Derm Flashcards
contact dermatitis –> type of hypersensitivity reaction?
type IV
sulfa drug –> develop target shaped lesions on body including palms –> what condition?
erythema multiforme
sulfa drug –> develop target shaped lesions on body including palms –> next step
remove drug –> watch & wait
sulfa drug –> develop target shaped lesions on body including palms –> stopped sulfa –> rash is spreading –> what condition?
erythema multiforme progressing to Steven’s Johnson
sulfa drug –> develop target shaped lesions on body including palms –> stopped sulfa –> now develop oral lesions –> what condition?
erythema multiforme progressing to Steven’s Johnson
most common cause of erythema multiforme?
chronic HSV
what is difference bw stevens johnson and toxic epidermal necrolysis?
SJS:
- <10% body surface area
- histology: basal cell degeneration
TEN:
- > 30% BSA
- histology: full thickness epidermal necrosis
sulfa drug –> patient developed SJS –> next step
- stop ALL meds (including steroids)
- admit to burn unit
how differentiate bw SJS/TEN and staph scalded skin syndrome?
- biopsy
- SSS: no mucosal involvement
drug rash –> occurs how many days after start drug?
7-14 days
targetoid lesion –> ddx (3)?
- erythema multiforme
- lyme disease
- syphilis
most common drug classes that cause erythema multiforme/SJS/TEN (4)?
- sulfa
- PCN/cephalosporins
- anti-retrovirals
- anticonvulsants
HSV is the MCC of erthyema multiforme –> what is another viral cause?
mycoplasma
actinic keratosis –> tx?
cryoablation
SCC –> spontaneously goes away –> what condition?
keratoacanthoma
keratoacanthoma –> what does it look like?
resembles SCC –> solitary firm round nodule w central crater ulceration or keratin plug
actinic keratosis –> what does it look like
adherent scale on erythematous base
porphyria cutanea tarda –> most common in patients with history of what? (4)
- alcoholism
- HCV
- smoking
- estrogen use
porphyria cutanea tarda –> common complication of disease
hemochromatosis
porphyria cutanea tarda –> presentation
sun exposed area –> chronic blister –> fail to heal properly –> erosion, skin hyperpigment
porphyria cutanea tarda –> management
avoid:
- sun
- alcohol
- excess iron
low dose antimalarial (ie hydroxychloroquine, chloroquine)
pemphigus vulgaris vs bullous pemphigoid
pemphigus vulgaris:
- fragile blisters
- affect oral mucosa
bullous pemphigoid:
- tense blisters
pemphigus vulgaris –> tx
oral prednisone
advjuvant: azthathioprine or cyclophosphamide
39F –> axilla & genitalia –> vesicles, crusting erythematous plaques –> burning, pruritis, malodorous drainage
what condition?
familial benign pemphigus (aka Hailey-Hailey disease)
58M –> trunk –> chronic papular eruption for 10 years duration –> itchy
What condition?
Grover disease (aka transient acantholytic dermatosis)
