Derm Flashcards
1
Q
Macule
A
flat, non-palpable lesions
represent a change in color or surface texture
2
Q
Papule
A
elevated lesions
ex. nevi, warts, insect bites, acne , skin cancers
3
Q
Plaques
A
palpable lesions
elevated above the skin surface
ex. psoriasis and granuloma annulare
4
Q
Vesicles
A
small clear serous filled blisters
superficial, not with in the dermis
ex. herpes, chicken pox, acute allergic contact dermatitis
5
Q
Bullae
A
clear fluid filled blisters
bigger than vesicles
may form within the epidermis or between the epidermis and dermis
ex. chemical damage or physical damage,
6
Q
Pustules
A
elevated lesions that contain pus
7
Q
Wheal
A
irregular superficial raised area of the skin
transient in nature
fluid is within the extravascular space
8
Q
urticaria
A
wheals or hives
elevated lesions caused by localized edema
ex. HSR, stings or bites
9
Q
Nodules
A
solid circumscribed elevated mass that is deep and firm in the dermis
10
Q
scales
A
accumulation of horny epithelium
ex. psoriasis, seborrheic dermatitis, fungal infections
11
Q
crusts
A
dried serum, blood, or pus
ex. impetigo, small pox
12
Q
erosions
A
open areas of skin that result from a loss of Epidermis
follow rupture of a bulla or vesicle
13
Q
exoriation
A
loss of epidermis
linear erosin
hollowed out crusted area
ex. scratch, scabies, abrasion
14
Q
Petechiae
A
circumscribed area of blood
small
ex. platelet abnormalities, vasculitis, infection (rocky mountain spotted fever, rickettsioses)
15
Q
Purpura
A
non blanching purple discoloration of the skin
non palpable
inflammation within BV
16
Q
comedone
A
Can be opened (black head)
or closed (white head)
beneath surface of the skin
can lead to formation of pustule or papule
17
Q
cyst
A
encapsulated deep seated mass filled with liquid or semisolid
appear in very severe acne
have a poor within the center
18
Q
tumor
A
elevated solid lesion
deeper in dermis than papule
larger than 2 cm in diameter
19
Q
fissure
A
linear crack or break from the epidermis to the dermis
can be moist or dry
20
Q
ulcer
A
concave, loss of epidermis and dermis
21
Q
decubitis ulcer/ pressure sore
A
forms when person sits in one position for a long time
ischemic ulcers from pressure or shearing forces
22
Q
telangiectasia
A
fine irregular lines produced from capillary dilation
23
Q
atrophy
A
thinning of skin surface
skin looks thin and paper like
ex. corticosteroids
24
Q
lichenification
A
thickening od epidermis
skin looks dry and leathery
ex. chronic dermatitis
25
Desquamation
normal process removing outer layer of epidermis
26
annular
refers to a circular border of a lesion
27
diffuse border
lesion with an irregular border
28
keloid
specialized scar--> overgrowth of tissue at the site of injury
firm, rubbery lesions or shiny fibrous nodules
29
erythematous
redness of skin caused by dilation of capillaries
30
non infectious diseases
```
Acne
eczema
psoriasis
atopic/seborrheic dermatitis
contact dermatitis
```
31
infectious diseases
bacterial, viral, fungal and ectoparasites SSTI
bites
wounds
burns
32
ceramide
waxy lipids that hold skin cells together..
| dry skin is lacking these
33
high sebaceous gland activity
acne, cradle cap, seborrheic dermatitis (0-1)
acne, seborrheic dermatitis (12-20)
rosacea (30-50)
34
low sebaceous gland activity
dry skin
| ages 1-8, >65
35
causes of acne
overproduction of the sebum
irregular shedding of skin cells
buildup of bacteria
36
Benzoyl peroxide
peeling agents
can be used with retinoids
2nd line
OTC
37
Topical retinoids
Tretinoin
Adapalene
Tazarotene
MOA: inc turnover of follicular epithelial cells and causes extrusion of comedones
Anti-inflammatory
38
Oral Retinoids
isotretinoin
39
Treatment of Mild Acne with Black heads and white heads
1) Retinoid
4-8 weeks
2) Benzoyl peroxide or topical antibiotic and consider increasing the dose of retinoid
40
Treatment of Mild acne with pustules/ papules
1) retinoid or topical antibiotics or both
2) retinoid with or without topical antibiotics or Benzoyl peroxide
3) use combination therapy of the above or add oral antibiotic (3 month trial)
4) women who aren't candidates for accutane use Oral contraceptive or spironolactone
41
Treatment of Moderate acne with pustules/papules/nodules
1) topical antibacterials (sulfacetamine and sulfur or other topical antibiotic with benzoyl peroxide with or without oral antibiotics
2) if after 8 weeks acne not controlled add retinoid
3a) if prescription fails use accutane
3b) if women aren't candidates for accutane use oral contraceptives or spironolactone
42
Treatment of Severe acne with papules/pustules/nodules
1a) if minimal scarring use topical antibacterials (sulfacetamine and sulfur or other topical antibiotic with benzoyl peroxide with or without oral antibiotics
1b) if scarring use accutane
2) most women relapse after second course of accutane use oral contraceptives or spironolactone
43
Topical treatments for rosacea
Azelaic acid
metronidazole
benxoyl peroxide
44
oral antibiotics for rosacea
tetracycline
minocycline- take with food to min ADR
doxycycline- Take with food to min ADR
erythromycin
ADR: stomach discomfort, N/V/D, sore mouth or tongue
45
Azelaic acid
kills P. acnes, Staph epidermidis
inhibits protein synthesis
ADR: pruritus, burning, stinging, tingling
46
metronidazole
used when there are pustules and papules and redness
| ADR: metallic taste, burning, skin irritation, dryness, pruritus
47
isotretinoin
used for severe rosacea
improves edema, erythema, decreases sebaceous gland activity and oily skin
ADR: depression, suicidal thoughts, bone or joint pain, skin infection, rash, birth defects if taken during pregnancy
48
psoriasis
red, scaly, sharply demarcated plaques in different sizes and shapes
49
potent topical corticosteroids
use BID
don't exceed 2g daily to avoid adrenal suppression
ADR: thinning of the skin, striae, telangiectasia, temporary loss of pigment
50
Topical vitamin D analogs
Calcipotriene
regulates the normal growth and production of kertinocytes
ADR: burning, stinging, skin irritation
51
Tar derivatives- shampoos
used to loose and soften scales and crusts
| ADR: dermatitis, allergic sensitization, photosensitivity
52
Anthralin
topical for chronic psoriasis
MOA: inhibits DNA synthesis, decreases epidermal mitosis
DI: long term use of corticosteroids
ADR: contact allergic reactions
53
Immunomodulators
used for severe psoriasis
1) T cell inhibitors
- Alefacept
- Eflaizumab
2) TNF inhibitors
- Etanercept
- Infliximab
- Adalimumab
3) IL-12, IL-23 inhibitors
- Ustekinumab
54
Phototherapy
UVB may improve mild to moderate psoriasis symptoms
oral or topical psoralens used as photochemotherapy?
55
Eczema
skin problems of :
- dryness
- redness
- crusting
- cracking
- blistering
- oozing
- thickening of the skin
56
Tacrolimus
MOA: inhibition of early activation of T lymphocytes and suppression of IL mediated itching
DI: CYP 3A4 inhibitors, Antiarrhythmic agents, Alcohol
ADR: stinging, burning, itching, soreness, HA, acne, folliculitis, stomach upset, flu like symptoms
Used for atopic dermatitis
57
Pimecrolimus
MOA: inhibition of early activation of T lymphocytes and suppression of IL mediated itching
DI: CYP 3A4 inhibitors, Antiarrhythmic agents, Alcohol
ADR: stinging, burning, itching, soreness, HA, acne, folliculitis, stomach upset, flu like symptoms
Used for atopic dermatitis
58
primary irritant contact dermatitis
```
inflammation of the skin
nonspecific response of the skin
usually located on the hands
characterized by burning, pruritus, pain
skin looks dry and fissured
less distinct boarders
```
59
allergic contact dermatitis
inflammation of the skin
nonspecific response of the skin
exposed areas of the skin, usually the hands
characterized by pruritus
skin has vesicles and bullae
there are distinct boarders, lines and angles
60
Domeboro
used as an astringent for temporary relief of minor skin irritations
61
Lichen simplex chronicus
chronic itching or scaling of the skin
skin can become thick and leathery
Use topical corticosteroids and oral antihistamins to treat
62
photosensitivity
cutaneous disease: effects of sunlight and drug
63
phototoxicity
drug is activated by exposure to sunlight
| goes away when you stop taking drug
64
photoallergy
UV exposure changes the structure of the drug, the body then recognizes it as an antigen and there is an allergic response with inflammation of the skin in sun exposed areas
65
seborrheic dermatitis
affects the scalp, face, upper chest, back and other oily areas of the body
cause: fungus that grows in sebum secretions on the skin
lamisil can be used if infection is over large portion of the body
66
Pyrethrin
OTC for lice
| MOA: inhibition of hydrolytic enzymes
67
Permethrin
OTC for lice or scabies
Drug of choice
MOA: delayed repolarization of neuronal cell membranes of parasite
68
Lidocain
Rx for lice or scabies
don't recommend if patient weighs less than 110 pounds
don't use during pregnancy, breastfeeding, HIV, or for those with seizures
ADR: Seizures, skin irritation
69
Benzyl alcohol
Rx for lice
don't use in children under 6
ADR: skin, scalp, eye irritation, seizure, coma, death
70
Natroba
Rx for lice
MOA: enhances nicotinic acetycholine--> paralysis of parasite
AADR: skin and eye irritation
71
crotamiton
Rx for scabies
72
impetigo
```
caused by: Staph aureus and group A beta hemolytic strep
red sore--> ruptures--> oozes--> honey colored scab
located around nose and mouth
Treatment:
- bacitracin
-polymixin
-neomycin
-mupirocin
-retapamulin
```
73
Tinea versicolor
```
M. furfur
creates an uneven pigment
treated with:
- ketoconazole
-slenium sulfide
-zinc pyrithione
-antifungal creams
```
74
Tinea cruris
Jock itch
| Treated with Azoles, allylamines (griseofluvin)
75
Tinea capitis
Head
Oral medications are used to treat
griseofluvin, terbinafine, itraconazole
76
Tinea pedis
Feet
OTC: miconazole, clotrimazole, tolnafitate
Rx: ketoconazole, terbinafine, buternafine
77
Tinea corporis
Body
| OTC and oral medications can be used depending on the spread of the fungus
78
onychomycosis
nail fungus
Oral medication is most effective
terbinafine, itraconazole, fluconazole, Griseofulvin
nail laquer- ciclopirox
79
Cold sores
Herpes simplex 1
contagious skin to skin contact
usually clears up on its on in a few weeks
Topical treatments: lidocaine, benzocaine, doconazole
Oral: Ovir drugs can also be used
80
Varicella
incubation period 10-21 days
contagious for 1-2 days before rash appears
acetaminophen and ibuprofen can be used
81
Herpes zoster
painful rash
inflammation of nerves
Therapy: NSAIDs, Ovir drugs (within the first 72 hours of shingle rash)
82
pityriasis rosea
scaly rash
Ovir drugs
Itch relievers
phototherapy
83
UV wavelengths that cause sunburn and cancer
UVB 290-320 nm (penetrate epidermis)
| UVA 320-400 nm (penetrate dermis)
84
Broad spectrum sunscreens
block UVA and UVB
chemical or physical barrier to sunlight
ADR: contact dermatitis, milaria, folliculitis
85
Sunburn treatments
1) cool water or burrows solution
2) emollients
3) NSAIDs (Rx- not helpful after 24-48 hours)
4) corticosteroids (Rx- not helpful after 24-48 hours)
5) analgesic rubs
- menthol
- methylsalicylate
- cayenne pepper
- diclofenac patches/ creams (Rx)
