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DCNP exam > acne and adnexal > Flashcards

acne and adnexal Flashcards

1
Q

first line for periorificial derm

A

PO doxy

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2
Q

abx dosing for periorificial derm

A

-doxy or minocycline 100mg BID for 4-8 weeks
-erythromycin 250mg BID - TID

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3
Q

topicals for periorificial dermatitis

A

metronidazole x 8-14 weeks

erythromycin or clindamycin BID x 7 weeks

tacrolimus or pimecrolimus BID (especially for corticosteroid induced periorificial derm)

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4
Q

rosacea:
treatment for facial redness

A

-alpha-2 agonists
brimonidine 0.33%
oxymetazoline 1%

-PO doxy 20-40mg

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5
Q

rosacea:
TOPICAL treatment for papules and pustules, perilesional erythema, demodex

A

TOPICALS
-metronidazole
-azelaic acid 20%
-sulfur wash or product
-ivermectin
-permetherin (off label)
-topical minocycline
-encapsulated BP 5%

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6
Q

rosacea:
SYSTEMIC treatment for papules and pustules, perilesional erythema, demodex

A

SYSTEMIC
-(submicrobial) doxycycline 40mg
-(antimicrobial) doxycycline or tetracycline (difference being higher dose) reason to not use is resistance can occur quickly
-isotretinoin in severe cases

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7
Q

symptoms of ocular rosacea (5)

A
  1. red eyes
  2. blepharitis
  3. gritty sensation
  4. burning
  5. itching
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8
Q

rosacea:
tx for ocular rosacea

A

-eyelid hygiene: ophthalmic wash and moisturizers
-topical ivermectin
-PO doxy
-refer to ophthalmology if no improvement

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9
Q

hallmark sign of hidradenitis suppurativa

A

double headed comedone (multiple blackheads within one follicle) - arises from follicular occlusion

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10
Q

topical therapy for HS

A

Topical ABX:
-topical abx are mainstay
-clindamycin + BP

Cleansers:
-BP
-chlorhexidine
-zinc pyrithione

Keratolytic agents:
-resorcinol 15% cream BID (antiseptic and keratolytic) between flares

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11
Q

PO antibiotics for HS

A

-tetracyclines
-clindamycin
-rifampin
-dapsone

-3 months until improvement

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12
Q

Hormonal therapy for HS

A

OCP’s:
-ethinyl estradiol / noregestrol
-ethinyl estradiol and cyproterone acetate

-progesterone only med may worsen HS

Spironolactone:
-100-150mg daily
-off label

Metformin:
-off label
-500mg BID-TID
-patients with history of PCOS

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13
Q

HS adjunct treatments

A

Zinc Gluconate
-anti-inflammatory
-90mg/day

IL TAC
-TAC 10 between 0.2-3mL

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14
Q

management of pain in HS patients

A

-Lidocaine 5% ointment
-Diclofenac 1% gel
-ice packs
-tylenol
-gabapentin
-lyrica
-duloxetine

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15
Q

lifestyle management for acne keloidalis nuchae

A

-discourage picking of lesions
-avoid tight collared shirts and close shaving
-avoid hats and helmets

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16
Q

Topical treatment for acne keloidalis nuchae

A

-topical steroids BID every 2 weeks
-retinoid like tretinoin 0.025%
-clindamycin for pustular lesions
-IL TAC 5-40mg/ml every 4 weeks
-cryotherapy

-antiseptic or tar containing shampoo can be helpful to prevent secondary bacterial infection

17
Q

Systemic treatment for acne keloidalis nuchae

A

-doxy 100mg BID
-minocycline 100mg BID
-PO retinoids (with concurrent folliculitis decalvans)

18
Q

topical treatment for dissecting cellulitis of the scalp

A

-antibacterial soaps
-chlorhexidine
-benzoyl peroxide

19
Q

systemic therapy for dissecting cellulitis of the scalp

A

-doxycycline 100mg BID
-minocycline 100mg BID
-PO retinoids for patients with concurrent folliculitis decalvans

20
Q

diagnostic criteria for primary hyperhidrosis

(at least 2 of the following) - there are 6

A
  1. bilateral and symmetrical distribution
  2. impairment in normal daily activities
  3. occurring at least once per week
  4. onset younger than 25 yrs old
  5. does NOT occur during sleep
  6. positive family history
21
Q

causes of secondary hyperhidrosis

(12)

A
  1. substance abuse (alcohol or narcotic withdrawal)
  2. COPD
  3. CHF
  4. endocrine/metabolic disorders
  5. febrile illness
  6. infections
  7. ingestion of spicy foods
  8. malignancies
  9. medications
  10. neurologic disorders
  11. menopause
  12. psych disorders
22
Q

topical treatment for primary hyperhidrosis

A

Aluminum chloride 20% (drysol)
-FIRST line
-apply at bedtime 2-3 times weekly to intact skin
-can cause localized irritation which is common reason for d/c

Glycopyrrolate (robinul)
-medicated cloths
-FDA approved for pts 9+
-wash hands immediately after use and avoid contact with eyes
-SE: mydriasis and headache

23
Q

oral treatment for primary hyperhidrosis

A

oral anticholinergics

-off label use
-glycopyrrolate and oxybutynin

24
Q

SE’s of anticholinergics

A

-dry mouth
-abdominal symptoms
-constipation
-urinary retention
-tachycardia
-drowsiness
-blurred vision

25
Q
A

DCNP exam (15 decks)

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