DERM Flashcards
What is xerosis
dry skin
Xerosis treatment
Emollients
* first line for ___
* restores barrier and skin ___
itching
function
Agents to reduce itching
menthol and camphor
* ___ sensation
pramoxine
* local ___
aluminum acetate
* alter C-fiber ___ transmission hydrocortisone
* anti- ___
- cooling
- anesthetic
- nerve
- inflammatory
Dermatitis - Inflammatory process of the upper
___ layers of skin
2
acute dermatitis
- itching is ___
- ___ dermatitic
- poison ivy
- 2 types: ___ and ___
- intense
- contact
- allergic and irritant
sub-acute dermatitis
- itching is common but less ___
- ___ dermatitis
- intense
- atopic
chronic dermatitis
- lichenification
- ___ dermatitis
stasis
Acute Contact Dermatitis
Irritant - non ___ reaction to frequent contact with everyday substances
* more common than allergic
* reaction within a few ___
- immunologic
- hours
Contact Dermatitis - Poison Ivy
T or F: poison ivy does not spread from lesions
True
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
- prevention
- 4
- 10%
- calamine
T or F: corticosteroid dose packs are first line therapy for acute dermatitis
False; do not provide treatment for long enough
Treatment of acute dermatitis
prednisone ___ mg per day; taper every ___ days
* minimum of ___ days of treatment
- 40-60 mg
- 3 days
- 10-14 days
Atopic Triad
- atopic dermatitis
- allergic rhinitis
- asthma
atopic dermatitis
Pruritis
symmetrical red papules or plaques
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
- anti-inflammatory
- vasoconstrictive
- 2%
- potency
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
- thinning
- dialated
- increased
- color
- tolerance
- HPA
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
- ointment
- face
- 2 weeks
- 50 grams
Topical Corticosteroids
high potency class 2
* betamethasone dipropionate ___
* fluocinolide
* same comments as very high potency class 1
cream
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 ___
- lotion
- anti-inflammatory
- long
- face
Topical Corticosteroids
low potency calsses 6-7
* ___
* desonide
* can use on ___ , groin, ___ , axilla
* mild ___ effect
* safest for ___ term use
- hydrocortisone
- face, genitals
- anti-inflammatory
- long
Topical Calcineurin Inhibitors
- MOA: blocks ___ cytokine genes
- ___ and ___
- considered ___ line treatment
- can be used on ___ area
- equivalent to ___ corts
- no risk of ___
- ___ use only
- $$$
- pro-inflammatory
- pimecrolimus and tacrolimus
- 2nd
- any
- atrophy
- intermittent
Crisaborole 2% Ointment
- mild-mode AD
- non-steroidal - ___ - 4 inhibitor
- good for patients who are scared of steroids
- BID for ___ days
- $$$
- phosphodiesterase
- 28 days
Dupilumab
Dupixent
* MOA: Human monoclonal antibody against ___ receptor alpha. Inhibits ___ and ___ signalling
* administered ___ every ___ weeks
* first biologic indicated for mod-severe AD for ages ___ +
- IL-4, IL-4, IL-13
- SC, 2 weeks
- 12+
Upadacitinib
Rinvoq
* moderate to severe AD
* MOA: ___ inhibitor
* Mediates signaling of cytokines and ___
* higher rates of major __ events and ___
- Janus kinase (JAK)
- growth factors
- CV, thrombosis
Ruxolitinib
Opzelura® 1.5% Cream
* mild to moderate AD
* MOA: ___ inhibitor
* medicates signalling of ___
* ___ term use
* MAX: ___ g per week
* avoid in ___ patients
- JAK
- cytokines
- short
- 60 g
- immunocompromised
comedone
hair follicale plugged with sebum, keratine, and dead skin
___ naturallly colonize the skin and sebaceous glands
* bacteria converts TG to ___ which irritates local cell resulting in ___
- Propionibacterium acnes
- FFA
- inflammation
non-inflammatory acne (2)
- whiteheads
- blackheads
inflammatory acne (3)
- papules
- pustules
- ruptured contents
secondary lesions are ___
scars
first choice for comedonal, noninflammatory acne (mild)
topical retinoids
first choice for Mild-moderate papulopustular inflammatory acne
adapalene + BP or clindamycin + BP
first choice for Severe papulopustular or moderate nodular acne
oral isotretinoin
first choice for Nodular or conglobate acne
oral isotretinoin
first choice for Maintenance therapy
adapalene
adapalene brand name
Differin
retinoid
tazorotene brand name
Tazorac
retinoid
tretinoin brand name
Retin-A
retinoid
Azelaic acid brand name
Azelex
antibacterial and keratolytic
benzoyl peroxide brand name
Oxy-10
antibacteria;, comedolytic/keratolytic, anti-inflammatory
topical antibiotcs
- clindamycin (Cleocin-T)
- erythromycin
- clindamycin + BP (BenzaClin, DUAC)
ora; antibiotics
- minocylcine and ___
- erythromycin and ___
- TMP/SMX
- most effective when ___ present
- doxycline
- azithromycin
- inflammatio
Oral Anti-androgen Therapy
- low dose oral ___
- ___ 100-150 mg per day
- ideal for females who have acne flares during ___
- contraceptives
- spironolactone
- menstrual
Topical Hormone Treatment
Clascoterone 1% Cream
* ___ receptor inhibtor
* may be used in both ___ and ___
* $$$
- androgen
- males and females
treatment for severe acne
Isotretinoin
* vitamin ___ derivative
* reduces ___ production and shrinks ___ glands
* acne will get worse before it gets better
- A
- sebum
- sebaceous
Rosacea - General Information
- chronic ___ instability
- facial ___
- more common in __
- vascular
- blushing
- women
- main trigger factor of rosacea
- main drug that triggers rosacea
- temperature
- vasodilators
rosacea. treatment
topical antibiotic
* ___ 1% applied ___
topical retinoid
* ___ acid 15% (Finacea)
- metronidazole
- azelaic
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
- Brimonidine
- alpha
- erythema
- ocular
Psoriasis
- chronic ___ inflammatory skin disorder
- ___ mediated
- ___ proliferation (7x faster than normal)
- thickened red patches covered by ___ white scales
- autoimmune
- T-lymphocyte
- keratinocyte
- silvery
severe psoriasis is > ___ % BSA
10 %
psoriasis triggers
- STRESS
- cold
- smoking
- drugs (NSAIDs, ACE, Li+)
T or F: some sun exposure is good for psorias
True
getting burnt will cayse more lesions so need to be careful
general treatment for psoriasis
- sun
- baths
- emollients
- keratolytics (salicylic acid 2%)
topical therapy for psoriasis
- most effective when less than ___ % BSA is effected
- 20%
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 ___
- scaly
- D, proliferation
- face
T or F: topical corticosteroids have the possibility of tacyphylaxis
True
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
- limited and resistant
- topical
- severe
- UVA, squamous
phototherapy for psoriasis
- ___ penetrates thicker lesions better
- ___ for thinner lesions
- 20-25 treatments given ___ per week
- UVA
- UVB
- 2-3x
psoriasis treatmet
___ taken PO before UVA
* photosensitizer
Methoxsalen
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
- necrosis
- T
- retinoids
liver
Key aspects of psoriasis treatment with biologic agents
- PA usually required
- many patiets will require supplemental ___ therapies
- avoids ___ vaccines
- topical
- live
