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rosh review > Cutaneous Disorders > Flashcards

Cutaneous Disorders Flashcards

1
Q

Tx for seborrheic dermatitis in peds AKA cradle cap

A

Soap and water
Emollient (petrolatum, mineral oil) or selenium sulfide shampoos
Low-potency topical corticosteroids only for extensive or persistent cases
Ketoconazole shampoo

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2
Q

Distinguishing diaper rashes (seborrheic dermatitis vs. candidal dermatitis vs. contact dermatitis)

A

Seborrheic Dermatitis
- “greasy,” transparent to pink-red patches that are macerated located on scalp, ears, face, chest, groin

Candidal dermatitis
- beefy red plaques with satellite lesions

Contact dermatitis
- Erythematous, indurated, scaly plaques (severe cases with vesiculation and bullae)

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3
Q

Which rare potentially life-threatening disease can present resembling a candidal diaper rash?

A

Langerhans cell histiocytosis

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4
Q

Tx for seborrheic dermatitis when involves body areas other than scalp in infants

A

Ketoconazole 2% cream or a low potency topical corticosteroid (hydrocortisone 1% cream)

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5
Q

Timing of rash in parvovirus B19 infection

A

URI sx for 3-4 days then “slapped cheek” rash

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6
Q

Most common cause of impetigo?

A

Staph aureus followed by group A strep

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7
Q

Tx for impetigo

A

Limited number of lesions: topical mupirocin

Numerous lesions or involvement of more than one area:: oral abx such as cephalexin or dicloxacillin

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8
Q

Symptoms of IgA vasculitis (Henoch-Schonlein Purpura)

A
  • Palpable purpura - lower extremities and buttocks (NORMAL platelets)
  • Colicky abdominal pain - can complicate to intussusception
  • Heme-positive stool
  • Microscopic hematuria, proteinuria, elevated BUN/Cr
  • Arthralgias
    Uncommon: orchitis or testicular torsion
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9
Q

Most commonly implicated medications leading to SJS or TEN

A
  • Allopurinol
  • Antiepileptic meds
  • Lamotrigine
  • Sulfonamide abx
  • Sulfasalazine
  • Oxicam NSAIDs
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10
Q

Classic drug reaction patterns: a series

A

Q117080

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11
Q

Which tinea infections in children always requires systemic antifungal therapy?

A

Tinea capitis, tinea unguium (onychomycosis)

Griseofulvin, terbinafine, fluconazole, itraconazole

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12
Q

What is the most common cause of death from seafood consumption in the United States?

A

Vibrio vulnificus septicemia

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13
Q

What is Dyshidrotic Eczema?

A

Vesicular rash typically found on the palms, soles, and sides of fingers that presents in the third decade of life with lifelong occurrences

Has similar appearance as herpes, lesions are opaque and deep-seated, either flush with the skin or slightly elevated and do not break easily

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14
Q

Description of erythema multiforme

A

Target-like lesions - central dark papule surrounded by a pale area and halo of erythema

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15
Q

Causes of erythema multiforme

A
  • Herpes simplex (most common viral cause)
  • Mycoplasma
  • Sulfonamides
  • Penicillins
  • Barbiturates
  • Phenytoin
  • NSAIDs
  • Oral hypoglycemics
  • Lupus
  • Hepatitis
  • Lymphoma
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16
Q

What is the most common corneal lesion in herpes zoster ophthalmicus?

A

Punctate epithelial keratitis

Pseudodendrites are also associated (no terminal bulb)

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17
Q

Main difference between staphylococcal scalded skin syndrome vs. SJS

A

SSSS - circumoral erythema without mucosal involvement

SSSS toxins target desmoglein 1 which is not predominant in mucosa

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18
Q

What is a fixed drug eruption?

A

Solitary erythematous patch that is round or oval and well-circumscribed

  • Typically pruritic
  • May become dusky and violaceous
  • Swelling, bullae, and erosion of lesion may occur
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19
Q

Common causes of fixed drug eruptions

A
  • Tetracyclines
  • Sulfonamides
  • Fluoroquinolones
  • Penicillins
  • Dapsone
  • NSAIDs
  • Barbiturates
  • Acetaminophen
  • Antimalarials
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20
Q

Why are breastfed infants less likely to get diaper dermatitis?

A

The pH of their feces is lower

21
Q

Risk factors for melanoma

A
  • Ultraviolet irradiation (particularly light-skinned individuals)
  • BRAF gene
  • Family hx
  • Dysplastic nevi
22
Q

What is the most important factor in melanoma?

A

Depth

23
Q

Characteristics of epidermal cysts (sebaceous cysts)

A
  • skin-colored lesion
  • present for long period of time
  • often with central punctate area
  • white or yellowish waxy material drainage
24
Q

What genetic condition is associated with numerous epidermoid cysts on face, ears, trunk?

A

Gardner syndrome

25
Q

What is a pilar cyst?

A

Firm, slow-growing nodule similar to epidermoid cyst, but grow from root of hair follicle, so more often located on the scalp

26
Q

What key clinical findings differentiates erysipelas from cellulitis?

A

Sharp demarcation from uninvolved skin
Can also spread to pinna of ear, whereas cellulitis cannot
Tends to have acute onset with systemic manifestations whereas cellulitis is more indolent

Erysipelas involves upper dermis and superficial lymphatics
Cellulitis involves deeper dermis and subcutaneous fat

27
Q

Common cause of erysipelas

A

Beta-hemolytic streptococci

28
Q

Classic manifestation of erysipelas

A

Butterfly pattern over face

29
Q

Tx for erysipelas

A

Mild-moderate: Amoxicillin, cephalexin

Systemic: Ceftriaxone or cefazolin

30
Q

Description of erythema multiforme

A

Sudden appearance of erythematous violaceous macules and papules
Commonly found on soles of feet and palms of hands
Lesions are target-like with a central dark papule surrounded by a pale area and a “halo” of erythema

31
Q

Causes of Erythema Multiforme

A
  • HSV (most common viral cause)
  • Mycoplasma
  • Drugs: SOAPS - sulfa, oral hypoglycemics, anticonvulsants, penicillin, nSAIDs
  • Lupus
  • Hepatitis
  • Lymphoma
32
Q

Tx of Erythema Multiforme

A

Mild: supportive - oral antihistamines and topical steroids

Severe (significant mucous membrane involvement): systemic corticosteroids

33
Q

Pathophysiology of Kerion

A

Starts as tinea capitis (painless) that then undergoes delayed-type hypersensitivity reaction to causative fungus which causes initial erythematous, scaly plaque to become boggy with inflamed purulent nodules and plaques and the hair follicle is destroyed by the inflammatory process leading to scarring alopecia

34
Q

Clinical presentation of Kerion

A

Q586281 image

  • Painful
  • Hair loss
  • Fever
  • Lymphadenopathy
35
Q

Tx for kerion

A

Oral griseofulvin
Abx to treat any secondary bacterial infection
Oral corticosteroids to treat severe inflammation

36
Q

What is black dot Tinea capitis?

A

Refers to an infection that causes the individual hairs to fracture, leaving the infected dark stubs visible in the infected regions

37
Q

Locations commonly involved in stasis dermatitis

A

Medial distal and pretibial area of the legs; bilateral malleoli

38
Q

What are the EFG prediction criteria added to the ABCD prediction rule for diagnosing unpigmented nodular melanomas?

A

Elevation
Firm on palpation
Continuous growth for 1 month

39
Q

Characteristics of basal cell carcinoma

A
  • Pearly nodule
  • Telangiectatic vessels
  • “Rolled” raised edge
40
Q

Characteristics of squamous cell carcinoma

A
  • Indurated and ulcerated papule
  • May bleed
  • Arise from actinic keratosis
41
Q

What are five treatments for genital warts caused by HPV?

A
  • Podofilox
  • Imiquimod
  • Cryotherapy
  • Trichloroacetic acid
  • Surgical removal
42
Q

What is the most common STD?

A

HPV

43
Q

Risk factors for MRSA

A
  • Recent hospitalization/surgery
  • Hemodialysis
  • HIV infection
  • IVDU
  • Purulence
  • Residence in long-term healthcare facility
44
Q

Abx regimens to cover cellulitis with MRSA coverage

A
  • Amoxicillin and minocycline
  • Amoxicillin and doxycycline
  • Bactrim
  • Clindamycin
45
Q

What risk factor has the strongest association for cellulitis

A

Lymphedema

46
Q

Pahtophysiology of pemphigus vulgaris

A

IgG autoantibodies against keratinocytes and their desmosomes

47
Q

Tx for pemphigus vulgaris

A

Steroids and immunomodulators such as azathioprine, cyclosporine, or methotrexate

48
Q

Dispo for pemphigus vulgaris

A

Admission - high mortality

49
Q

Mechanism of pemphigus vulgaris

A

Bullae and blister formation from deposition of immunoglobulin G autoantibodies in the epithelial cell surface

IgG against keratinocytes in desmosomes causing acantholysis

rosh review (22 decks)

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