Derm Flashcards
Onset of rash with RMSF
2-5 days after fever
RMSF rash
- petechiae erupting on both wrists, forearms, and ankles
- rapidly progress towards trunk and becomes generalized
- 10% do not develop rash
First line treatment for RMSF
Doxycycline
Erythema migrans
-bulls eye rash
When does erythema migrans rash occur
-7-14 days after deer tick bite
Measles rash description
-Koplick spots: small, white, round spots on red base of buccal mucosa
Scabies rash description
- pruritic especially at night
- serpiginous rash on interdigital webs, waist, axilla, penis
Scarlet fever rash description
-sandpaper rash with sore throat
Meningococcemia rash
purple-colored to dark-red painful skin lesions all over body
Meningococcemia (meningitis) presentation
- sore throat
- cough
- fever
- Headache
- stiff neck
- photophobia
- change in LOC
People at highest risk for meningitis
- first year college students in dorms
- asplenia
- defective spleen (sickle cell)
- HIV
- complement immune system deficiencies
What level of precaution is needed for meningitis
droplet
What CN does herpes zoster ophthalmicus affect
-CNV
Most common type of melanoma in AA and Asians
- Acral Lentiginous melanoma
- palms, under nails, soles of feet
Acral lentiginous melanoma presentation
- dark brown to black lesions on nail beds, palmar, and plantar surfaces
- subungal melanoma: longitudinal brown to black bands on nail bed
BCC presentation
- pearly or waxy skin lesion with atrophic or ulcerated center that does not heal
- bleeds easily with trauma
Actinic keratosis
- precursor to SCC
- dry, round, red colored lesions with rough texture
- does not heal
> ___% hematoma of nail matrix has high risk of permanent ischemic damage to nail bed if not drained.
25
SJS and TENs
- multiple lesions ranging from hives to necrosis
- TEN more severe than SJS
HIV patients taking which medication is at higher risk for SJS
Bactrim
3 layers of skin
epidermis
dermis
subcutaneous
Common skin conditions of AA
- keloids
- hyperpigmentation
- traction alopecia
T/F People with darker skin need more sun exposure to synthesize vitamin D
true
Vitamin D deficiency in pregnancy
infantile rickets
Which cancer is most common
BCC
Macule
flat
-<1 cm
papule
palpable solid
<0.5 cm
Plaque
flattened elevated with variable shape
>1 cm
Bullae
fluid filled
>1 cm
Vesicle
filled with serous fluid
<1 cm
Pustule
elevated lesion <1 cm filled with purulent fluid
Lichenification
-thickening of epidermis due to chronic itching
Acral
-distal portions of the limbs like hands and feet
Annular
ring shaped
exanthem
cutaneous rash
Flexural
skin flexure are body folds
Morbilliform
rash that resembles measles
Nummular
coin-shaped
round
Serpiginous
shaped like a snake
Verrucous
wart-like
Xanthelasma
raised and yellow-colored soft plaques
-if <40, r/o HLD
Melasma
- mask of pregnancy
- upper cheeks, malar area, forehead, chin
- can be permanent, may lighten over time
Vitiligo is more common in patients with
autoimmune disease
Vitiligo treatment
refer to derm
Cherry angioma treatment
none needed
Xerosis
-inherited skin disorder that is extremely dry skin
Acanthosis nigricans can indicate what
-diabetes
-metabolic syndrome
-obesity
Cancer of GI tract
Acrochordon
skin tags
-more common in diabetics and obese
Steroid class range
1 (superpotent) to 7 (least potent)
Topical steroids on children and face
- use class 7: 0.5%-1% hydrocortisone
- Class 6: fluocinolone
How long do topical steroids need to be used for HPA axis suppression to occur
> 2 weeks
Psoriasis patho
- inherited
- squamous epithelial undergo rapid mitotic division and abnormal maturation
Koebner phenomenon
new psoriatic plaques form over areas of skin trauma
Auspitz sign
pinpoint areas of bleeding in skin when scales from a psoriatic plaque are removed
Fingernail presentation with psoriasis
pitting
Psoriasis medications
- topical steroids
- topical retinoids
- tar preparations
- severe disease: MTX, cyclosporine, biologics
Topical tacrolimus BBW
- rare malignancy
- use sunblock
Goeckerman regimen
-UVB light and tar-derived topical may induce remission in severe psoriasis
Guttate sporiasis
- drop-shaped lesions
- severe psoriasis from GABHS
Actinic keratoses treatment
-refer to derm for biopsy
Tinea versicolor treatment
- selenium sulfide and topical azole antifungals (ketoconazole, terbinafine)
- will take several months for pigment to fill in
Mild eczema treatment
- hydrocortisone 2.5%
- low-potency, group 5
Moderate eczema treatment
- Triamcinolone acetonide
- medium potency, group 4
Halcinonide (Halog)
high potency topical steroid
group 2
Contact dermatitis treatment
- stop exposure
- topical steroids once to twice a week 1-2 weeks
- calamine lotion
- oatmeal baths
- consider referral to allergist
superficial candidiasis presentation
- bright red shiny lesions
- itch or burn
- intertriginous areas
thrush presentation
- severe sore throat
- white adherent patches
- hard to dislodge
Superficial candidiasis treatment
- Nystatin powder and/or cream in skin folds
- OTC antifungals: miconazole, clotrimazole
- Prescription: terconazole, ciclopirox
- keep dry and aerated
Thrush treatment
- Nystatin oral suspension (swish and swallow)
- Magic mouthwash: lidocaine, diphydramine, Maalox for severe sore throat