Derm Flashcards
Nonpainful mass that evolves into abscesses, fistulas, yellow/thick discharge… The culprit?
Actinomycosis - gram pos, transmitted by humans only. Due to gingivitis, cavities, OMFS trauma
Pustule that ulcerates over time with nonpurulent discharge in a healthy person who is outdoors… What is the culprit?
Sporotrichosis - fungus into subq tissue
Tx with ittaconazole for 3 months
Chronic urticaria
Symp lasting >6 wks and disapear in a day
Due to histamine released from mast cells
Most idiopathic, other causes by stress, nsaids, cold/heat
No need for lab tests unless other systemic symp
Tx for chronic urticaria
H1 blocker, can add singulair and conside brief course steroids
Topical steroids not recommended
Should resolve in few yrs
Acne recommendations
Water based products (no oil)
Antibacterial face scrubs no evidence
Middle age adult with shiny, pruritis, polygonal shaped violaceous plaque and papule on flexure regions extremitieS, genitals
Dx clinically and with skin biopsy
Not infectious
Thought to be due to immune activation with t cells against basal keratinocytes of epidermis.
Assoc with hep c
Pruritic rash worse at night found on flexor regions of wrists, fingers. Excoriations with small crusting and linear burrows
Scabies
Dx with skin scrapings for mites, ova, feces
Tx of scabies
Permethrin cream and then wash 14 hrs later
Otherwise oral ivermectin
Bedding and clothes should be placed in plastic bag for at least3 days bc the mites cannot live away from human skin got more than 3 days.
Tx of photoaging and actinic keratosis (20% risk of SCC)
All trans retinoic acid which is fda approved to reduce fine wrinkles, hyperpigmentation, rough skin
Can also use for AK- 5FU, imiquimod
T cell lymphoma of skin due to mycosis fungiodes treatment
Interferon alpha
Tx of seborrheic dermatitis
Tar based cream and shampoo
Well demarcated circular areas of complete hair loss. Also see fingernail pitting.
Tx?
Alopecia areata
Often self limited but may relapse and be chronic and progressive
Incr risk autoimmune dz
Tx with intralesional steroids or TOPICSl steroids but be aware even wo tx may go away in a yr and its no cure.
What does hair loss from medications look like? Ie what kind of meds?
Thinning of hair
Bb, anticoag, anticonvulsanta, antithyroid
Hair loss from tinea capitus looks like:
Hair loss from trichitillomania looks like
Tinea capitus will have inflammation, black dot alopecia from breakage of hair near scalp
Trichotillomania - irregular shaped areas of hair loss with diff length hair
Scarring, nodular lesions, tenderness of axilla suspicious for? Treatment?
Hidradenitis - inflamm disorder of skin in axilla, groin etc
Icr w weight, fam hx, smoking
Tx
Mild- topical clinda
Moderate - scarring and sinus tract involvement- oral abx like doxy
Scarring, nodular lesions, tenderness of axilla suspicious for? Treatment?
Hidradenitis - inflamm disorder of skin in axilla, groin etc
Icr w weight, fam hx, smoking
Tx
Mild- topical clinda
Moderate - scarring and sinus tract involvement- oral abx like doxy
Photosensitivity (sunburn) in someone on acne treatment due to what tx?
What is tx?
Benzoyl peroxide and oral tetracycline and doxycycline
Tx w NSAIDS to help w pain and redness, oral antihistamines. Not enough evidence for topical antihistamines
What side effects to worry about in someone on oral isotretinoin?
HyperTG causing pancreatitis (so avoid alcohol), women to use two oral contraceptives, hyperglc. Men on it dont have to worry too much about contraception bc very little amount in semen
Well circumscribed erythematous patch that becomes bullae and then ulcerates on abdomen?
What is tx?
Ecthyma gangrenosum - due to pseudo
Going into artery and vein and causing ischemic necrosis
Vs pyoderma gangrenosum usually on legs
Tx is only iv abx. Not surgical debridement. Need two drugs including tobra or amikacin.
Erysipelas is due to which organism
Strep a!!!! Not staph
Red, painful demarcation, edem, elevated
Wart on plantar foot tx?
How long for eradication?
Salicylic acid. First soak foot in warm water 20 min then salicylic acid and duct tape for 3 days and then sandpaper it down
2-3 weeks and then need to continue tx for 2 weeks more
Treatment for tinea capita? Is it assoc with periauricular LAD?
With ORAL antifungal like oral griseofulvin. Yes assoc with LAD!
Note that lice does not cause alopecia like tinea capitus does
Tx of keloid scar w
Excision
Cryosurg
IntraLESIONAL steroids
Intralesional steroids which are injections
Tx of rosacea
Complication!?
If just erythema and telangiectasia- topical brimonidine
If papular postular - topical metronidazole or azelaic acid
Complication is ocular complaint like foreign body, blepharitis:keratitis:conjunctivits and chalazions
Recent dx of diabetes and now w red crusting skin rash w central clearing, weight loss
Glucagonoma- check for high glucagon lvl
Tx is surg
What is sunscreen rec for a kid who plays outdoors and fam hx of melanoma?
Put on sunscreen spf at least 30
Spf DOES protect against melanoma, basal and squamous!!
Lichenified pruritis plaque along beltline is
Allergic contact dermatitis!! To nickel, rubber, leather etc
Tx of seborrheic dermatitis?
Shampoo- selenium or zinc or tar
Rash on hands, f, malaise and weight loss, difficulty climbing up stairs or raising from chair (proximal muscle weakness), w high ck has? What is test to dx?
Dermatomyositis
Dx w clinical and ANA, other tests like anti jo, la, sm, rnp
dont need skin biopsy unless equivocal results
Dermatomyositis has incr risk of ?
Malignancy!!
Need routine screening done
Hypopigmented spots w fam hx of deadness suggests what dz
nf-2!! Vs nf1 you get hyperpig
Deaf bc bl acoustic neuroma
Vs tuberous sclerosis have many organ hamartomas and cysts
Sturge weber us port wine stain and meningial angiomatosis
Osler rendu weber is telangiectasia and lesions of cns
Mulitple red colored papules w central umbilication in hiv pt is
Cutaneous crypto
Dx w BIOPsY not india ink which is for csf
Slow growing but hard tumor on abdomen w previous abd surgeries that took them out
Desmoid tumor are locally aggressive benign neoplasms w high rate recurrence
Vs dermatofibroma benign after truama or insect bite
