Please enable JavaScript.
Coggle requires JavaScript to display documents.
inland Clin med Derm - Coggle Diagram
Clin med Derm
Functions of Skin
Protection
Synthesis of Vitamin D with UV light
Regulates body heat
Prevents unnecessary water loss (insensible loss)
Sensory reception
Dermis
Strong Flexible tissue
Cells:
Fibroblasts
Macrophages
Mast Cells
WBCs
Fiber Types:
Collagen
Elastic
Reticular
Critical Role in Temp Regulation
Vessels
Dilate to cool
Two layers
Papillary
areolar connective tissue
dermal papillae
Reticular
Reticulum - network of collagen and reticular fibers
Overview
Lesions
Describe:
Size, Shape, Color, Texture, Elevation, Pedunculation, Exudate, Location, Distribution, Configuration.
Primary vs secondary
Primary : Initial reaction to an underlying problem that alters component of skin
List?
Macule, Patch, papule, nodule, tumor, plaque, wheal, cyst, vesicle, bulla, pustule, telengiectasia, burrow
Secondary: Changes to the appearance of primary lesion
List?
Scale lichenification, keloid, scar, excoriation, fissure, erosion, elcer
Tests:
Wood's Lamp
transillum to detect bacterial/fungal skin infections. Detect pigment disorders (vitiligo)
Patch and Scratch
test for allergies
Diascopy
test for blanchability. Pressure applied with finger over a clear slide.
Vascular
inflammatory or congenital
non-vascular
nevus
hemorrhagic
petichia or purpura
Tzanck Smear
to ID herpes Simplex
Tzanck cells - multinucleated giant cells
Gold Standard
Others?
skin biopsy, immunofluorescence, gram stain, culture, side lighting, diascopy
Special Signs
Darier Sign
Rubbing lesion causes an urticarial flare
Auspitz Sign
pinpoint bleeding after scale is removed
pathognomonic for Psoriasis
Nikolsky Sign
Pushing blister skin of blister causes further separation of the dermis.
Photo-Patch Test
Documents photoallergy
Patch Test
Demonstrates hypersensitivity reaction
Koebner Phenomenon
Minor trauma leads to more lesions
Medication
Corticosteroids
Which is more potent?
Ointment
Correct
Which is more potent, 1 or 7?
Class 7 least potent
Used to treat?
1 more item...
Treatment duration?
1 more item...
Class 1 most potent
Used to treat?
1 more item...
super high potency not to exceed 3 weeks if possible
1 more item...
Pediatric treatment?
Low strength for sorter duration
1 more item...
No potent/ super potent topical steroids in kids younger than 12
Cream
less potent
Potency can be increased with?
when applied to moist skin
occlusive dressing
by as much as 100x
Exception!!
betamethazone is super high strength optimized cream
Antibiotics
Impetigo on exam?
Honey colored crusts
Treat with?
mupirocin
NSAIDS
Side effects
Striae
Stretch marks
Atrophy
Skin thinning
Telangiectasia
prominent capilaries
Purpura
bruising and discoloration of skin
Diseases
Adult with
Recurring pruritic rash on face and hands
Lichenification in flexural regions
History of allegies and asthma
Diagnosis?
Atopic Dermatitis
On Exam:
3 more items...
Pathophys
1 more item...
Differential Diagnosis (DDx)
3 more items...
To diagnose:
2 more items...
To Treat:
6 more items...
Atopic triad?
Eczema/AD, Allergies, Asthma
Additionally
Xerosis
Cheilitis
Define?
Cracks and inflammation in corners of mouth
Itching when sweating
Define?
Abnormally dry skin
Child with
Sharply demarcated erythema
vesicular lesions on dorsal surface of foot bilaterally
Diagnosis?
Contact dermatitis
Etiology
3 more items...
Pathophys
1 more item...
On Exam
3 more items...
DDx
2 more items...
Treatment
2 more items...
Infant with
Erythematous and papulovesicular lesions over convex surface of buttocks
Diagnosis?
Diaper Dermatisis
Common condition
2 more items...
Pathophys
1 more item...
Adult with
Round plaques composed of groups of small papules and vesicles on lower extremities
Dx?
Nummular eczema
3 more items...
African American man
Type II DM
25 y.o female with
Discrete erythematous micropapules and micropapulovescicles around the mouth
small clear area b/w the vermilion border
1 more item...
25 y.o. male with
Hx of HIV
1 more item...
Elderly obese male with
2 more items...
Eczema / Dermatitis
Define:
Pattern of cutaneous inflammation that presents with intensely pruritic, erythematous, eczematous skin lesions
Chronic symptoms:
Dryness, scaling, lichenification, fissuring and pruritus
Specific Diseases:
Atopic Dermatitis
Contact Dermatitis
Ear/Nipple/Eyelid Dermatitis
Diaper Dermatitis
Nummular Dermatitis
Coin shaped
African American males with DM
