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PHRM 825 > DERM > Flashcards

DERM Flashcards

1
Q

What is xerosis

A

dry skin

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2
Q

Xerosis treatment

Emollients
* first line for ___
* restores barrier and skin ___

A

itching
function

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3
Q

Agents to reduce itching

menthol and camphor
* ___ sensation
pramoxine
* local ___
aluminum acetate
* alter C-fiber ___ transmission hydrocortisone
* anti- ___

A
  • cooling
  • anesthetic
  • nerve
  • inflammatory
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4
Q

Dermatitis - Inflammatory process of the upper
___ layers of skin

A

2

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5
Q

acute dermatitis

  • itching is ___
  • ___ dermatitic
  • poison ivy
  • 2 types: ___ and ___
A
  • intense
  • contact
  • allergic and irritant
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6
Q

sub-acute dermatitis

  • itching is common but less ___
  • ___ dermatitis
A
  • intense
  • atopic
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7
Q

chronic dermatitis

  • lichenification
  • ___ dermatitis
A

stasis

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8
Q

Acute Contact Dermatitis

Irritant - non ___ reaction to frequent contact with everyday substances
* more common than allergic
* reaction within a few ___

A
  • immunologic
  • hours
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9
Q

Contact Dermatitis - Poison Ivy

T or F: poison ivy does not spread from lesions

A

True

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10
Q

Contact Dermatitis - Poison Ivy
* ___ is key
* Ivy-Block - reapply every ___ hours
* topical therapy OK if less than ___ % BSA involved
* Treat with: ___ lotion, topical or oral antihistamines, topical or oral corticosteroids

A
  • prevention
  • 4
  • 10%
  • calamine
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11
Q

T or F: corticosteroid dose packs are first line therapy for acute dermatitis

A

False; do not provide treatment for long enough

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12
Q

Treatment of acute dermatitis

prednisone ___ mg per day; taper every ___ days
* minimum of ___ days of treatment

A
  • 40-60 mg
  • 3 days
  • 10-14 days
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13
Q

Atopic Triad

A
  • atopic dermatitis
  • allergic rhinitis
  • asthma
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14
Q

atopic dermatitis

Pruritis

A

symmetrical red papules or plaques

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15
Q

Topical Corticosteroids

Classified according to potency which corresponds to ___ activity and ___ potency
* only ___ % absored when applied to normal intact skin
* vehicle impacts delivery and ___ of corticosteroids

A
  • anti-inflammatory
  • vasoconstrictive
  • 2%
  • potency
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16
Q

Side effects of topical corticosteroids
* ___ of skin
* ___ blood vessels
* ___ bruising
* skin ___ changes
* development of ___ (tachyphylaxis)
* risk of ___ suppression with long term use of high potency agents

A
  • thinning
  • dialated
  • increased
  • color
  • tolerance
  • HPA
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17
Q

Topical Corticosteroids

very high potency class 1
* betamethasone dipropionate ___
* halobetasol proprionate
* clobetasone proprionate
* do not use on ___
* do not use longer than ___ weeks
* no more than ___ grams per week

A
  • ointment
  • face
  • 2 weeks
  • 50 grams
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18
Q

Topical Corticosteroids

high potency class 2
* betamethasone dipropionate ___
* fluocinolide
* same comments as very high potency class 1

A

cream

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19
Q

Topical Corticosteroids

mid potency classes 3-5
* triancinolone acentonide
* mometasone furoate
* betamethasone dipropionate ___
* used on mores skin surfaced for exacerbations
* moderate ___ effect
* safer for ___ term useage
* dont use long term on ___

A
  • lotion
  • anti-inflammatory
  • long
  • face
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20
Q

Topical Corticosteroids

low potency calsses 6-7
* ___
* desonide
* can use on ___ , groin, ___ , axilla
* mild ___ effect
* safest for ___ term use

A
  • hydrocortisone
  • face, genitals
  • anti-inflammatory
  • long
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21
Q

Topical Calcineurin Inhibitors

  • MOA: blocks ___ cytokine genes
  • ___ and ___
  • considered ___ line treatment
  • can be used on ___ area
  • equivalent to ___ corts
  • no risk of ___
  • ___ use only
  • $$$
A
  • pro-inflammatory
  • pimecrolimus and tacrolimus
  • 2nd
  • any
  • atrophy
  • intermittent
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22
Q

Crisaborole 2% Ointment

  • mild-mode AD
  • non-steroidal - ___ - 4 inhibitor
  • good for patients who are scared of steroids
  • BID for ___ days
  • $$$
A
  • phosphodiesterase
  • 28 days
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23
Q

Dupilumab

Dupixent
* MOA: Human monoclonal antibody against ___ receptor alpha. Inhibits ___ and ___ signalling
* administered ___ every ___ weeks
* first biologic indicated for mod-severe AD for ages ___ +

A
  • IL-4, IL-4, IL-13
  • SC, 2 weeks
  • 12+
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24
Q

Upadacitinib

Rinvoq
* moderate to severe AD
* MOA: ___ inhibitor
* Mediates signaling of cytokines and ___
* higher rates of major __ events and ___

A
  • Janus kinase (JAK)
  • growth factors
  • CV, thrombosis
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25
Q

Ruxolitinib

Opzelura® 1.5% Cream
* mild to moderate AD
* MOA: ___ inhibitor
* medicates signalling of ___
* ___ term use
* MAX: ___ g per week
* avoid in ___ patients

A
  • JAK
  • cytokines
  • short
  • 60 g
  • immunocompromised
26
Q

comedone

A

hair follicale plugged with sebum, keratine, and dead skin

27
Q

___ naturallly colonize the skin and sebaceous glands
* bacteria converts TG to ___ which irritates local cell resulting in ___

A
  • Propionibacterium acnes
  • FFA
  • inflammation
28
Q

non-inflammatory acne (2)

A
  1. whiteheads
  2. blackheads
29
Q

inflammatory acne (3)

A
  1. papules
  2. pustules
  3. ruptured contents
30
Q

secondary lesions are ___

A

scars

31
Q

first choice for comedonal, noninflammatory acne (mild)

A

topical retinoids

32
Q

first choice for Mild-moderate papulopustular inflammatory acne

A

adapalene + BP or clindamycin + BP

33
Q

first choice for Severe papulopustular or moderate nodular acne

A

oral isotretinoin

34
Q

first choice for Nodular or conglobate acne

A

oral isotretinoin

35
Q

first choice for Maintenance therapy

A

adapalene

36
Q

adapalene brand name

A

Differin

retinoid

37
Q

tazorotene brand name

A

Tazorac

retinoid

38
Q

tretinoin brand name

A

Retin-A

retinoid

39
Q

Azelaic acid brand name

A

Azelex

antibacterial and keratolytic

40
Q

benzoyl peroxide brand name

A

Oxy-10

antibacteria;, comedolytic/keratolytic, anti-inflammatory

41
Q

topical antibiotcs

A
  • clindamycin (Cleocin-T)
  • erythromycin
  • clindamycin + BP (BenzaClin, DUAC)
42
Q

ora; antibiotics

  • minocylcine and ___
  • erythromycin and ___
  • TMP/SMX
  • most effective when ___ present
A
  • doxycline
  • azithromycin
  • inflammatio
43
Q

Oral Anti-androgen Therapy

  • low dose oral ___
  • ___ 100-150 mg per day
  • ideal for females who have acne flares during ___
A
  • contraceptives
  • spironolactone
  • menstrual
44
Q

Topical Hormone Treatment

Clascoterone 1% Cream
* ___ receptor inhibtor
* may be used in both ___ and ___
* $$$

A
  • androgen
  • males and females
45
Q

treatment for severe acne

Isotretinoin
* vitamin ___ derivative
* reduces ___ production and shrinks ___ glands
* acne will get worse before it gets better

A
  • A
  • sebum
  • sebaceous
46
Q

Rosacea - General Information

  • chronic ___ instability
  • facial ___
  • more common in __
A
  • vascular
  • blushing
  • women
47
Q
  • main trigger factor of rosacea
  • main drug that triggers rosacea
A
  • temperature
  • vasodilators
48
Q

rosacea. treatment

topical antibiotic
* ___ 1% applied ___

topical retinoid
* ___ acid 15% (Finacea)

A
  • metronidazole
  • azelaic
49
Q

new rosacea treatment

  • ___ 0.33% (Miravasco)
  • ___ -2 adrenergic agonist
  • treatment for persistent facial ___
  • available in drops of ___ rosacea

originally for glaucoma to cause vessles in eye to shrink

A
  • Brimonidine
  • alpha
  • erythema
  • ocular
50
Q

Psoriasis

  • chronic ___ inflammatory skin disorder
  • ___ mediated
  • ___ proliferation (7x faster than normal)
  • thickened red patches covered by ___ white scales
A
  • autoimmune
  • T-lymphocyte
  • keratinocyte
  • silvery
51
Q

severe psoriasis is > ___ % BSA

A

10 %

52
Q

psoriasis triggers

A
  • STRESS
  • cold
  • smoking
  • drugs (NSAIDs, ACE, Li+)
53
Q

T or F: some sun exposure is good for psorias

A

True

getting burnt will cayse more lesions so need to be careful

54
Q

general treatment for psoriasis

A
  • sun
  • baths
  • emollients
  • keratolytics (salicylic acid 2%)
55
Q

topical therapy for psoriasis

  • most effective when less than ___ % BSA is effected
A
  • 20%
56
Q

Topical therapy for psoriasis (first line)

  • emollients
  • corticosteroids - preferred for ___ lesions
  • calipotriene/calcitriol - Vit ___ analogs, inhibit ___ of lesions
  • corticosteroids + tazarotene
  • calcineurin inhibitor - for areas not suitable for corts like the ___
A
  • scaly
  • D, proliferation
  • face
57
Q

T or F: topical corticosteroids have the possibility of tacyphylaxis

A

True

58
Q

phototherapy for psoriasis

  • targeted phototherapy for ___ and ___ plaques
  • for mild-moderate patients who do not respond to __ agents
  • used in combination with systemic/biologic treatment in patients with ___ disease
  • ___ has greater risk of skin aging and ___ cell cancer
A
  • limited and resistant
  • topical
  • severe
  • UVA, squamous
59
Q

phototherapy for psoriasis

  • ___ penetrates thicker lesions better
  • ___ for thinner lesions
  • 20-25 treatments given ___ per week
A
  • UVA
  • UVB
  • 2-3x
60
Q

psoriasis treatmet

___ taken PO before UVA
* photosensitizer

A

Methoxsalen

61
Q

Severe Psoriasis treatment

First line: Biologics
* tumor ___ factor inhibitors
* ___ cell activation inhibitors
Second Line: systemic therapy
* oral ___
* cyclosporine
* methotrexate

methotrexate has long term effects of ___ dysfunctiion

A
  • necrosis
  • T
  • retinoids

liver

62
Q

Key aspects of psoriasis treatment with biologic agents

  • PA usually required
  • many patiets will require supplemental ___ therapies
  • avoids ___ vaccines
A
  • topical
  • live

PHRM 825 (49 decks)

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