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Case 16
fam med cases
22
Medical
Graduate
01/25/2011

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Cards

Term
Ddx for erythematous patch + long Hx of sun exposure
Definition
Squamous Cell Carcinoma (>2cm high risk; scaly, erythematous base, irreg borders, easy bleeding),
Actinic keratosis (scaly patches easily felt),
Basal cell carcinoma (waxy appearance, no itching or change in skin color, rarely mets),
Melanoma (Dark brown or black pigmented lesions, )
Fungal infection (most acute presentation)
Term
Macule
Definition
flat, <1cm
Term
patch
Definition
flat, >1cm
Term
papule
Definition
solid, raised, <1cm
Term
plaque
Definition
solid, raised, >1cm
Term
nodule
Definition
solid, raised, >1cm; in epidermis, dermis or subQ
Term
tumor
Definition
solid mass of skin or subQ, larger than a nodule
Term
vesicle
Definition
fluid filled, raised, <1cm
Term
bulla
Definition
fluid filled, raised, >1cm
Term
Pustule
Definition
elevated lesion w pus
Term
wheal
Definition
area of elevated edema in upper epidermis
Term
Typical Distribution patterns of skin lesions
Definition
Psoriasis: extensor surfaces
atopic eczema: flexor surfaces of extremities
erythema multiforme, syphillis, eczema: Palms and soles
Term
Skin lesion w pain
Definition
Herpes simplex or herpes zoster
Term
Prostate exam finds symmetrically firm and enlarged prostate...
Definition
BPH. Firm, nodular, asymmetric or indurated suggests malignancy
Term
Corticosteroid creams
Creams v Ointments v. Lotions and gels
Definition
Creams: mix of oils and water, cosmetically most acceptable, best for acute inflamm

ointments: little or no water, enhanced potency

lotions and gels: alcohol, often used in scalp, good for exudative inflamamation (poison ivy)
Term
Group 1-6 topical corticosteroids used for
Definition
Group 1,2 (most potent) Psoriasis, lichen planus, eczema, alopecia areata
Group 3.4,5: Atopic dermatitis, nunmmular eczema, statis dermatitis, seborrheic dermatitis
Group 6.7 (weakest): Dermatitis in eyelids and diaper area, mild dermatitis on face, and mild intertrigo
Term
Side fx of topical corticosteroids
Definition
Skin atrophy, hypopigmentation

Also: HPA axis suprression, glaucoma, HTN,
Term
Tinea Capitis Rx
Definition
Oral therapy: Griseofulvin
Term
Tinea unguium (onychomycosis) Rx
Definition
Oral therapy: Griseofulvin (long term therapy needed)
Term
Tinea pedis, tinea magnum, tinea corporis and tinea cruris Rx
Definition
opical antifungal medications; 'Azole' cream, gel, lotion or shampoo
Term
Squamous cell carcinoma in-situ Rx
Definition
1) Surgical excision
2) Moh's microscopic surgery (surgeon reviews pathology)
3) Topical 5-fluorouracil
4) Cryosurgery
5) Patient education: limit sun exposure and skin self exam
Term
BPH Rx
Definition
1.Behavior modification (limit fluids, diuretics)
2.Alpha adrenergic antagonists
3.5 alpha reductase inhibitors
4. Combo therapy
5. Surgery (if combo therapy fails, or risk of infection)
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