Derm

Question 1

Pemphigus Vulgaris

causes? sx? tx?

Answer 1

AI, Ab to desmosomes

cause: Idiopathic, ACEi, Penicillamine
sx: nikolsky sign, painful, mucosal ulcers, life-threatening, 30s-40 yoa
tx: steroids

Question 2

Bullous Pemphigoid

sx? tx?

Answer 2

ab to hemidesmosomes

sx: deep blisters & thick bullae but are less likely to rupture, will usually resolve, seen in 70s-80s,
tx: steroids

Question 3

Porphyria Cutanea Tarda(PCT)

cause?

Answer 3

disoder or porphyrin metabolism resulting in photosensitivity reaction to an abnormally high accumulation of porphyrins

Question 4

Things associated with Porphyria Cutanea Tarda(PCT)

Answer 4

alcoholism, liver disease, Chronic hepatitis C, Oral contraceptives, liver disease(hemochromatosis), diabetes

Question 5

sx of Prophyria Cutanea Tarda(PCT)

Answer 5

nonhealing blisters on sun-exposed areas of the body such as the BACKS OF HANDS & FACE, hyperpigmentation of the skin, hypertrichosis of the face(lots-o-hair)

Question 6

tx of Porphyria Cutanea Tarda(PCT)

Answer 6

avoid triggers, use sunblocks, phlebotomy to remove iron, Deferoxamine, Chloroquine

Question 7

Stevens-Johnson Syndrome(SJS) vs Toxic Epidermal Necrolysis(TEN)

Answer 7

SJS = 10-15% of the body and mucous membrane involvement

TEN = 30+%, nikolsky’s

Question 8

side effect of terbinafine

Answer 8

hepatotoxic

Question 9

Erysipelas

sx? tx?

Answer 9

GAS> staph

sx: fever, chills, bacteremia, BRIGHT RED ANGRY SWOLLEN APPEARANCE TO THE FACE
tx: abx

Question 10

Scabies tx?

Answer 10

permethrin or oral ivermectin

Question 11

Seborrheic Keratosis

Answer 11

benign hyperpigmented lesions occuring in elderly = stuck on appearance

Question 12

Actinic Keratosis

sx? tx?

Answer 12

precancerous lesions on sun-exposed areas of the body. usually asymptomatic
tx: cryotherapy, topical 5FU, etc.

Question 13

Squamous Cell Carcinoma of the skin

sx? tx?

Answer 13

sun exposed areas & seen with some ummunosupressive drugs, often presents as ulcer
tx: surgical removal

Question 14

Basal Cell Carcinoma of the skin

sx? dx? tx?

Answer 14

sun exposed areas, shiny or pearly appearance

dx: shave or punch bx
tx: Mohs Microsurgery = EM surgery = great for delicate places

Question 15

Kaposi’s Sarcoma

dx? tx?

Answer 15

purplish lesions found on the skin predominantly of patients with HIV and CD4 counts <100 = HHV8

dx: clinical!
tx: HART to raise CD4 + ADRIAMYCIN & VINBLASTINE

Question 16

Psoriasis

sx? tx?

Answer 16

sx: silvery scales develop on the extensor surfaces, nail pitting,
tx: emollients, salicylic acid, steroids, vit D/A

Question 17

Atopic Dermatitis

sx? tx?

Answer 17

AKA ECZEMA!

sx: hx of atopy, red, itchy plaques of the flexor surfaces, high IgE levels
tx: topical steroids, antihistamines, coal tars, phototherapy

Question 18

Seborrheic Dermatitis

sx? tx?

Answer 18

AKA DANDRUFF

sx: oversecretion of sebaceous material, HSR to superficial fungal organism = PITYROSPORUM OVALE, often seen on face around eyebrows/nasolabial foles, elderly
tx: topical hydrocortisone, topical antifungal ketoconazole

Question 19

Pityriasis Rosea

Answer 19

idiopathic/transient dermatitis, pruritis eruption that begins with a herald patch, erythematous salmon colored that can look like syphilus that spares the palms and soles.

Question 20

Acne treatment hierarchy

Answer 20

Benzoyl peroxide > Clindamycin,erythromycin, sulfacetamide > topical retinoids&raquo_space; oral abx(minocyclin, tetracyclin, clindamycin) & oral Retinoic acid = isotretinoin(strong teratogens)

Question 21

Rosacea

sx? tx?

Answer 21

inflammatory pustules of rosacea that can look like acne, redness of the nose and cheeks
tx: UV light and laser, tropical bromonide(a2 ag), metronidazole

Question 22

PV or Bull pemphgoid. which will give you oral ulcers?

Answer 22

PV