Common Derm disorders and infections Flashcards
Atopic dermatitis or eczema s&s?
red, itchy, dry, onset usually early childhood.
pruritic, erythematous dry patches of skin, often scale. can get lesions that ooze and crust.
atopic dermatitis tx?
- moisture
- avoid hot water and harsh soaps with scents
- moisturizing cream
- light weight cotton clothes
- topical steroids, BID 3-4 weeks, hydrocortisone 1%
- antihistamiens - benadryl 6-8 hours and hydroxyzine
- chronic - can use tacrolimus and primecrolimus
Psoriasis vulgaris S&S? Triggers?
thick silvery erythematous scales, r//t immune disorder
location - extensor extremities, scalp, sacrum
triggered by NSAIDs, BB, prednisone, lithium
Psoriasis vulgaris tx?
first-line - topical steroids (moderate to high potency) such tramcinolone 0.1%, behthamesone 0.05%. BID - TID for 2-3 weeks.
along with calcipotriene (vitamin D) or coal product ALSO moisture
- still symptomatic tazorotene, anthralin, vitamin D, UVB/A light, oral retinoids or methotrexate if severe involving large body area. , cyclosporine limit use due to nephrotoxicity
TNF antagonists - etenarcept, infliximab and adalimumab
herpes zoster description?
vesicles along dermatome with eythematous base. rupture and crusts call off in 2-3 weeks.
HZ tx?
pain management - tylenol 3
post herpatic neuralgia - neurotin, tegretol, elavil
cool compress
antiviral pills within 48 hours (acyclovir 800 mg 5 times a day for 7-10 days)
zoster vaccine if > 60 years
hand-foot-mouth disease s&s?
oral lesions, sore throat, low grade fever, swollen cervical lymph
hands and feet - small reddish flat or slightly raised surrounded by reddish halo
Tx tinea capitis?
griseofulvin 20-25 mg/kg/day 6-8 weeks
selenium sulfide 1% shampoo QID x 2 weeks then twice weekly
tx tinea corpis?
lotrin 1% BID until 7-10 days after rash clears
Accutane dose for acne?
PO 0.5-2 mg/kg daily divided in two doses for 15-20 weeks
Oral antibiotics for acne?
tetracycline 500 mg BID, doxycycline, erythromycin
topical antibiotics for acne?
clindamycin or erythromycin
or benzoyl peroxide + clindamycin once daily at HS
Tinea vesicolor s&s?
light brown or white scaling spots. r/t yeast and increased fatty acid in skin. In microscope see hypea and spores.
tx tinea vesicolor?
selenium sulfide lotion 2.5% 10 min daily x 7
doesn’t resolve can try antifungals such as clotrimazole (lotrimin), ketoconazole, oral -terbinafine (lamisil)
Onychomocyosis s&s?
yellow thick white crumbly nail.
onychomocyosis tx?
Oral: terbinafine 250 mg daily x 6 weeks
itraconazole 400mg daily x 7 days each month for 2 months
itraconazole 200 mg daily x 2 months
griseofulvin 250 mg TID x 6 months (check LFTs)
Topical: ciclopirox (penlac)
tinea pedis s&s?
white, soft, peels, scaling on toes, webbing, and sole of foot.
tinea pedis tx?
topical antifungals:
butinafine (lotrimin)
terbinafine (lamisil) 250 mg daily, 6-12 weeks
cool compress
impetigo s&s?
vesicles which break and form honey-colored crusts.
seborrheic dermatitis tx?
head - antidandruff shampoo. nizoral 1%. topical steroid short term.
face, trunk and pther regions can use topical 3% ketoconozale cream or sodium sulfacetamide wash. if doesnt help try topial 1-2.5% hydrocortisone.
pityriasis rosea
oval dermacarted salmon-colored patches ith fine collarette scale, may be preceded by herald patch
pityriasis rosea tx?
symptom management w/antipruritics
seborrheic dermatitis s&s ?
moist papules covered in greasy scales that may coalesce into red patches and plaques. often non pruritic and mildly erthematous plaques with waxy, yellow scale on face.
cellulitis description?
localized painful expanding erythema and edema, may have pustules or vesicles
candidiasis
red denuted skin with scaling and satelitte pustules
erythema infectiosum “slapped cheek” or fifths disease
erythematous bring red macules and papules over cheeks
erythema multiforme
target lesions with reddish center and pale ring and surrounding darker rings
rubella (german measles)
discrete maculopapules which occassionally coalesce, spreading caudally and have fine desquamation.
measles
erythematous pruritic macules which become
rosacea s&S?
erythema, telangiectasia, inflamm papulopustular eruptions.
tx of rosacea?
topical antimicrobials, immunosupp, and acne products. first line - metronidazole cream
other: erythrmoycin and clindamycin, . azelaic acid gel, bezoyl peroxide, retinoids.
tacrolimus ointment if refractory common.
oral antibiotic can be considered.
AVOID medium and high corticosteroid creams.
tx lyme diseasE?
doxycycline, cefuorxime axetil, amoxicillin, select macrolides. 14-28 days.
proph 200mg doxy can be used if early. must feed for 24 minutes to vause lyme.
tx of angular cheulitis?
topical nystatin
what is tzanck test?
HSVZ test
acne mild definition
Less than 20 comes phones or fewer 15 inflame lesions. Total less than 30
moderate acne definition
20-100 comed, 15-50 inflamm, total 30-125
severe acne defintiion
more 5 nodules, total inflamm > 50, TL > 125
antibiotics commonly used for acne
clindamycine, erthromycine, tetracycline (doxycycline and minocycline primary for oral)
HSV symptoms
prodrome: burning or tenderness at site. painful vesicles appear at site and tender lymphade in regional nodes. ulceration occurs and lesions crust over. heal on own 2-3 weeks.
HSV tx?
acyclovir 200 mg PO 5 times a day 7-10 days
recurrent 400 mg PO BID for 5 days or continuous for suppression
drug eruptions are r/t what huypersensitivity type?
immunoglobulin E depedent
common S&S of drug reaction?
irching, burning, pain with or without rash. maculopapular rash common. onset7-10 days after drug statered. lasts 1-2 weeks and then fades.
s&S of erythema multiforme?
small vesicles or ulcers to widespread bullous lesions. think SJS
management of drug reaction.
close monitor 48 hours. cool compress. topical corticosteroid ointment. oral antihistamines
allergic dermatitis
moisture, avoid irritant. steroid cream, medium - high potency. oral steroid if diffuse or periorbital or genital regions
what is woods lamp used for?
check for tinea caused by certain fungal species.
candidiasis signs and symptoms
thrush - white or gray mem plaques on mucosa. scrape off and bright erythematous
other locations - pink or red moist patches bordered by thin collarette of scale.
candidiasis tx?
nystatin and diflucan most common tx.
what is auspitz sign?
scales removed, tiny blleds occur. common in psoriasis
management of urticaria?
H1 blocker and H2 as augementation . benadryl has been replaced by nonsedatiing ones.
h1 - zyrtec, claritin or loratidine.
H2 - tagemet or cimietidine, ranitidine (zantaz)
Tricyclics (tryptyline) and leukitrine receptor antagonists (singulair)
