Alex Shared "Derm" - 45 Picmonics

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Derm

Actinic Keratosis
Sun Exposure
Papules or Plaques
Small, Rough
Erythematous
Precursor to Squamous Cell Carcinoma
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53 secs
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
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2 mins
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
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2 mins
ABCDEs of Melanoma
Asymmetry
Border
Color
Diameter
Evolving
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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
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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
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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
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2 mins
Atopic Dermatitis / Eczema
Presentation
Pruritic Vesicles
Inflammatory Skin Rash
Cheeks in Children
Skin Flexural Areas
Associated with Asthma and Allergic Rhinitis
Treatment
Tacrolimus
Moisturizers
Corticosteroids
Phototherapy
Avoid Triggers
Antihistamines
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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
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2 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
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1 min
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
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4 mins
Mycosis Fungoides / Sézary Syndrome
Mechanism
Neoplastic CD4+ Cells
Adults 40 - 60 Years Old
Mycosis Fungoides
Neoplastic CD4+ Cells Infiltrate Skin
Rashes Or Plaques
Pautrier's Abscesses
Sézary Syndrome
Neoplastic CD4+ Spread from Skin to Systemic Involvement
Sézary Cells With "Cerebriform Nuclei"
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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
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2 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
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2 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
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2 mins
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
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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
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2 mins
Streptococcus Pyogenes Disease
Pyogenic
Pyogenic
Pyogenic Pharyngitis
Impetigo
Cellulitis
Toxigenic
Toxic Shock-Like Syndrome
Scarlet Fever
Sandpaper Rash
Strawberry Tongue
Immunologic
Immunologic
Rheumatic Fever
Antibodies to M Protein
Acute Glomerulonephritis (Post Streptococcal Glomerulonephritis)
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2 mins
Stevens-Johnson Syndrome
Etiologies
Drugs
Symptoms
< 10% of Body Surface Area (BSA) Involved
10-30% BSA Overlaps with Toxic Epidermal Necrolysis (TEN)
Fever
Affects Skin and Mucous Membranes
Bullae Formation
Necrosis
Sloughing of Skin
High Mortality Rate
Treatment
Supportive Care
IVIG (Intravenous Immunoglobulin)
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3 mins
Pemphigus Vulgaris
Pathophysiology
Autoantibodies against desmosomes
Symptoms
Flaccid Bullae on Skin
Oral Mucosa Involvement
Intraepidermal Acantholysis
Fluid Loss
Infection
Nikolsky Positive
Diagnosis
Biopsy showing Autoantibodies
Treatment
IVIG and Plasmapheresis
Oral Steroids
Immunosuppressants
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2 mins

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