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derm Flashcards

1
Q

alopecia areata

A

ass with autoimmune
exclamation point hairs

complete scalp hair loss: totalis
complete hair loss on scalp and body–> universalis

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2
Q

androgenic alopecia

A

minoxidil and oral finasteride- androgen inhibitor

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3
Q

eczema

A

triad: eczema, allergic rhinitis and asthma
increase IGE production: ALLERGEE
flexor creases- blisters/papules/plaques- then looks similar to psoriasis when it crus over (antecubital or popliteal folds)

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4
Q

nummular eczema

A

coin shaped lesions (knees and elbows)- sharply defined- tx is topical corticosteroids- antihistamines, wet dressings. tracolimus, pimecrolimus (good alternatives to steroids- topical calcineurin inhibitors)

maintain skin hydration

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5
Q

dyshidrosis

A

tense vesicles on soles, palms and fingers (lateral digitis)

tx: topical steroids

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6
Q

lichen complex chronicus

A

skin thickening in patients WITH ECZEMA due to rubbing/scratching
EXAGGERATED SKIN LINES
- dont scratch lesions- topical steroids

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7
Q

lichen planus

A

INCREASED INCIDENCE WITH HEP C!!
idiopathic- cell mediated immune response!!
purple, polygonal, planar, pruritic papules WITH FINE SCALES!!
skin, mouth, scalp, genitals, nails- mucous
KOEBNER’s phenomenon-
WICKHAM Striae- oral mucosa fine white lines
TX: corticosteroids

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8
Q

pityriasis rosea

A

viral infection- HHV7
HERALD PATCH- salmon colored macule on trunk - then smaller oval salmon-colored papules with circular scaling along cleavage lines IN A CHRISTMAS tree pattern
NO TX: antihistamines for pruritis, oatmeal baths

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9
Q

Psoriasis- plaque, pustular, or guttate

A

hyperplasia- proliferation cells in the stratum basale and stratum spinosum due to T cell ACTIVATION and cytokine release
plque: silver/white scales- extensor surface- elbows/knees/scalp/neck nape- nail pitting- oil spot (discoloration under nail)
auspitz sign- bleed when removing plaque
koebner - new skin lesions at trauma

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10
Q

psoriatic arthritis

A

inflammatory arthritis associated with psoriasis- join stiffness more than 30 minutes- relieved with activity
sausage digits- pencil in cup deformity

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11
Q

TX FOR PSORIASIS

A 
topical steroids 1st LINE
vitamin D analogs 
topical tar
topical retinoids
vitamin A analogs

sever: phototherapy, UVB, PUVA, methotrexate

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12
Q

TINEA versicolor

A

malassezia furfur- YEAST!
hypo or hyperpigmented macules with FINE scaling- fails to tan
KOH PREP- hyphae and spores- SPHAggeti and meatballs
wood lamp- yellow-green flourescene-

TX: ANTIFUNGALS- selenium sulfide, zinc, azoles, itraconazole or fluconazole

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13
Q

seborrheic derm

A

hypersens to MALAssezia furfur possibly?
IN AREAS OF HIGH sebaceous gland oversecretion- scalp, face, eyebrows, body folds
worse in winter
CRADLE CAP FOR INFANTS!!- red plques with fine white scales
ADULTS- SCALP, eyelids, folds
TX: selenium sulfide, ketoconazole shampoo, zinc, steroids, antifungals (itra, fluco, keto, terbinafine),
FOR BABY with cradle cap: ketoconazole, baby shampoo

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14
Q

hypersenstivity reactison

A

triggers: food, bites, drugs, exercise induced, infectious
type I: ige mediated- urticaria and angioedema- immediate
type 2: antibodies mediated= causes cell lysis
type 3/: immune antibody-angine complex
type Iv: delayed- erythema multiforme - morbilliform-

Morbilliofrm/erythematous- most common

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15
Q

urticaria

A

blanchable, edematous pink papules, wheals or plaques- hives disappear within 24 hours and new crops come
can have dermatographism- local pressure causes wheals in that area
darierls sign: when skin is rubbed- urticaria formed
USE ANTIHISTAMINES AS TX

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16
Q

erythema mulltiform

A

TYPE IV hypersensitivyt reaction
HSV MC
SULFA, BETA LACTAMS, phenytoin, phenobarbital!!!
TARGET LESIons! : dusty-violet red, purpric macules/vesciles or bullae in the CENTER- surrounded by edematous rim and red halo

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17
Q

EM MINOR

A

no mucosal membrane lesions

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18
Q

EM major

A

involvement of more than 1 mucous membranes (oral, genital or ocular)- NO EPIDERMAL DETACHEMENT!
TX: symptomatic, STEROIDS

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19
Q

SJS

A

SULFA or anticonvulsant meds- NSAIDS< allopurinol, abx
10% of sloughing of body surface area
blisters everywhere, fever, URI symptoms- involves more than 1 mucous membrane WITH EPIDERmal detachment- NIKOLSKY sign
TREAT AS SEVERE BURNS!!

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20
Q

TEN

A

sloughing of more than 30 % of body

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21
Q

acne

A

due to increased sebum
clogged sebaceous glands
propionibacterium acne overgrown
inflammatory resposnse

blackhead-s - open
closed (white heads)

severe: nodular or cystic acne

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22
Q

management of acne

A

mild: retinoids, benzoyl peroxide, topical abx, ocps
retinoids- inflammatory acne
benzoyl peroxide: decreases propionibacterium
topical abx: clinda
MODERATE: oral abx and anti androgen agents like doxy or minocycle= tetracyclines and spironolactone

SEVERE: isotretinoin- highly teratogenic- must ahve 2 pregnacy tests before therapy- 2 forms of contraception

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23
Q

rosacea

A

triggers are ETOH, increase temp, hot drinks, hot /cold weather, hot baths, spicy foods

acne like rash and redness, facial flusing, telngiectasia, skin coaresening, papulopustules with burn and stinging.
NO BLACKHEADS!!!- this is what distinguishes from acne
TX: METRONIDAZOLE

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24
Q

TX FOR ROSACEA

A

METRONIDAZOLE! TOPICAL!!!!

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25
actinic keratosis
MC premalignant skin condition to squamous cell carcinoma DRY ROUGH SCALY sandpaper skin lesion- HYPERKERATOTIC plques!! Tx: cryosurgery
26
seborrheic KERATOSIS
sebborheic- means its benign= MC benign skin tumor- velvet, warty lesion- GREASY /stuck on appearance NO TREATMENT but cryoterhapy if you want
27
common plantar warts
thrombosed capillaries- has red brown punctations
28
verruca plana- flat warts
flesh colored papules- seen on face, hands, shins
29
genital- condyloma acuminata
painless, soft fleshy califlower
30
warts dx
whitening of lesion with acetic acid application- most will resolve within 2 years
31
gardasil vaccination
11-26 women gardasil 9 treats for 6,11,16, 18 and other types of HPV gardasil alone for 6,11,16,18
32
vitiligo
AUTOIMMUNE DESTRUCTION OF MELANOCYTEs- skin depigmentation | tx: corticosteroids, systemic phototherapy,
33
basal cell carcinoma
SLOW GROWING! MC type of skin cancer in US translucent, pearly, waxy papul with CENTRAL ulcerations and RAISED, rolled borderes- face, nose, trunk BLEEDS EASILY! - telangiectatic vessesll punch or shave biopsy 0 electro desiccation, mohs
34
malignant melanoma
UV RADIATION MOST COMMON REASON! agressive- high mets potential!!! ABCDE: assymetry, border,s irrgeular, color, diameter more than 6 mm, evolution THICKNESS- used as prognastic for METS!! full thickenss wide exciesional biposy plus lymph node biopsy
35
SQUAmous cell carcinoma
red, elevated, thickened nodule with WHITE SCALY or crusted, bloody margins do biopsy wide local surgical excision
36
kaposi
HHV- 8, HIV , HAART therapy
37
erythema nodosum
anterior shins- painful, erythematous- due to ESTROGEN exposure, sarcoidosis, IBS, coccidiodomycosis!!!
38
ipetigo
``` highly contagious- HONEY COLORED RUST!! staph AUREUS MC also can be GABHS tx: mupirocin- bactroban tid X 10 cephalexin- if systemic- 1st generation cephalosporin ```
39
folliculitis
hair follicle=- staph aureus- | topical mupirocin, clinda, erythromycin
40
furuncle (boil)
deeper infection of the hair follicle- Tender - fluctuant ABSCESS with CENTRAL plug- I AND D heat compresses
41
carbuncle
larger more painful than furuncles- but interlocking- abscesses with MULTIPLE openings or plus cellulitis
42
cellulitis
mc caused by S. aureus!! and GROUP A beta hemolytic STREPtococcus - similar to impetigo cuases erysipelas: strep A!!! mc - well demarcated margins of cellultis= intensely erytehmatous - involves FACE mostly!!!-
43
TX for erysipelas
IV penicillin, vanycomycin if pen allergy or mrsa suspected
44
cellulitis tx
cephalexin, dicloxacillin - 7-10 days | MRSa: iv vanco or linezolid
45
cat bite
pasteurella multocida- AMOX/clauvulanate FIRST LINE | doxy- if pcn allergic
46
dog bite
amox/clavulanate
47
human bite
amox/clavulantte
48
puncture wound through shoe
CIPRO- covers PSEUDOMANS
49
paronychia
infection of nail margin- MC staph | warm soaaks, or cephalexin , I and D
50
scabies
very itchy, linear burrows, intertriginous zones- web sapces between fingers/toes- more intense at night- papules or nodules on scrotum, glans or penile shaft, body folds- SCABIES!
51
tx for scabies
permethrine topical- FIRST line | or LINDANE- don't use after bath or shower- causes siezures- not to be used on young children or teratogenic
52
molluscum
poxiridael family- highly contagious | DOME SHAPEd=- flehs colored pearly white, waxy papules with CENTRAL umbilication- no treatment
53
dermatophytosis
fungal skin infections: trichophyton, microsporum, IF MICROSPORUM- you will see green flourescence in wood's lamp
54
tinea capitus
alopecia- ring worm- po grisofulvin
55
tinea pedis
athlet'es foot- topical antifungal or po griseofulvin
56
onychomycosis
nail infection- itraconazole and terbinafine. systemic would be grisofulvin
57
pemphigus vulgaris
AUTOIMMUNE!!!- desmosome disruption- no more barrier function- ANTI DESMOSOME/anti epithelia ab- TYPE II HSN painful FLACCID skin bullae- ruptures easily - nikolsky sign IGG throuthout the epidermis- skin biopsy dx HIGH DOSE CORTICOSTEROIDS OR METHOTREXATE!
58
bullous pemphigoid
ELDERLY!! type II just like- DRUG INDUCED! TENSE BULLAE- dont rupture easily NO NIKOLSKY! systemic corticosteroids
59
MELASMA
too much estrogen (OCPS, pregnancy), sun exposure | tX: hydroquinone
60
BROWN RECLUSE SPIDER
local burning, then blanced area, erythematous margin around ischemic center, then heorrhagic BULLAE!!! NECROSIS! local woundcare, pain control
61
BLACK WIDOW SPIDER
usually contact with spider--outdoor activities, furniture outside use, gardening SYSTEMIC SYMPTOMS- black widow tortures you systemically - muscle pain, spasms and rigidity- OPIOIDS FOR PAIN!! or muscle relaxants
62
burn management
``` rule of 9 head: 9 whole arm: 9 Trunk : 36 lower limbs: 18 each genital is 1 ```
63
burn!!!!
wash with mild soap and water- COOL COMPRESS!- do not apply ice directly!!! debridement, remove the ruptured blisteres aBX: silver sulfadiazine- DONT USE ON FACE!!! - no use if sulfa allergy or pregnancy or small children!!! superficial burns- no dressing cover partial and full thickness burns with sterile dressing to prevent infection IV fluids
64
superficial burn
epidermis- red, DRY, painful, +refill inteact
65
superficial partial thickness- 2nd degree
epiderm and superficial portion of derm- pink, moist, weeping, +blistering MOST PAINFUL OF ALL BURNS!!!- very tender +refill intact
66
deep partial thickness burn- 2nd degree
epiderm into deep portion of dermis, +blistering- not very finally - absent capillary refill- scarring
67
full thickness - THIRD
WAXY, white, leathery, dry, painless no capillary refill
68
4th DEGREE
black, charred, dry, painless, absent capillary refill
69
carbon monoxide
odoroless, tasteless, colorless- 200 times more affinity to hemoglobin- seizures, brain hypoxia, coma, cardiac arrhtymias, diagnosed with ABG, give 100% oxygen
70
high voltage electric injuries
ECG- rhabdo

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