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common conditions 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
how is moderate to severe rosacea treated?
same oral tx as with acne vulgaris-- oral abx or isotretinoin
26
#1 benign epidermal tumor in older ppl
seborrheic keratosis
27
which two conditions may arise within a seborrheic keratosis lesion
bowen dz (SCC in situ) malignant melanoma
28
sharply defined, brown, oval or round lesions with velvety, verrucous surface & "stuck on" appearance
seborrheic keratosis
29
is tx required with seborrheic keratosis? 5 ways to tx it?
not required bc its benign tx-- cryotherapy, ED/C, shave biopsy, laser
30
most common premalignant skin condition that may progress to SCC
actinic keratosis
31
two keratosis conditions associated with sun/UV exposure
seborrheic and actinic keratosis
32
pathophys of seborrheic vs actinic keratosis
seborrheic-- benign immature keratinocyte proliferation actinic--- atypical keratinocyte proliferation
33
rough macules or papules that feel like sandpaper with transparent or yellow scaling; can be skin color, red or hyperpigmented plaques
actinic keratosis
34
how do you treat actinic keratosis?
few-- cryotherapy numerous-- 5-Fluorouracil 5% cream
35
what sucks about the 5-FU cream
can be temporarily disfiguring- red ulcers & crust formaton
36
when should you refer or biopsy patient with AK?
failed cryotherapy painful or growing pigmented changes hyperkeratotic young w/ AK near previous cancer scar hard to tx location like lips, ears
37
genetic disorder of keratinization of hair follicles
keratosis pilaris
38
small, rough, folliculocentric keratotic papules on outer upper arms and thighs; genetic
keratosis pilaris
39
seasonal variation pattern with keratosis pilaris
better in summer and worse in winter
40
3 ways to tx keratosis pilaris
prevent dryness-- mild soapless cleansers lubrication lactic acid lotion (Lac-Hydrin)
41
firm hyperkeratotic papules with red-brown punctuations from thrombosed capillaries; border can be round or irregular
veruuca vulgaris & plantaris
42
verruca vulgaris
43
verruca plantaris
44
periungal verruca
45
verruca plana
46
filliform wart
47
condyloma acuminara (genital warts)
48
first line tx of warts
cryotherapy or topical salicylic acid
49
which parts of the body can you use trichloroacetic acid to tx warts
palms and soles; burning and stinging may occur clinician applied
50
how do you use duct tape to tx wart
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
which two wart tx require derm consultation
intralesional immunotherapy-- injection Q 3 wks pulse dye laser-- to destroy vasculature; give salicylic acid before
52
two other patient applied therapies for warts
Cantharidin Imiquimod
53
low grade dermatitis that primarily affects kids & often coexists with xerosis and atopic dermatitis; more noticeable w/ tanning
pityriasis alba
54
when do you tx pityriasis alba? list 3 tx
tx if symptomatic moisturizing creams & sun screen low potency topical steroids topical calcineurin inhibitors
55
which is better on oily skin- gel or cream?
gels
56
which is better on dry skin? cream/lotion or gel?
cream/lotion
57
when are solutions better vehicles?
larger area & hair-bearing areas
58
alternative to topical retinoid in mild comedomal acne
OTC salicylic acid
59
exfoliates epidermis; stimulate local immunity
salicylic acid MOA
60
blistering agent used to tx warts and molluscum ; cover with tape after treatments
cantharidin
61
how often do you reapply cantharidin? when do you stop?
Q 3 wks stop if no response after 4 treatments
62
topical immunomodulator for anogenital warts & 5% for non-anogenital
imiquimod
63
what should you do to warts before using imiquimod? when should you stop imiquimod?
pare it (trim) stop if no change after 3 months
64
how often should you do cryotherapy?
Q 2 wks shows improved resolution
65
opens comedomee reducing acne formation with skin irritation as most common ADR
topical retinoids
66
agent with both antibacterial & comedolytic properties used once daily with visible improvements after 3 wks of using
benzoyl peroxide
67
ADR of skin irritation, erythema, stinging, tightening or burning sensation
Benzoyl peroxide
68
topical abx applied once daily with BP to reduce resistance and increase efficacy; well tolerated
topical clindamycin
69
alternative to clindamycin in combo w/ BP but has very high resistance
topical erythromycin
70
Oral abx used in moderate to severe acne at 100mg BID w/ food
doxycycline
71
oral abx that should be avoided in kids <8yo & pregnant people w/ teeth discoloration as a SE
doxycycline
72
photosensitivity, GI issues, pseudotumor cerebri, esophageal issues
ADR of doxycycline
73
crosses BBB allowing for increased toxicity, vestibular ADR, SLE-like syndrome with same avoidances & dosing as doxycycline
Minocycline
74
inhibits acne through the androgen action on the pilosebaceous unit
hormonal therapy
75
hyperkalemia, menstrual irregularities, breast tenderness, GI sxs, HA, fetal feminization of male fetus
ADR of spironolactone

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