CLIPP 32 - Derm Flashcards
Acute urticarial causes
histamine release triggered by allergens, viruses, or temperature
Atopic Triad
atopic dermatitis (eczema), asthma, allergic rhinitis (hayfever)
Treatment of Seborrheic Dermatitis
baby oil and small brush, daily shampooing, low potency topical steroid
4 triggers of acne
make-up, mechanical factors, occlusion, overzealous cleaning
Treatment of Chronic Nickel Contact Dermatitis
avoidance, emollient, medium-potency topical steroid (BID x 2 wks)
Acute Contact Dermatitis Manifestations
Vesicles, edema, erythema, pruritis. Commonly caused by poison ivy, poison oak, poison sumac (toxicodendrons)
Impetigo treatment
topical antibiotic (mupirocin), systemic antibiotics if invasive or abscess formation
Mild Potency Topical Steroids (classes and example)
Class 6&7
hydrocortisone acetate 1% (OTC)
Intermediate Potency Topical Steroids (classes and example)
Class 4&5
triamcinolone acetonide, 0.1%
Potent Topical Steroids (classes and example)
Class 2&3
betamethasone dipropionate, 0.05%
Super Potent Topical Steroids (classes and example)
Class 1
clobetasol propionate, 0.05%
4 Side effects of topical steroids
skin atrophy, telangiectasias, hypopigmentation, HPA suppression
Pediculosis Capitis (Head Lice) Pharmacologic Treatment
- 1% permethrin lotion, once weekly x 2-3wks
- benzyl alcohol 5%/malthion 0.5% in areas of permethrin resistance
- lindane 1% no longer recommended
Pediculosis Capitis (Head Lice) Non-pharmacologic Treatment
- occlusive treatment in combination with wet combing
- wash items in hot water or dry on high heat
- seal unwashable items in an airtight bag for >26 hours
Scabies Treatment
- permethrin 5% cream, once weekly x 2wks applied overnight and washed off in morning
- moderate potency topical steroid for post-scabetic itch if necessary
- oral ivermectin if permethrin allergy
Treatment for
Tinea corporis (ringworm)
Tinea pedis (athlete’s foot)Tinea versicolor (malassezia)
Tinea capitis
- 6-8weeks
- selenium sulfide lotion (malassezia)
- oral griseofulvin (tinea capitis), terbinafine, or itraconazole
Kerion
significant allergic response to tinea capitis. inflamed, weeping, boggy lesion. treat with oral steroids
Common warts
Caused by HPV
Molluscum Contagiosum
virus causing small, smooth, umbilicated lesions
Common Diaper Rash causes and treatments
- Irritant dermatitis (zinc oxide cream)
- candidiasis (nystatin)
- bacterial infection (oral antibiotics)
Uncommon but serious Diaper rash causes
- zinc deficiency
- Langerhans cell histiocytosis
Treatment for mild acne
- OTC benzoyl peroxide
- retinoids or adapalene
Treatment for moderate acne
- topical clindamycin or erythromycin (P. acnes)
- oral doxycycline or tetracycline
- contraceptive pills
Treatment for severe acne
-refer to dermatology for oral isotretinoin
Treatment for warts (and molluscum contagiosum)
- observation
- daily salicylic acid application
- duct tape?
- liquid nitrogen
- cantharidin (no longer FDA approved)
- Candidal antigen therapy (limited evidence, painful, expensive)
- Curettage (scarring, high recurrence)
Acute Rash Differential (8)
-urticaria, papular urticaria, streptococcal infection, erythema multiforme, drug eruption, roseola, erythema infectiosum (fifth disease), erythema migrans
Chronic Rash Differential (4)
-seborrheic dermatitis, eczema (Atopic dermatitis), candida rash, psoriasis
Pustular Differential (5)
Staph folliculitis, acne vulgaris, hidradenitis suppurativa, rosacea, perioral dermatitis
Ringworm differential (4)
-nummular eczema, psoriasis, pityriasis alba, pityriasis rosea
