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USMLE Step 2 CK Bits & Pieces High yield short focused points, monographs, charts, illustrations, tables, and other stuff related to the USMLE Step 2 CK Exam.


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  #1  
Old 10-12-2013
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Skin Dermatology Pictures for the CK Exam

Let's attach here pics or just post about dermatologic conditions that we find hard to recognize, always miss in questions or just find interesting.

Met interesting one while doing rheumatology:

Keratoderma blenorrhagicum: skin lesions on palms and soles, may spread to scrotum, scalp and trunk, resembling psoriasis characteristic for Reiter's
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Old 10-13-2013
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Default ich

Dermatology Pictures for the CK Exam-ichthyosis-vulgaris.jpg

This patient has ichthyosis vulgaris, a common skin disorder that affects almost 1 in 250 individuals with variable penetrance. It is an autosomal disorder and is the most common form of ichthyosis. Affected individuals are born without obvious skin defects and typically present within the first year of life. There is usually xerosis (dry skin) and a variety of scales affecting the extensor surface of the extremities. The scales often present in a mosaic, fish-scale pattern, which gives rise to the name. The disease typically improves with age.
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Dermatology Pictures for the CK Exam-non-bi.jpg

This child has nonbullous impetigo, a superficial bacterial infection transmitted by direct contact. Nonbullous impetigo is caused by group A β-hemolytic Streptococcus pyogenes and results in transient erythematous papules or thin-roofed vesicles that rupture and form honey-colored crusts.
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Default Dermatitis herpetiformis

Associated with Celiac disease. Should slowly dissappear after starting gluten free diet. Called Celiac disease of skin.
Usually its said to be found on extensor surfaces, but convex surfaces might me more appropriate. itchy rash, which usually exists on the convex surfaces of the body, such as knees, elbows, scalp and buttocks.
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Default Dermatitis herpetiformis

Called Celiac disease of skin.
itchy rash, which usually exists on the convex surfaces of the body, such as knees, elbows, scalp and buttocks.
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Default Pityriasis Rosea

Herald patch+Christmas tree appearance transient dermtitis. May mimic secondary syphilis but spares palms and soled. If symtpomatic steroids or uv light. Mild self-limitd resolvs without scaring in 8 weeks. Christmas tree pattern- longer axis of oval macules and papules oriented along lines of skin cleavage. Multiple plaques with collarette scale.
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Dermatology Pictures for the CK Exam-basal-cell-carcinoma.jpg


basal cell carcinooma "pearly papule"
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Dermatology Pictures for the CK Exam-bullous-pemphi.jpg
bullous pemphigoid. Tense bullae
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Dermatology Pictures for the CK Exam-atopic-dermatitis.jpg

atopic dermatitis "flexure surfaces"
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Dermatology Pictures for the CK Exam-actinic-keratosis.jpg

actinic keratosis.. Precursor to squamous cell carcinoma
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Dermatology Pictures for the CK Exam-allergic-contact-dermatitis.jpg
allergic contact dermatitis. 'nickel" from wearing earrings on new piercing.
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Dermatology Pictures for the CK Exam-diabetic-neurotropic-ulcer.jpg
diabetic foot. "neurtropic ulcer"
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Dermatology Pictures for the CK Exam-cutaneous-melanoma..jpg
cutaneous melanoma.... Irregular border, discoloration, raised above surface, yack yack yack......
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Dermatology Pictures for the CK Exam-erythema-nodosum.jpg
erythema nodosum: Most popular in sarcoidosis patients
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Dermatology Pictures for the CK Exam-homozygous-familial-hypercholesterolemia.-planar-xanthomas-seen-knees.jpg
homozygous familial hypercholesterolemia. The planar xanthomas seen on the knees
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Dermatology Pictures for the CK Exam-keraroacanthoma.jpg
KERATOACANTHOMA dome-shaped, symmetrical, surrounded by a smooth wall of inflamed skin, and capped with keratin scales and debris
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Dermatology Pictures for the CK Exam-lyme-dz.jpg

lyme disease : Target Rash!!
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Dermatology Pictures for the CK Exam-melanoma.jpg

acral lentiginuous melanoma.
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Dermatology Pictures for the CK Exam-mycosis-fungoides.jpg
mycosis fungoides: Sezary syndrome !!
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Dermatology Pictures for the CK Exam-stasis-dermatitis.jpg

STASIS DERMATTIS: refers to the skin changes that occur in the leg as a result of "stasis" or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins.
Insufficient venous return results in increased pressure in the capillaries with the result that both fluid and cells may "leak" out of the capillaries. This results in red cells breaking down, with iron containing hemosiderin possibly contributing to the pathology of this entity.
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Default Squamous cell cancer

non healing ulcerative red lesions, with frequent scale,
risks sun and tobacco.
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Default Kaposi sarcoma

only a/w aid acquired through sexual contact. HHV8
reddish-purplish violaceous vascular skin cancer. also found in GI and lung.
Rx: antiviral not surgical.
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oral Kaposi with overlying candidiasis infection in HIV pt
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Default Basal cell carcinoma

pearly, rolled borders, teleangiectasias, central crusting and ulceration. nonhealing ulcer. palisading nuclei .

I personally never am able to differentiate basal cell form squamous cell skin cancers. both look pearly with nonhealing ulcers etc..

Wiki sais "translucensy " is key word for basal cell carcinoma
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Default Seborrheic Keratosis

Leser–Trélat sign due to colon cancer
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Cradle Cap :- Infantile seborrheic dermatitis.
A rash that begins as scaling and redness on a baby's scalp
Noninfectious
Slowly disappears over a period of weeks or months
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Default Rosacea

Rosacea chronic condition facial erythema and sometimes pimples.

Rosacea typically begins as redness on the central face across the cheeks, nose, or forehead. in some advanced cases, a red lobulated nose (rhinophyma), may develop
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Default erythema multiforme

One of the most interesting cutaneous hypersensitivity manifestations, at least to me More common in children and young adults, typical target lesions, palms affected too. Associated with M. pneumoniae infection, HSV, cancer, autoimmune disorders and drugs (sulfa, beta lactams, phenytoin). Dear friends, enjoy!
Dermatology Pictures for the CK Exam-erythema-multiforme-target-lesion.jpg

Dermatology Pictures for the CK Exam-2009-09-06_164641_erythema_multiforme.jpg
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Quote:
Originally Posted by KovachMarina View Post
One of the most interesting cutaneous hypersensitivity manifestations, at least to me More common in children and young adults, typical target lesions, palms affected too. Associated with M. pneumoniae infection, HSV, cancer, autoimmune disorders and drugs (sulfa, beta lactams, phenytoin). Dear friends, enjoy!
Attachment 3368

Attachment 3369
Your post Helped me answer one q today. Although while doing q i had no idea why i had such hunch about myco pneumo with association of erythema multiforme
Just understood that while watching this thred. thanks. continue posting !!!!!
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Default Erythema toxicum

Erythema toxicum neonatorum, only in neonatal period. Aka urticaria neonatorum.

characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules. Fluid from lesions will show eosinophilia. Thought to be an activation of immune system, type of hypersensitivity. Benign, transient self- limited.
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Last edited by tamta; 10-18-2013 at 12:48 PM.
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Default Milia

"Milk spots" around nose, eyes, genitalia. Neonatal but also any age.
Keratin filled cysts that can appear just under epidermis, or roof of mouth
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Default nummular dermatitis

coin- shaped lesions, itchy, eczema due to dehhydration, keep moisturized
nummus=coin
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  #33  
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Default Not sure if it's high yield...

Vibrio vulnificus, besides causing diarrhea in patient with hemochromatosis and liver disease, can also cause skin lesions in these patients
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Old 10-19-2013
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RHINOPHYMA is a large bulbous ruddy nose cused by granulomatous infiltration commonly due to untreated Rosacea. history of drinking & facial flushing are supportive.Dermatology Pictures for the CK Exam-rhinophyma_06_30_06_0101_sq_930.jpg
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  #35  
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Default Erysipelas

Strep infection.
Erysipelas does not affect subcutaneous tissue. It does not release pus, only serum or serous fluid. May misdiagnose it as cellulitis, but the style of the rash is much more well circumscribed and sharply marginated than the rash of cellulitis.

Patients typically develop symptoms including high fevers, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection
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  #36  
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Default Condyloma Acuminata

HPV warts. reccurence is high despite excision or fulguration for large lesions, or for smaller lesions acid or podophylin
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  #37  
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Default Lichen Planus

I do remember well mnemonic of Ps but in ever recognize this lesion.
just found out what is lichen- a composite organism consisting of fungus and a photosynthetic partner
skin form, mucosal form (mouth tongue, lip, GI etc)
considered autoimmune with unknown trigger.

associated with Hep C. !!!
Purple Pruritic Polygonal Planar Papules and Plaques
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  #38  
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Default Lichen Planus

Wickham's striae net-like lesion in Lichen planus
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  #39  
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Default Mongolian spots

African, asian, huspanic, native american newborns. Mongolian Spots may look like bruises but don' t change colour, and go away in two three weeks
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Default Zinc deficiency

Acrodermatitis enteropathica is an autosomal recessive metabolic disorder affecting the uptake of zinc, characterized by periorificial and acral (in the limbs) dermatitis, alopecia (loss of hair), and diarrhea.
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Default HI

I thought 'Pearly appearance' is present only in B.C.Ca, not in Sq.C.Ca, where did u get that info?

another interesting clue is
Basal C.Ca is present above the upper lip level usually
n sq C Ca below the upper lip level-Goljan


Quote:
Originally Posted by tamta View Post
pearly, rolled borders, teleangiectasias, central crusting and ulceration. nonhealing ulcer. palisading nuclei .

I personally never am able to differentiate basal cell form squamous cell skin cancers. both look pearly with nonhealing ulcers etc..

Wiki sais "translucensy " is key word for basal cell carcinoma
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  #42  
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Quote:
Originally Posted by ddaydreamer View Post
I thought 'Pearly appearance' is present only in B.C.Ca, not in Sq.C.Ca, where did u get that info?

another interesting clue is
Basal C.Ca is present above the upper lip level usually
n sq C Ca below the upper lip level-Goljan
Nearly everywhere the last source was wiki as i remember. It would ne so nice if it were divided only by upper or lower lip. Usully they are both presented on face and i have had mistakes and remember that that division does not work well.
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Default Staphylococcal scalded skin syndrome

I always miss this one with scarlet fever clinically from question stem.
Visually quite easy to recognize SSSS with positive Nikolsky, superficial flaccid blisters, when unroofed erythematous base, scalding desquamation, perioral crusting
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  #44  
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Default Scarlet fever

Sand paper texture, usually preceded by other infection like pharyngitis. Caused by group A strep. Toxin mediated. Also strawberry tongue.
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  #45  
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Default Rheumatic nodules. Who would say!

Autoimmune vasculitis causes these changes on extensory surfaces. Although it's not dermatologic disease, I think we should keep these changes in mind
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Default Yea

Altered taste sensation(somewhat specific 2 dis) & poor wound healing are also seen.

Quote:
Originally Posted by tamta View Post
Acrodermatitis enteropathica is an autosomal recessive metabolic disorder affecting the uptake of zinc, characterized by periorificial and acral (in the limbs) dermatitis, alopecia (loss of hair), and diarrhea.
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  #47  
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Default Vs abuse

There is a sharp demarcation in dis. In abuse, the rash merges into d surrounding tissue

Quote:
Originally Posted by tamta View Post
African, asian, huspanic, native american newborns. Mongolian Spots may look like bruises but don' t change colour, and go away in two three weeks

Last edited by ddaydreamer; 11-05-2013 at 11:09 PM. Reason: Typo
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Old 11-06-2013
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Quote:
Originally Posted by tamta View Post
I do remember well mnemonic of Ps but in ever recognize this lesion.
just found out what is lichen- a composite organism consisting of fungus and a photosynthetic partner
skin form, mucosal form (mouth tongue, lip, GI etc)
considered autoimmune with unknown trigger.

associated with Hep C. !!!
Purple Pruritic Polygonal Planar Papules and Plaques
However Lichen Planus is not caused by Lichen but an autoimmune process 'exact cause unknown'
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Post Yup

The lesion resembles Lichen, however its not caused by Lichen.

The classic appearance is purple color, unless when they involve the oral cavity, they are more of transparent in nature

other associations with HCV- MPGN, Cryoglobulinemia, Plasma cell cancers, arthritis,

Quote:
Originally Posted by thind View Post
However Lichen Planus is not caused by Lichen but an autoimmune process 'exact cause unknown'
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  #50  
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Quote:
Originally Posted by ddaydreamer View Post
The lesion resembles Lichen, however its not caused by Lichen.

The classic appearance is purple color, unless when they involve the oral cavity, they are more of transparent in nature

other associations with HCV- MPGN, Cryoglobulinemia, Plasma cell cancers, arthritis,
Yes dental amalgam too...the guy in the picture has it!
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Me again with some cutaneus manifestations of systemic diseases.
Keratoderma blennorrhagicum resembles psoriasis, present on palmes and soles and associated with reactive arthritis
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Quote:
Originally Posted by tamta View Post
Acrodermatitis enteropathica is an autosomal recessive metabolic disorder affecting the uptake of zinc, characterized by periorificial and acral (in the limbs) dermatitis, alopecia (loss of hair), and diarrhea.
And thanks to you, I answered one question right!
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Default Chalazion

Quote:
Originally Posted by KovachMarina View Post
And thanks to you, I answered one question right!
I am very glad sorry have not paid enough attention to this thread for these days.

Attached is Chalazion

There is confusion with the terms stye, hordeolum and chalazion

A hordeolum (or a stye) is term used by the medical profession to denote a localized inflammation and/or infection of the hair follicles of the eyelid or the meibomian glands. It is usually an acute problem but can be recurrent. These are usually somewhat painful with erythema and the entire general eyelid may be edematous. Generalized cellulitis can also occur. In 90-95% of cases, Staphylococcus aureus is the cause.

A chalazion is a term used by the medical profession to denote a swelling caused by blockage of sebaceous glands and formation of granulomas. This is also said to be granulomatous inflamm of meibomian gland. It usually occurs in the meibomian glands in the tarsal plates, but also can occur in the sebaceous glands of Zeis. It is a chronic problem and it is usually painless. Internal hordeola may lead to chalazia. Chalazia can become quite large and put pressure on the cornea and thereby cause visual changes.
Chalazia usually are treated with warm compresses (4 times/day).

Attachment shows chalazion
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A chalazion is a term used by the medical profession to denote a swelling caused by blockage of sebaceous glands and formation of granulomas. This is also said to be granulomatous inflamm of meibomian gland. It usually occurs in the meibomian glands in the tarsal plates, but also can occur in the sebaceous glands of Zeis. It is a chronic problem and it is usually painless. Internal hordeola may lead to chalazia. Chalazia can become quite large and put pressure on the cornea and thereby cause visual changes.
Chalazia usually are treated with warm compresses (4 times/day).

Attachment shows chalazion again
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A hordeolum (or a stye) is term used by the medical profession to denote a localized inflammation and/or infection of the hair follicles of the eyelid or the meibomian glands. It is usually an acute problem but can be recurrent. These are usually somewhat painful with erythema and the entire general eyelid may be edematous. Generalized cellulitis can also occur. In 90-95% of cases, Staphylococcus aureus is the cause.

So key is painful!!!!!!
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Default Dacryocystitis

Key word medial canthal region redness and inflammatory changes.
Usually infants but also adults >40. Purulent discharge from punctum, fever leukocytosis. Stap aureus and b hemolytic strep.
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Default Hordeolum

Infection of sebaceous gland of the eye

When it affects the meibomian (posterior) glands, it is relatively large and is known as an internal hordeolum. The smaller and more superficial external hordeolum (sty) is an infection of the anterior glands of Moll or Zeis

I suppose this is internal hordeolum not external attached
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So seems very hard to diff visually these two. Maybe this helps didn't like it very much though, but anyway maybe you will find interesting.

So main point is
Hordeolum- painful,
Chalazion - painless
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  #59  
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Great thread tamta!!!
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Default Dermatomyositis

Gottron's papules
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Default Deratomyositis

Shawl sign
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Default Dermatomyositis

Keep in mind underlying malignancy with dermatomyositis
Bx: perimysial CD4+

This baby has everything together i guess. Heliotrope rash+ looks like shawl sign
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Default Erythema nodosum

This one gives ,e lot of trouble when differentiating systemic diseases: so far sarcoidosis, coccidioidomycosis, TB, recent strep pharyngitis can give it also just learned from wiki, non-hodgkin lymphoma, behcet's and even pregnancy
Also inflamm bowel disease like Crohn's
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Last edited by tamta; 11-24-2013 at 11:22 AM.
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Default Behçet's disease

Missed this with sarcoidosis because of similar : anterior uveitis, erythema nodosum. What points to Behçet are: multiple recurrent oral and genital ulcers, not to forget ulcers are apthous and painful.
Hypopyon also in anterior uveitis.
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Default Senile purpura

Ecchymoses on extensor surfaces on legs and arms. In elderly patients caused by perivascular connective tissue atrophy. It is unsightly but not dangerous, does not require workup, usually fades with time.
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Default Livedo reticularis

Reticular lace like pattern
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Default Cholesterol emboli

...................
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Default Pyoderma gangrenosum

A/w inflammatory bowel diseases, arthritides, hematologic dx
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Pyoderma gangrenosum
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Default Tuberous Sclerosis

Shagreen patch
Adenoma Sebaceum- angiofibromas on face
Ash leaf hypopigmentation
Retinal lesions (angiofibromas?)
Cardiac Rhabdomyoma
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Default Macula

For those like me who use opthalmologic terminology but don't really have idea what macula is
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  #72  
Old 12-20-2013
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Default Acanthosis Nigricans

it means Insulin Resistance, not only DM it can also be seen with PCOS, anything with Insulin Resistance. Obesity, Excess androgens. Can even see it with Prader -Willi (these kids are obese).
Also Cushing's, Addison's
Neck and Axilla most common.

Malignant Acanthosis Nigricans is a/w occult malignancies.
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  #73  
Old 12-20-2013
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Default Neurofibromatosis

NF1
Neurofibromas: cutaneous, flesh colored, soft lesions attached to peripheral nerves.
Lisch nodules in Iris
Cafe au lait spots- hyperpigmented cutaneous lesions
Optic glioma

NF 2 is a/w Acoustic neuromas and meningiomas. Can also have cafe au lait.
Attached Thumbnails
Dermatology Pictures for the CK Exam-neurofibromatosis_9_080424.jpg   Dermatology Pictures for the CK Exam-lisch-nodules-t1.jpg   Dermatology Pictures for the CK Exam-neurofibromatosis-10.png   Dermatology Pictures for the CK Exam-neurofibromatosis-cafe-ait-macule.jpg   Dermatology Pictures for the CK Exam-gl_popup_img_opticglioma.jpg  

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  #74  
Old 12-21-2013
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Default Tinea Capitis, Pedis, Barbae, Cruris, Corporis

Tinea Capitis, Pedis, Barbae, Cruris, Corporis

The edge of rash appears elevated and is scaly
prevent by not touching and avoiding cloths of those with disease


Attached Thumbnails
Dermatology Pictures for the CK Exam-tinea_capitis-1.jpg   Dermatology Pictures for the CK Exam-th.jpg   Dermatology Pictures for the CK Exam-barbae.jpg   Dermatology Pictures for the CK Exam-tinea_cruris1336859007266.jpg   Dermatology Pictures for the CK Exam-tinea-corporis14.jpg  

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  #75  
Old 12-25-2013
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Default Venous Stasis Ulcers

These look pretty high yield for exam. and venous stasisi ulcers can look pretty bad, even turn into cancer
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  #76  
Old 12-25-2013
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Default Arterial Ulcers

arterial ulcers are more distal
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  #77  
Old 01-16-2014
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Default

Wow tamta Really nice job...hope to start a different thread of different things to help ppl too.
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  #78  
Old 02-12-2014
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Wink

Quote:
Originally Posted by tamta View Post
African, asian, huspanic, native american newborns. Mongolian Spots may look like bruises but don' t change colour, and go away in two three weeks
I believe it takes up to 9 months for the discolouration to fade
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  #79  
Old 02-12-2014
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Default

Quote:
Originally Posted by Rochelle View Post
I believe it takes up to 9 months for the discolouration to fade
yes it can even take more..
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  #80  
Old 11-17-2014
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Default Behcet disease or Silk Road disease

recurrent oral aphthous ulcers, genital ulcers, and uveitis. As a systemic disease, it can also involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems. This syndrome can be fatal due to ruptured vascular aneurysms or severe neurological complications

Additionally: Skin hypersensitivity: Pathergy

arthritis

treat with colchicine, steroid if not responding
Attached Thumbnails
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  #81  
Old 11-17-2014
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Default Dupuytren Contracture

Flexion contracture of 4-5th fingers in the flexor tendons

Immobility and tendon nodules
easrly x: collagenase injection
Advanced: triamcinolone or lidocaine
Surgery if progression cannot be stopped otherwise
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  #82  
Old 11-17-2014
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Default Fibromyalgia trigger points

labs adn radiology normal

Rx: duloxetine, pregabalin, gabapentin, TCAs amitriptyline or milnacipran
Depression very common
Attached Thumbnails
Dermatology Pictures for the CK Exam-fibromyalgia_ezr-1-.jpg   Dermatology Pictures for the CK Exam-schematic-acr-trigger-points-fibromyalgia.gif   Dermatology Pictures for the CK Exam-tender-points.gif  
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  #83  
Old 11-18-2014
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Default Dactylitis

Sausage digits common in Psoriathic arthritis, also Ankylosing spondylitis
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  #84  
Old 12-21-2014
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Default Sweet Syndrome

"Juicy" bright red, well demarcated plaques, sharp cut-off separating from normal skin that appear on the neck, upper trunk, and extremities.

in children and adults most commonly, preceeding GI resp illness FEBRILE NEUTROPHILIC ERMATOSIS. fever arthralgia, arthritis, myalagia. considered to be a reactive syndrome.

may have nuderlying AML

In myelodysplastic syndrome pts development of Sweet syndrome may coincide with transformation to AML
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  #85  
Old 12-21-2014
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Default Pitted Keratolysis

pts with hyperhidrosis are at risk. crateriform pitted lesions on pressure baring areas of feet.
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  #86  
Old 01-21-2015
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Default

http://en.m.wikipedia.org/wiki/Hirsu...oronae_glandis
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  #87  
Old 01-28-2015
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Tophaceous gout
Due to urate crystals deposited in soft tissue.
Look for patient taking thiazides.
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  #88  
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Default ecthyma gangrenosum

Caused by pseudomonas in immunocompromised patients.
treatment:aminoglycoside plus extended spectrum antibiotic(piperacillin,carbepenem etc)
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  #89  
Old 03-12-2015
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Default Men 2 b

Mucosal neuromas in MEN2 B
also buzzword Marfanoid habitus. Medullary thyroid Cancer,Pheochromocytoma
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  #90  
Old 03-13-2015
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Default NF1

Lisch nodules, Cafe au lait spots, axillary freckling
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  #91  
Old 03-14-2015
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Default Aplasia Cutis

Congenital abscence of skin (usually part of some area)

Seen with Methimazole use thats why in pregnancy esp first trimester PTU is used.
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  #92  
Old 04-03-2015
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Default NDL

Necrobiosis Lipoidica diabeticorum
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  #93  
Old 07-21-2015
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Default Stari

Since the late 1980s, physicians in the south central and southeast United States have observed Lyme disease-like rashes on patients with a recent history of tick bite. However, the tick vector associated with these lesions is Amblyomma americanum, the Lone Star tick

There appear to be some very subtle differences between Lyme and STARI rashes. STARI lesions are smaller on average and less variable in shape than those of Lyme disease, and also tend to have more central clearing – ironically, making them more likely to consistently resemble the iconic “bull’s eye” rash of Lyme disease than Lyme rashes themselves. Another difference in rash presentation is that secondary (multiple) lesions tend to be less common in STARI than in Lyme disease. In general, however, it is almost never possible to distinguish between Lyme and STARI rashes on the basis of appearance alone.

STARI should be treated similarly to early Lyme disease. Thus, antibiotic therapy is the treatment of choice, and is usually continued for two to three weeks. Doxycycline and amoxicillin
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  #94  
Old 08-22-2015
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Default Gutatte psoriasis

Guttate psoriasis is a variant of psoriasis that occurs 2-3 weeks after a streptococcal infection (eg pharyngitis, cellulitis) and is commonly seen in children and young adults. Diagnosis is made primarily by clinical examination.
Hundreds of small, discrete, raindrop-like erythematous plaques with a fine scale on the trunk, extremities, scalp, face and neck can occasionally coalesce to form plaques. Palms and soles are usually spared.
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  #95  
Old 08-22-2015
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Default Inverse Psoriasis Vs. Intertrigo

Inverse psoriasis is an unusual type of psoriasis that occurs in skin folds. These patches look different than other types of psoriasis. They are usually smooth, deep red, and glistening without any scale. commonly armpits, buttocks, groin, under breast. Rt with tacrolimus topical. Patietns usualy develop smooth patches or plaques in skinfolds instead of on the extensors.

can be confused with and mimic Intertrigo which is infectious or non infectious skin inflammation of intertriginous areas (inguinal perianal genital integluteal, axillary or inframammary) risks obesity, increase moisture, fungal overgwroth (DM immunosuppresion) Candida mcc and treatment is topical antifungals miconazole, nystatin, terbinafine
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  #96  
Old 08-22-2015
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Default Inverse Psoriasis

Rx with Topical Tacrolimus . Mimics Intertrigo whichi s mostly from Candida Rx with topical antifungals
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Old 08-28-2015
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Default Calcific uremic arteriolopathy in ESRD

very painful subcut nodules plaquelike, violaceous (purpuric) progresses to Necrotic ulcer.
pics before and after treatment with Parathyroidectomy, Hemodyalisis and IV sodium thiosulfate 20 g thrice weekly for 7 weeks

in contrast to atherosclerosis pulses are intact
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  #98  
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Default NLD

Necrobiosis lipoidica diabeticorum

most common in diabetics and on skin indurated yellowish plaques with central atrophy
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Old 08-28-2015
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Default Discoid Lupus

commonly on face, scalp, ears
scaly pigmented erythematous plaques (hyper pigmented rims)

almost always above the neck (and maybe below but always + above neck)
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Default Discoid lupus

Discoid Lupus pic
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