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derm 2 Flashcards

1
Q

Other term for pityriasis versicolor + etiology

A
  1. Tinea versicolor

2. Superficial fungal infection

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2
Q

treatment of pityriasis versicolor

A

Antiseborrheic shampoos or lotions (selenium sulfide or ketoconazole)

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3
Q

Treatment of epidermal inclusion cyst/sebaceous cyst

A

Excision, not I&D (need to remove epithelial lining)

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4
Q

Treatment of dermatitis herpetiformis

A

Dapsone to induce remission + gluten free diet for long term control

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5
Q

Dermatitis herpetiformis clinical features

A

small tense papules + Vesicular + extremely pruritic, so excoriations on elbows, knees, buttocks

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6
Q

Dermatitis herpetiformis diagnosis

A

skin biopsy (IgA deposition)

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7
Q

Dermatophyte infection clinical features

A

annular scaly patch (don’t necessarily have to have central clearing)

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8
Q

Treatment of tinea pedis

A

Topical Azole or terbinafine cream BID for 2-4 weeks (avoid oral azoles)

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9
Q

Differential for lower extremity ulcers

A

PAD, DM2, *venous stasis ulcers

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10
Q

Treatment of venous stasis ulcer

A

Compression therapy

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11
Q

Location + clinical features of venous stasis ulcers

A
  1. Distal lower leg (particularly medial aspect of the ankle)
  2. Irregular border + surrounding hyperpigmentation + thickened surrounding skin and subcutaneous tissues + surrounding varicose veins and edema
  3. Result from minor trauma, medical procedure, or acute stasis dermatitis flare
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12
Q

Porphyria cutanea tarda clinical features

A

Skin fragility + small, easily ruptured vesicles in sun-exposed areas, which then rupture, forming erosions, dyspigmentation, scarring. mainly hands

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13
Q

Common initial site of involvement with pemphigus vulgaris

A

Oral mucosa

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14
Q

What to evaluate patients with seborrheic dermatitis for?

A

HIV (not hyperlipidemia) (extremely common among patients with HIV)

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15
Q

Cause of Xanthoma?

A

secondary to dyslipidemia, different subtypes associaed with hypercholesterolemia and hypertriglyceridemia

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16
Q

Eruptive xanthomas clinical features

A

Rapid onset of numerous yellow papules with surrounding erythema + extensor surfaces of extremities and buttocks

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17
Q

Eruptive xanthoma association

A

hypertriglyceridemia

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18
Q

Tuberous xanthoma association

A

familial hypercholesterolemia

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19
Q

Tuberous xanthoma vs. eruptive xanthoma

A

Tuberous are larger (up to 3 cm)

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20
Q

Management of actinic keratosis that recurrs after cryotherapy

A

Biopsy (may be a basal or SCC), never proceed directly to wide local excision for BCC or SCC

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21
Q

Other skin manifestation of amyloidosis

A
  • yellow waxy papules and plaques around eyes (look like xanthomas)
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22
Q

Treatment of pruritic urticarial papules and plaques of pregnancy (PUPPP)

A

Topical steroids (topical steroids are safe in pregnancy)

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23
Q

AK management vs basal cell

A
  • basal cell = wide local excision
  • AK = cryotherapy and surgical procedures, are the primary approach for isolated lesions [3]. Field-directed therapies, such as topical fluorouracil, imiquimod, and PDT, are particularly useful for treating areas with multiple AKs.
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24
Q

Pemphigus vulgaris diagnosis

A
  • punch biopsy with immunofluorescent staining
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25
Q

Miliaria presentation

A
  • lesions ranging from small, thin-walled vesicles (miliaria crystallina) to erythematous papules and pustules (militia rubra)
  • flesh colored papules and or pustules (miliaria profunda)
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26
Q

keratosis pilaris cause + clinical features

A
  • retained keratin from plugged hair follicles
  • pruritic or pustular lesions in upper arms (most common), face, trunk, and lower extremities
  • worse in cold and dry climates
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27
Q

folliculitis presentation

A
  • erythematous, pustular eruption

- lesions can be asymptomatic or cause significant pruritus and pain

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28
Q

treatment of miliaria

A

sweat reduction with cool baths, compresses, or light and loose clothing

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29
Q

Presentation of poorly differentiated SCC

A

IF poorly differentiated – fleshy, soft, granulomatous papules and nodules
- can ulcerate, bleed, become necrotic, or cause pain and pruritus

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30
Q

pyogenic granuloma presentation

A
  • small red papule that grows rapidly over weeks to months + friable and can bleed with minor trauma
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31
Q

When you can discontinue cervical cancer screening

A
  • prior adequate screening + no significant RF’s for cervical cancer (immunosuprresion, multiple sexual partners, tobacco use or STI hx, history of HSIL)
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32
Q

larva migrans clinical features

A
  • serpigenous red or brown lesion (due to larva migration) + pruritic + commonly from sand and soil in Caribbean, Africa, Southeast Asia
  • hookworm infection
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33
Q

larva migrans treatment

A

Ivermectin

34
Q

cutaneous leishmaniasis presentation

A
  • red papule that forms an ulcer with granulomatous tissue at the base with raised margins
35
Q

swimmers itch presentation

A
  • pruritic maculopapular rash within hours of exposure to contaminated water + rash limited to areas exposed to water
  • caused by schistosome
36
Q

Sweet syndrome presentation

A
  • abrupt onset of painful erythematous lesions (papules, plaques, or nodules) + *febrile
  • think rash + fever (without evidence of infection or failed antibiotics) = sweet
  • often preceding infection
37
Q

Treatment and management of sweet syndrome

A
  • Dramatic response to topical (mild sweet syndrome) or systemic steroids
  • Age appropriate cancer screening
38
Q

lichen planus treatment

A

topical high-potency steroids

39
Q

associations of lichen planus

A

hep C

40
Q

lichen planus diagnosis

A
  • mainly clinical (if uncertain punch biopsy)
41
Q

other patients with greater than 5mm PPD induration who need treatment

A
  • nodular or fibrotic changes on CXR (consistent with previously healed TB)
42
Q

Next step after positive PPD

A

CXR to rule out active infection

43
Q

SJS and TEN presentation

A
  • acute flu-like syndrome
  • rapid onset macules, vesicles
  • necrosis and sloughing of epidermis
  • mucosal involvement
44
Q

Drugs that can cause SJS and TEN

A
  • allopurinol
  • abx (sulfonamides) (bactrim)
  • anticonvulsants (carbamazepine, lamotrigine, phenytoin)
  • NSAIDs
  • sulfasalazine
45
Q

Other triggers for SJS and TEN

A
  • mycoplasma
  • vaccination
  • GVHD
46
Q

SCC clinical features

A

tender, bleeding, or ulcerated papules, plaques, or nodules = sun-exposed areas or areas of chronic inflammation

47
Q

Association of porphyria cutanea tarda

A
  • hep c
48
Q

diagnosis of porphyria cutanea tarda

A
  • high serum/urine uroporphyrin level
49
Q

Treatment of porphyria cutanea tarda

A
  • phlebotomy (it is a disorder of heme synthesis)

- treat HCV if present

50
Q

Lab features of porphyria cutanea tarda

A

mildly elevated liver enzymes + iron overload

51
Q

Pityriasis rosea clinical features

A
  • salmon-colored plaques involving trunk, neck, and proximal limbs
  • begins with single large lesion (herald Patch)
52
Q

Pityriasis rosea treatment

A
  • reassurance (self limited)
53
Q

Guttate psoriasis clinical features + vs. pityriasis

A
  • scaly plaques + following streptococcal infection

* no herald patch (vs. pityriasis)

54
Q

Treatment of seborrheic dermatitis

A
  • antifungals + steroids
55
Q

guttate psoriasis clinical features

A

Psoriasis + following streptococcal infection

56
Q

nummular eczema clinical features

A

round papules and plaques + highly pruritic

57
Q

treatment of guttate psoriasis

A

phototherapy

58
Q

solar purpura clinical features

A

elderly patient + easy bruising limited to forearms and hands

59
Q

Behcet clinical features

A
  • recurrent genital + oral ulcers *ulcers lead to scarring + ocular lesions + acne + pathergy + asymmetric arthritis + renal disease + GI (nausea, abdominal pain)
  • may have limited ulcer disease
  • commonly misdiagnosed has having genital herpes
  • may not state person is from endemic area
60
Q

oral leukoplakia clinical features

A
  • white patches or plaques over the oral mucosa
  • can’t be scraped off
  • patient with smoking and drinking history
61
Q

appearance of oral SCC

A
  • nodular, erosive, ulcerative lesions with surrounding erythema or induration
62
Q

Treatment of aphthous ulcers (aphthous stomatitis)

A

topical steroids

63
Q

necrobiosis lipoidica diabeticorum clinical features

A
  • asymptomatic, annular yellowish plaques on the shins in a diabetic patient
  • granulomatous
64
Q

necrobiosis lipoidica diabeticorum treatment

A
  • high potency steroids or intralesional steroids
65
Q

Treatment of tinea versicolor

A

topical therapy (ketoconazole, terbinafine, selenium sulfide)

66
Q

AK presentation

A

rough, scaly, erythematous macules or papules

67
Q

Indications for biopsies of AKs

A
  • unclear dx
  • large (greater than 1 cm)
  • indurated, ulcerated, tender, or rapidly growing
  • not responding to therapy
68
Q

treatment of viral conjunctivitis

A
  • warm or cold compresses
69
Q

treatment of bacterial conjunctivitis

A
  • erythromycin or azithromycin drops
  • polymyxin-trimethoprim drops
  • if contact lens: quinolone drops
70
Q

Treatment of crusted scabies

A
  • oral ivermectin
71
Q

Initial treatment of psoriasis

A
  • high potency topical steroids (safe to use on extensor surfaces because won’t induce significant skin atrophy)
  • topical vitamin D derivatives
72
Q

treatment of severe plaque psoriasis

A
  • phototherapy

- systemic therapy

73
Q

treatment of facial and intertriginous psoriasis

A
  • topical tacrolimus

- low-potency steroids

74
Q

high potency steroids

A

betamethasone

clobetasol

75
Q

venous lakes clinical features

A
  • gray-blue-purple nodules on lips and ears of old people that disappear when compressed
76
Q

management of chronic venous stasis ulcers

A
  • aspirin (accelerates ulcer healing) + compression
77
Q

Association of skin tags

A
  • insulin resistance, dm2

- pregnancy

78
Q

Association of recurrent herpes zoster

A

HIV

79
Q

Management of keratoacanthoma

A
  • biopsy (difficult to distinguish KA from SCC)
80
Q

Basal cell carcinoma clinical features

A
  • slow growing
  • pearly, rolled border
  • overlying telangiectasia
81
Q

dermatitis herpetiformis presentation

A
  • pruritic
  • papules, vesicles and bullae
  • extensor surfaces of elbows, knees, back, and buttocks
  • see photo online

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