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A- 6 Chronic Dermatitis and Drug eruptions > Contact derm > Flashcards

Contact derm Flashcards

1
Q

chemical prod paresthesia of fingertips w cyanosis and gangrene. nails yellow.

A

oxalic acid.

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2
Q

oxalic acid is best neutralized a what?

A

lime water

milk of magnesia.

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3
Q

is a protoplasmic poison prod white eschar om skin.

may prod glomeruloneph, arrhythmia

A

Phenol (carbolic acid). neutralized by 65% ethyl or isopropyl alcohol.

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4
Q

phosphorus burns tx

A

Rinse w water.

ff by app of copper sulfate to prod precipitate.

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5
Q

wht chemicals expand the airbag?

A

sodium azide and cupric oxide propellant cartridge release nitrogen gas w expands bag exceeding 160kph (96 mph)

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6
Q

Dusts of what prod folliculitis.

A

Lime, Zinc, Arsenic.

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7
Q

Capsaicin dermatitis tx

A

Insoluble in water.

Acetic acid 5% ( white vinegar) or antacids (maalox) relieve the burning.

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8
Q

What us chloroacetophenone

A

Lacrimator for tear gas dermatitis.
delayed appearance 24 -72 hrs after exposure.
irritation, sensitizaruon w erythema and severe vesiculation.

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9
Q

Tx for tear gas dermatitis

A

Lavage agfected skin w sodium bicarbonate sol and instillation of boric acid solution in eyes.

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10
Q

what is yperite (dichlorodiethyl sulfide)

A

used jn chemical warfar. sulfur mustard gas. Erythema vesicles bulla used in chemical warfare.
most freq affected sites are covered by clothing, humidified by sweat, groin axilla genitalia

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11
Q

What is chloroacetophenone

A

Mace a mixture of tear gas
causes allergic sensitizaruon.
tx : chnge clothes, washing w oil/ milk. ff by washing w water

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12
Q

crude petroleum prod what lesions

A

Itching folliculitis acneiform eruptions.

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13
Q

Solvents cause approx how many percent if occupational dermatitis?

A

10%

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14
Q

allergic contaxy derm hs what hypersensitivty type?

A

type 4 hypersistivity

Cell mediated

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15
Q

Tx acute general allergic contact derm

A

Syst steroid beginnig w 40-60mg/day of prednisone in a single oral dose. tapering slowly to topical steroid.
Eruption limited- Local app of top steroid cream, lotion, aerosol spray.

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16
Q

strong patch test reactions induce a hyperirritability also called as what sundrome

A

Excited skin syndrome

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17
Q

a std patch test is applied for how many hrs?

A

48 hrs. then exposed to 5 to 15 j/m2 of UVA and read for another 48 hrs.

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18
Q

most frequent site for nail polish dermtitis?

A

Eyelids

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19
Q

Toxicodendron ( Poison ivy) dermatitis appeara after how many hrs after exposure?
what is the 1st symptom?

A

48 hours.

marked pruritus is the 1st symptom.

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20
Q

black dot sign is seen in where?

A

Poison ivy reaction

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21
Q

tx poison ivy

A

eruption severe or extensive- Sys steroid begin 40-60 mg prednisone single oral dose daily tapered off over a 3 week period.

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22
Q

most common cause or allergic cont derm in florists

A

Peruvian lily

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23
Q

seaweed dermatitis is caused by a marine blue green alga caled

A

Lyngbya majuscula Gomont.

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24
Q

reported to cause hemorrhaguc bullae on the feet of farmers.

A

Randox (2- chloro- N, N- diallyl- acetamide)

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25
trimming during landscaping induce irritant derm caused by
Calcium oxalate crystals.
26
Best screening agents for drmatitis from clothing.
Ethylene urea melamine formaldehyde resin. | Dimethylol dihydroxyethylene urea formaldehyde resin
27
shoe dermatitis is most freq caused by the ff rubber accelerators.
Mercaptobenzothiazole, carbamates, tetramethylthiuram disulfide
28
preservative used in antihumidity sachets.
Dimethyl fumarate.
29
most common causw of allergic contact derm in children and adults
nickel
30
in a patch test rxn. Nickel xan be detected by applying wht to the test object? ahat is the positive xolor rxn
Dimethyl- glyoxime solution | cotton swab used to apply the sol will turn orange- pink.
31
dental gold lesions
oral lichenoid eruptions
32
what chemical is the most often the cause for shoe allergy and glove allergy.
Mercaptobenzothiazole- Shoe allergy. | Thiuram- Glove allergy
33
among transdermal meds which one induces the highest rate of allergic rxn?
Clonidine
34
contact urticaria ans anaphylaxis are reported most often w what drug? Than w other antibiotics.
bacitracin
35
4 structural classes of corticosteroid.
``` Class A- Hydrocortisone; Tixocortol pivalate grp B - Triamcinolone acetonide, budesonide grp C- Betamethasone grp D- hydrocortisone 17- butyrate group. ``` freq cross reactions bet B and D. Tixocortol pivalate and budesonide - best screening agents.
36
are these immunologic or non immunologic reactions? latex, potatoes, phenylmercuric propionate
IgE mediated type. | Immunologic type
37
What are non immunologic type?
``` Does not need prior sensitization. nettle rash ( plants), DMSO; sorbic acid, benzoic acid, cinnamic aldehyde, cobalt chloride, trafuril. ```
38
vast majority of drug reactions.
``` Simple exanthem (75-95%) Urticaria (5-6%) ``` females 1.3-1.5 times more. except under age 3 yo the boys are most likely affected w drug reactions.
39
RAST has how many percent false negative results rate in penicillin type 1 allergy.
20%
40
useful in eval type 1 immediate hyper rxnz
skin testing
41
Exanthem in adverse drug rxn spares the face, if its not spared what is the dx considered?
DRESS
42
most common cause of drug rxn?
Penicillin | TMP SMX
43
Ampi - amox given during ebv infectuon cases how many percent exanthem in adults and children
29-69%- adults | 100%- children
44
TMP given to aids pxs causes exanthem in how many percent
40%
45
antimalarials % in exanthem
25 percent
46
overall incidencd of DRESS.
1/1000 and 1/10000
47
characteristix feat of DRESS
Rash long lastings symptom fever greater 38 Multiorgan inv CBC : Eosinophilia - > 1500 absolute eosinophilia lymphocyte activation Frequent reactivation of HHV6, HHV7; EBV, CMV, (60-80% of cases demonstrate HHV family reactivation)
48
skin eruption in DRESS
Morbilliform others: facial erythema edema periorbital sparing impetigo like crusting on chun
49
allopurinol minocycline w has renal or pulmo involvement.
Allo- Renal | Mino- Pulmo.
50
first line tx DRESS
``` Stop causative agent High dose sys steroid (1-2 mg/kg/day) Pulse IV steroid IVIG cyclosporine ```
51
most common anticonvulsant causing dress
Carbamazepine
52
after how many weekds after starting medicarion does sulfonamide hypersensitivity syndrome occur
3 weeks
53
minocycline hyperses syndrome, pxs has deficiency or what enzyme
Glutathione S transferases
54
minocycline hypersens. percent of liver and renal involvement.
Liver 75% | Renal 17%
55
dapsone hypersesy. most characteristic lesion and tx
Morbilliform eruption that heals w desquamation. icterus and lymphadenopathy. -80% of pxs. Tx- corticosteroids. mainstay
56
SCORTEN is scoring for what?
TEN/ SJS most common model to predict mortality
57
SCORTEN Scoring w percent mortality.
0-1 - 3.2% mortality | >5- 90% mortality
58
histo SJS ten
Lymphocytic infiltrate at DEJ necrosis of keratinoxytes cellular necrosis
59
TEN has elevated what ligand
ELEV FAS ligand FAS TEN
60
in europe what is yhe most common cause of Sjs ten (drug) in children?
allopurinol. children- sulfonamides, antibioticsF antieleptics. acetaminophen.
61
what scoring can be used to point out causality in sjs ten
ALDEN score
62
what HLA haplotype is present in vast majority of carbamazepine induced SJS/TEN patients?
HLA B 1502
63
Mechanism for IVIG In TEN.
Blocking binding of FasL To Fas, stopping keratinocyte apoptosis.
64
Ave time of epidermal regrowth who survive sjs ten-
3 weeks
65
most common sequelae of sjs ten
Ocular scarring | vision loss

A- 6 Chronic Dermatitis and Drug eruptions (9 decks)

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