Emergencies and Miscellaneous Problems

Emergencies and Miscellaneous Problems is further divided into

Dermatologic Emergencies

» “Dermatologic emergencies” sounds like an oxymoron. Are there dermatologic emergencies?
» What are the major groups of dermatologic emergencies?


Vesiculobullous Disorders and Drug Reactions
» How does toxic epidermal necrolysis differ from the Stevens-Johnson syndrome or erythema multiforme major?
» How do you treat TEN?
» How do you treat Stevens-Johnson syndrome?
» What is pemphigus vulgaris?
» Describe Nikolsky’s sign and its relationship to pemphigus vulgaris.
» How is pemphigus vulgaris treated?
» What is the DRESS syndrome?


Infectious Diseases
» Are any dermatologic emergencies infectious in origin?
» Can emergent infections be differentiated by their cutaneous presentations?
» What is the differential to consider in hemorrhagic lesions other than infection?
» What causes necrotizing fasciitis?
» Describe the clinical presentation of necrotizing fasciitis.
» Can other cutaneous infections look like necrotizing fasciitis?
» Are there any parasitic disease “emergencies” that have cutaneous manifestations?
» Are there any other parasitic disease emergencies?
» Do mycobacterial infections cause any dermatologic emergencies?


Autoimmune Disorders
» What collagen vascular diseases may become dermatologic emergencies?
» What are the cutaneous findings in acute and bullous SLE?
» How does neonatal lupus erythematosus (NLE) present?
» Why are prompt recognition and treatment of NLE important?
» Why is dermatomyositis considered an emergency?
» What is leukocytoclastic vasculitis?
» What are the skin signs of Still’s disease?


Inflammatory Cutaneous Disorders
» Why is pyoderma gangrenosum a dermatologic emergency?
» How does pyoderma gangrenosum present?
» Under what circumstances do childhood vascular anomalies become dermatologic emergencies?
» How are hemangiomas treated?
» Is acne fulminans a dermatologic emergency?
» What is the treatment for acne fulminans?
» Are there drug eruptions that are dermatologic emergencies?
» What are the mucocutaneous findings in Kawasaki’s disease?
» How do you treat Kawasaki’s syndrome?

Environmental Disorders
» Is heatstroke considered a dermatologic emergency?
» What are the cutaneous signs of child abuse?
» What are the skin signs of a lightning strike?
» What is scleredema neonatorum?
» What are the cutaneous findings in cholesterol emboli?
» How are cholesterol emboli diagnosed?




Occupational Dermatology





Psychocutaneous Diseases

» How do the fields of psychiatry and dermatology overlap?
» What types of psychocutaneous disease are encountered in dermatology?
» How often do patients with dermatologic disorders have associated psychologic morbidity?
» What is the differential diagnosis of patients who complain that they are infested with parasites?
» Define obsession or compulsion, phobia, delusion, and hallucination.
» What is “delusions of parasitosis”?
» How do you diagnose this disorder?
» How do you treat this problem?
» What are the major side effects of pimozide?
» What if the patient is noncompliant with pimozide treatment?
» What is Ekbom syndrome?
» What is dysmorphophobia?
» Name the three major categories of self-inflicted skin lesions. What differentiates them?
» What are the clinical manifestations of dermatitis artefacta?
» How should patients with dermatitis artefacta be treated?
» What is the Gardner-Diamond syndrome?
» How do Munchausen syndrome and Munchausen syndrome by proxy differ?
» What is the differential diagnosis of patchy nonscarring alopecia?
» What is the psychiatric diagnosis associated with trichotillomania?
» How do you differentiate among the different forms of nonscarring alopecia?
» Can a biopsy help in the differential diagnosis of patchy nonscarring alopecia?
» What is trichotemnomania?
» What are neurotic excoriations?
» How do you treat this disorder?
» What are the side effects of fluoxetine?
» What is glossodynia?
» Name some primary dermatologic disorders that might result in secondary psychiatric problems. What sorts of problems might these patients have?
» Can stress exacerbate a primary dermatologic disorder?
 

Approaching the Pruritic Patient

» What is the most common symptom of dermatologic disease?
» What is an “itch”?
» Is an itch a separate modality of pain or a submodality of pain?
» What causes an itch?
» Describe the difference between localized and generalized pruritus.
» What is the best approach to evaluation of a patient with localized pruritus?
» What are the common causes of localized pruritus?
» What is notalgia paresthetica?
» What is the physician’s best approach when seeing a patient with generalized pruritus?
» After obtaining a complete history and physical examination, what clinically oriented classification scheme should be followed?
» What are common causes of generalized pruritus?
» How prevalent is an underlying systemic disease in a patient who seeks medical attention for pruritus?
» What is “winter itch”? In which patient population is it common?
» The patient complains that “wool makes me itch” or “I am allergic to wool.” What disease does this patient probably have?
» What treatment should the physician consider if a patient presents with pruritus and “hives”?
» What disease should the physician consider if the patient volunteers that his spouse also suffers from itching?
» Is pruritus in HIV-infected patients common? What are the common causes of pruritus in these patients?
» Which psychiatric disorder often presents with intractable pruritus?
» Which patients with renal failure experience “renal itch”?
» Which patients with liver disease are most likely to experience pruritus? What is the best screening laboratory test?
» What are the common causes of cholestic pruritus?
» Which hematologic disorders are known to present with pruritus?
» Is generalized pruritus a common symptom of endocrine disorders?
» Can itching cause skin disease?
» What is the best symptomatic treatment for a patient with pruritus?




Nail Disorders

» What functions do nails serve?
» Why are nails important in medicine?
» Do any systemic diseases have specific nail findings?
» What are Beau’s lines? How are they formed?
» What is a splinter hemorrhage?
» Are splinter hemorrhages always associated with subacute bacterial endocarditis?
» What is the difference between Mees’ lines and Muehrcke’s lines?
» What are “half-and-half” nails, and with what internal disease are they associated?
» What is nail fold capillaroscopy? How is it useful?
» What is clubbing?
» How is hypertrophic osteoarthropathy related to clubbing?
» What is the yellow nail syndrome?
» Are there any characteristic nail changes in primarily dermatologic diseases?
» What are nail pits?
» Are there any differences between the nail pits of psoriasis and alopecia areata?
» What other nail findings are seen in psoriasis? What is the significance of nail changes?
» How does a pterygium differ from pterygium inversus unguium?
» What is the most common cause and sequela of a subungual hematoma? How is it treated?
» Do malignant melanomas occur in the nails?
» How do you tell the difference between a subungual hematoma and a malignant melanoma?
» What nail changes are considered peculiar to human immunodeficiency virus (HIV) infection?
» What is onychocryptosis? Why does it occur?
» What is a paronychia?
» Which infectious organisms cause paronychia?
» How do you treat an acute paronychia?
» What is the most common cause of green nails?
» What is the difference between onychomycosis and tinea unguium? What organisms most commonly cause tinea unguium? Where does the infection typically start?
» List the antifungal medications most often used in the treatment of toenail onychomycosis.
» What should patients expect when undergoing treatment of onychomycosis?
» What is “habit tic” disorder? How is it different from median nail dystrophy?
» List the common benign “tumors” that occur in and around the nail unit.
» What is an exostosis?
» Name the four most common malignant tumors of the nail unit.




Dermatologic Trivia

» What does the X in histiocytosis X mean?
» The suffix -itis has come to mean inflammation. What is inflamed in “pruritis”?
» What is the difference between pruritus and itch?
» Several names are used for the disease caused by Bartonella bacilliformis: bartonellosis, verruga peruana, Peruvian warts, Oroya fever, and Carrión’s disease. Who was Carrión?
» What other illnesses are caused by Bartonella species?
» Sporotrichosis is also called “Schenck’s disease,” and the causative organism is named Sporothrix schenckii. Who was Schenck?
» What is the difference between Klippel-Trénaunay-Weber syndrome and Klippel-Trénaunay-Parkes-Weber syndrome?
» Which other eponymous dermatologic conditions include the name Weber?
» What is ciguatera poisoning?
» What are the neurocutaneous manifestations of ciguatera poisoning?
» From what is cantharidin made?
» What is Spanish fly?
» Seriously now, cantharidin has been confirmed as an aphrodisiac. Who uses it and how does it work?
» Who is generally considered the father of modern dermatology?
» Name the eight orders in which Willan classified cutaneous disease.
» What were Willan’s four subtypes of pustules?
» What is a hunterian chancre?
» Why does Jonathan Hunter’s name grace this ulcer?
» Mucicarmine is a histologic stain used to detect mucin. From what natural source is mucicarmine obtained?
» How does the Food and Drug Administration differentiate between an underarm deodorant and an underarm antiperspirant?
» What is Compound 606?
» Who was James Lind?
» If citrus products prevent scurvy, why did the Royal Navy suffer from so many scurvy outbreaks a century after Lind?
» Hansen’s disease (leprosy) is generally considered a tropical condition. Where was G.H. Armauer Hansen working when he discovered the causative bacillus of leprosy?
» In the United States, most persons with newly diagnosed Hansen’s disease are immigrants from Southeast Asia, but in one region of the country, Hansen’s disease is endemic. Where is this region of endemic Hansen’s disease?
» What seems to be the natural reservoir of Hansen’s disease in these states?
» Has there ever been a “leper colony” in the United States?
» Who was Father Damien?
» Urology textbooks list about 50 causes of discolored urine. Several inherited metabolic disorders with cutaneous manifestations can cause discolored urine. If an infant’s diapers have a black discoloration, what genodermatosis should you include in your differential diagnosis?
» If an infant’s diapers have a reddish discoloration, what genodermatosis should you include in your differential diagnosis?
» What is the eponymic name for erythropoietic porphyria?
» What is “North Carolina spotless fever”?
» What is the carrier protein of a hapten called?
» Do hair removal techniques (shaving, plucking, depilatories, waxing, electrolysis) cause new hair growth to be increasingly dark, coarse, or thick?
» Fifth disease is the common childhood exanthem also known as erythema infectiosum and is caused by parvovirus B19. (Everyone knows that.) But what is fourth disease?
» Onchocerciasis is found in both Africa and South America. Where did the disease originate, and how did it cross the Atlantic?
» What skin disease does the sailor’s curse, “I’ll be jiggered” refer to?
» Tungiasis (jiggers) was originally confined to the subtropical and tropical regions of the New World. How did it get to Africa, where it is now extensively entrenched in the sub-Sahara region?
» The first written account of poison ivy appeared in 1609 in the journal of this famous settler of the New World. Who wrote this account?
» What is the name of the dermatologist who invented adhesive tape?
» How many keratinocytes (skin cells) do you shed per minute?

 

 

 

 

 

 

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