Derm Flashcards
Mild acne treatment
Benzoyl peroxide and salicylic acid cleansing
Topical retinoids for comedones (Tretinoin, Adapalene/Differin)
Antimicrobials (clindamycin, erythromycin)
Moderate acne treatment
Oral abx for max 12 weeks (tetracycline/minocycline/doxycycline)
Hormones (OCP)
Spironolactone (Aldactone)
Severe acne treatment
Isotretinoin (accutane, clarus, epuris)
Monotherapy
*Make sure pt is not pregnant
**Pt should be on 2 forms of birth control while on isotretinoin
Alopecia areata
AI dz: T cell lymphocytes cluster around germinative zones of hair follicles –> inflammation –> hair loss
Hair follicles still alive
Alopecia areata tx
Topical minoxidil = vasodilator
Topical anthralin
Cortisone or triamcinilone actonide injections
Oral steroid
Contact dermatitis tx
If >20% affected –> oral prenisone
Topical corticosteroids = first line for localized allergic contact dermatitis (topical triamcinolone)
Bulla
Fluid-filled blister >0.5cm in diameter
Vesicle
Fluid-filled blister <0.5cm indiameter
Furuncle
Purulent infected hair follicle
Pustule
Visible collection of pus in skin <1cm in diameter
Abscess
Localized collection of pus in a cavity >1cm in diameter
Nodule
Circumscribed palpable mass >0.5cm diameter
Plaque
Flat topped palpable mass which is >1cm in diameter
Macule
Circumscribed area of altered skin colour without elevation <1cm in diameter
Patch
Circumscribed area of altered skin colour without elevation >1cm in diameter
Telengiectasia
Visible dilatation of small cutaneous blood vessels
Petechia
Purpuric lesion of 2mm or less in diameter
Ecchymosis
Large purpuric lesion
Most common causes of erythematous perianal rashes in neonates
Irritant diaper dermatitis
Seborrheic dermatitis
Candida diaper dermatitis
Carbuncle
Painful cluster of boils
Melanoma dx
Excisional bx
Try to take it all if possible but if not take darkest portion
Melanoma tx
Wide excision with adequate margins
Sentinel LN biopsy
Systemic therapy if stage III or IV
Adequate margins for melanoma
In situ –> 0.5cm margins
= 1 mm –> 1cm margins
1.01 - 2mm –> 1-2 cm margins
>2.01 mm –> usually 2cm margin
Acute urticaria time frame
<6wks
Chronic urticaria time frame
> /= 6 wks
Primary inflammatory cells of urticaria
Mast cells and basophils
Usual medications that can cause urticaria
Antibiotics (penicillins, cephalosporins), NSAIDs
Most common cause of chronic urticaria
Dermatographism
Bullous pemphigoid
Most common AI subepidermal blistering disorder
Common in elderly pt >60yo
Tx: Superpotent topical steroid or immunomodulators, if systemic required - tetracycline abx, systemic corticosteroid, azathioprine, MTX, mycophenolate
Scabies tx
Permithrin 5% from neck down with 2 treatments spaced 1 wk apart
Acute Urticaria tx
1st line: antihistamines (diphenhydramine, hydroxyzine, cetirizine)
Chronic urticaria tx
ANtihistamines (2nd generation as first line - ie. cetirizine, desloratadine, loratadine) 1 pill daily for at least a week
2nd line: omalizumab
3rd line: cyclosporin, montelukast, MTX
Avoid systemic steroids if you can
Corns vs warts vs calluses
Corns are painful with direct pressure, interrupt dermatoglyphics
Warts bleed with paring, black speckled apperance due to thrombosed capillaries, destory dermatoglyphics
Calluses have layers, no thrombosed capillaries or interruption of epidermal ridges
Corn treatment
Relieve pressure in shoes
Topical salicylic acid
Junctional nevus
Flat, regular borders, demarcated
Tan-dark brown
Form from melanocytes at dermal-epidermal junction
Compound nevus
Often formed from junctional Tan-dark brown Domed, regularly bordered, smooth, round NOT on palms or soles Form from melanocytes at dermal-epidermal junction that migrate into dermis
Dermal nervus
Soft, dome-shaped, skin coloured to tan/browm
Form from melanocytes exclusively in dermis