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MSK Exam 1
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
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
Lichen Planus
Pathophysiology
Mucocutaneous Disorder
30-60 year olds
Signs & Symptoms
Pruritic
Plaques or Papules
Purple & Polygonal
Often Mucosal or Genital Involvement
Wickham Striae
Diagnosis
Biopsy
Sawtooth Infiltrate of Lymphocytes
Treatment
Topical Corticosteroids
Considerations
Hepatitis C Association
2 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
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)
3 mins
Systemic Lupus Erythematosus (SLE) Diagnosis and Clinical Features
IM DAMN SHARP acronym
Immunoglobulins
Malar rash
Discoid rash
Antinuclear antibody
Mucositis
Neurologic disorders
Serositis
Hematologic disorders
Arthritis
Renal disorders
Photosensitivity
2 mins
Systemic Lupus Erythematosus (SLE) Mechanism, Treatment and Complications
Mechanism and Characteristics
Systemic Autoimmune Disease
9:1 female to male ratio
Treatment
Glucocorticoids
NSAIDS
Hydroxychloroquine
Cyclophosphamide
Complications
Lupus nephritis
Libman-Sacks Endocarditis
Secondary Antiphospholipid Antibody Syndrome
Other
Drug-induced lupus
2 mins
Polymyositis / Dermatomyositis Disease
Pathophysiology
Idiopathic Inflammatory Myopathy
More Common in Women
Endomysial Inflammation with CD8+ Cells (Polymyositis)
Perimysial Inflammation with CD4+ Cells (Dermatomyositis)
Signs and Symptoms (Both)
Symmetric Proximal Muscle Weakness
Dysphagia
Lung and Cardiac Involvement
Signs and Symptoms (Dermatomyositis)
Malar Rash
Shawl-like Shoulder Rash
Gottron Papules on Knuckles
Heliotrope Rash
3 mins
Polymyositis / Dermatomyositis Diagnosis and Treatment
Diagnosis
Increased CK (CPK)
Increased Aldolase
Anti-JO-1 Antibody
Anti-SRP Antibody
Antinuclear Antibody
Abnormal EMG
Biopsy
Treatment
Corticosteroids
Methotrexate
Azathioprine
Treatment For Resistant Disease
Intravenous Immunoglobulin (IVIG)
Cyclophosphamide
Rituximab
Calcineurin Inhibitors
2 mins
Vitiligo
Pathophysiology
Autoimmune Destruction of Melanocytes
Presentation
Hypopigmentation
Acral Areas and Around Orifices
Diagnosis
Clinical Presentation + Woods Lamp
Risk Factors
Other Autoimmune Diseases
Treatment
Glucocorticoids
Tacrolimus
Phototherapy
2 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
2 mins
Bullous Pemphigoid
Linear Deposits of IgG
Affects Hemidesmosomes
Epidermal Basement Membrane
Tense Blisters on Skin
Nikolsky Negative
Contain Eosinophils
Rarely Affect Oral Mucosa
2 mins
Anti-desmoglein Antibodies
Pemphigus Vulgaris
Flaccid Blisters
Skin and Oral Mucosa
Positive Nikolsky's Sign
59 secs
Actinic Keratosis
Sun Exposure
Papules or Plaques
Small, Rough
Erythematous
Precursor to Squamous Cell Carcinoma
53 secs
Erythema Nodosum
Pathophysiology
Panniculitis
Painful Inflammation
Subcutaneous Fat
Anterior Shins
Risk Factors
Coccidioidomycosis
Pregnancy or OCP Use
Crohn's Disease
Tuberculosis (TB)
Histoplasmosis
Sarcoidosis
Ulcerative Colitis
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
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
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
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
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
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