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common conditions Flashcards

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Dermatology Board Prep flashcards
1
Q

how long does it take for acne vulgaris to improve

A

8-12 wks

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2
Q

what causes acne excories

A

picking at acne

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3
Q

what causes ice pick scarring

A

being aggressive to comedomes

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4
Q

how do you treat mild comedonal acne (first line & 2 alts)

A

topical retinoid #1
Alt: azelaic acid & salicyclic acid

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5
Q

how do you treat mild papulopustular and mixed acne (2)

A

topical retinoid + benzoyl peroxide OR
benzoyl peroxide and topical clindamycin

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6
Q

why do we not use topical abx alone with acne?(2)

A

it promotes appearance of abx-resistance strains of the bacteria causing the acne
using BP with it also improves tx efficacy

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7
Q

morning tx regimen for acne

A

wash face w/ benzoyl peroxide cleanser or wash face then apply BP gel to entire face

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8
Q

night tx regimen for acne

A

thin layer of topical retinoid to entire CLEAN face

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9
Q

why should you never apply topical retinoid and BP at the same time?

A

topical retinoid will get oxidized by BP

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10
Q

when can you use oral treatment with acne? how about isotretinoin?

A

if its moderate to severe acne
use accutane with cystic acne

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11
Q

typical course of treatment for oral acne tx

A

3-4 months
if longer, follow closely for ADR

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12
Q

preferred oral antibiotic for acne

A

tetracyclines– doxycycline and minocycline

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13
Q

when can you give oral hormone therapy for acne

A

moderate to severe acne

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14
Q

noninflammatory, papules with a central, dilated, follicular orifice with gray, brown, or black keratotic material

A

open comedomes

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15
Q

noninflammatory dome-shaped, smooth skin-colored, whitish or grayish papules

A

closed comedomes

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16
Q

deep-seated, inflamed, often tender, large papules (5mm+) or nodules (5mm+) that often heals with scarring

A

cystic/nodular acne

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17
Q

4 primary features of rosacea

A

flushing (transiet erythema)
non-transient erythema
inflammatory papulopustules
telangiectasia

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18
Q

4 secondary features of rosacea

A

burning or stinging
dry appearance esp central facial skin
ocular sx
phymatous changes

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19
Q

visible, enlarged, cutaneous blood vessels mostly on central face esp cheeks

A

telangiectasias

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20
Q

red (except on dark skin) enlarged nose from tissue hypertrophy associated with rosacea

A

rhinophymatous rosacea

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21
Q

5 triggers of rosacea

A

emotion
hot spicy food & drinks
ETOH
sunlight or extreme weather
meds

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22
Q

6 meds that can cause rosacea

A

niacin
doxorubicin
interferon
nifedipine
nitroglycerin
topical steroids

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23
Q

how do you treat redness from rosacea

A

topical brimonidine– vasoconstriction

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24
Q

how do you treat papulopustular rosacea (2)

A

1 topical metronidazole once a day

alt: azelaic acid once daily or BID

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25
Q

how is moderate to severe rosacea treated?

A

same oral tx as with acne vulgaris– oral abx or isotretinoin

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26
Q

1 benign epidermal tumor in older ppl

A

seborrheic keratosis

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27
Q

which two conditions may arise within a seborrheic keratosis lesion

A

bowen dz (SCC in situ)
malignant melanoma

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28
Q

sharply defined, brown, oval or round lesions with velvety, verrucous surface & “stuck on” appearance

A

seborrheic keratosis

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29
Q

is tx required with seborrheic keratosis? 5 ways to tx it?

A

not required bc its benign
tx– cryotherapy, ED/C, shave biopsy, laser

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30
Q

most common premalignant skin condition that may progress to SCC

A

actinic keratosis

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31
Q

two keratosis conditions associated with sun/UV exposure

A

seborrheic and actinic keratosis

32
Q

pathophys of seborrheic vs actinic keratosis

A

seborrheic– benign immature keratinocyte proliferation
actinic— atypical keratinocyte proliferation

33
Q

rough macules or papules that feel like sandpaper with transparent or yellow scaling; can be skin color, red or hyperpigmented plaques

A

actinic keratosis

34
Q

how do you treat actinic keratosis?

A

few– cryotherapy
numerous– 5-Fluorouracil 5% cream

35
Q

what sucks about the 5-FU cream

A

can be temporarily disfiguring- red ulcers & crust formaton

36
Q

when should you refer or biopsy patient with AK?

A

failed cryotherapy
painful or growing
pigmented changes
hyperkeratotic
young w/ AK
near previous cancer scar
hard to tx location like lips, ears

37
Q

genetic disorder of keratinization of hair follicles

A

keratosis pilaris

38
Q

small, rough, folliculocentric keratotic papules on outer upper arms and thighs; genetic

A

keratosis pilaris

39
Q

seasonal variation pattern with keratosis pilaris

A

better in summer and worse in winter

40
Q

3 ways to tx keratosis pilaris

A

prevent dryness– mild soapless cleansers
lubrication
lactic acid lotion (Lac-Hydrin)

41
Q

firm hyperkeratotic papules with red-brown punctuations from thrombosed capillaries; border can be round or irregular

A

veruuca vulgaris & plantaris

42
Q
A

verruca vulgaris

43
Q
A

verruca plantaris

44
Q
A

periungal verruca

45
Q
A

verruca plana

46
Q
A

filliform wart

47
Q
A

condyloma acuminara (genital warts)

48
Q

first line tx of warts

A

cryotherapy or topical salicylic acid

49
Q

which parts of the body can you use trichloroacetic acid to tx warts

A

palms and soles; burning and stinging may occur
clinician applied

50
Q

how do you use duct tape to tx wart

A

cover for 6 days then debride with nail file or pumice and leave open on 6th night then repeat no more than 2x a month

51
Q

which two wart tx require derm consultation

A

intralesional immunotherapy– injection Q 3 wks
pulse dye laser– to destroy vasculature; give salicylic acid before

52
Q

two other patient applied therapies for warts

A

Cantharidin
Imiquimod

53
Q

low grade dermatitis that primarily affects kids & often coexists with xerosis and atopic dermatitis; more noticeable w/ tanning

A

pityriasis alba

54
Q

when do you tx pityriasis alba? list 3 tx

A

tx if symptomatic
moisturizing creams & sun screen
low potency topical steroids
topical calcineurin inhibitors

55
Q

which is better on oily skin- gel or cream?

A

gels

56
Q

which is better on dry skin? cream/lotion or gel?

A

cream/lotion

57
Q

when are solutions better vehicles?

A

larger area & hair-bearing areas

58
Q

alternative to topical retinoid in mild comedomal acne

A

OTC salicylic acid

59
Q

exfoliates epidermis; stimulate local immunity

A

salicylic acid MOA

60
Q

blistering agent used to tx warts and molluscum ; cover with tape after treatments

A

cantharidin

61
Q

how often do you reapply cantharidin? when do you stop?

A

Q 3 wks
stop if no response after 4 treatments

62
Q

topical immunomodulator for anogenital warts & 5% for non-anogenital

A

imiquimod

63
Q

what should you do to warts before using imiquimod? when should you stop imiquimod?

A

pare it (trim)
stop if no change after 3 months

64
Q

how often should you do cryotherapy?

A

Q 2 wks shows improved resolution

65
Q

opens comedomee reducing acne formation with skin irritation as most common ADR

A

topical retinoids

66
Q

agent with both antibacterial & comedolytic properties used once daily with visible improvements after 3 wks of using

A

benzoyl peroxide

67
Q

ADR of skin irritation, erythema, stinging, tightening or burning sensation

A

Benzoyl peroxide

68
Q

topical abx applied once daily with BP to reduce resistance and increase efficacy; well tolerated

A

topical clindamycin

69
Q

alternative to clindamycin in combo w/ BP but has very high resistance

A

topical erythromycin

70
Q

Oral abx used in moderate to severe acne at 100mg BID w/ food

A

doxycycline

71
Q

oral abx that should be avoided in kids <8yo & pregnant people w/ teeth discoloration as a SE

A

doxycycline

72
Q

photosensitivity, GI issues, pseudotumor cerebri, esophageal issues

A

ADR of doxycycline

73
Q

crosses BBB allowing for increased toxicity, vestibular ADR, SLE-like syndrome with same avoidances & dosing as doxycycline

A

Minocycline

74
Q

inhibits acne through the androgen action on the pilosebaceous unit

A

hormonal therapy

75
Q

hyperkalemia, menstrual irregularities, breast tenderness, GI sxs, HA, fetal feminization of male fetus

A

ADR of spironolactone

DERM (13 decks)

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