- Flashcards
What is a term that describes a appearance of hair on a Nevus
Hypertrichosis
Most important prognostic factors in melanoma?
- Breslow thickness (most important prognostic factor)
- Ulceration
- Mitotic index
- Sentinal lymph node biopsy (if Breslow is more than 1mm)
Nikolky’s sign?
top layers of the skin slip away from the lower layers when rubbed, blisters and erosions appear when the skin is rubbed gently. Positive in Pemphigus Vulgaris.
Treatment of neonatal herpes?
high dose intravenous acyclovir (20mg/kg 3 times daily) for 3 weeks
How do we diagnose HSV?
- Clinical
• Tzanck smear (Fast, cheap, multinucleated giant cells)
• PCR (Gold standard in HSV encephalitis, CSF, vesicle fluid)
• Viral culture (Takes time 2-5 days, accurate)
Treatment of erythema multiforme?
Treatment:
1.Topical steroids and antihistamines (itchy!!)
2. Acyclovir suppressive therapy in reccurent cases
How do we diagnose VZV
Clinical
• Tzanck smear
• PCR (vesicle fluid)
• Viral culture
• Serology (IgG/IgM):
• In pregnant women
• Retrospective diagnosis of varicella in immunocompetent • Before immunosuppressive therapy
Treatment of zoster?
800mg 5x/day within 3 days of rash po (old age / pregnant)
800mg 5x/day within 7 days of rash po (ophthalmic)
10mg/kg, 3x/day as soon as vesicles appear iv (immunocompromised)
For at least 5 days.
“dew drops on a rose petal” describes which rash?
Scattered vesicular rash of chickenpox
Prophylaxis of VZV?
Immunization – live attenuated vaccine:
• Infants12monthsand15months
• Adults60yearsold
• Seronegativehealthcareworkers&othercontactsof
immunocompromised patients within 5 days of exposure (post exposure prophylaxis)
VZIG - high risk contacts (10 days of exposure): • Immunocompromised
• Pregnant women • Neonates
Treatment of molluscum?
• NO Treatment: spontaneous remission in 6-9 months
• Curettage/ Cryotherapy/ electrocautery/ laser
• Imiquimod
What stain do we use for molliscum after skin biopsy and what do we find under the microscope?
Giemsa stain, molluscum bodies
Generalized warts. What do we suspect?
Defective skin barrier -> AD
Immunocompromised-> HIV
How to diagnose HPV wart?
Clinical
PCR
Skin biopsy (MOST ACCURATE)
Management of pyoderma gangrenosum
Refer to dermatology urgently
Topical and systemic steroids
Management of folliculitis declavans?
- Topical antibiotics
- Oral antibiotics such as
(minocycline, tetracycline, rifampicin, clindamycin) - Severe forms oral corticosteroid may be necessary.
- Oral isotretinoin can result in long-term remissions in
some patients.
Treatment of LP?
TOPICALS:
- Potent topical steroids
- Topical calcineurin inhibitors, pimecrolimus cream
- Topical retinoids
- Intralesional steroid injections
SYSTEMIC:
- steroids
- hydroxychloroquine
- phototherapy
- acitretin (erosive LP to avoid progression to SCC)
Positive koebnerization in which diseases?
Viral warts (auto inoculation)
Lichen planus
Psoriasis
Vitiligo
Management of Pityriasis rosea?
Management :
• General advice
• Rash clears up in about six to twelve weeks
• shower with plain water and bath oil, aqueous cream,
• Apply moisturising creams to dry skin.
• Expose skin to sunlight cautiously (without burning).
-oral acyclovir
- topical steroids may reduce itching
- extensive cases: phototherapy.
Management of nappy dermatitis due to Candidiasis?
Stop the use of the highly potent corticosteroid
• In acute phase: mild corticosteroid
• Add topical imidazole cream for candida infection
• Educate the mother on how to change her daughter’s diapers
Select a larger size diaper to reduce friction
• Wash hands before and after changing the nappies
• Diapers should be changed once wet or soiled
• Gently clean the baby’s skin with water and a soft
cloth
• Wet wipes are convenient but expensive and can lead
to contact allergy
• Pat the skin dry gently
• Allow the skin to air dry
• Apply emollients containing zinc oxide (barrier
cream)
Treatment of seborrheic dermatitis?
• Antifungal shampoo
• Corticosteroid scalp application
• Topical steroids
• Oral ketoconazole/itraconazole
D.D of a hypopigmented lesion?
• Pityriasis alba (ill-defined borders) WOOD’S LIGHT: NO FLUORESCENCE
• Post inflammatory hypopigmentation (history of other skin lesions preceeding the appearance of the spots.)
• Vitiligo (depigmented milky, white macules and patches) WOOD’S LIGHT: BLUE WHITE FLUORESCENCE
• Tinea versicolor (more sharply demarcated/ may coalesce.) WOOD’S LIGHT: ORANGE/ YELLOW FLUORESCENCE
• leprosy
D.D of HAND DERMATITIS
Infectious -> fungal
Exogenous -> irritant or contact dermatitis
Endogenous -> AD/ psoriasis
WHAT DO WE USE TO DIAGNOSE ALLERGIC CONTACT DERMATITIS?
Patch testing!!!!
