NR511 / NR 511 Differential Diagnosis

and Primary Care Midterm Exam

Review

1. Pre-Cancerous lesions: Actinic Keratosis

- Assess:

o Inspection: the question may provide a description of the rash; flesh colored,

hard, sand-paper like

- Diagnose: Based on presentation

- Treat: most often cryotherapy

- Who is at risk? Sun exposure

- What is the risk of it developing into something else? Pre-cancerous lesion that can

progress to a squamous cell carcinoma

- Do I need to refer the patient? To dermatologist to help prevent its progression

2. Fungal Skin Infections

- Assess: popular rash, satellite lesions

- Diagnose: based on presentation; common type: candida albicans

- Treat: antifungal cream, pill; keep area as dry as possible; favors moisture, warmth

and poor air circulation (consider the location of the rash

- Who is at risk? Can be opportunistic (immunocompromised patients); look at

patient’s age; older, younger (could be diaper rash); diabetics, antibiotic therapy

- What is the risk of it developing into something else? Not likely

- Do I need to refer the patient? Only if no improvement

3. Common Types of Fungal Infections-Consider appearance and distribution

- Tinea versicolor- Flat to slightly elevated brown papules and plaques that scale when

they are rubbed along with areas of hypopigmentation; pruritic; most commonly

found on trunk and shoulders

- Balanitis- Candidiasis in the glans of the penis

- Tinea Corporis-Annual lesions with scaly borders and central clearing on the trunk

- Tinea Pedis- Athlete’s foot-feet and between toes

- Tinea Cruis- Jock itch-groin

4. Bacterial Skin Infections: Warm, Red, Painful without sharply demarcated border

- Cellulitis: is a spreading infection of the epidermis and subcutaneous tissue that

usually begins after a break in the skin

- Folliculitis: bacterial infection of the hair follicle; papules are characteristic of

folliculitis

5. Viral Skin Infections

- Erythema infectiosum (fifth disease): erythematous, warm rash; gives the appearance

of slapped cheeks: Sore throat, slight fever, upset stomach, headache, fatigue, and

itching are among other symptoms. Usually resolves on its own

- Varicella rash: is contagious 48 hours before the onset of the vesicular rash, during

the rash formation and during the several days it takes the vesicles to dry up;

characteristic rash appears 2-3 weeks after exposure

- Warts: caused by the human papillomavirus; most warts recur despite treatment.

Contrary to popular opinion, warts do not have roots; the underside of a wart is

smooth and round. Abrading the skin can spread the virus; vigorous rubbing, shaving,

and nail biting, can do the same