Derm Flashcards
What are the primary and secondary lesion types in HSV?
Primary: clustered vesicles
Secondary: pustules
What are the signs/symptoms of HSV?
May have prodrome of pain
Pain/burning (herpes hurt)
Commonly seen on mouth (HSV-1) & genitals (HSV-2)
What are the diagnostic tools that can be used for HSV?
Tzanck smear
Serology
PCR
Pt report/exam
What is the treatment for HSV?
Acyclovir (400mg TID)
Valacyclovir (1000mg BID)
Both for 7-10 days
What are the characteristics of Staphylococcal Scalded Skin Syndrome (SSSS)?
More seen in children < 5
Diffuse redness of the skin w/scalding
Diagnosed based of H&P, but can culture/biopsy
What is the treatment for SSSS?
Admit
Start IV abx such as Nafcillin (100-150mg/kg per day in divided doses q6 hrs)
Supportive care
What are the signs/symptoms of pityriasis rosea?
Itchy, salmon colored rash that starts with a herald patch and changes to plaques in 1-2 weeks
Follows skin cleavage planes
What is the treatment for pityriasis rosea?
Self-limiting lasting 3-8 weeks
Antihistamines, emollients, UVB
What are the signs/symptoms of herpes zoster?
“Dew drops on a rose petal”
Itchy, tingling, painful rash that follows a dermatome distribution
May have a prodrome, aches, low grade fever
What is the treatment for herpes zoster?
Antiviral (Acyclovir, Valacyclovir) within 72 hrs
Pain relief (NSAIDs, narcs if severe)
Gabapentin for neuropathic pain relief
What are the characteristics of rosacea?
Common in women 30-50 yo
Symmetric flushing & telangiectasias on cheeks, nose, chin, or forehead
Can have episodic burning/stinging
What is the treatment of rosacea?
NO topical steroids
Avoid triggers/things that cause flushing (heat, alcohol, stress)
Topical abx (if pustules/papules), switch to oral abx if topicals fail
What are the characteristics of atopic dermatitis (eczema)?
“the itch that rashes”
Starts in childhood
Red patches w/papules
Can be on flexural surfaces (inside elbow), neck, face, back of hands
NOT on flexural surfaces in infants
What is the treatment for atopic dermatitis (eczema)?
Avoid triggers
Moisturize w/ointment
Antihistamines for itch
Topical steroids
What commonly presents in children following a viral infection?
Viral exanthem
What are the signs/symptoms of viral exanthem?
Red macules widely spread on the trunk that blanche w/recent history of viral infection
What is the treatment of viral exanthem?
It clears w/the infection
What are the signs/symptoms of stasis dermatitis?
Heaviness/aching in the legs that gets better w/rest
Itchy
Hyperpigmentation (if long term)
Rash must be on the legs for dx
What is the treatment for stasis dermatitis?
Compression stockings
Elevate legs
Treat the cause of the edema
What are the signs/symptoms of molluscum contagiosum?
Dome shaped, flesh colored, umbilicated papules on the face, trunk, &/or genitalia
What is the treatment for molluscum contagiosum?
Conservative (self-limited)
Education on contagiousness
Maybe cryotherapy, curettage, or Imiquimod
What is the treatment for furuncles/carbuncles?
Warm compress, incise & drain once mature
Maybe abx that cover staph
What is a more superficial cellulitis that is only caused by strep?
Erysipelas
What are the signs/symptoms of erysipelas?
Bright, red, glistening, smooth, hot well demarcated plaque that is often on the cheek
What is the treatment for erysipelas?
IV abx w/strep coverage
What presents with a painful, hot, firm, red patch with advancing borders?
Cellulitis
What is the treatment for cellulitis?
Oral abx if not severe
IV abx if severe
Cover for staph and strep
What presents as white plaques commonly in the skin folds that are itchy and bleed when removed?
Candidiasis
What is the treatment for candidiasis?
Nystatin or Clotrimazole
1 dose oral Diflucan
What presents with scaling/hair loss on the scalp of a small child?
Tinea capitis
What is the treatment for tinea capitis?
Oral antifungals (Griseofulvin or Terbinafine)
What diagnostic tool is used for androgenetic alopecia (male pattern baldness)?
The Hamilton classification
What is the treatment for androgenetic alopecia (male pattern baldness)?
Oral finasteride (anti-androgen)
Topicals
Wigs
Hair transplant
What are the signs/symptoms of scarlet fever?
Red rash on the upper trunk that has a “sandpaper” feel
Strawberry tongue
What is the treatment for scarlet fever?
Scarlet fever is a result of untreated/under treated group A strep
Treat w/penicillin and Clindamycin
What is the treatment for severe acne vulgaris?
Topical benzoyl peroxide
If that does not work alone, add topical retinoid/abx
What commonly presents with itching/burning in hair bearing areas such as inner thighs, buttocks, face, scalp, etc.?
Folliculitis
How do you treat folliculitis?
Remove triggers
Topical antibiotics (superficial)
Oral antibiotics (if deep or local doesn’t work)
Consider coverage for pseudomonas if recently in hot tub
What commonly presents in children with honey-colored crusted lesions?
Impetigo
What is the treatment for impetigo?
Topical mupirocin (if limited)
Cephalexin (if systemic abx req.)
What can commonly present with swelling of the lips and eyelids that results from a reaction to a particular drug (commonly seen with ACE inhibitors)?
Angioedema
What is the treatment for angioedema?
If drug induced, stop the drug
Work up for allergic reaction and give epi if anaphylactic
Antihistamines & maybe short course of systemic steroids
What is the treatment for tinea corporis (ring worm) and tinea cruris (jock itch)?
Topical antifungal (-azoles)
What presents as a well defined plaque that has a red base and silver scales and is commonly seen extensor surfaces?
Psoriasis
What are 2 diagnostic assessments for psoriasis?
Koebner: scratching leads to more lesions
Auspitz: remove scale & get pinpoint bleeding
What is the treatment for psoriasis?
Topical corticosteroids (if limited)
Retinoids, Methotrexate, biologics (if mod-severe)
Avoid systemic steroids
What presents with greasy yellow or grey scales over erythematous patches or plaques, and is commonly seen in patients w/Parkinson’s or HIV?
Seborrheic dermatitis
What is the treatment for seborrheic dermatitis?
Depends on the location
Scalp: antifungal shampoo (ketoconazole)
Face: low potency corticosteroid cream or topical antifungal
Trunk: topical antifungals, topical corticosteroids
