chapter 6 dermatology Flashcards
pruritus
obstructive biliary disease pvera contact dermatitis scabies lichen planus
contact dermatitis
T4HSN new exposure to offending agent nickel earrings well circumscribed vesicles/bullae patch testing to determine AG
atopic dermatitis
first year of life
weeping skin head/diaper
FH/PH of allergies + asthma
scratching the skin - breaks bacterial
AH, topical steroids, topical tacrolimus
seb derm
cradle cap, blepharitis
scaly skin
selenium + ketoconazole topically + steroid topically
fungal infections
clear centrally + expand peripherally
distorted toe nails
if flouresces green under woods lamp = microsporum
if not, tricophyton
dx w/ scraping + KOH prep to visualize fungus or culture.
which fungal infections need PO tx?
tinea capitis + onchomycosis
otherwise use azoles or griseofulvin
candidiassis
oral thrush is normal
immunodeficiency / diabetes if recurrent
tx w/ local nystatin /azole + PO nystatin/ketoconazole
scabies
mite visible burrows: finger web spaces + wrist
pruritus
secondary bacterial infections
immunocompromised = norwegian scabies, crusted == thousands of mites, looks like prosiasis
dx via microscopy
tx via permethrin cream
tinea versicolor
multiple patches of various sizes and color on torso notice in summer dx w/ KOH tx w/ selenium and amidazole malassezia
lice
dx w/ microscopy
tx w/ permethrin
decontamination of bedsheets
warts
HPV
older children = hands
6 * 11 = salicylcic acid, liquid nitrogen, curretage
genital
16 * 18 = cervical cancer
molluscum
pox virus - kids and sex
freeze or curretage
if giant or diffuse - HIV
rosacea
acne – middle age
erythema, alcohol, hot
bulbous red nose + blepharitis
oral tetracycline + topical metronidaozle
hirsutism
PCOS, cushing, drugs (minoxidil, steroids, phenytoin)
virilization: deep voice, frontal baldning, clitoromegaly
- -> check androgen secreting ovarian tumor
male pattern baldness
genetic
psoriasis
MTX cyclosporine biologics
UV light corticosteroids
herald patch on trunk followed by similar itchy lesions
syphillus testing
reassurance
pityriasis roasea
lichen planus -pruritic, purple, white like lesions
monitor oral lesiosn for oral cancer
tetracyclines
OCPs
phenothiazines
photosensitivity
erythema multiforme
sulfa drugs
herpes
penicillin
idiopathic
if severe: SJS : wide spread
TX: w/ supportive: fluid, pain control, super ifnection monitoring
erythema nodosum
inflammation of subQ tissue tender red nodules sarcoid cocci UC strep/TB/drugs (sulfa)
Tx: leg elevation, compressive bandages
pemphigus vulgaris = life threatening middle aged elderly patients == flaccid bullae in oral mucosa, rupture easily == nikolsky sign + == IgG to desmoglein 3 + lace lake fishnet IF pattern = tx w/ steroids
pemphigous bullous = linear pattern, also tx w/ steroids, niklosky neg
decubitus ulcers
stage 1: intact skin
stage 2: partial thickness loss of dermiss (blister)
stage 3: full thickness
stage 4: full thickness w/ exposed bone/muscle
unstageable: eschar
periodic turning use of special air mattresses
cleanliness and dryness
skin inspection
when missed, lesions become infected
tx w/ surgical debridgement
+ abx if infected
excessive perspiration
MI TB infection hyperthryoidism pheochromocytoma
dysplastic nevi syndromre
genetic syndrome: multiple moles
FH melanoma
tx w/ f/u and bx, avoid sun, suscreen
keratoacanthoma
mimics skin cancer
flesh colored on face
rapid onset and rapid involution
tx w/ observation
keloids
overgrowths of scar
blacks
pink back chest delts ear piercing
BCC
shiny papule head
umbilicated center w/ pearly borders, easy bleeding
sunlnight increases risk
tx w/ excision
SCC
preexisting AKs
bowen disease
black dots on palm or nail in blacks
melanoma
paget disease of breast
crusted nipple
invasive DCIS
stomatitis
fissuring of corners - angular chomatitis
B complex + vitamin C
