Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PDAT1 > 6 - Dermatology: Hair Loss & Warts > Flashcards

6 - Dermatology: Hair Loss & Warts Flashcards

1
Q

What is Epidermis and what type of cells does it condain?

A
  • *EXTERNAL** layer composed of
  • *layers of KERATINOCYTES**

but also containing MELANOCYTE + other cells
(produce melanin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the DERMIS and what does it contain?

A

Area of supportive connective tissue
underneath the epidermis

contains:

Sweat Glands / Hair Roots / Nerve Cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Melanocyte

A

Cell found in the Epidermis

that produces MELANIN

eumelanin / pheomelanin = biopolymer agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Melanosome vs Melanophage

A

MelanoSOME = VESICLE that transports melanin

MelanoPHAGE = melanin phagocytized by dermal macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hyperpigmentation Pathophysiology

A

INCREASE in synthesis or desposition of MELANIN

EPIdermal –> Increased Melanin production

Dermal -> does NOT usually have melanin
Transfer / accumalation within melanophages
production by ectopic melanocytes
exogenous pigments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Associated Disorders of HYPERpigmentation

A

Solar Lentigines
age spots, tan-dark-brown macules on sun exposed areas

Maturational Hyperpigmentation
dyschromia, darkening on lateral aspects of face due to sun

Post-inflammatory** **HYPERpigmentation
darkening of skin after injury / inflammation

  • *Melasma**
  • *facial** HYPERpigmentation on sun-exposed areas often associatioed w/ hormonal changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medications that cause HYPERpigmentation

A

Amiodarone / Anticonvulsants
Antimalarial Agents / Antineoplastic agents

HRT / Oral Contraceptives

Heavy Metals

Minocycline / Phenothiazines / TCA’s

Zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tyrosinase Inhibitors

MoA / Treatments

for HYPERpigmentation

A

Act on Melanocytes @ cytoplasm

  • *Tyrosinase is the enzyme that oxidates this reaction**
  • *Tyrosine -/-> DOPA -/-> Dopaquinone** -> MELANIN

Treatments:
Hydroquinone / Mequinol

Azelaic/Kojic/Glycolic ACID

Alpha-Arbutin / Licorice Extract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Copper Interaction

MoA / Treatments for HYPERpigmentation

A

In Melanocyte @ cyto, copper interacts
Tyrosine –> DOPA –> Dopaquinone -> MELANIN

KOJIC ACID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Reduction in Melanosome Transfer

MoA / Treatment for HYPERpigmentation

A

IN Keratinocyte & melanocyte interface:
Melanosome –/–> Protease activated receptor-2

RETINOIDS

NIACINAMIDE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

INCREASED Keratinocyte TURNOVER

MoA / Treatment for HYPERpigmentation

A

more keratinocytes turnover / new skin

Retinoids

GLYCOLIC Acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

RX-treatment for HYPERpigmentation

A

Retinoids
Tretinoin / Tazarotene

Hydroquinone 3% or 4%

Azelaic Acid 20%

Mequinol/tretinoin = Solage

Fluocinolone/hydroquinone/tretinoin = Tri-Luma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-Rx Treatment for HYPERpigmentation

A

SUNSCREEN

Hydroquinone 1.5 / 2%

Azelaid Acid 10%

Glycolic / Kojic Acid

Niacinamide

Botanical combinations = Meladerm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Basic treatment ideas for HYPERpigmentation

A

DAILY SUNSCREEN USE is CRUICIAL

more DIFFICULT to treat DERMAL H-P

Better to use multiple medications for melasma/PIH
beware of use of _LASERS_ –> PIH

some OTC cosmeceuticals contain MERCURY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ADR’s of HYPERpigmentation Treatments

A

Generally:
skin Irritation / HYPERsensitivity / SUN sensitivity

BOTH HYPER/hypoPigmentation

Hydroquinone: OCHRONOSIS
yellow -> blue/black discoloring

Retinoids: Inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

EX-ST

for HYPERpigmentation

A

Treatment + Sunscreen with NO improvement in 3 MONTHS

<12 years old

HYPERpigmentation of large BSA

Disease / Drug -induced

Lesions CHANGING
in size/shape/color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Suggested treatment for HYPERpigmentation

A

As long as NO EX-ST
>12 yo / large BSA / lesions changing / disease-drug-induced

HYDROQUINONE 2%** +/- **AHA _(_acid product)
with SUNSCREEN

after 3 months
improvement-> continuesunscreen+QD/BID treatment prn

no improvement –> SEE MD

18
Q

Pathophysiology of WARTS

A

Caused by HPV = human papilloma virus
various strains are common

Various warts caused by different strains
HPV-1 = plantar

HPV stays on the epidermal layer
proliferation -> WART in about 4-Weeks after infaction

19
Q

Types of cutaneous WARTs that can be SELF TREATED

A

Common = Hands
often in children/adolescents, skin colored / DOME/ rough surface

Plantar / Mosaic = FEET
adolescents & Young Adults

20
Q

Types of Cutaneous WARTS that we can NOT treat

A

SEE MD

Flat / Filiform on FACE

Periungual on NAILS

21
Q

Basic Treatment ideas for WARTS

A

Non-treatment
Most can resolve on OWN (70% in 2years)
less likely if ADULT or IMMUNE compromised

SELF TREATMENT
1) Salicylic Acid = chemical destruction/keratolytic
2) Cryotherapy = physical destruction
Complementary = DUCT TAPE

  • *Micellaneous**
  • *Prevention of transmission** = important
  • *SEEMD for Physical removal**
22
Q

Efficacy & Duration
Salicylic Acid

for WARTS

A

with NO treatment = 70% resolve, 46% will remain wart free

TAKES WEEKS
Greater efficacy for HANDS > feet

Equally effective vs Cryotherapy

23
Q

Efficacy & Duration
CRYOTHERAPY

for WARTS

A

with NO treatment = 70% resolve, 46% will remain wart free

  • *wart removal after 10 DAYS**
  • *single use** that will produce a BLISTER –> can be repeated

Equally effective vs Salicylic Acid

maybe more effective on hands?

24
Q

Salicylic Acid

ADR

A

used for WARTS, generally well tolerated

Skin irritation

see MD if > 12 weeks

  • AVOID* use in patients with
  • *PERIPHERAL NEUROPATHY**
25
Q

Cryotherapy

ADR

A

treatment for WARTS, generally well tolerated

Erythema / Blistering / Pain-Tendernes

SEE MD after >3 treatments

Applicator can NOT be used MORE THAN ONCE
to _avoid spreading the virus_

26
Q

EX-ST for treating WARTS

A

Ensure that it is actually a wart
not CORNS / CALLUSES / Malignant growth, these show PAIN

  • *<4 years old**
  • *Pregnancy / Breast Feeding**
  • *>12 weeks** SA treatment or >3 Cryotherapy Treatments

Debilitating conditions that affect sensitivity / circulation (blood)

LARGE or MULTIPLE warts
or located on face / breast / armpits / nails / anus / genitalia

Immunosuppressive medications

27
Q

Salicylic Acid 40%

Type of Dosage form / Dosage & Direction

Treatment of WARTS

A

Plasters / Pad / Strip
typically used for the FEET

Apply & Remove after 48 HOURS
repeat PRN

for 12 weeks,
if no improvement –> SEE MD

28
Q

Salicylic Acid 17%

Type of Dosage form / Dosage & Direction

Treatment of WARTS

A

Liquid / Gel

in a collodion vehicle

apply QD / BID

for up to 12 weeks
if no improvement –> SEE MD

29
Q

Salicylic Acid 15%

Type of Dosage form / Dosage & Direction

Treatment of WARTS

A

PATCH
(Trans-Ver-Sal), in a Kg-g vehicle

Apply for 8 hours, repeat QD

for up to 12 weeks,
if no improvement –> SEE MD

30
Q

Cryotherapy

Type of Dosage form / Dosage & Direction

Treatment of WARTS

A

Freeze Away / Freeze Off

repeat after 10 DAYS PRN

for up to <3 Treatments,
if no improval –> SEE MD

31
Q

Hair Growth Cycle

ACT

A
  • *Anagen**
  • *active** GROWTH phase, 2-6 years
  • *Catagen**
  • transitio*nphase,1-2 weeks
  • *Telogen**
  • *resting** phase, 2-4 months

return to anagen

32
Q

What type of Hair loss should we NOT TREAT

A
  • *Scarring Alopecia**
  • *inflammatory disorder** –> leads to PERMENANT hair loss

ABRUPT hair loss
effluviums / cosmetic

AUTOIMMUNE hair loss
alopecia AREATA

FUNGAL
tinea captis

33
Q

Medications that cause HAIR LOSS

A

Beta-Blockers / ACE-Inhibitors

Allopurinol / Anticoags / Gemfibrozile

Anticonvulsants / Anti-depressants

  • *ANDROGENIC ACTION**
  • *HRT** / Contraception / Testosterone / Steroids

Chemotherapeutic agents

34
Q

General Causes for HAIR LOSS

A

Medication

HORMONAL CHANGES

Physical STRESS / TRAUMA

Chronic illness / Diet change or deficiency

GENETICS

35
Q

Finasteride (Propecia)

MoA / Dose / Indication / ADR

A
  • *5-Alpha-Reductase Inhibitor**
  • *Testosterone –/–> dihydrotestorone** -> androgen receptor

for male AGA (androgenetic allopecia)
1mg QD

used for at LEAST 12 MONTHS

ADR:
ED / decreased libido / ejaculation / decreased sperm count

36
Q

Minoxidil

MoA / Dose / Indication / ADR

(Rogaine)

A

Increases ANAGEN duration & ENLARGES Vellus
Terminal Hair –> Vellus (live active hair)

  • *5%** suggested for males (AGA)
  • *2%** > 5% for females (FPHL)

need to use for AT LEAST 4 MONTHS
does NOT reduce blood pressure = NO systemic absorption

ADR:
itching / irritation / dryness / contact dermatitis (FOAM decreased)

37
Q

Complementary Treatment for HAIR LOSS

A

BIOTIN

IRON

ZINC

Specialty shampoos

38
Q

Efficacy of

Minoxidil vs Finasteride

A

5% > 2%
for AGA & FPHL

  • no high quality studies* in comparing finasteride vs minoxidil
  • finasteride may be more efficacious > minoxidil for MALE AGA*

Some data SUPPORT DUAL USE of both for MALE AGA

39
Q

EX-ST for Self care of HAIR LOSS

A
  • *<18 years old**
  • no NEW HAIR appearing after 4 MONTHS –> SEE MD*
  • *Pregnancy / BF** / postpartum
  • *recent D/C of oral contraceptives**

SUDDEN / PATCHY hair loss

Patients with no FMH of hair loss
or Positive Hair-pull Test

loss of eyebrows / eyelashes / nail change
scalp scaling / sunburn / other damage

AUTOimmune disease / FEVER of inflamation

Endocrine dysfuntion / medical treatments

40
Q

Self-Care assessment for HAIR LOSS

A

after assuring NO EX-ST
>18 y/o + no SUDDEN loss / pregnancy / d/c HRT

STOP use of Hair/grooming that can cause

**Male** = **Minoxidil 5%**
Female = Minoxidil **2%** -\> 5%

New hair after 4 months?
Yes -> continue treatment INDEFINITELY
NO –> SEE MD

41
Q

Compound W

Active Ingredients / Dosage Forms / Indication

A

SALICYLIC ACID
(a Keratolytic) for WARTS

  • *17%** = Liquid / Gel
  • *40% = Pads / Strips**
  • *Freeze-Off**

DNU for >12 weeks –> see MD

<4 years old

42
Q

DUOFILM

Active Ingredients / Dosage Forms / Indication

A

SALICYLIC ACID

17% LIQUID
flexible collodion + alcohol + castor oil

Wart Removal
soak for 5 minutes, then thoroughly wash
can use a protective cover after
QD - BID

_DNU >12 weeks_
<4 y/o

PDAT1 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions