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Derm
Acne Vulgaris Presentation and Pathophysiology
Presentation
Papules/Comedones in Mild Cases
Blackheads Open, Whiteheads Closed
Pustules in Mild-Moderate Cases
Nodules/Cysts in Severe Cases
Pathophysiology
Inflammation at Hair Follicle/Sebaceous Gland
Increased Androgens
Colonization by Cutibacterium Acnes
3 mins
Rosacea
Characteristics
Episodes Provoked by Alcohol, Heat, or Emotions
Erythematotelangiectatic Rosacea
Facial Flushing and Telangiectasias
Sun Protection
Topical Brimonidine
Papulopustular Rosacea
Papules and Pustules
Topical Metronidazole
Phymatous Rosacea
Rhinophyma
Laser Ablation
Considerations
Avoid Triggers
2 mins
Actinic Keratosis
Sun Exposure
Papules or Plaques
Small, Rough
Erythematous
Precursor to Squamous Cell Carcinoma
53 secs
Basal Cell Carcinoma of the Skin
Pathophysiology
Most Common Skin Cancer
2/3 of Cases Due to UV Light Exposure
Pink, Pearl-like Lesions
Rolled Borders
Telangiectasias
Commonly Upper Lip
Diagnosis
Shave Biopsy
Pallisading Nuclei
Treatment
Mohs Micrographic Surgery
2 mins
Squamous Cell Carcinoma of the Skin
Epidemiology
2nd Most Common Skin Cancer
UV Light Exposure
Long-term Immunosuppression
Arsenic Exposure
Signs/Symptoms
Ulcerative Red Lesion
Precursor Actinic Keratosis
Commonly Lower Lip
Diagnosis
Biopsy shows Keratin Pearls
Treatment
Mohs Micrographic Surgery
2 mins
ABCDEs of Melanoma
Asymmetry
Border
Color
Diameter
Evolving
1 min
Melanoma Diagnosis
Signs
ABCDE Mnemonic
Asymmetry
Border irregularity
Color variation
Diameter > 6mm
Evolution over time
Diagnosis
S-100 Tumor Marker
LDH (Lactate Dehydrogenase) Screens for Metastasis
Treatment
Wide Local Excision
Adjuvant Therapy
1 min
Melanoma Mechanism and Characteristics
Mechanism
Associated with Sunlight Exposure
Mutation in B-RAF kinase
Large Number of Moles
Fair-Skinned People at Higher Risk
Growth Phases
Radial Growth Phase
No Metastasis
Vertical Growth Phase
Depth of Tumor Correlates with Risk of Metastasis
1 min
Types of Malignant Melanoma
Superficial Spreading
Most Common Cause of Melanoma
Nodular
Aggressive and Rapidly Arising
Acral-Lentiginous
Males
Asians and African Americans
Lentigo Maligna
Geographic Shape
Sun Exposed Areas
2 mins
Lice
Clinical Features
Pediculosis Capitis, Corporis, Pubis
Pruritis
Hyperpigmentation
Louse-borne Diseases
Trench Fever
Bartonella Quintana
Epidemic Typhus
Rickettsia Prowazekii
Relapsing Fever
Borrelia Recurrentis
Treatment
Permethrin
Malathion
Ivermectin
3 mins
Scabies
Pathophysiology
Sarcoptes Scabiei Mite
Signs & Symptoms
Pruritus
Papules with Burrows
Webs of Fingers and Toes
Axilla and Nipples
Diagnosis
Skin Scraping
Dermoscopy
Mites and Eggs on Magnification
Treatment
Permethrin Cream
Oral Ivermectin
Lindane Cream
Considerations
Wash All Linens In Hot Water
3 mins
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
2 mins
Staphylococcus aureus Disease
Skin Infections
Impetigo
Abscesses
Exfoliative Toxin
Scalded Skin Syndrome
Toxic Shock Syndrome (TSST 1)
Binds to MHC II and T Cell Receptor
Food Poisoning
Acute Bacterial Endocarditis
Pneumonia
Osteomyelitis
2 mins
Pityriasis Versicolor (Tinea versicolor)
Mechanism
Lipid-Dependent Fungus
Fatty Acids Damage Melanocytes
Malassezia Furfur
Hot, Humid Weather
Signs and Symptoms
Hypopigmentation
Hyperpigmented Patches
Diagnosis
Spaghetti and Meatball Appearance on KOH Prep
Fragmented Hyphae with Clusters of Yeast
Treatment
Topical or Oral Antifungals
Selenium Sulfide
Zinc
4 mins
Pityriasis Rosea
Preceded by Upper Respiratory Tract Infection
Single "Herald Patch"
"Christmas Tree" Distribution
Plaques with Collarette Scale
Self-resolving in 6-8 Weeks
2 mins
Psoriasis
Presentation
Epidermal Hyperproliferation Keratinocytes
Defined Red Salmon Plaques
Silvery Scales
Extensor Surfaces
Bleeding when Removed
Auspitz Sign
Pruritus
Nail Changes
Histological Finding
Munro Microabscesses
Nucleated Cells in Stratum Corneum
Treatment
Retinoids
Topical Corticosteroids
Tar
Immunosuppressants
2 mins
Genital Warts - Condylomata Acuminata
Mechanism
Human Papillomavirus (HPV)
Assessment
Papillary Cauliflower Like Growths
Bleeding
Vaginal Discharge
Interventions
Wart Removal
Trichloroacetic acid (TCA)
Podophyllin resin
Cryotherapy
Considerations
HPV Vaccine
Cervical Cancer
2 mins
Pox Virus
Characteristics
Enveloped
Double-Stranded DNA
Linear
Non-Icosahedral
Signs and Symptoms
Smallpox
Cowpox
Molluscum Contagiosum
Umbilicated Flesh-Colored Domed Lesions
1 min
Verrucae
Warts
Characteristics
Papillary Cauliflower Like Growths
Low-Risk Human Papillomavirus
Epidermal Hyperplasia and Hyperkeratosis
Koilocytes
Management
No Treatment Needed
Topical Salicylic Acid
Cryotherapy
2 mins
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