Derm Block 3 Flashcards
Staph A morphology and staining pattern
If this microbe infects the skin, what four infections can it cause?
The elaboration of these toxins can lead to ?
Gram + Cocci
Cellulitis Impetigo Folliculitits Furuncles
Bullous impetigo
SSSS
? are the secondary invaders of traumatic skin lesions
What four infections can it cause upon infecting the skin?
Group A B-hemolytic strep- Gram + Cocci
Lymphangitis Impetigo Cellulitis
Erysipelas
What causes Non-Bullous Impetigo
How does it start and what does if classically look like
This condition is more common in ? PT populations and frequently co-infected w/ ?
GABHS
Stratum Corneum pustule, ruptures to honey crusted lesion w/ regional adenopathy
2-5y/o Peds in warm/moist climates
Staph
How is Non-Bullous Impetigo Tx
If ABX are used, what is the purpose of their use
Soak, removes crust
Local: Topical Mupirocin
Wide: Diclox/Cephalexin
Prevent acute glomerulonephritis after impetigo
What causes Bullous Impetigo
What PT population is this MC in
How is this form different?
Staph impetigo
Infant/adolescent
Less exudative crusting- center collapses w/ tube-like rim
How is Bullous Impetigo Tx
If PTs have recurrent cases of impetigo, what test needs to be ordered?
Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex
Staph A carrier, Tx w/ Mupirocin
Cellulitis is a skin infection that extends to ? layer
How does it present
What are the microbe etiologies
Into SQ
Erythema Edema Pain
GABHS- MC
Pseudomonas in DM
Staph
H influenza
What parts of the body are more likely to be the portal of entry for cellulitis microbes?
How does cellulitis present in clinic?
Compromised areas by stasis/lympedema
Warm Adenopathy Red Tender Swollen w/ poor defined border
Streaks= lymphangitis
How are cellulitis PTs Tx outpatient
How are they Tx inpatient
How are DM w/ Pseudomonas Tx
How are PTs w/ H influenza Tx
Compress/Elevate
Diclox/Cephalexin/Clinda/TMP
Nafcillin
Vanc if PCN allergy
Aminoglycosides
Cephalosporin
Define Erysipelas and what microbe causes it
Erysipelas is AKA ?
Superficial cellulitis of lymphatics from Strep Pyogene
St Anthoneys Fire
How does Erysipelas present and what makes this presentation different
How is Erysipelas Tx
Sharp demarcated, raised plaque w/ pain/erythema on
face, ears, legs after 48hr prodrome
PO: Cephalexin Amox/Diclox
IV: Cephazolin Ceftriaxone
Define Blistering Distal Dactylitis
How is it Tx
Superficial infection of anterior finger pad MC 2-16y/o
InD w/ Anti-Strep ABX
Define Folliculitis
What is the MC form of infectious folliculitis
Define Superficial Folliculitis
Inflamed hair follicle from infection, chemicals or injury
Staph, common in nares or areas of occlusion
Perifollicular pustules w/ undamaged hair in center
How is folliculitis worked up
How is it Tx
What adjunct can be added for Tx
Culture pustule- scrape pustule off w/ 15 blade onto swab
Removal, hygiene
E/C-mycin Diclox Cephalexin
Benzoyl Peroxide (keratolytic, anti-bacterial)
How is persistent/deep folliculitis (sycosis barbae) Tx
If folliculitis is in the scalp and present long term, Tx PT for ?
Systemic ABX
Folliculitis decalvans
Define Sycosis Barbae
How is it Tx
What is done for PTs that have resistant cases or are Tx failures?
Inflammation of whole follicle, Staph Impetigo of beard
Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex
Eval for dermatophyte infection
w/ hair removal, culture
Define Furuncle
Define Carbuncle
Where do both of these have in common?
Boil/abscess, walled collection of pus w/ pain
Multi-headed boil, associated w/ cellulitis
Painful perifollicular infections on traumatic areas of skin
How are furuncles/carbuncles Tx
Recurrent furuncles are commonly infected w/ MRSA and Tx w/ ?
How is MRSA furunculosis Tx
InD
ABX if cellulitis is present
Mupirocin
Chlorhexidine/bleach bath
Culture dependent: Clinda/TMP
What causes SSSS
Dec function of ? organ allows for toxins to accumulate?
How do the toxins spread in the body?
Staph A exfoliative toxins
Dec renal clearance
Hematogenously
SSSS typically starts as ? presentation in kids
What does the prodrome of this syndrome present as
Bullous impetigo
Malaise Fever Irritability
Skin tenderness
If mild case of SSSS presents and is going to be Tx on outpatient basis, what ABX are used?
Pseudomonas usually infects ? PTs in ? locations
B-lacatm resistant- Diclox, Cephalexin
DM
Warm/moist
What PE finding is indicative of Pseudomonas
What does this smell like?
Pyoverdin- light green pigmentation w/ woods lamp
Fruity/grape like
Define Hot Tub Folliculitis
These PTs are at low risk for ?
How are they Tx
8hrs-5d after exposure
Pruritic round, urticarial plaques w/ central pustule
Sepsis
Antihistamine PRN
Local- Vinegar soaks
Wide- Cipro
Pseudomonas Cellulitis is usually found in ? PTs
These types of growth are encouraged by presence of ?
How are these PTs Tx
Debilitate/DM PTs as secondary infection of tinea
Occlusion
Broad spectrum suppression
Acetic Acid
Aluminum acetate
PO Cipro
Where do Pseudomonas Toe web infections usually present?
How does it present on PE
How are Pseudomonas toe web infections Tx
Between 4-5th toe as secondary infection after tinea
Thick white macerated skin, w/ green glow on Woods
Post-op shoe (DM PT)
Acetic acid/Aluminum chloride
Gentamycin cream once dry
PO Cipro- topical Tx failure
What causes Trichomycosis Axillaris
This infection is associated w/ ? and produces ?
Corynebacterium, Gram + opportunistic infection
Heavy sweating, malordorous smell w/ white hair
How is Trichomycosis Axillaris Tx
What microbe causes Erythrasma
Shave area
Topical Erythro, Clinda Naftifine- fungal infection
Coryn minutissiumum
What are the predisposing RFs for Erythrasma?
APHID HO Advanced age Poor hygiene Humid/warm ImmSupp DM
Hyperhidrosis
Obese
? is the MC site for Erythrasma infections to appear
How does Erythrasma appear on PE
What color is it under Woods Lamp
4th interdigital space
Macular brown itching scales
Looks like T cruris, does NOT spare scrotum/labia
Coral red
How is Erythrasma Tx
Define Pitted Keratolysis
What are the distinctive features found on PE
Erythromycin
Clindamycin
Clarithromycin- severe or refractory
Pits on weight bearing areas of feet from Kytococcus sedentarius
Malodor
Slimy/hyper hydrosis skin
How is Pitted Keratolysis Tx
What med is added if case is unresponsive to topical Txs?
TxOC: Topical E/C-mycin, Mupirocin w/ Drysol
PO Erythromycin
Define Wart
What process causes these growths
Typically these are confined to ? and lack ?
Beningn epidermal neoplasm from HPV
HPV infection of keratinocytes induces hyperplasia/keratinosis
Epidermis, no roots
How would warts be described in PE
What causes the black dots mislabeled as ‘roots’?
Verrucous papule w/ cylinders that fuse= Dx mosaic pattern
Thrombosed vessels trapped in projections
Common Wart is called ? and are MC located ?
How are they Tx
Verruca Vulgaris
Hands
Salycylic acid
Imiquimod 5%
Cantharidin (by provider)
LN2
Define Filiform Warts and where are the MC found
How are they Tx
Flat warts are AKA ? and commonly found ?
Finger-like projection
Face
Curettage- TxOC
Verruca Plana on shaved areas of body
How are Verruca Plana warts Tx
How are Plantar Warts differentiated from clavi?
How are Plantar Warts Tx
Tretinoin cream
Imiquimod
Cryosurgery
5-FU
Llook for black dots/lack of skin lines (corns have skin lines)
Cantharidin LN2 Imiquimod
Pare/soak Salicyclic acid
Define Sub/Periungual wart
Since these types are more resistant to Tx, what can be done?
Painful wart next to nail from cuticle biting
Cryosurgery
Cantharidin
Salicyclic acid
Duct tape- last option (6d, 12hr break, 6 more days)
Genital warts are AKA and cause by ?
What preventative measure slows but does NOT prevent spread
How do genital warts appear in clinic?
Condyloma acuminata
Veneral warts
HPV 6 11 16 18 52 56
Condoms
Smooth pink w/ projections on broad base
ImmSupp PTs can present w/ ? alternative presentation?
? forms of HPV are the high risk/cervical sup-types
? forms are rarely associated w/ cervical Ca
Coalesce into large cauliflower masses
16*, 18
6, 11
How are genital warts Tx by providers/
How are they Tx by PT Tx methods
Podophylin resin Excision/curettage Trichloroacetic acid Cryosurgery CO2 laser
Podofilox- 4d on, 4-6wks off
Imiquimod- every other day at bed time x 16wks
5-FU- LAST option
? two genital wart DDxs may be seen in 10% of normal male PTs
Pearly Penile Papules- angiofibromas on corona
Bowenoid- resemble flat genital warts
Sex transmitted HPV, quasi-premalignant, self resolve
Where is Molluscum Contagiosum commonly seen?
If found ?, suspect abuse
How does it present on PE
Kids via autoinnoculation on arms/face
Groin
Dome shaped papules w/ central umbilication, leak caseous material
What is the etiology of Molluscum Contagiosum
How are PTs w/ few lesions Tx
How are PTs w/ multiple lesions Tx
DNA Poxvirus
Curette w/ anesthesia- best
LN2
Trichloroacetic acid peel
? is the primary mode of herpes virus transmission
First outbreak usually appears ?days after innoculation and lasts ?
Viral cultures can occur for __ days when PTs present w/ active genital lesions
ASx viral shedding x 16 days after outbreak
6d, x 14days
5 days
? is the Gold Standard for Dx of herpes simplex
Why is this same day turn around so important
? form of HSV commonly has Abs found in PTs
PCR
Differentiates HSV 1 from 2
HSV-1
How are HSV and zoster PTs managed?
What PT education must go w/ this Rx
? medication is added to anti-viral therapy for herpes labialis
F/A/V-clovir <72hrs of onset
Improves/Shortens Sxs, but not curative
Penciclovir
Docosonal
Herpes zoster is reactivated ? and presents uniquely as ?
When is an emergent referral needed?
What vaccines are used for Herpes Zoster prevention
Varicella from dorsal root
Single dermatome
Ophthalamic branch of trigeminal d/t corneal blindness risk
Zostavax- live vaccine
Shingrix- recombinent vaccine
50 or older
Define Dermatophytes
Where is their existence limited to on the body?
What are the 3 genera of ringworms?
Fungi infecting stratum corneum (keratin layer), hair and nails
Can’t survive on mucosal layers
Microsporum Epidermophyton
Trichophyton
? mycoses infection have minimal, if any, inflammations
? infections commonly have inflammatory responses?
T versicolor (pityriasis)
T nigra
B/W piedra
T capitus (head) T barbae (beard) T faciei (face) T corporis (body ring worm) T cruris (groin, jock itch) T manuum (hand) T pedis (foot)
? is the MC mycoses infection of the skin?
Onchomycosis is AKA ?
T rubrum
Unguium, nails
What is the mode of transmission of dermatophytes?
How are these infections Dx
Human to human
Animal to human
Soil to human
Fomites
KOH Prep
DTM culture (red= +)
Woods lamp
Typically dermatophytes don’t have fluorescence response under Woods Lamp except for ?
How are superficial lesions from T Corporis Tx
How long are PTs to continue Tx?
T versicolor
Clotrim/Micon/Ketocon-azole
Continue x 7d after erythema resolves
What meds are used for T corporis if case is extensive/deep?
What med is reserved for Peds Tx?
Terbinafine
Itraconazole
Fluconazole
Griseofulvin
How are cases of T pedis Tx if interdigit presentation?
How is it Tx for moccasin presentations?
Topical: Terbinafine Clotrimazole
PO: Fluconazole Itraconazole
Terbinafine
T manuum is more common in ? and Tx as ? due to ?
T barbae is Tx w/ ?
T faciei is Tx w/ ? unless ?
MC men
Same as T pedis
2:1 ration presentation
PO agent only
Topicals unless near eyes
T cruris usually presents ? on the body
How is T Cruris Tx
What PT education needs to go w/ these Tx
Scrotum/Labia
Eyrthrasma does not spare
Tx of fungal and candidia:
C/M/K-azole
2wks, 2cm past borders
T capitis is more frequent in kids and can present in ranges from ? to ?
Of the 4 patterns of infection ? type is MC
How is this Dx and Tx
Scale/broken-Alopecia
Black dot type- hair broken at orifice
Gauze, Tooth brush
Kids: Griseofulvin
Adults: Griseofulvin Itraconazole Terbinafine
Inflammatory T Capitis cases are called ? and presents as ?
What abnormal lab result would be seen
How is it Tx
Kerion
PAIN inflammation w/ tender/boggy nodules that drain
Negative KOH
PO Griseofulvin/Terbinafine
Define T incognito
How does it present
Where is it MC seen on the body
Fungal infection Tx w/ topical steroids
Inflammation improves while fungi flourish
Groin Face Dorsal hands
Candidiasis becomes pathogenic w/ damage to ? layer of skin
Can also become pathogenic if ? pre-existing conditions are present
Stratum corneum
Pregnant
DM ImmSupp ABX therapy Topical steroids OCPs Maceration
What are the 4 possible morphologies/distributions of candidiasis?
? lesions are a classic presentation for candidiasis
PO- thrush
Angular chelitis
Vulvovaginitis
Intertriginous
Satellite
How is Candidiasis Dx
How is this Tx
How is it Tx if PT is pregnant
KOH- pseudohyphae w/ budding spores
Fluconazole
Clotrimazole
Miconazole
Nystatins
How is Oropharyngeal candidiasis Tx
How is angular chelitis Tx
Nystatin (Peds)
Clotrimazole troche
Fluconazole
Topica antifungal then,
Group 5 steroid, d/c when inflammation is gone
How is Candidiasis intertrigo, diaper/balantitis cases Tx
What causes Pityriasis/Tinea Versicolor
Where is it found in the body?
Topical M/K/C-azoles
Pityrosporum orbiulare and P Ovale growth
Highly sebaceous areas: stratum corneum/hair follciles
What causes Pityriasis Versicolor yeast to change?
What is the changed form called?
Hot/humid climate
Budding form into mycolele form
How does Pityriasis Versicolor present?
What causes PTs to present to clinic?
Rapidly enlarging round macules of various color, turn darker LPP and darker in DPP
ASx w/ itch during inflammation
Appearance concerns
MC site of Pityriasis Versicolor
What other parts of the body may be affected?
Where are outbreaks MC seen in kids?
Mid chest, Upper back
Antecubital fossa
Neck
Extensive eruption- upper arm/lower face
Face
How is a Pityriasis Versicolor presentation different from a Pityriasis Rosia presentation?
How are these cases Dx
No Herald patch
Woods lamp accentuates altered pigmentation
KOH- short, borad hyphae in clusters, ‘spaghetti, meatballs”
How is Pityriasis Versicolor Tx?
What is used to prevent reoccurences?
Limited dz w/ topicals: Ketoconazole shampoo Selenium sulfide Extensive dz w/ POs: K/I/Fluconazole
Ketoconazole 2% shampoo preents re-occurrences
Define Sporotrichosis
What PT populations are most likely to have this condition?
Saprophytic funus (Sporothrix) in SQ tissue, MC, least serious deep infection
Florist Farmer Hunter
How does Sporotrichosis present
What is the MC site?
Painless papule/ulcer that increases in number over wks
Finger
How is Sporotrichosis Dx
How is it Tx
Punch/excision biopsy for stain and culture
Itraconazole x 3-6mon
What are the 3 types of hair
Terminal- thick, pigmented; required androgen to regulate growth
Vellus- short, fine; independent of androgens
Lanugo- fetal hairs
Average scalp has ? hairs w/ a growth phase lasting ?
How fast does hair grow?
100K
1000 days
0.3-0.4m/day
6”/year
What are the 3 stages of hair growth?
Anagen (growth), 100 hairs enter phase each day, majority of hairs
Categen (transition)
Telogen (resting), 100 lost per day
Define Pull Test
What result is neg/Dx
How do PTs prep for this test
60 hairs grasped and pulled from 4 areas of scalp
Neg= 6 or fewer hairs, normal Pos= more than 6 hairs, active hair shedding
Don’t shampoo 24hrs prior
Define Telogen Effluvium
This can be a following result of ?
Females w/ loss of resting hair, increases daily x 4wks
Delivery OCP d/c Weight loss
How is Telogen Effluvium Dx
What DDx must be ruled out?
CBC CMP
Serum ferritin
Thyroid panel
Anagen effluvium: chemo/rad, poison (thalium, aresnic)
How is Telogen Effluvium Tx
Male pattern baldness is AKA ?
Reassurance, Time for full recovery
Androgenetic alopecia from shorter anagen cycles
5a reduct: T into DHT
What are the two types of hair follicles and their sensitivity to androgens?
What age group can this be seen in?
How is Androgenetic Alopecia Tx
Top/vertex: sensitive
Side: insensitive
12-40y/o
Dutasteride PO
Topical Minoxidil
Finasteride PO
Who is the best androgenetic alopecia candidate for Minoxidil therapy?
How long does it take for results to be seen?
<30y/o w/ hair loss <5yrs
1/3 see results in 8-12mon
What is the MOA of Finasteride in the Tx of Androgenetic Alopecia
How long does it take for PTs to see results?
How long to PTs take this med but w/ ? potential s/e?
Inhibits T to Dihydro-T conversion
3mon
Indefinitely
Sex dysfunction
PT w/ BPH and Androgenetic Alopecia may benefit from ? med
? female PTs are more likely to develop Androgenetic Alopecia
Dutasteride- dual inhibitor of Type 1/2a 5a-Red
3x potency of Finasteride
Post-menopause d/t decrease of estrogen, causes increase of androgens
What labs need to be checked in females presenting w/ Androgenetic Alopecia
What can be used for Tx
DHEA-S
Prolactin
T
SHGB
Minoxidil
Define Alopecia Areata
Define Alopecia Totalis
Define Alopecia Universalis
Partial loss of any hair
Total loss of scalp hair
Loss of all hair
Define Alopoecia Areats
What saying may be used to describe the hair in these PTs
What type of pattern does it take on?
Sudden ASx hair loss
Exclamation point hair
Ophiasis- band hair loss in P/O/T lobes
? is the etiology of Alopecia Areata
How is this Tx
Autoimmune FamHx/genetic part
<10y/o: potent steroid + 5% minoxidil
+10y/o:
<50%: Triamcinolone (IL), Minoxidil
> 50%:
Minoxidil Anthralin Topical imm-therapy Systemic CCS
When is the prognosis for Alopecia Areats the best?
When is it the worst?
Even w/ resolution, how are these PTs different?
Adults first attack of a small area
Totalis, universalis or ophiasis
Hair grows back fine/white
Define Trichorrhexis Nodosa
How are they Tx
? lab work needs to be screened for
Brittle hair shafts due to over working causes weak points/nodes in shafts
Stop all hair Tx
Hypothryoidism
Define Folliculitis Decalvans
What are the etiologies of this condition
What microbe may be cultured from follicles and how is it Tx?
Chronic pustular eruptions of scalp, leads to permanent alopecia patch
Chronic bacterial folliculitis
Altered host response
Staph A
Clinda
Define Dissecting Cellulities
What can this condition cause to be formed on PTs heads?
How is it Tx
Rare inflammatory nodules in black men
Tracts, fibrosis and hypertrophic scars but PAINLESS
Isotretinoin
Define Hirsutism
What is the etiology
Terminal hairs on females in male-like patterns (face, chest, areolae)
High androgens
Inc sensitivity
What are 5 possible causes of hirsutism?
PCOS- MC cause of anovulatory infertility and hirsutism
Androgen secreting tumor (adrenal, ovary)
Cushing
CCS, PO
Obesity
How is Hirsutism managed
Define Hypertrichosis
Spironolactone
OCPs
Low dose CCS
Eflonithine- removes facial hair
Excess hair density, length Not androgen sensitive
? drugs can cause hypertrichosis
What non-medical issues can cause this condition?
Phenytoin
Cyclosporine
Minoxidil
Steroids
Genetic
Internal malignancy
? part of the nail has parallel ridges w/ vessels at the base
Define Hyponychium
Eponychium may be AKA ?
Nail bed
Segment of skin lacking nail cover
Cuticle
What nail variants may be seen on PTs w/ psoriasis?
What is the MC nail finding of Lichen Planus
What happens if the matrix becomes inflammed
Oil spots
Onycholysis
Longitudinal grooves/ridges
Pterygium unguis- proximal nailfold adheres to scarred matrix
? types of drugs can cause nail changes?
Define Onychomycosis
What DDx must be r/o
Chemo
Tetracyclines
Tinea of nails, aka Tinea unguium
Psoriasis
What step must be done prior to giving PO antifungals for onychomycosis Tx
What are the 3 types of patterns that may be seen
KOH and culture w/ 15 blade
Distal subungual- MC
White superficial
Proximal subungual
How is Onychomycosis Tx
What needs to be monitored in these PTs
Terbinafine
Itraconazole
CBC, LFTs
What med may be used for Onychomycosis that doesn’t involve the lunula
What med is used for distal lateral onychomycosis
Ciclopirox nail lacquier
Efinaconazole
How is Onychomycosis prevented
What two habits increase the incidence of brittle nails, especially in females?
Shoes/boots Don't pick nails Rotate foot wear/socks No communal showers Trim nails
Water imersion
Nail polish removers
How can brittle nails from chronic exposure be Tx
What can be used/added to toes to help prevent recurrent ingrown toenails?
B7, biotin, increases thickness
Phenol
Subungual hematoma is a result of trauma to ?
If severe, how is it Tx asap
Nail plate
Trephination
Define Habit-tic Deformity
Since the Tx is for PTs to stop, what is the underlying cause?
Longitudinal band of horizontal grooves w/ yellow discoloration from irritating proximal nail fold of thumb
OCD/psych
Define Acute Paronychia
How are they Tx
Rapid red/painful swelling of abscess on proximal/lateral nail
InD
Anti-Staph ABX
How are Pseudomonas infections under the nails Tx
What ABX is added for severe cases or Tx failures
Chlorine bleach/vinegar w/ water
Cipro
Define Beau’s Lines
Define Yellow Nail Syndrome
Transverse depressions of all nails at base of lunula weeks after stressful event, self resolves
Associated w/AIDS and respiratory/lymphedema dzs
What is the name of the angle measured for finger clubbing
Define Koilonychia
What is this finding associated w/ ?
Lovibond’s angle, >180 abnormal
Spoon nails- central depression, lateral elevation of plate
IDA
Define Mees Lines
What are the RFs
White line in nail plate
Sepsis RF/LF Arsenic poisoning CHF Chemo
Define Terry’s Nails
What are the RFs
White/pink nails retain 0.5-3mm distal band of normal color
Cirrhosis
CHF
Adult onset DM
Age
Define Sarcoptes Scabiei
What will Pts complain of
What is the most common location to see these?
Scabies mite from skin to skin contact
Itching worse at night
Finger webs Wrists Side of hand/feet Penis/butt/scrotum Palm/sole of infants
What med is used for Human Scabies Tx
What med is used when the PT population changes
What PT education needs to happen
Permethrin over night x 7days
Anti-histamine PRN
Inflamed skin- 1% HC in Eucerin
Institutions/Nursing home/Topical failure:
Ivermectin 12mg on day 1, 8
Worsening Sxs day 2-3 is not Tx failure
When/why would Lindane be sued for Scabies Tx
What PTs is this med c/i in?
Toxic from WW2
<2y/o, pregnant
What is the name of scabies?
How does this variant present differently
What underlying Dx must be considered
Norwegian crusted scabies
Very little itch, primarily on hand/face
HIV
Define Pediculosis
Where does Capitis present
How does Pediculosis Corporis present
Lice
Nits in hair
Red papules on neck
Red papules on wrist/ankles
Eyelash only in kids
What color does pediculosis show on Wood’s lamp?
These bugs can carry what two dzs?
Yello-blue green
Typhus
Trench fever
How is head lice Tx
How is body lice Tx
What would be the next test ordered/dx to r/o
1% Permethrin w/out shaving head
5% Permethrin
STDs
Where/how do fleas present
How are these Tx
Grouped red bites on ankle/lower legs
Antihistamine
Topical ABX/steroids
How doe bed bugs present
When is the best time to look for these
Pruritic edematous papules in rows of 3-5 bites
Look at night, 7mm
What is the name of the etiology of bed bugs
How are they Tx
What are the stages of bed bug development
Cimex lectularius
Antihistamines
Topical steroids
Egg
Stage 1-5
Adult
Define Chiggers
What is no longer an approved Tx method
Mites that attach to humans from grass
Nail polish removal
What is different about fire ant presentations
What scientific family do they belong to along w/ ?
Why is this grouping important?
Stings
Hymenoptera:
Bees- Apoidea
Wasps/Hornet/yellow jacket- Vespoidea
Ants- Formicidae
Allergic to one group, allergic to others
How are fire ant stings Tx
Brown spiders belong to ? family
Sarna lotion
Anti-histamine
Cool compress
Steroids if severe
Loxosceles
What type of venom do Brown Recluse carry
What do PTs complain of on presentation
Cytolytic venom, leads to necrosis
Erythematous lesion
PainLESS bite
What is the progression of a severe brown recluse reaction
What is the name for this sign
What department/surgeon may be consulted for grafting?
Hrs: Pain at site
24hrs: blister w/ blue discolor
3-4days: ecchymotic center
1wk: necrotic ulcer/eschar
Erythema Blanch Ecchymosis
(Red White and Blue) sign
GenSurg
North American recluse spiders rarely cause?
? PTs are more likely to have this
Systemic effects: F/C N/V Arthralgia Petechia
Peds
Since there is no anti-venom for brown recluse bites, how are these PTs managed
When is debridement considered?
Analgesic
Tetanus
ABX
> 2cm and 2-3wks later
What is the name of the Recluse look alike but lacks violin
Name of Black Widow genus
Hobo spider Tegenaria agrestis
Latrodectus
? type of venom do black widows have
This type of venom causes the body to release large amounts of ?
Neurotoxic
ACh, NorEpi
Define Latrodectism
What is the name of the lesion seen
Trunk spasms in abdomen/back from Widow bite
Target lesion- white center, red rim
How are Widow bites Tx
Creeping Eruption is AKA ?
This is ? MC
Benzos
Opioids
Antivenom for severe cases
Tetanus
Cutaneous Larva Migrans
MC skin dz among travelers in tropical countries
What causes Cutaneous Larva Migrans
How are these Tx
Dog/cat hookworm
Topical steroids
Severe: Ivermectin
Albendazole, topical for kids
Pseudomonas Cellulitis can occur around the ear due to ?
Pseudomonas cellulitis in DM PTs need to have ? monitoring?
External Otitis
Blood sugars
Wart infections can be divided into what 3 categories?
Latent- normal, nothing happening
Sub-clinical- nearly ASx
Clinical- active Sxs
Calvans Tx length
Dissecting cellulitis
Clinda x 10wks
Isotretinoin, not painful
Kerion, painful
