06/27/2017

Skin mci screening test and indian medical pg examz high yield important topics study tips

By Live Dr - Wed Feb 11, 3:17 am

Skin

Layers of epidermis
Stratum corneum

Stratum lucidum

Stratum granulosum

Stratum spinosum

Stratum basale

Block disease
Eccrine sweat glands Crystalline miliaria
Apocrine sweat glands Hydradenitis suppurativa

(Fox-Fordyce disease)

Sebaceous glands Fordyce disease

Wood’s lamp examination

disease appearance
T. vesicolor Golden yellow
P. aeruginosa Aqua green
Porphyria cutanea tarda Pink-orange
Leprosy Blue-white
Hypopigmentation Pale white
Hyperpigmentation Purple brown
Vitiligo Bright-white/ blue-white
Albinism Bright-white/ blue-white
Erythrasma Coral red, pink
T. schonlenii Pale green
Microsporum Yellow green
Tuberous sclerosis Blue white
Pseudomonas infection Greenish white or pale blue
Porphyria cutanea tarda Pinkish red -urine
Pityriasis versicolor Golden yellow fluorescence
Tinea capitis Green fluorescence

Special types of tinea

Tinea cruris Affects groin
Tinea corporis affects trunk
Tinea capitis Scalp
Tinea mannum. Affects only the palms with scaling

QUOTE CORNER

Problems cannot be solved by the same level of thinking that created them.- Albert Einstein

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Trichophytic granuloma / Majocchi’s granuloma Perifollicular granuloma which is annular, raised and crusty, seen on wrists, and shin, caused by tinea rubrum and T. mentagrophytes.
Tinea umbricata / Jock itch/ Crotch itch / Dhobi’s itch Concentric rings, of scales forming extensive patches with polycyclic borders.

Caused by tinea concentricum.

Tinea pedis / athlete’s foot T. mentagrophytes causes vesicular or bullous lesions in web spaces
Tinea falcei Affects face unilaterally.
Tinea nigra Black non scaly macules on palms and soles

Caused by T. hortae T. werneckii.

*T. capitis is not caused by Epidermophyton flocculosum, trichophyton concentricum, T. rubrum.

Special types of Acne

Acne conglobata Severe cystic acne with comedones, abscesses, sinuses and nodules.
Acne fulminans Inflammatory nodules, cysts plaques, fever, constitutional symptoms, treated with steroids.
Acne venerata Caused by contact with comedogenic chemicals
Acne cosmetica Caused by contact with comedogenic cosmetics
Tropical acne Acne on back, buttocks, thigh because of high humidity of tropical climate.
Acne excoriae Picker’s acne Seen in females caused by compulsive picking of  the lesions
Occlusion tetrad
Nodulocystic acne

Dissecting cellulites of scalp

Hydradenitis suppurativa

Pilonidal sinus

TYPES OF ALOPECIA

Alopecia areata Patches of smooth area with loss of hair.

At the periphery of patches are exclamation hair ( attenuated bulb with splayed pigmented distal end)

Alopecia totalis Total loss of scalp hair
Alopecia universalis When hair has been lost over the entire body

TRIVIAL TRUTH

That dust on rugs and your furniture is not only dirt. It’s mostly made of dead skin cells. Everybody loses millions of skin cells every day which fall on the floor and get kicked up to land on all the surfaces in a room. You could say, “That’s me all over.”

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Gray patch Characterized by scaly gray patches with stubs of broken hair and easy pluckability of hair.

Caused by ectothrix   fungi.

Shows greenish yellow fluorescence under woods lamp.

Black dot Areas of alopecia studded with black dots representing hair broken off at surface of the scalp, caused by endothrix fungi.
Kerion celsii Is a boggy indurated area exuding pus.

May be followed by scarring and permanent alopecia

Favus/ Witkop Affects scalp, glabrous skin, nails.

Concave Sulphur yellow crusts / scutulae form around loose wiry hair, atrophy leads to smooth glossy thin paper/ scars.

Phases of growth of hair

Anagen growing phase
Telogen resting phase
Catagen transitional phase

*Atopic dermatitis, infantile eczema/ neurodermatitis

Also called Besnier’s prurigo

Signs of atopy
Dennie Morgan folds

(Extra fold beneath the eyelid is called the Denny Morgan fold)

Extra crease line just below the lower eyelid, exceeding midline(pupil)

Keratosis pilaris

Follicular papules on the extremities

Hertoghe’s sign-

Thinning of lateral eyebrows

White dermographism-

Tripler response o is replaced by blanching of skin

Nikolsky sign
Sliding of superficial layers of skin on the deeper layers when a tangential force is applied with the pulp of thumb, especially over bony prominences
Positive in
Staphylococcal scalded skin syndrome-

Toxic epidermal necrolysis

Pemphigus

Epidermolysis bullosa congenital

Pemphigus

QUOTE CORNER

Most great people have attained their greatest success just one step beyond their greatest failure.-  Napoleon Hill

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Koebner’s phenomenon
Appearance of lesions at the site of trauma
Seen in
Psoriasis

Vitiligo

Warts

Lichen planus.

pemphigus pemphigoid
Nikolsky sign present Absent
Bullae are intraepidermal and flaccid Bullae are subepidermal and tense
Mucosa involved Mucosae are not involved
Acantholysis present Absent
Involves upper part of body Lower part of body
Age-40-60 Age 60-80
Prognosis poor Prognosis good

Pemphigus vulgaris

Immunoflorescence shows intercellular Ig G deposits in the fish net pattern

Leprosy

bb Inverted saucer appearance
ll Bilaterally symmetrical, small, oily lesions. Sensations present
tt Sensations are absent.
BT Satellite lesions are seen

Piedra

Black piedra Piedra hortai
White piedra Trichosporon bigelli
Apple jelly granulation tissue

pale scanty granulation tissue base

Tuberculous ulcer
Necrotic tissue with slough Spreading ulcer
Wash leather slough Syphilitic ulcer

*Butcher’s wart / Anatomists wart- Cutaneous tuberculosis / verrucosa cutis

Slowly progressive asymptomatic lesion that follows penetrating trauma

Treated with akt.

*Pseudofolliculitis barbae-

Seen in blacks. Caused due to close shaving of curved hair, which pierce the skin.

Treatment is to stop shaving.

TRIVIAL TRUTH

The main purpose of eyebrows is to keep sweat out of the eyes.

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*Pityriasis versicolor

Hypopigmented or hyperpigmented perifollicular finely scaly macules coalescing to form patches seen on upper arm, neck, trunk, underarms.

Caused by Malassezia furfur.

*Ping pong scabies- mite is transmitted from one house member to another.

*Inguinal bubo appears 2- 4 weeks after genital ulceration.

*Bull’s eye lesion or iris lesion or target lesion

Seen in erythema mutiforme

*Miyagawa’s granulocorpuscles are found in lymphogranuloma venereum, when smears are stained with Giemsa

*Commonest cause of photoallergic dermatitis in India is Parthenium

*Impetigo of Bockhart

Acute superficial folliculitis

Pustules heal without scarring.

*Lyell’s disease-Toxic epidermal necrolysis.

*Pastia’s line-

Linear petechial lesions found in scarlet fever in antecubital and Axillary folds.

*Desert sore / Veldt sore is a superficial ulcer caused by corynebacterium diphtheriae.

*Meleney’s gangrene-

Caused by peptostreptococcus and staphylococcus aureus or enterobacteriaceae.

*Hot tub folliculitis

Caused by pseudomonas  aeruginosa. Occurring 1-4 days after bathing in hot tubs, swimming pool or whirlpool.

*Rose spots of salmonellosis occur between umbilicus and nipples.

*Chicken pox

Rash is described as dew drops on rose petals

Centripetal distribution.

QUOTE CORNER

Man can live about forty days without food, about three days without water, about eight minutes without air, but only for one second without hope- Anonymous

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single skin patch paucibacillary

leprosy

multibacillary

leprosy

Number of skin lesions 1 2-5 6 or more
Nerve involvement Absent Only one nerve may be involved More than one nerve trunks involved
Skin smear Negative Negative Positive
Treatment Single dose of Rifampicin, Ofloxacin, Minocycline 600 mg rifampicin  once a month,

100 mg of dapsone daily

600 mg rifampicin  once a month,

100 mg of dapsone daily

330mg of clofazimine Once a month and 50 mg daily

Treatment duration Single dose 6 monthly pulses must be completed in 9 months 12 monthly pulses must be completed in 18 months.
chicken pox measles rubella
Enanthem Pharyngeal Koplik’s spot Forchheimers spots
Exanthem Macules-paules, vesicles, scbs Maculopapular Small amcules and paules
Lesion distribution Centipetal Face, trunk and limbs Face trunk and limbs
Infective period 2 days before rash Appears to 6 days after beginnig of last crop of rash 5 days before to 5 days after the appearance of arsh 7 days before to 10 days afetr the appearance of rash

TRIVIAL TRUTH

Blondes have more hair than dark-haired people

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