DERM 2 Flashcards
Tx for seborrheic keratosis?
- Scissor biopsy
- Electrosurgery/Freezing
“I have warts or moles that are growing”
Seborrheic keratosis
What skin condition is characterized by the following: small, rough, pink or brown macules, papules, or plaques on sun-exposed areas?
Actinic keratosis
Tx for lice?
- Permethrin, malathion, lindane, benzyl alcohol
- Innoculate close contacts
- Wash bedding/clothes in hot water
Tx for scabies?
- Permethrin
- Treat close contacts
What skin condition is characterized by inflammatory, erythematous, itchy papules found on flexor surfaces of wrists, elbows, genitalia, feet, and finger webs?
Scabies
What spider bite is characterized by the following: burning pain 1-24 hours after bite, fever, chills, malaise, nausea, possible necrosis, and a wound that may be asymptomatic for up to 3 days?
Brown recluse spider
What spider bite is characterized by the following: burning within minutes of bite that resolves within hours, systemic onset within 30 minutes: cramps, dyspnea, sweating, N/V, restlessness, or sense of impending death?
Black widow spider
Test for brown recluse?
UA for hemolysis
Which spider bite requires cool compresses?
Brown recluse
What skin condition is characterized by the following: pink pearly papules, sometimes with telangiectasias, rolled margins, possibly ulcerated center, on face and neck?
Basal cell carcinoma
Where is the superficial form of BCC found?
Trunk or extremities
What kind of biopsy would you use for BCC?
Shave, but punch can assess depth
Tx for BCC?
- Meds: 5-flurouracil, imiquimod
- Radiation, phototherapy
- Surgical excision preferred if tolerable (Mohs, excision)
What is the acral form of malignant melanoma?
Nails
How big of an excision is necessary for a malignant lesion 1-2 mm thick?
1-2 cm
How big of an excision is necessary for a malignant lesion around 1 mm thick?
1 cm
What skin condition is characterized by the following: slow-growing, hyperkeratotic lesions, possible ulceration, crusting in sun-exposed areas?
SCC
Where does SCC most commonly metastasize to?
The lungs
From where does SCC most commonly metastasize?
Ears and vermilion border (lips)
Tx for SCC?
- Total excision
- Electrosurgery
- Mohs
What is alopecia totalis?
Hair loss of the entire scalp
What is alopecia universalis?
Hair loss of entire body
What two conditions are associated with hair loss?
- Lupus
- Thyroid issues
Tx for alopecia areata?
- Intralesional steroids
- Oral corticosteroids
Which type of hair loss is characterized by miniaturization of follicles and pattern baldness?
Androgenetic alopecia
Tx for androgenetic alopecia?
Minoxidil or Finasteride
Tx for onycomycosis?
- Oral anti-fungals first line (side effects)
- Cicloporox nail solution better tolerated
- Nail debridement
What nail condition is characterized by inflammation of skin folds surrounding nails?
Paronychia
What organism causes green changes in nails?
Pseudomonas
Tx for paronychia?
- Tetanus if indicated
- ABX, antifungals
- Incision and drainage
Tx for condylomata acuminata?
- Imiquimod
- Podophyllin
- TCA acid
- Cryosurgery
What lesions can be detected using acetowhitening test?
Condylomata acuminata
What viral skin infection can also manifest as encephalitis or pneumonia?
HSV
- Fever
- Lymphadenopathy
Tx for molluscum contagiosum?
- Cantharidin (harsh med)
- Podophyllin
- Cryosurgery
What skin condition is characterized by the following: non-umbilicated center, black dots, raised, rough?
Verrucae
What infection has dermatomal pattern?
Varicella-Zoster
Tx for varicella-zoster infection?
- Antivirals within 72 hours
- Gabapentin for pain
Tx for cellulitis?
- Oral dicloxacillin
- Cephalexin
- Clindamycin or IV cefazolin
- Nafcillin
Tx for severe cellulitis?
Hospital admission
What diagnosis should be considered whenever a pt. has a prolonged, unexplained systemic illness?
Vasculitis
What condition is characterized by the following: palpable purpura, livedo reticularis, nodules, ulcers, gangrene, nail changes, malaise, fatigue, weight loss and sweating?
Vasculitis
Tx for vasculitis?
- GLUCOCORTICOIDS
- Then stronger immunosuppressives
What skin condition is characterized by the following: sharply demarcated erythema, raised borders, shiny plaques, HA, vomiting, and a possible prodromal phase?
Erysipelas
What organism causes erysipelas?
S. pyogenes
Tx for Erysipelas?
- Mild: Penicillin
- Moderate-severe: Cefazolin
- MRSA: Vancomycin
What skin condition is characterized by the following: honey-colored crusts, bullae, common around mouth, and satellite lesions?
Impetigo
What organism usually causes impetigo?
S. aureus
Tx for impetigo?
Mild: topical ABX
Moderate-Severe: oral ABX
What skin condition is characterized by perifollicular swelling with a pus plug?
Furuncle/carbuncle/abscess
Tx for abscesses?
Oral ABX
-Vancomycin if MRSA
What skin condition is characterized by brown, velvety patches of skin?
Acanthosis nigricans
What condition is associated with acanthosis nigricans?
Diabetes
Tx for acanthosis nigricans?
Treat underlying disorders
Based on rule of 9s, how much BSA does each part of body contribute?
- Upper extremities: Both 9% (adult and child)
- Lower extremities: adult 18%, child 14%
- Anterior trunk: both 18%; Posterior: 18%
- Head and neck: adult 9%, child 18%
- 1% genitals
Tx of pressure ulcers?
- ABX for cellulitis or osteomyelitis
- Zinc and vit. C if deficiency
- High protein diet
- Silver dressings/ sealed padding
What skin condition consists of acute, tender, cyst-like abscesses in apocrine gland tissue, sinus tracts, and hyperhidrosis?
Hidradenitis suppurativa
Tx for hidradenitis suppurativa?
Oral ABX
What skin condition is characterized by the following: rapidly erupting rash that blanches and often disappears within 24 hours?
Urticaria (hives)
First-line tx for urticaria?
- 1st gen. antihistamines
- 2nd gen. H1 blockers
Tests for vitiligo?
-TSH
