Derm Flashcards
2 Mutations Associated w/ Melanoma + Specific Tx for Each
BRAF - dabrafenib + trametinib OR vemurafenib + cobimetinib
C-KIT - imatinib
How do you treat Kaposi Sarcoma?
Treat HIV w/ HAART - will disappear as CD4 count improves
May use vincristine or interferon injections into lesions
What is imiquimod use to treat?
LOCAL IMMUNOSTIMULANT
- actinic keratoses
- molluscum contagiosum
- condyloma acuminata
What is a topical alternative to steroids in eczema and psoriasis?
topical tacrolimus
BECAUSE STEROIDS CAUSE ATROPHY
Which drugs can cause pemphigus vulgaris?
ACE inhibitors
Penicillamine
Phenobarbital
PCN
Pemphigus vulgaris v. Bullous Pemphigoid
PV - oral involvement (“vulgar mouth”) - flaccid bullae because only involves epidermis; slough (Nikolsky sign)
BP - tense bullae because antibodies against basement membrane; no oral invovlement
Tx of Pemphigus vulgaris and Bullous Pemphigoid
PV - prednisone, azathioprine, mycophenalate, rituximab or IVIG if refractory
BP - prednisone, if mild can use erythromycin, dapsone, nicotinamide
Porphyria Cutanea Tarda
Associated w/ Hep C and alcoholic liver disease, estrogen use and iron overload
Dx - 24 urine uroporphyrins
Blistering rash when skin is exposed to abnormal porphyrins when exposed to light (SUN)
Deficiency in uroporphyrin decarboxylase
Tx - treat underlying disease (stop alcohol, stop estrogen, phlebotomy for iron excess)
How do you treat skin infections in someone with PCN allergy?
Macrolides (azithromycin, erythromycin, etc), clindamycin, doxy or bactrim in mild infections
Vancomycin, linezolid, daptomycin, tigecycline or ceftaroline in severe infection
Tx of tinea capitis and tinea unguium
Terbinafine OR itraconazole»_space;> griseofulvin
Describe the Spectrum of Drug Reaction Rashes (4)
Morbilliform - MILD, skin intact, no tx
Erythema Multiforme - target lesions on trunk, no mucous membrane involvement, prednisone
SJS - mucous membranes involved; IVIG not steroids
TEN - > 30% involved; IVIG not steroids
What other diseases are associated w/ erythema multiforme?
Herpes
Mycoplasma
Staph Scalded Skin Syndrome
Reaction to toxin on surface of staph
Looks like TEN w/ Nikolsky sign
Tx = nafcillin or oxacillin + supportive care
Tx of Mild, Moderate and Severe Acne
Mild - topical benzyl peroxide then + topical clindamycin or erythromycin
Moderate - add TOPICAL vit A derivatives (tretinoin, tazarotene) then try oral doxycycline
Severe - ORAL vit A derivatives (isotretinoin) - pregnancy test + birth control
Impetigo v. Erysipelas v. Cellulitis
Impetigo = epidermis only, weeping/crusting/draining; staph or strep; (may use topicals - mupirocin)
Erysipelas - strep»_space; staph, can get PSGN, invades dermal lymphatics
Cellulitis - extends from dermis to subQ tissue
