Burnin' Love
This chronic skin change is due to venous hypertension and slow flow in the microvasculature, which then causes damage to the small vessels leading to edema. Decreased oxygen leads to activation of inflammatory cells.
What is stasis dermatitis?
Bonus Treatment:
Compression bandages or stockings
Leg elevation at rest
Calf muscle exercise to improve venous return
This rash is characterized by red patches or erosions with peripheral satellite pustules.
What is Candidasis?
Which of the ABC's of Melanoma is NOT included in the list below?
Asymmetry
Boarders
Color
Evolving
What Is Diameter?
Specifically greater than 6cm
A 72 year old man with a history of PD presents with symmetric erythematous patches with overlaying greasy scale on his scalp and face. He is concerned because his friend told hime he may have a yeast infection on his face.
What is KETOCONAZOLE or selenium sulfide or tar shampoos?
Acute flares: mild topical corticosteroids such as 1% HCz
**AVOID: Aggressive systemic therapy may cause rebound.
Fun fact, more common in Parkinson's patients.
This skin condition is notable for dryness of the skin and can present as Eczema craquelé (cracked riverbed appearance with erythematous, fissured, and cracked skin) and is often noted on the lower legs of a patient.
What is xerosis?
More than 2/3 of the patients with this problem are over the age of 50 and it is described as clusters of vesicles and pustules on an erythematous base involving a thoracic dermatome.
What is herpes zoster?
This is the second most common form of skin cancer and requires Moh's surgery for removal and can occur in longstanding, non-healing wounds (such as a burn or radiation scar).
What is squamous cell carcinoma.
A 65 year old patient comes to you stating they have developed red spots all over their skin. They are round, bright red and dome-shaped.
What is nothing OR
Shave biopsy, electrodessication, or laser ablation.
Diffuse erythema and erythematous papules and papulopustules are seen on the cheeks, forehead, and chin
What is Rosacea?
A new admission at the nursing home states that have had horrible sleep since their new roommate joined the room. Initially you assume this is because they are prone to wander the room, however, it's due to constant itching around the ankles. The roommate shouts, "Yeah, my ankles have been itching too!"
What is scabies?
Often in sun-exposed areas these poorly circumscribed white scaly macule are typically frozen off before turning into cancer.
What is actinic keratosis?
A 66 year old develops the same rash that her 20 year old grand daughter has and she has tons of questions. She noticed this raised area on her elbows and scalp after the passing of her sister. She says, "All these problems are happening with my skin, and now my fingers look like sausages, Doc! HELP!"
What is stress management?
First line approach is understanding the inflammatory process should be treated by addressing underlying trigger.
Also Accept:
This skin condition is common in older adults because of increased folds in the skin due to decreased dermal elasticity. Risk factors include moisture, decreased mobility, diabetes and steroid use leading to decreased immunity.
What is intertrigo?
You are seeing a VA patient in GeriPACT clinic for weekend follow up and they tell you their entire weekend was spent bagging up clothes and washing everyone's hair in the home. They have which dermatologic issue?
What is louse infestation (lice)?
What is Irregular variegation in pigment (shades of brown and blue-black) and irregular borders suggest melanoma, a malignant tumor of melanocytes
What is melanoma?
67 year old man and physical exam notes the nose shows thickening of the skin and changes consistent with an early rhinophyma (bulbous or “ruddy” nose). He hasn't tried anything yet, but is hoping you can provide first line therapy.
What are TOPICAL BENZOYL PEROXIDE or METRONIDAZOLE?
Second line: ORAL ANTIBIOTICS SUCH AS TETRACYCLINES FOR SEVER CASES.
Alt therapy: topical azelaic acid, topical tretinoin and oral isotretinoin for severe cases
This skin condition is notable for scratching that relieves itching and leads to a vicious cycle. There are skin changes that include hyperpigmentation, lichenification and scale.
What is lichen simplex chronic-us?
(neurodermatitis)
This is tricky because you have to be sure there were no irritants, contact term, or drug allergy present
This pesky blood sucker is known to cause a pruritic eruption in a straight line. Sometimes people mistake them for apple seeds on their furniture.
What are bed bugs?
This is a pearly papule that is eroded in the center and has a characteristic rolled border
What is Basal cell Carcinoma?
BONUS:
Clinical pattern w/ Description
Nodular
Most common variant; waxy, translucent papule with overlying telangiectasias, often with central ulceration
Morpheaform
Scar-like appearance; can look atrophic
Superficial
Erythematous macule or papule with fine scale or superficial erosion often surrounded by telangiectasia
A 68-year-old man has pain on his left cheek and on the left side of his nose. The pain began 3 days ago and is intensifying; he now has red splotches and small blisters. He recalls no trauma. He has not used new medications or personal products and has not traveled recently or been in contact with sick persons. On exam you find erythematous papules and clear-to-hemorrhagic crusted and eroded vesicles on his nasal tip and left cheek. You prescribe oral antiviral therapy, what's next?
What is refer for emergent ophthalmology consultation?