derm Flashcards
1
Q
tx acne vulgaris
A
tretinoin
benzoyl peroxide
azelaic acid
salicylic acid
erythromycin or clindamycin (topical)
doxycycline or sulfamethoxazole (oral)
isotretinoin 20 weeks if severe and unresponsive to others ^^
2
Q
tx treatment resistant acne (before isotretinoin)
A
spironolactone
combo oral BC
3
Q
what acne meds are C/I in pregnancy
A
tretinoin
isotretinoin
doxy
4
Q
MC premalignant skin condition
A
actinic keratosis (may progress to squamous cell CA)
5
Q
what should you do when you see actinic keratosis
A
punch or shave biopsy
6
Q
alopecia areata is thought to be due to
A
underlying autoimmune disease
7
Q
PE alopecia areata
A
smooth, non scarring hair loss w patches of smaller hairs termed exclamation hairs
8
Q
tx alopecia areata
A
intralesional corticosteroids
9
Q
MC type of skin cancer in US
A
basal cell CA
10
Q
sx basal cell CA
A
small, raised papule that are pink, white or flesh colored; translucent, waxy, or pearly quality with raised “rolled” borders and central depression and/or ulceration with overlying telangiectatic surface vessels
bleeds easily
11
Q
dx basal cell CA
A
punch or shave biopsy
12
Q
what topical can you use for basal cell CA
A
Imiquinod
13
Q
sx bullous pemphigoid
A
pruritus w eczematous or urticarial plaques followed by multiple tense large bullae (1-3 cm) that don’t rupture easily
14
Q
PE bullous pemphigoid
A
negative Nikolsky - no epidermal detachment
15
Q
dx bullous pemphigoid
A
skin biopsy w direct immunofluorescence - linear C3 and IgG along the dermal epidermal junction sub epidermal blisters, and eosinophilia
16
Q
MC cause cellulitis
A
Group A strep (MC)
staph aureus
17
Q
RF cellulitis
A
skin inflammation (abrasion)
lowered immunity
skin infection (tinea, rash)
edema
obesity
recent surgery or trauma or animal bites
18
Q
sx cellulitis
A
localized macular erythema (flat margins not sharply demarcated)
swelling
warmth
tenderness
19
Q
Tx cellulitis
A
Nafcillin, cefazolin, clindamycin, dicloxacillin, cephalexin, doxycycline, and trimethoprim-sulfamethoxazole
20
Q
MC cause condyloma acuminata
A
HSV 6 and 11
21
Q
tx condyloma acuminata
A
resolution w/in 18 mos
Imiquimod or Pdophyllotoxin or Sinecatechins
cryotherapy, trichloroacetic acid, surgical removal
22
Q
atopic dermatitis is also called
A
eczema
23
Q
eczema/atopic dermatitis sx
A
pruritus is hallmark and required for dx
erythematous, ill-defined blisters, papule, or plaques w oozing
lesions dry and crus over and scale
MC ON FLEXOR SURFACES
24
Q
tx eczema/atopic dermatitis
A
topical corticosteroids
skin hydration
25
pathophysiology seborrheic dermatitis
increased sebaceous gland activity + hypersensitivity to malassezia furfur
26
seborrheic dermatitis is associated w what neurologic dz
parkinson dz
HIV
27
sx seborrheic dermatitis
erythematous plaques or patches covered w fine white-yellow greasy scales
common in areas w high sebaceous gland secretion (scalp - dandruff), eyelids, beard, mustache, nasolabial folds, chest, groin
28
tx seborrheic dermatitis
anti fungal shampoo
low potency topical corticosteroids, topical anti fungal agents for face
oral anti fungal if resistant
29
sx dyshidrotic eczema
sudden onset of pruritic "tapioca-like" small tense vesicles on the soles, palms, fingers (lateral aspect of digits)
30
tx dyshidrotic eczema
Topical corticosteroids
31
MC cause erysipelas
Group A strep (S. pyogenes)
32
sx erysipelas
intensely erythematous, raised area with sharply demarcated borders
MC involves lower extremities and face
often associated w systemic manifestations
33
MC cause erythema multiforme
herpes simplex virus (MC)
mycoplasma spp (esp in kids)
34
meds that can cause erythema multiforme
sulfa drugs
beta-lactams
phenytoin
phenobarbital
35
erysipelas
a variant of cellulitis (more superficial infxn)
35
sx erythema multiforme
target lesions hallmark finding - a dusky, central area or blister, a dark red inflammatory zone surrounded by a pale ring of edema, and an erythematous halo on the extreme periphery of the lesion
negative nikolsky sign
36
sx erythema multiforme
target lesions hallmark finding - a dusky, central area or blister, a dark red inflammatory zone surrounded by a pale ring of edema, and an erythematous halo on the extreme periphery of the lesion
negative nikolsky sign
minor - no mucosal membrane involvement
major - mucosal membrane involvement
37
tx erythema multiforme
supportive
remove offending drugs
topical steroids, antihistamines, analgesics, skin care etc
prophylactic acyclovir if recurring
38
erythema infectiosum is also called
fifth disease
39
erythema infectiosum is caused by
parvovirus B19
40
sx erythema infectiosum
erythematous malar rash "slapped cheek: and circumoral pallor
lacy, reticular maculopapular rash on extremities
may have arthropathy or arthralgias
associated w fetal loss
41
tx erythema infectiosum
supportive
42
cause of rubeola
measles virus
43
sx rubeola
high fever + cough, coryza, conjunctivitis
kopek spots - small 1-3 mm pale white or blue papule w an erythematous base on the buccal mucosa
morbilliform maculopapular brick-red rash beginning at the hairline
44
cause of hand, foot, mouth dz
coxsackie virus (esp type A)
45
sx hand, foot, mouth dz
oral - erythematous macula's that become painful oral vesicles surrounded by a thing halo of erythema
exanthema - grayish-yellowish vesicular, macular, or maculopapular nonpruritic contender skin lesions on distal extremities (includes palms and soles)
46
roseola infantum is caused by
HHV 6
47
sx roseola infantum
abrupt onset high fever
rose-pink macular or maculopapular, BLANCHABLE, rash beginngin on the TRUNK AND NECK before spreading to face
nagayama spots - erythematous papule, macules, or ulcers on the soft palate and uvula
48
cause of rubella / German measles
rubella virus
49
sx rubella
low grade fever
posterior cerical and posterior auricular lymphadenopathy most prominent
pink or light red non confluent maculopapular rash that last 3 days
forchheimer spots - small red macules or petechiae on the soft palate
arthralgia and arthritis
50
MC cause folliculitis
staph aureus
51
sx folliculitis
peri follicular papule and/or pustules w surrounding erythema on hair bearing skin
52
tx folliculitis
topical mupirocin
53
hidradenitis suppurativa
painful, chronic inflammatory suppurative condition involving skin and subq tissue
chronic follicular hair follicle obstruction
54
sx hidradenitis suppurativa
recurrent, painful, and inflamed nodules
fibrotic hypertrophic scars
intertriginous skin MC - axillae
55
tx hidradenitis suppurativa
topical clindamycin
56
MC cause impetigo
staph aureus
57
tx impetigo
topical mupirocin
58
MC cause kaposi sarcoma
HHV 8
seen in immunosuppressed (like HIV)
59
sx kaposi sarcoma
painless
nonpruritic
macular, papular, nodules, plaque-like brown, pink, red or violaceous lesions
60
tx kaposi sarcoma
antiretroviral if associated w HIV
61
lice is termed
pediculosis
62
tx pediculosis
permethrin
63
lichen planus is associated w
hepatitis C
64
sx lichen planus
purple (violaceous)
polygonal
planar
pruritic
papules or plaques w fine scales
Wickham's striae - fine gray-white lines on the skin lesions or on the oral mucosa
Koebner's phenomena - new lesions at sites of trauma (also seen in psoriasis)
65
erysipelas
a variant of cellulitis (more superficial infxn)
66
tx lichen planus
topical corticosteroids
67
lichen simplex chronics (neurodermatitis)
skin thickening in pts w atopic dermatitis secondary to repetitive rubbing and scratching
68
sx lichen simplex chronicus
scaly, well-demarcated, rough hyperkeratotic (lichenified) plaques w exaggerated skin lines
69
tx lichen simplex chronicus
avoid scratching
topical corticosteroids
70
sx lipoma
soft, painless subcutaneous nodules that are easily mobile
no tx needed!!!
71
MC cause of skin cancer related death
melanoma
high malignant potential
72
MC type of melanoma
superficial spreading
73
all types of melanoma
superficial spreading
nodular
lentigo maligna
aural lentiginous
desmoplastic
74
superficial spreading melanoma
MC
arises de novo or from pre-existing nevus
MC on trunk in men and legs in women
75
nodular melanoma
associated w rapid vertical growth phase
76
lentigo maligna melanoma
arises in chronically sun-damaged or sun-exposed areas of skin in older individuals such as face
begins as tan or brown macule that darkens
77
aural lentiginous melanoma
MC in darker-pigmented individuals
palms, soles, nail beds, areas without sun exposure
78
erysipelas
a variant of cellulitis (more superficial infxn)
79
most aggressive type of melanoma
desk-plastic
80
what is discouraged for melanoma
shave biopsy
81
dx and tx melanoma
dx - complete biopsy
tx - complete local wide surgical excision
82
melasma is also called
chloasma
83
RF melasma
increased estrogen exposure (OCP, pregnancy, women)
sunlight exposure
84
sx melasma
mask-like hypertmelanotic symmetrical macules esp on face and neck
85
dx melasma
clinical
wood lamp to deter pattern of pigment deposition
86
tx melasma
sun protection
hydroquinone 4%
if combo - fluocinolone acetonide + hydroquinone + tretinoin
87
erysipelas
a variant of cellulitis (more superficial infxn)
88
causes of onchomycosis
dermatophytes - trichophyton and epidermophyton (T rubrum MC)
89
sx onchomycosis
nail that is opaque, thickened, discolored and/or cracked
90
dx onchomycosis
50% of dystrophic nails are due to fungal infxn
confirmation with rapid test (KOH wet mount prep, histopathologic exam with a PAS strain, or PCR + fungal culture)
periodic acid-schiff test - performed on nail plate clippings
91
tx onchomycosis
systemic antifungals
oral terbinafine first line
caution for hepatotoxicity and drug-drug interactions
92
paronychia
infection of lateral and proximal nail folds including the tissue that borders the root and sides of the nail for < 6 weeks
93
MC cause paronychia
staph aureus
94
sx paronychia
rapid onset of painful erythema and swelling to the proximal and or lateral nail folds
95
tx paronychia without fluctuance
triple antibiotic ointment or topical mupirocin
warm compress, warm water, antiseptic soap (chlorhexidine, povidone-iodine)
OTC analgesics
96
tx paronychia w fluctuance or immunocompromised
oral dicloxacillin or cephalexin
I & D
97
paronychia can progress to
felon (closed space infection of fingertip pulp space)
98
tx pityriasis rosea
topical corticosteroids
99
sx psoriasis
plaque - MC type; raised, well-demarcated, pink-red plaques or papules w thick silvery white scales. MC on EXTENSOR surfaces.
Auspitz sign - punctate bleeding w removal of plaque or scale
Koebner's phenomena - new lesions at sites of trauma (seen in lichen planus, eczema, vitiligo)
nail involvement - pitting. yellow-brown discoloration under the nail (oil spot) pathognomonic
100
guttate psoriasis often appears after
strep pharyngitis
101
tx psoriasis
topical corticosteroids
102
SJS versus TEN
sis < 10%
TEN > 30%
103
scabies is due to
sarcoptes scabiei
104
sx scabies
intense pruritus esp at night
105
tx scabies
permethrin
106
MC benign epidermal skin tumor
seborrheic keratosis
107
sx seborrheic keratosis
well-demarcated round or oval velvety warty lesions w a greasy or stuck on appearance
108
premalignant potential w seborrheic keratosis
none
109
which spider bite forms bullae
brown recluse
110
dx all tinea infections
KOH prep
111
tx tinea capitis
oral griseofulvin
oral terbinafine
112
tx tinea pedis, cruris, corporis, intertrigo
topical antifungals
113
tinea versicolor cause
malassezia furfur
114
erysipelas
a variant of cellulitis (more superficial infxn)
115
verrucous papule is also known as
a wart
116
tx warts
liquid nitrogen cryotherapy
salicylic acid plaster w paring
117
tx vitiligo
topical corticosteroids
