signup and view all the answers

Which symptom is typically associated with acute measles infection?

Conjunctivitis Signup and view all the answers

What is the preferred method for confirming a diagnosis of tinea versicolor?

Potassium hydroxide (KOH) preparation Signup and view all the answers

What treatment modality is considered first-line for tinea versicolor?

Topical antifungals Signup and view all the answers

In the case of the 5-year-old boy diagnosed with measles, what immediate step should be taken?

Obtain a viral culture Signup and view all the answers

Which characteristic skin lesion might be found in a patient with tinea versicolor?

Flat, hypopigmented macules Signup and view all the answers

What underlying health condition does the 21-year-old man have that may impact his dermatological health?

Type 1 diabetes mellitus Signup and view all the answers

What symptom is indicative of severe dehydration seen in the 5-year-old boy?

Dry mucous membranes Signup and view all the answers

What type of rash is typically associated with measles?

Erythematous maculopapular rash Signup and view all the answers

What pattern of skin lesions would most likely be seen in a potassium hydroxide preparation for tinea versicolor?

Spaghetti-and-meatballs Signup and view all the answers

What triggers the immunological response in scabies?

Mite secretions and decomposing bodies Signup and view all the answers

Which symptom is least likely to be experienced by a patient with scabies?

High fever Signup and view all the answers

Which area is typically not a predilection site for scabies infestation?

Elbows Signup and view all the answers

What is the recommended treatment for scabies in a case where topical permethrin is contraindicated?

Oral ivermectin Signup and view all the answers

Which statement regarding the diagnosis of scabies is accurate?

Direct visualization of mites or their feces is necessary. Signup and view all the answers

What is the primary preventive measure recommended for scabies spread within a household?

Treatment of all contacts even if asymptomatic Signup and view all the answers

In which condition is a child with eczema more likely to be at risk for developing scabies?

Weakened skin barrier function Signup and view all the answers

What is the duration of the intense itching experienced by a patient diagnosed with scabies?

It intensifies at night. Signup and view all the answers

What key characteristics must be evaluated in a skin lesion to assess for malignant melanoma?

Asymmetry and irregular borders Signup and view all the answers

For the diagnosis of malignant melanoma, which procedure is considered definitive?

Skin biopsy Signup and view all the answers

What is a significant factor influencing the prognosis of malignant melanoma?

Breslow thickness of the tumor Signup and view all the answers

Which physical findings might suggest a diagnosis of squamous cell carcinoma rather than malignant melanoma?

Nonhealing, bleeding ulceration Signup and view all the answers

In assessing a skin lesion for possible malignancy, which feature is least indicative of an immediate concern?

Lack of any sensation (pain or itch) Signup and view all the answers

What is a significant complication associated with measles that could affect the central nervous system?

Encephalitis Signup and view all the answers

Which of the following sign patterns would suggest a diagnosis of tinea versicolor upon examination?

Spaghetti-and-meatballs pattern in KOH preparation Signup and view all the answers

In the case of the 5-year-old boy with measles, which symptom indicates severe dehydration?

Decreased skin turgor Signup and view all the answers

What is the recommended first-line treatment for tinea versicolor?

Selenium sulfide lotion Signup and view all the answers

What systemic condition does the 21-year-old man have that may alter his symptoms of a rash?

Type 1 diabetes mellitus Signup and view all the answers

Which symptom is commonly associated with the diagnosis of measles in children?

Coryza Signup and view all the answers

What should be the immediate next step in the management of a patient diagnosed with measles?

Obtain a viral culture Signup and view all the answers

What immune response complication can occur in patients with tinea versicolor?

Hyperpigmentation Signup and view all the answers

What key indicator about the rashes can help distinguish measles from tinea versicolor?

Blanching maculopapular rash Signup and view all the answers

Which demographic factor might impact the expression and severity of measles in the 5-year-old boy?

Recent immigration Signup and view all the answers

What is the most likely diagnosis for a firm, non-tender nodular lesion with central ulceration on a patient who has significant sun exposure?

Basal Cell Carcinoma Signup and view all the answers

Which treatment method is most appropriate for basal cell carcinoma located on the face?

Mohs Micrographic Surgery Signup and view all the answers

What is a distinguishing feature of squamous cell carcinoma compared to basal cell carcinoma?

Often has keratinized lesions and may bleed Signup and view all the answers

Which biopsy method is primarily used for diagnosing squamous cell carcinoma?

Shave biopsy Signup and view all the answers

Which symptom is NOT typically associated with basal cell carcinoma?

Intermittent bleeding Signup and view all the answers

What feature is characteristic of basal cell carcinoma lesions?

Pearly telangiectatic papules Signup and view all the answers

What is a common risk factor for developing squamous cell carcinoma?

Chronic immunosuppressive therapy Signup and view all the answers

Which characteristic distinguishes melanoma from basal cell carcinoma?

Asymmetrical appearance of lesions Signup and view all the answers

What is the most common type of skin cancer?

Basal Cell Carcinoma Signup and view all the answers

Which factor contributes most significantly to the risk of developing skin cancers like basal cell carcinoma?

History of outdoor work Signup and view all the answers

What type of skin lesions are characteristic of Tinea Versicolor?

Nontender, round, white macules Signup and view all the answers

Which of the following is the underlying cause suspected for Pityriasis Rosea?

Idiopathic, possibly viral Signup and view all the answers

What is the first-line treatment for Tinea Versicolor?

Topical antifungals like Selenium sulfide Signup and view all the answers

Which laboratory confirmation method is used for diagnosing Tinea Versicolor?

Potassium hydroxide preparation of skin scraping Signup and view all the answers

Which finding would distinguish Tinea Versicolor from Pityriasis Rosea?

Fine scaling upon scraping Signup and view all the answers

What additional history is significant in the case of the 13-year-old boy with Tinea Versicolor?

Recent travel to a tropical area Signup and view all the answers

What is a common misconception about the lesions of Pityriasis Rosea?

They are always itchy Signup and view all the answers

In which demographic is Tinea Versicolor most commonly diagnosed?

Teenagers and young adults Signup and view all the answers

What are the general characteristics of the lesions seen in Pityriasis Rosea?

Multiple oval lesions in a Christmas tree pattern Signup and view all the answers

Which treatment is typically not indicated for Pityriasis Rosea?

Antiviral medications Signup and view all the answers

Which of the following is NOT a feature of the ABCDE criteria used for assessing malignant melanoma?

Bleeding Signup and view all the answers

In a case of a nonhealing ulcer on the left upper extremity, which characteristic of the lesion is most consistent with squamous cell carcinoma?

Intermittent bleeding Signup and view all the answers

What is the definitive method for diagnosing malignant melanoma?

Skin biopsy Signup and view all the answers

Which of the following factors is most relevant for determining the prognosis of malignant melanoma?

Tumor thickness according to Breslow depth Signup and view all the answers

What is the most appropriate initial treatment for a diagnosed melanoma based on the Breslow depth?

Wide local excision Signup and view all the answers

What mechanism leads to the intense itching experienced by patients with scabies?

Immunological response to mite excretions and bodies Signup and view all the answers

Which statement about the signs and symptoms associated with scabies is accurate?

The rash typically presents as a maculopapular formation Signup and view all the answers

In a case of scabies, what is the most critical diagnostic requirement for confirming the infestation?

Direct visualization of mites or their products Signup and view all the answers

What preventive measure should be taken to minimize scabies transmission within a household?

Treat all household contacts regardless of symptoms Signup and view all the answers

Which of the following correctly represents the agents used to treat scabies?

Topical permethrin and oral ivermectin Signup and view all the answers

What is a common misconception regarding the transmission route of scabies?

Scabies can spread through contaminated objects Signup and view all the answers

Which skin examination finding is atypical for a scabies infection?

A well-defined border rash on the abdomen Signup and view all the answers

In terms of clinical presentation, which symptom can be expected to worsen during the night in a person with scabies?

Pruritus (itching) Signup and view all the answers

What complication is specifically increased in patients diagnosed with measles?

Encephalitis Signup and view all the answers

What is the primary characteristic of the rash observed in measles?

Erythematous maculopapular exanthem Signup and view all the answers

Which physical examination finding in the 5-year-old boy suggests dehydration?

Reduced skin turgor Signup and view all the answers

What is the primary sign indicative of tinea versicolor during a potassium hydroxide preparation?

Spaghetti-and-meatballs pattern Signup and view all the answers

In the management of the 5-year-old boy with measles, what is the next step recommended?

Obtain a viral culture Signup and view all the answers

What typical symptom may accompany the rash in a patient with tinea versicolor?

Pruritus Signup and view all the answers

What primary action should be taken when treating tinea versicolor?

Topical selenium sulfide Signup and view all the answers

What history detail might suggest an environmental trigger for the rash in the 21-year-old man?

Travel to a tropical location Signup and view all the answers

In a patient presenting with skin lesions and an unknown vaccination history, what is a concerning complication to monitor for regarding measles?

Keratoconjunctivitis Signup and view all the answers

What is the appropriate first step in the evaluation of suspected tinea versicolor?

KOH preparation Signup and view all the answers

What is the characteristic feature of the rash observed in measles?

It is erythematous, maculopapular, and partially confluent. Signup and view all the answers

Which symptom is considered pathognomonic for measles?

Koplik spots Signup and view all the answers

What is the recommended duration for isolating a patient diagnosed with measles from the onset of the rash?

4 days Signup and view all the answers

What is the primary method for confirming a diagnosis of measles?

Detection of measles-specific IgM antibodies or PCR Signup and view all the answers

In measles management, what additional benefit does Vitamin A supplementation provide?

It helps mitigate complications such as encephalitis. Signup and view all the answers

During a physical exam of a measles patient, which finding would warrant immediate airborne precautions if hospitalized?

The patient has conjunctivitis. Signup and view all the answers

What is the role of live attenuated vaccines in measles prevention?

They induce long-term immunity against the virus. Signup and view all the answers

Which of the following is a potential complication associated with measles in immunocompromised patients?

Pneumonia Signup and view all the answers

In cases of measles, which symptom would likely precede the rash?

Fever and respiratory distress Signup and view all the answers

What is a common sign that may suggest the presence of measles in a child who has not been vaccinated?

Presence of Koplik spots in the mouth Signup and view all the answers

What microscopic finding is typically observed in a potassium hydroxide preparation for Tinea Versicolor?

Long hyphae among yeast cells Signup and view all the answers

Which treatment options are appropriate for managing Tinea Versicolor?

Selenium sulfide or oral fluconazole Signup and view all the answers

In the context of Pityriasis Rosea, which feature is most characteristic of the rash?

Oval, scaly papules in a Christmas tree pattern Signup and view all the answers

Which symptom could suggest a differential diagnosis for the 10-year-old girl's rash?

Fever preceding the rash Signup and view all the answers

What is a significant comparison between Tinea Versicolor and Pityriasis Rosea in terms of diagnosis?

Pityriasis Rosea may require KOH preparation to exclude Tinea. Signup and view all the answers

Which underlying condition in the 13-year-old boy's family could contribute to his skin condition?

Type 1 diabetes mellitus Signup and view all the answers

How long do lesions from Pityriasis Rosea typically persist before resolution?

6-8 weeks Signup and view all the answers

What is an expected finding when scraping the lesions of Tinea Versicolor?

Fine scaling of the lesions Signup and view all the answers

What might indicate a potential viral cause in a child presenting with rash, especially when associated with prior systemic symptoms?

Fever and sore throat before rash onset Signup and view all the answers

Study Notes

Scabies

Highly contagious skin infection caused by the mite Sarcoptes scabiei.
Transmitted through direct skin-to-skin contact.
Mites burrow into the skin causing intense itching, especially at night.
Common sites: Interdigital folds, genitalia.
Diagnostic confirmation: Visualization of mites, eggs, or feces using a dermatoscope.
Treatment: Topical permethrin 5% lotion or oral ivermectin.
Prevention: Thorough washing of textiles and treatment of all household contacts.

Measles

Viral infection caused by the Paramyxovirus.
Characterized by: fever, cough, runny nose, conjunctivitis, Koplik spots (small white spots on the inner lining of the cheek), and a red, flat rash that spreads from the face to the rest of the body.
Diagnostic confirmation: Detection of Measles-specific IgM antibodies or PCR.
Treatment: Symptomatic management and vitamin A supplementation.
Prevention: Live attenuated vaccine.
Isolation: Isolate patients for 4 days from onset of rash. Airborne precautions in hospitalized patients.

Tinea Versicolor

Fungal infection caused by Malassezia furfur.
Characterized by: hypopigmented, hyperpigmented, or erythematous skin lesions that typically occur on the trunk and chest.
Diagnostic confirmation: Observing "spaghetti-and-meatballs" pattern in potassium hydroxide (KOH) preparation.
Treatment: Topical antifungals (Selenium sulfide or zinc pyrithione) or oral antifungals (fluconazole).

Pityriasis Rosea

Idiopathic rash, suspected viral etiology (HHV 6 and 7).
Characterized by: Prodromal flu-like symptoms followed by multiple, oval, scaly papules, resembling a "Christmas tree" pattern on the trunk.
Diagnostic confirmation: Clinical diagnosis. KOH preparation for exclusion of tinea and RPR/VDRL for exclusion of secondary syphilis.
Treatment: Spontaneous resolution within 6-8 weeks.

Skin Cancer

Most important skin cancers: Basal cell carcinoma (BCC), Squamous cell carcinoma (SCC), Melanoma.
Most common type: Basal cell carcinoma.

Basal Cell Carcinoma (BCC)

Characterized by: Painless, pearly, firm, telangiectatic papules.
Most common location: Face or other sun-exposed areas.
Diagnostic confirmation: Excisional biopsy, shave biopsy, or punch biopsy.
Treatment: Surgical excision with margins (3-5 mm for trunk and extremities, Mohs micrographic surgery for face).

Squamous Cell Carcinoma (SCC)

Characterized by: Nodular lesion with intermittent bleeding and itching.
Lesions often become keratinized and can ulcerate with crusting and bleeding.
Perineural invasion, numbness, paresthesia, and itching can occur.
Diagnostic confirmation: Shave biopsy.
Treatment: Surgical excision or Mohs surgery. Radiation or chemotherapy may be needed for high metastatic potential.

Scabies

Pathogen: Sarcoptes scabiei
Transmission: Direct physical (skin-to-skin or sexual) contact
Pathophysiology: The mite's excretions and decomposing bodies cause an immune response
Symptoms: Pimple-like rash, burrows, intense itching that worsens at night
Predilection Sites: Interdigital folds, male genitalia
Diagnosis: Visualization of mites, eggs, or feces using a dermatoscope
Treatment: Topical permethrin 5% lotion, oral ivermectin
Prevention: Wash all textiles, treat all household members even if asymptomatic.

Case 1: 4-Year-Old Boy
Symptoms: Pruritic rash on hands and feet for 2 weeks, worse at night
Diagnosis: Scabies

Case 2: 26-Year-Old Man
Symptoms: Pruritic rash with small red bumps in linear pattern, worse at night
Diagnosis: Scabies
Confirmation: Visualization of mites, eggs, or feces using a dermatoscope
Treatment: Topical permethrin
Prevention: Treat all close contacts.

Measles

Pathogen: Paramyxovirus, an RNA Virus
Complications: Encephalitis

Case 5: 5-Year-Old Boy
Symptoms: Progressive rash starting on the face and spreading to the trunk and extremities, runny nose, cough, red crusty eyes
Diagnosis: Measles
Next Steps: Obtain a viral culture

Tinea Versicolor

Pathogen: Malassezia furfur
Pathophysiology: Malassezia furfur damages melanocytes leading to hypopigmentation. An inflammatory response may result in hyperpigmentation.
Symptoms: Hypopigmented, hyperpigmented, or erythematous skin lesions, commonly on the trunk and chest.
Diagnosis: Clinical, KOH preparation shows "spaghetti-and-meatballs" pattern
Treatment: First-line: topical antifungals (selenium sulfide or zinc pyrithione). Second-line: oral antifungals (fluconazole).

Case 6: 21-Year-Old Man
Symptoms: Pruritic hypopigmented rash on upper body, started after a trip to the Bahamas
Diagnosis: Tinea Versicolor
Confirmation: KOH preparation showing hyphae and yeast cells
Treatment: Topical or oral antifungals

Case 7: 13-Year-Old Boy
Symptoms: Rash on chest and back starting as a few lesions and spreading.
Diagnosis: Tinea Versicolor
Confirmation: KOH preparation
Treatment: Topical or oral antifungals

Pityriasis Rosea

Etiology: Idiopathic, suspected viral etiology (HHV 6 and 7)
Symptoms: Prodromal flu-like illness, multiple scaly oval papules in a "Christmas tree" pattern on the trunk, itching. Lesions usually resolve within 2 months.
Diagnosis: Usually clinical, laboratory tests only if uncertain
Confirmation: KOH preparation to rule out tinea, RPR or VDRL to rule out syphilis
Treatment: Spontaneous resolution in 6-8 weeks

Case 8: 10-Year-Old Girl
Symptoms: Pruritic rash spreading from single lesion on upper abdomen to trunk, neck, and arms. Previous fever, sore throat, malaise.
Diagnosis: Pityriasis Rosea

Skin Cancer

Important skin cancers: BCC, SCC, melanoma
Most common type: Basal cell carcinoma

Common Key Words

Painless lesion
History of sun exposure (Australia, summer, outdoor job)
Increase in size over months

Basal Cell Carcinoma

Symptoms: Nodular lesion with central ulceration, non-tender, firm, pearly telangiectatic papules, most appear on sun-exposed areas.
Diagnosis: Excisional, shave or punch biopsy
Treatment: Surgical excision with 3-5 mm margins for trunk and extremities. Mohs surgery for lesions on the face.

Case 9: 48-Year-Old Woman
Symptoms: Small swelling on neck slowly enlarging, has worked outdoors her entire life.
Diagnosis: Basal Cell Carcinoma

Squamous Cell Carcinoma

Symptoms: Common in patients with history of transplants, immunosuppressive therapy, ionizing radiation, burn injuries. Nodular lesion with intermittent bleeding and itching. Lesions can become keratinized, ulcerate with crusting and bleeding. Perineural invasion results in numbness, paresthesia, and itching.
Diagnosis: Shave biopsy demonstrating keratin pearls, atypical keratinocytes invading the dermis.
Treatment: Surgical excision or Mohs surgery. Radiation or chemotherapy for lesions with high metastatic potential.

Case 10: 65-Year-Old Man
Symptoms: Non-healing ulcer on left upper extremity, enlarging, ulcerated, bleeding and itching.
Diagnosis: Squamous Cell Carcinoma

Malignant Melanoma

Symptoms: ABCDE criteria: asymmetry, border, color, diameter > 6 mm, evolving. "Ugly duckling" sign - lesion significantly different from others.
Diagnosis: Skin biopsy
Treatment: Wide local excision with margins based on Breslow depth
Prognosis: Tumor thickness (Breslow depth)

Case 11: 63-Year-Old Man
Symptoms: Skin lesion on chest, increasing in size, painless and not pruritic.
Diagnosis: Malignant Melanoma

Scabies

Pathogen: Sarcoptes scabiei
Transmission: Direct contact with an infected person.
Pathophysiology: The mite's excretions and decomposing bodies trigger an immune response.
Signs and Symptoms:
- Pimple-like rash
- Burrow tracks in the skin
- Intense itching, especially at night
Predilection Sites: Interdigital folds, male genitalia.
Diagnosis: Visualize the mites, eggs, or feces using a dermatoscope.
Treatment:
- Topical: Permethrin 5% lotion.
- Oral: Ivermectin.
Prevention:
- Wash all textiles (clothing, bedding).
- Treat all household members, even if asymptomatic.

Measles

Pathogen: Paramyxovirus, an RNA virus.
Signs and Symptoms:
- Fever
- Cough
- Runny nose
- Conjunctivitis
- Koplik spots (small white spots on the inside of the mouth, considered pathognomonic for measles)
- Erythematous maculopapular rash (starts behind ears and spreads down to the feet, rarely affects the hands and soles)
Diagnosis:
- Gold standard: Detecting measles-specific IgM antibodies or PCR.
Treatment: Supportive care with Vitamin A supplementation to reduce mortality.
Prevention: Live attenuated vaccine.
Isolation: Isolate patients for at least 4 days from rash onset (longer for immunocompromised individuals). Use airborne precautions for hospitalized patients.

Tinea Versicolor

Pathogen: Malassezia furfur
Pathophysiology: M. furfur damages melanocytes, leading to hypopigmentation. The immune response to the pathogen may cause hyperpigmentation.
Signs and Symptoms:
- Hypopigmented, hyperpigmented, or erythematous skin lesions.
- Common sites: trunk and chest.
Diagnosis: Clinical diagnosis is often sufficient.
Confirmation: Potassium hydroxide (KOH) preparation reveals a "spaghetti-and-meatballs" pattern.
Treatment:
- First-line: Topical antifungals (selenium sulfide or zinc pyrithione).
- Severe or unresponsive cases: Oral antifungals (fluconazole).

Pityriasis Rosea

Etiology: Idiopathic but a viral etiology (HHV 6 and 7) is suspected.
Signs and Symptoms:
- Preceded by flu-like symptoms.
- Multiple oval, scaly papules in a "Christmas tree" pattern on the trunk.
- Itching is common.
- Lesions typically resolve within 2 months, sometimes causing postinflammatory hyperpigmentation or hypopigmentation.
Diagnosis: Usually clinical.
Confirmation:
- KOH preparation to rule out tinea.
- RPR or VDRL to rule out secondary syphilis.
Treatment: Typically self-resolves within 6-8 weeks.

Malignant Melanoma

Signs and Symptoms:
- ABCDE criteria:
  - Asymmetry: Two halves of the lesion don't match.
  - Border: Irregular border with indistinct margins.
  - Color: Varied pigmentation within the lesion.
  - Diameter: Greater than 6 mm.
  - Evolving: Changes in size, shape, or color over time.
- "Ugly Duckling" sign: A lesion that looks different from other moles on the patient's body.
Diagnosis: Skin biopsy.
Treatment: Wide local excision with surgical margins determined by the Breslow thickness.
Prognosis: Tumor thickness, measured by Breslow depth, is a significant prognostic factor.

Case Scenarios

Case 1: 4-Year-Old Boy
- Diagnosis: Scabies
- Symptoms: Pruritic rash on hands and feet.
- History: Mother has eczema.
- Physical Exam: Maculopapular rash with linear tracks affecting fingers and toes.
Case 2: 26-Year-Old Man
- Diagnosis: Scabies
- Symptoms: Pruritic rash on arm and back.
- History: Recently moved into a new apartment with roommates who also developed similar rashes.
- Physical Exam: Rash with a linear pattern on the arm and clusters of lesions on the back.
Case 3: 6-Year-Old Boy
- Diagnosis: Measles
- Symptoms: Progressive rash starting on face and spreading to the entire body. Cough and runny nose.
- History: Recently visited the Philippines. Immunization records unavailable.
- Physical Exam: Fever, generalized lymphadenopathy, erythematous maculopapular rash.
Case 4: 11-Year-Old Boy
- Diagnosis: Measles
- Symptoms: Fever, cough, runny nose, and itchy eyes.
- History: Emigrated from Syria recently. No routine childhood vaccinations.
- Physical Exam: Fever, conjunctivitis, Koplik spots.
- Complications: Risk of encephalitis.
Case 5: 5-Year-Old Boy
- Diagnosis: Measles
- Symptoms: Progressive rash, runny nose, cough, and red eyes.
- History: Immigrated from Turkey 3 months ago. Father and brother have Behçet disease.
- Physical Exam: Fever, generalized lymphadenopathy, dry mucous membranes, erythematous maculopapular rash, aphthous ulcers.
- Next steps: Obtain viral culture.
Case 6: 21-Year-Old Man
- Diagnosis: Tinea Versicolor.
- Symptoms: Hypopigmented rash on upper body.
- History: Recently traveled to the Bahamas.
- Physical Exam: Hypopigmented rash.
- Confirmation: KOH preparation showed hyphae and yeast cells.
Case 7: 13-Year-Old Boy
- Diagnosis: Tinea Versicolor.
- Symptoms: Rash on chest and back.
- History: Recently returned from the Caribbean.
- Physical Exam: Multiple, nontender, white macules on chest and trunk.
- Confirmation: KOH preparation.
Case 8: 10-Year-Old Girl
- Diagnosis: Pityriasis Rosea.
- Symptoms: Pruritic rash that started as one lesion and spread to the trunk, neck, and arms.
- History: Had fever, sore throat, and malaise before the onset of the rash.
Case 10: 65-Year-Old Man
- Diagnosis: Squamous Cell Carcinoma
- Symptoms: Nonhealing ulcer on the left upper extremity.
- History: No history of trauma.
- Physical Exam: Ulcerated lesion.
Case 11: 63-Year-Old Man
- Diagnosis: Malignant Melanoma.
- Symptoms: Skin lesion on the chest.
- History: Lesion thought to have increased in size.
- Physical Exam: Skin lesion.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.