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LMCC > Derm > Flashcards

Derm Flashcards

1
Q

Mild acne treatment

A

Benzoyl peroxide and salicylic acid cleansing
Topical retinoids for comedones (Tretinoin, Adapalene/Differin)
Antimicrobials (clindamycin, erythromycin)

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2
Q

Moderate acne treatment

A

Oral abx for max 12 weeks (tetracycline/minocycline/doxycycline)
Hormones (OCP)
Spironolactone (Aldactone)

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3
Q

Severe acne treatment

A

Isotretinoin (accutane, clarus, epuris)
Monotherapy
*Make sure pt is not pregnant
**Pt should be on 2 forms of birth control while on isotretinoin

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4
Q

Alopecia areata

A

AI dz: T cell lymphocytes cluster around germinative zones of hair follicles –> inflammation –> hair loss
Hair follicles still alive

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5
Q

Alopecia areata tx

A

Topical minoxidil = vasodilator
Topical anthralin
Cortisone or triamcinilone actonide injections
Oral steroid

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6
Q

Contact dermatitis tx

A

If >20% affected –> oral prenisone

Topical corticosteroids = first line for localized allergic contact dermatitis (topical triamcinolone)

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7
Q

Bulla

A

Fluid-filled blister >0.5cm in diameter

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8
Q

Vesicle

A

Fluid-filled blister <0.5cm indiameter

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9
Q

Furuncle

A

Purulent infected hair follicle

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10
Q

Pustule

A

Visible collection of pus in skin <1cm in diameter

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11
Q

Abscess

A

Localized collection of pus in a cavity >1cm in diameter

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12
Q

Nodule

A

Circumscribed palpable mass >0.5cm diameter

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13
Q

Plaque

A

Flat topped palpable mass which is >1cm in diameter

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14
Q

Macule

A

Circumscribed area of altered skin colour without elevation <1cm in diameter

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15
Q

Patch

A

Circumscribed area of altered skin colour without elevation >1cm in diameter

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16
Q

Telengiectasia

A

Visible dilatation of small cutaneous blood vessels

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17
Q

Petechia

A

Purpuric lesion of 2mm or less in diameter

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18
Q

Ecchymosis

A

Large purpuric lesion

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19
Q

Most common causes of erythematous perianal rashes in neonates

A

Irritant diaper dermatitis
Seborrheic dermatitis
Candida diaper dermatitis

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20
Q

Carbuncle

A

Painful cluster of boils

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21
Q

Melanoma dx

A

Excisional bx

Try to take it all if possible but if not take darkest portion

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22
Q

Melanoma tx

A

Wide excision with adequate margins
Sentinel LN biopsy
Systemic therapy if stage III or IV

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23
Q

Adequate margins for melanoma

A

In situ –> 0.5cm margins
= 1 mm –> 1cm margins
1.01 - 2mm –> 1-2 cm margins
>2.01 mm –> usually 2cm margin

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24
Q

Acute urticaria time frame

A

<6wks

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25
Q

Chronic urticaria time frame

A

> /= 6 wks

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26
Q

Primary inflammatory cells of urticaria

A

Mast cells and basophils

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27
Q

Usual medications that can cause urticaria

A

Antibiotics (penicillins, cephalosporins), NSAIDs

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28
Q

Most common cause of chronic urticaria

A

Dermatographism

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29
Q

Bullous pemphigoid

A

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

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30
Q

Scabies tx

A

Permithrin 5% from neck down with 2 treatments spaced 1 wk apart

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31
Q

Acute Urticaria tx

A

1st line: antihistamines (diphenhydramine, hydroxyzine, cetirizine)

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32
Q

Chronic urticaria tx

A

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

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33
Q

Corns vs warts vs calluses

A

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

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34
Q

Corn treatment

A

Relieve pressure in shoes

Topical salicylic acid

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35
Q

Junctional nevus

A

Flat, regular borders, demarcated
Tan-dark brown
Form from melanocytes at dermal-epidermal junction

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36
Q

Compound nevus

A 
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
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37
Q

Dermal nervus

A

Soft, dome-shaped, skin coloured to tan/browm

Form from melanocytes exclusively in dermis

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38
Q

Perioral dermatitis tx

A

AVOID all topical steroids
Topical metronidazole 0.75% gel or 0.75-1% cream to affected area BID
Systemic tetracyline abx

39
Q

Rosacea tx 1st line

A 
Oral tetracyclines 
Topical metronidazole 
Oral erythromycin
Topical azelaic acid
Topical ivermectin
AVOID topical steroids 
Avoid triggers
40
Q

Tacrolimus and Pimecrolimus are types of…

A

Topical calcineurin inhibitors
Good for steroid-sparing agent
Can be used on face and neck

41
Q

Seborrheic dermatitis tx

A

Possibly associated with Malassezia (yeast)
Ketonozaole or mold steroid to face
Salicylic acid in olive oil or derma-smoothe lotion to remove scales on scalp, ketoconazole shampoo, head and shoulders (zinc pyrithione), steroid lotion (betamethasone)

42
Q

6Ps of Lichen planus

A 
Purple 
Pruritic 
Polygonal
Peripheral
Papules
Penis (60% in mouth, vulva, glans - mucous membranes)
43
Q

Pathognomonic sign of lichen planus

A

Wickham’s striae (white/grey lines over surface)

44
Q

Pityriasis rosea

A

Christmas tree pattern on back
Herald patch preceding other lesions by 1-2wks
Suspected caused by HHV-6 or HHV-7 reactivation
No tx required
Clears spontaneously in 6-12wk

45
Q

Psoriasis tx

A

Topical steroids +/- topical vitamin D3 analogues (ie.Calcipotriol/Dovobet)
If severe, consider UVB or PUVA phototherapy or systemic biologic therapy

46
Q

Guttate psoriasis often caused by…

A

Streptococcal pharyngitis

47
Q

Pemphigus vulgaris vs bullous pemphigoid

A 
VulgariS = Superficial, intraepidermal, flaccid lesions
PemphigoiD = Deeper, tense lesions at dermal, epidermal junction
48
Q

Nibolsky’s sign

A

Epidermal detachment with shear stress

49
Q

Asboe-Hansen sign

A

Pressure applied to bulla causes it to extend laterally

50
Q

Pemphigus vulgaris

A

AI blistering disease most commonly in mouth
IgG against epidermal desmoglein -1 and -3 leading to loss of intracellular adhesion in epidermis
Tx: Prednisone +/- steroid sparing agents (ie. azathioprine, cyclophosphamide, cyclopsorine)

51
Q

Celiac disease often a/w this skin condition

A

Dermatitis Herpetiformis

52
Q

Dermatitis herpetiformis

A

Transglutaminase IgA deposits in skin alone or in immune complexes leading to eosinophil and neutrophil infiltration
Grouped papules/vesicles/urticarai on erythematous base
Tx: Dapsone, gluten free diet for life (reduce risk of lymphoma)

53
Q

Common causative agents for exanthematous drug reaction

A

Penicillin
Sulfonamides
Phenytoin

54
Q

Drug reaction with Eosinophilia and Systemic Symptoms (DRESS)

A

Starts with face or periorbitally and spreads caudally
No mucosal involvement
Onset 1-6wk after first exposure to drug
Persists wks after withdrawal of drug
Common culprits: Anticonvulsants, allopurinol, sulfonamides
Tx: D/C drug, prednisone, consider cyclosporine in severe cases

55
Q

Steven Johnson Syndrome

A

Epidermal detachment BSA <10%

56
Q

Toxic epidermal Necrolysis

A

Epidermal detachment BSA >30%

57
Q

Gene a/w SJS/TENS with carbamazepine

A

HLA-B1502

58
Q

Gene a/w SJS/TENS with allopurinol

A

HLA-B5801

59
Q

Common causative agents for SJS/TENS

A 
Anticonvulsants
Sulfonamides
Allopurinol
NSAIDs
Cephalosporins 
Can also be caused by viral or mycoplasma infections
60
Q

Neurofibromatosis inheritance pattern

A

Autosomal dominant

61
Q

AI diseases linked to vitiligo

A

Thyroid
Pernicious anemia
Addison’s disease
Type I DM

62
Q

Treatment of vitiligo

A

Sun avoidance
Topical calcineurin inhibitor or topical corticosteroids
PUVA or NB-UVB

63
Q

Impetigo cause

A

GAS, S. aureus or both

64
Q

Tx of Impetigo

A 
Topical antibacterials (2% mupirocin or fusidic acid TID for 7-10d only)
Systemic abx (ie. cloxacillin or cephalexin for 7-10d)
65
Q

Erysipelas tx

A

1st line = Penicillin, cloxacillin or cefazolin

2nd line = clindamycin or cephalexin

66
Q

Common tx for DM foot infections

A

TMP/SMX and metronidazole

67
Q

Tinea capitis tx

A

Terbinafine PO x 4wk
Oral agents required to penetrate hair root where dermatophyte resides
Adjunctive antifungal shampoos or lotions may be helpful

68
Q

Onychomychosis tx

A

Terbinafine or Intraconazole PO 6wk for fingernails, 12wk for toenails for SEVERE onychomycosis (Itraconazole should not be used with statins, terbinafine should not be used with SSRI)
Mild to moderate: topical efinaconazole

69
Q

Lice tx

A

Permethrin 1%, repeat in 1wk after tx

70
Q

HSV-1

A

Typically cold sores
Tx during prodrome to prevent vesicle formation
Topical antiviral cream, oral antivirals are more effective

71
Q

HSV-2

A

Usually sexually transmitted

1st episode: Acyclovir 200mg PO 5x/d x 10d, maintenance acyclovir 400mg PO BID

72
Q

HSV smear

A

Tzanck smear

73
Q

Hutchinson’s sign

A

Shingles on tip of nose signifies ocular involvement

Shingles in this area involves V1 (ophthalmic branch of trigeminal nerve)

74
Q

Mollascum contagiosum tx

A

Topical cantharidin

75
Q

Candidal paronychia tx

A

Oral antifungals recommended

76
Q

Topical therapies for actinic keratosis

A

5-fluorouracil cream for 2-4wks

Imiquimod

77
Q

Most common oral mucosal premalignant lesion

A

Leukoplakia

78
Q

Basal cell carcinoma

A

Rarely metastatic
Most common malignancy
Tx: Imiquimoid 5% cream, cryotherapy, fluorouracil, photodynamic t herapy for superficial
Shave excision, electrodessication for most types of BCCs
LOCAL excision (<1cm margin, wide excision not necessary)
Mohs surgery

79
Q

Squamous cell carcinoma tx

A

Surgical excision with primary closure, Mohs
Lifelong follow-up
+/- radiation (higher rates of mets if >2cm in diameter, >4mm deep)

80
Q

Melanoma treatment

A

Excision (full depth of dermis) + margins AFTER histologic dx
High dose IFN for stage II
Chemotherapy and high dose IFN for stage III
Node dissection if Stage IB or higher (if 0.8mm or thicker)
Increased rate of mets in melanoma

81
Q

Growth stage of hair growth

A

Anagen phase

82
Q

Transitional stage of hair growth

A

Catagen stage

83
Q

Resting stage of hair growth

A

Telogen phase

84
Q

Androgenetic alopecia tx

A

Minoxidil (Rogaine)
Spironolactone (in females)
Cyproterone acetate in females (Diane 35)
Finasteride (5-alpha-reductase inhibitor)

85
Q

Type of hair loss from chemotherapy

A

Anagen effluvium

86
Q

Type of hair loss from stress

A

Telogen effluvium

87
Q

Scarring alopecia

A

Irreversible loss of hair follicles with fibrosis

Always requires biopsy

88
Q

Erythema Nodosum

A 
Acute or chronic inflammation of subctuaneous fat 
DDx: NODOSUMM
No cause 
Drugs (sulfa, OCP)
Other infxns (GAS, TB) 
Sarcoidosis 
UC < CD 
Malignancy (leukemia, Hodkin's lymphoma) 
Many infxns
89
Q

Most common type of melanoma

A

Superficial spreading

90
Q

3 most important determinant of prognosis of melanoma

A

Tumour thickness
Histologic ulceration
Mitotic rate

91
Q

Onychomycosis

A

Most commonly caused by dermatophytes (specifically Trochiphyton rubrum)

92
Q

Paronychia

A

Nail fold infection
Commonly caused by Staph aureus or Strep pyogenes
Tx: Topical Gentamycin

93
Q

Acute radiation dermatitis

A

Moist desquamation
Can occur acutely, late or “radiation recall”/months-years after
Improved by using intensity modulated radiation therapy (allows maximum focus on tumour while minimizing radiation to surrounding tissues)

LMCC (22 decks)

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