d3 Flashcards

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1
Q

Clinical feature of TEN/SJS?

A

4-28 days after the first and 2 days after the second exposure
Acute influenza-like prodrome
Rapid onset erythematous bullae, macule, and vesicle
Necrosis and sloughing of the epidermis
Mucosal involvement
S.Sign–Sepsis sign including AMS and Seizure

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2
Q

SJS and TEN nomniclature?

A

<10 % SJS
>30% TEN
10-30 % 0verlap

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3
Q

Common triggers?

A
Drug
Another factor(M.Pnumonia.GVH disease and vaccination)
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4
Q

Drug?

A
Allopurinol
Ab(TMP-SMX)
Anticonvelsant(Carbamazepine,Lamotrigen and Phenitoin)
NSAID
SULFASALAZINE
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5
Q

Risk factor for onychomycosis?

A
T.Runrum
Old age
T.Pedis
DM
PAD
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6
Q

Exam finding?

A

Thick, Brittle nail and discolored mail

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7
Q

Diagnosis?

A

KOH, PAS, and culture

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8
Q

Managment?

A

1st line:Terbinafine and intraconazole

2nd line: Grisofulvin,fluconazol

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9
Q

Do condylomata accumulate etiology?

A

HPV

MC STI in the USA

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10
Q

Lesion?

A

Verrucous
Papiliform
Pink/skin-colored
may have Iching and burning

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11
Q

Managment?

A

Usually self-limited
Trichloroacetic acid/podophyllin
Immunotherapy(imiquimod)
Surgery(cryosurgery,excision or lesser tx)

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12
Q

Pudofolliculitis barbe pathophysiology?

A

Enterance of hair to parafolicular line
Occur in area of barbe
Shaving by the blade is risky(leave hair below skin)

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13
Q

lesion?

A

area of barbe
Papular
Painful
Sign of complication

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14
Q

Sign of complication?

A

Hyperpigmentation
Bacterial infection
Keloid

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15
Q

Managment?

A

Leave hair cutting
Use a single blade or non-blade cutter(clamper)
Hot Water compression before shaving

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16
Q

Managment of psoriasis?

A

Topical if area <5%

Systemic if area > 5 and presence of P.artheritis

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17
Q

Topical Tx?

A

Topical GC

Topical vit D(calcipotriene), calcineurin inhibitor or retinoid if GC induced skin thinking feared

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18
Q

Systemic?

A

UV phototherapy
Methotrexate
Apremilast
TNF alpha inhibitor(apremilast)

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19
Q

Dermatofibroma?

A
Usually, affect LE
Hyperpigmented
Painless
Discrete and firm
dimple when periphery compressed(buthole sign)
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20
Q

When did treatment require?

A

If symptomatic

Cosmetic reason

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21
Q

Rosacea CM?

A

chronic
erythematous
affect convex of face
symptom(flushing, skin sensitivity…..)

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22
Q

Pathophysiology?

A

A chronic inflammatory reaction to microorganism, UV light, or vasomotor dysfunction

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23
Q

Symptoms are precipitated by?

A

Hot/spicy food
Alcohol
Sun exposure
High ambient Tempratue

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24
Q

managment?

A

General measure

Specific Tx based on the type

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25
Q

General measure?

A

Maybe enough for mild and moderate case
A gentle cleanser and emollient
Avoid precipitating factor
Use for all type

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26
Q

Erythematotelengectatic rosacea?

A

erythema, flushing, and telangiectasia
Topical brimonidine
Laser/Intense pulsed light therapy

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27
Q

Papulopustular rosacea?

A

superimposed infection
papule and pustule
1st line: Topical metronidazole/azelik acide/ivermectine
2nd line: Oral tetracycline

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28
Q

Phymatous rosacea?

A

Irregularly thickened skin
Oral isotritinoin
Laser therapy/surgery

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29
Q

Ocular rosacea?

A

Burning, foreign sensation, blepharitis, conjunctivitis and keratitis, and corneal ulcer
Lid scrubs and ocular lubricant
Topical/systemic antibiotic

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30
Q

Irritant contact dermatitis cause?

A

Physical/chemical irritation

Soap/deteregent,chemical/acide/alkali

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31
Q

CM?

A

commonly in hard
erythema
fissure

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32
Q

Allergic contact dermatitis triggers?

A
Poison oak/ivy/sumac
Nicker
Ruber/latex
Leather dye 
medication
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33
Q

CM?

A
Well demarcated
area of skin in contact
papule/vesicle
chronic lichenification
weeping
crusting
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34
Q

Disease-associated with seborrheic dermatitis?

A

Parkinson

HIV

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35
Q

Urushiol?

A

MCC of Allergic CT
Produced by Toxicodendron (poison IV/oak/sumac)
Founded in a wooded area and unclean building
Form linear eczematous lesion at the area of contact
The lesion may have a secondary infection

36
Q

Drug-induced acne triggers?

A
Glucocorticoid,androgen
Immunomodulator(azathioprine, EDGF inhibitor......)
Anticonvulsant (phenitoin)
Antipsychotic
Antituberculosis drug(Isoniazide)
37
Q

Presentation?

A

Monomorphic papule/pustule
Lack of comedones, cyst, and nodule
Location and age may be atypical for acne

38
Q

Managment?

A

Stope the causative drug

Anti Acne Tx is not effective

39
Q

Chery hemangioma caracter?

A
MC benign VT
Common in 3rd and 4th decade
Papular
Small
Bright red
Sharpley demarcated
always cutaneous(not involve mucosa or deep tishue)
40
Q

pathology?

A

congested capillary and post-capillary venule in the papillary dermis

41
Q

prognosis?

A

Not regress

Tx only for the cosmic reason

42
Q

Clinical presentation of urticaria?

A
Well-Circumscribed
Raised
Erythematous
Itchy
It May have a different shape
Develop within minute and hour and resolve within 24 hr
Central pallor
43
Q

Etiology?

A
Infection
IgE mediated
Direct mast cell activation
NSAID
50% Idiopathic
44
Q

Do factors cause direct mast cell activation?

A

Narcotics
Muscle relaxant
Contrast medication

45
Q

mast cell activation in the superficial dermis?

A

Urticaria

46
Q

Mast cell activation in the deep dermis and sc tissue?

A

angioedema

47
Q

Tuberous sclerosis manifestation?

A

Dermatologic
Nurologic
CVS
Renal

48
Q

Dermatologic?

A

Ash-leaf spot
Shagreen patches
Malar angiofibroma

49
Q

Ash-leaf spot?

A

Hypopigmented lesion

50
Q

angiofibroma?

A

Red/flesh-colored papule

Mistaken as acne

51
Q

Shagreen patches?

A

A shagreen patch (arrows) is an irregularly shaped, irregularly thickened, slightly elevated soft skin-colored patch, usually on the lower back, made up of excess fibrous tissue.

52
Q

Neurologic?

A
CNS tumor (subependymal tumor..)
Epilepsy(infantile spasm..)
Intellectual disability
Autism
Behavioral disorder(hyperactivity)
53
Q

CVS?

A

Rhabdomyoma

54
Q

Renal?

A

Angiomyolipoma

55
Q

HPV wart common in?

A

Plantar
Palmar
genital

56
Q

Plantar common in?

A

Young
HIV
Organ transplant

57
Q

Moccasin-type tinea pedis?

A

scales/fissure
Hyperkeratosis
Flaking
extension to sole, side, or dorsum of the foot

58
Q

Vesiculobullous type?

A

painful bullae

erythema(lateral foot)

59
Q

Female & male pattern hair loss?

A

Chronic, progressive thinning of hair
F: Vertex, the center of the hair, No hairline
M: Vertex, Temporal area, frontal hairline

60
Q

Genetics?

A
Polygenic inheritance
Hormonal factor (DHT)
61
Q

Managment?

A

M:minoxidine,fenastride
F:Minoxidine

62
Q

Androgen level in FPHL?

A

mostly normal

elevated in case of PCOS

63
Q

Acute palmoplantar eczema also called?

A

dyshidrotic eczema

64
Q

CM?

A

Recurrent acute episode
Deep-seated, pruritic vesicle on hand and feet
Palm and sole with typical palm side involvement

65
Q

Complication?

A

Desquametization
Chronic dermatitis
Secondary infection

66
Q

Biopsy?

A

Intraepidrmal spongiosis

lymphocyte infiltration

67
Q

management?

A

emollient

potent topical medication

68
Q

Epidermolysis bullosa?

A
Inherit disorder
Epithelial fragility(bullae, erosion, and ulcer)
Triggered by minor trauma
Lesion heal w/o scaring
Thickening of the skin of the sole
69
Q

Benefit of antiviral in herps zoster?

A

Should begin in 72 hr
Decrease symptom duration
Decrease PHN risk

70
Q

the d/c between drug-induced and idiopathic lichens planus?

A

DILP: more diffuse

71
Q

What is a drug that can cause DILP?

A

ACE inhibitor
Tiazide
Betablocker
Hydroxychloroquine

72
Q

Pemphigus vulgaris AB taarget?

A

Desmosome

73
Q

CM?

A

Flaccid bulla and ulcer
Mucosal erosion
Nikolisky sign

74
Q

Histopathology?

A

Intraepidermal cleavage
acantholysis
tombstone cells along the basal layer

75
Q

Managment?

A

Systemic CS
CS sparing agents
Aggressive wound care

76
Q

CM of erythema nodusum?

A

Tender
Erythematous
Nodule
MC in the anterior leg

77
Q

Etiology?

A
Infection
IBD
Sarcoidosis
Medication(Ab or OCP)
Malignancy
78
Q

Pathology?

A

Septal paniculitis

No vasulitis

79
Q

Natural history?

A

Spontaneous resolution

Hyperpigmentation

80
Q

Sebhoric keratosis?

A
Any part of the body except palm and sole
Flat macule
Wart-like lesion
Pink/white
Brown/dark
Velvety/greasy surface
Stuck-on lesion
81
Q

Biopsy?

A

Basal cell
Variable pigmentation
Hyperkeratosis
Keratine containing cyst

82
Q

Lether trelat sign?

A

Multiple seborrheic keratosi

Indicate occult internal malignancy

83
Q

managment?

A

Observation

removal if cosmetic

84
Q

Ichthyosis Vulgaris?

A

Inherited disorder

Due to filaggrin gene mu

85
Q

CM?

A
Diffuse dermal scaling
Dry
Rough
horny Plates
resemble reptile
86
Q

Prognosis?

A

Mild in early life and sever latter

life long disease

87
Q

Managment?

A

Emollient only is not effective
Keratinolytics(coal tar/salicylic acid)
Topical retinoid for controlling the symptom