PACC buzzwords hair, skin, nails, lymph, head/neck

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89 Terms

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Acne Vulgaris

hypersensitivity of the sebaceous glands + inflammation + adolescents

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Rosacea

Variable erythema and telangiectasia + papules & pustules + females 30/50s

Triggers = alcohol, foods, hot drinks, heat, emotion

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Sebaceous hyperplasia

Benign condition of sebaceous glands

-Middle-aged male adults

-↓ levels of androgens

- Whitish-yellow or skin-colored papules with central umbilication

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Stevens-Johnson Syndrome

Severe mucocutaneous reaction with target lesions and (+) Nikolsky sign

- pmhx of medications (e.g., ABX)

Asboe-Hansen sign or "bulla spread sign”

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Toxic Epidermal Necrolysis

  • Severe mucocutaneous reaction 

  • Most commonly triggered by medications

Characterized by extensive necrosis and detachment of the epidermis

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SJS; TEN

______ = less severe, skin detachment is <10% BSA

_______ = more severe, skin detachment >30% BSA

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Rubella

Maculopapular rash that spreads from face --> trunk/extremities

- spares palm & soles

- conjunctivitis

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Forchheimer spots

Associated with Rubella; small, red papules or spots on the soft palate

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Roseola

Caused by HHV-6; rash starts on neck/trunk and spreads; common in children under 2 years

- BLANCHING rash

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Erythema Infectiosum

'Slapped cheek' rash caused by Parvovirus B19

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viral illness (Coxsackevirus)

Etiology of hand foot mouth disease?

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hand-foot-mouth (Coxsackevirus)

rash of the hands and feet, including the palms & soles (in oral mucosa)

- mouth/throat pain

- refusal to eat

-

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Chancre (syphilis)

Painless lesion on penis/vulva

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Secondary synphilis

Fever, HA, anorexia + widespread, pruritic rash that includes palms/soles + lymphadenopathy + pmhx of painless lesion on genitalia

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Pilonidal disease

Occurs at or near the upper part of gluteal cleft

- 20/30 yo male

- hx pressure/stretching of anus

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S. aureus

MC etiology of folliculitis?

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Folliculitis barbae

Infection of hair follicles in the beard area

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Hot-tub folliculitis

Folliculitis associated with whirlpools, hot-tubs, swimming pools

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Pseudomonas

MC etiology of Hot-tub folliculitis

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cellulitis

U/L skin redness/swelling/warmth + lower extremities + poorly demarcated

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erysipilas

U/L redness/painful/itching + clearly demarcated raised border

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Impetigo

Bacterial skin infection with honey-colored exudate/crust

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candidiasis

Tenderness, itching, and pain in moist areas + satellite lesions + DM/obese/immunocomprimised

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Tinea pedis

Fungal infx + rash in between toes/on feet

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Tinea corporis

Fungal infx + rash + patch or plaque that spreads centrifugally

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Tinea cruris

Fungal infx + rash + erythematous or hyperpigmented patch on the proximal medial thigh

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Tinea capitis

Fungal infx + rash + Scaly patches with alopecia and patches of alopecia with visible black dots

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lice

Pruritus of the scalp/neck + school-aged children

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Scabies

________ is common in crowded conditions with burrows and intense itching

- pruritis is worse at night

- excoriations/burrows in between the finger webs

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Molluscum contagiosum

Dome-shaped shiny papules with central umbillication

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Varicella zoster

Causes vesicular lesions on an erythematous base

- dew-drop on rose petal appearance

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Herpes zoster (shingles)

Rash + nerve pain that does NOT cross midline

- MC in thorax or lumbar spine

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HPV

_________causing warts/verrucae; associated with thrombosed capillaries

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Oral herpes (HSV-1)

Painful, recurring vesicles or ulcers (may begin with tingling, itching or burning)

- blisters (cold sores) in/around mouth or lips

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Genital herpes (HSV-2)

Painful, recurring vesicles or ulcers (may begin with tingling, itching or burning)

- PAINFUL papules, vesicles, or ulcers around the genitals or anus

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Actinic keratosis; cutaneous squamous cell carcinoma

Adult w/ fair skin + solitary or multiple lesions on highly sun exposed areas + scaly plaque/macule

What is this patient predisposed to?

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Seborrheic keratosis

Benign, waxy/scaly skin growth that typically appears in middle-aged and older adults

- verrucous/greasy

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cutaneous horn

straight or curved, hard, yellow-brown projection from the skin

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SCC

Patient with lightly pigmented skin + bump that "won't heal" +

- Hyperkeratotic debris (MALIGNANT)

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BCC

MC skin cancer?

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BCC

Scaly patch, a new bump, or a sore that won’t heal

- Pearly pink papule/nodule

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melanoma (most serious form of skin cancer)

Asymmetric, irregular borders, changed-color lesion

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Melasma

Recurring disorder of hyperpigmentation, often 2/2 hormone production (e.g., PREGNANCY)

- occurs on sun-exposed skin

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Vitiligo

Autoimmune condition with chalky/milky lesions; common in females around 20 years

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Koebner phenomenon

Skin condition worsening at sites of trauma or injury

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Eczema

Chronic, pruritic, inflammatory skin disease with rash, dry skin

-Occurs most frequently in children

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Lichen Planus

Skin condition with fine, white Wickham stria

- pruritic, purplish, polygonal, plain-topped, papules

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Pityriasis Rosea

Skin rash with a solitary salmon-colored herald patch or Christmas tree pattern on the back

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Plaque psoriasis

Erythematous plaques with a thick, silvery scale

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Guttate psoriasis

Multiple, small psoriatic papules and plaques

- “Drop-like”

- Seen after Strep pharyngitis

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Auspitz sign

pinpoint bleeding after removal of scale overlying a psoriasis plaque

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Erythema multiforme

Skin reaction with concentric target lesions

- SYMMETRIC

- Negative Nikolsky sign

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Human herpesvirus 8 (HHV 8)

Etiology of kaposi sarcoma (HIV skin contition)?

Lesions on lower extremities, face (nose), oral mucosa, & genitalia arranged in a linear fashion. Vascular tumor

- not painful or pruritis

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Stasis dermatitis

Skin inflammation on the lower extremities with weeping patches & plaques

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Acanthosis Nigricans

Velvety plaques on the posterior neck associated with insulin resistance

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Lyme (Borrelia burgdorferi)

Erythema migrans + local adenopathy

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RMSF (Rickettsia rickettsii)

Rash that begins on the wrists and ankles and spreads centripetally to involve the trunk and extremities.

-Rash on the palms and soles***

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Pemphigus vulgaris

Mucus membrane involvement - erosions of mouth, nose, pharynx, larynx, vagina

- PAINFUL lesions

- (+) Nikolsky sign

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Pemphigus vulgaris

flaccid & easily ruptured; (+) Nikolsky; oral mucosa = prodrome

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Bullous pemphigoid

Tense & firm topped bullae with uticaria as prodrome

- (-) Nikolsky sign

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epidermoid inclusion cyst

- Discharge of a foul-smelling "cheeselike" material

- Flesh-colored-to-yellowish, firm, round nodules

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solar lentigo

sharply circumscribed, pigmented macule

Histology: hyperplasia of the epidermis & ↑ pigmentation of basal layer

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Hidradenitis Suppurativa

Skin tunnels in intertriginous skin areas like axillary**, groin, perianal, perineal, and inframammary regions

- MC in women

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Telogen Effluvium

Diffuse, nonscarring hair loss with < 50% of scalp hair loss

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Anagen effluvium

Acute loss of anagen hair fibers secondary to chemotherapy or toxin exposure and represents loss of > 80%

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Paronychia; Staphylococci

Pain in the lateral nail fold due to infection = _________.

Etiology?

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Koilonychia

Spoon-shaped nails seen in iron deficiency anemia

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Thyroglossal Duct Cyst

Soft, painless mass on the anterior neck due to a remnant of thyroid development

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Branchial Cleft Cysts

Painless swellings on the lateral neck along the SCM

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Torticollis

lateral neck flexion and neck rotation of an infant 2-4w

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Epstein Barr virus

Tonsillitis + symmetric lymphadenopathy (posterior cervical chain) + exudate *

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Graves Disease

Autoimmune condition with protruding eyes due to hyperthyroidism

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basilar skull fx

-Retroauricular or mastoid ecchymosis (ie, Battle sign) typically appears one to three days after the fracture is sustained

-periorbital ecchymosis

-Clear rhinorrhea or otorrhea

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Lymphatic Filariasis

Parasitic infx caused by nematodes (roundworms)+ lymphangitis/lymphedema + odd enlargement of extremities (elephantiasis)

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Toxoplasmosis

Caused by Toxoplasma gondii leading to retinochoroiditis

- cervical lymphadenopathy

- pregnant women & gardeners

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Toxoplasmosis

Ophthalmologic examination reveals multiple yellow-white cotton like patches with indistinct margins located in small clusters in the posterior pole

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Cat-scratch disease

Caused by Bartonella henselae presenting with ecchymosis and mistaken for insect bites

- lesions are 2-5 mm

- lymphadenopathy

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Most common in patients 20-30 years of age and then after 55 years of age

BIMODAL

Ages affected by Hodgkin lymphoma?

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Hodgkin lymphoma

Palpable, painless lymphadenopathy

- weight loss, fever

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Acute Lymphocytic Leukemia (ALL)

common type of cancer that affects CHILDREN (<5 years old at highest risk)

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CLL

Lymphocytic Leukemia with early satiety/abdominal fullness

- older male, 72 yo

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Chronic Myeloid Leukemia

95% of cases caused by abnormal Philadelphia chromosome. rare blood cancer that develops when the bone marrow makes too many myeloid cells

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multiple myeloma

Bone pain and pathologic fractures that doesn't make sense

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Lymphedema

Edema with peau d'orange appearance due to lymphatic obstruction

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Rubella

Rash starts on face & spreads caudally; spares palms & soles; caused by Matonaviridae

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Roseola

Rash starts on neck/trunk and spreads; nonpruritic

- ABRUPT FEVER (but child is still okay)

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Measles

Rash that blanches caudally; Koplik spots in buccal mucosa; conjunctivitis

- cough, fever, conjunctivitis

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measles

Koplik spots

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Etiology of Roseola?

HHV 6 or 7