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60 Cards in this Set
- Front
- Back
BCC Mimickers |
Nevus Sebaceous hyperplasia Sebborheic keratosis Angiofibroma |
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Pigmented/skin-coloured Should not grow No rolled border or ulceration |
Intradermal nevus |
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Yellowish papule +/- telangiectasia and central dimple |
sebaceous hyperplasia (oil gland overgrowth) |
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flesh-coloured or pink firm papule (mostly on nose); doesn't grow |
angiofibroma |
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rough, irregular surface; stuck-on appearance; not pearly |
Seborrheic keratosis (benign overgrowth of keratinocytes; mimicker for melanoma) |
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Pearly papule or nodule with rolled border and telangiectasis |
nodular BCC |
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Thin scaly plaque that is well-defined and pink/translucent; +/- telangiectasia and rolled border |
superficial BCC |
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White, bound-down/scar-like areas +/- pink colour, telangiectasia, rolled border |
sclerosing BCC |
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Treatments for BCC |
usually surgical: curettage and electrodessication excision with wide margins Mohs micrographic surgery field therapy (for superficial BCC) Topical chemo cryosurgery (for pre-SCC) radiation therapy (if you can't have surgery, since it can lead to secondary carcinogenesis) |
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Higher risk of metastasis: BCC or SCC? |
SCC |
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SCC in non-sun-exposed areas could be related to... |
chemical carcinogens (arsenic) |
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Higher incidence of SCC |
immunocompromised patients
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friable (bleeds with trauma) erythematous indurated hyperkeratotic lesion with crusting |
SCC |
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higher risk of metastasis in SCC if: |
immunosuppression large, deep, or recurrent lesion |
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spectrum leading to SCC |
photodamaged skin -> actinic keratosis-> bowen's disease (SCC in situ)->SCC |
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Circumscribed, pink-red patch or thin plaque with scaly or rough surface |
Bowen's disease (SCC that does not invade the dermis) |
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rough, scaly, thin, red-pink papules and plaques |
actinic keratosis |
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risk factors for AK |
cumulative and prolonged UV exposure age fair skin immunosuppression |
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erythematous patch with rough, gritty scale on lips |
actinic cheilitis |
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AK treatments |
localized (usually liquid nitrogen cryotherapy) field (if there's many in one area; topical or photodynamic) |
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volcano-like erythematous nodule with central keratinous core; rapid growth and sharp demarcation |
keratoacanthoma (often spontaneously involutes) |
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melanoma risk factors |
personal/family history fitzpatrick skin type 1-3 intermittent sun exposure with sunburns tanning beds immunosuppression >50 common nevi, any dysplastic nevi, or 1 large congenital nevus |
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ABCDEs of melanoma |
Asymmetry Border irregularity Colour variation Diameter > 6mm Evolution |
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types of melanoma |
-superficial spreading (most common, younger) -nodular (thicker=poor prognosis) -lentigo maligna melanoma (elderly, chronic sun-exposed sites, slow-growing) -Acral lentiginous (bottom of feet) -Amelanotic |
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Management of melanoma |
excisional biopsy to assess Breslow depth re-excision with wide margins follow-up skin exams |
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progression of benign melanocytic nevi |
junctional->compound->dermal |
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flat brown maccule confined to epidermis |
junctional nevus |
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raised, coloured papule in epidermis and dermis |
compound nevus |
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raised, skin-coloured papule (that used to be flat and brown for a long time) |
dermal nevus |
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round, firm papule secondary to insect bite/trauma; dimples when squeezed |
dermatofibroma (scar tissue) |
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forms of psoriasis |
guttate chronic plaque erythrodermic pustular palmoplantar inverse |
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Treatment of psoriasis |
Topical: steroids, vitamin d derivatives, calcineurin inhibitos phototherapy Systemic medications |
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mildly pruritic pink scaly plaques, with herald patch, in christmas tree pattern on trunk and on peripheral extremities |
pityriasis rosea |
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treatment for pityriasis rosea? |
spontaneous resolution over 6-8 weeks, so treatment is symptomatic (topical steroids, emollients, cool compresses) |
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6 P's of lichen planus |
purple pruritic peripheral polygonal penile papules (idiopathic inflammatory disease) |
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location of lichen planus |
skin (flexural surfaces), mucous membranes (white, lacy reticular lesions in mouth), and nails |
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treatment of lichen planus |
steroids (topical, intralesional, or oral depending on location and severity) |
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forms of cutaneous lupus |
acute subacute (psoriasiform and annular) chronic (discoid and panniculitis) |
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Chronic, pruritic, ill-defined, scaly, erythematous rash |
atopic dermatitis |
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scaling, oozing, blistering, pruritic, dermatitic rash under belly button |
allergic contact dermatitis (likely to nickel of belt buckle) |
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treatment of allergic contact dermatitis |
topical steroids |
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bilateral swollen lower legs with ulceration, oozing, and crusting (diagnosis and treatment) |
stasis dermatitis, a cutaneous sign of venous hypertension and insufficiency treat with compression stockings and elevation, topical steroids, and wound care (oral antibiotic if needed) |
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a drug rash that has no internal involvement |
simple rash (exanthem (maculopapular) or urticarial (very itchy)) |
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drug reaction leading to widespread, symmetrical, slightly raised rash and fever, fatigue, organ inflammation |
complex exanthem |
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blistering complex drug rash with mucosal involvement, skin necrosis |
steven-johnson syndrome-->toxic epidermal necrolysis |
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complex urticarial rash |
serum sickness-like reaction |
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potential drug causes for psoriasis |
lithium, some beta-blockers, anti-TNF drugs |
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phenytoin and carbamazepine can cause... |
severe, complex reactions fatal in 10% of cases |
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allopurinol-related rashes |
hard to treat, may cause SJS/TEN |
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treatment for drug-related rashes |
stop the drug |
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what is the highest class of potency for a topical corticosteroid? |
class 1 (7 (hydrocortisones) is least potent) |
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best vehicle for delivery of corticosteroids? |
ointment |
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location for lowest potency of corticosteroid application? highest? |
lowest: face, folds, genitals highest: palms, soles, scalp |
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what immunosuppressant would you consider for psoriasis, atopic dermatitis, and morphea? |
methotrexate (except in pregnancy and livery disease) |
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treatment for genital herpes? |
oral antivirals (acyclovir, valciclovir, famciclovir) |
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treatment for zoster? |
oral antivirals within 72h of rash onset |
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treatment for genital warts? |
destructive methods, topical creams (does not reduce transmission) |
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treatment for molluscum contagiosum? |
self-resolve, or topical treatment/cryotherapy |
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treatment for tinea capitis? |
oral antifungals (topical won't penetrate hair follicles) antifungal shampoo for family members |
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treatment for onychomycosis (tinea unguium)? |
oral antifungal (terbinafine) or topical (low efficacy) |