Derm Conditions

Question 1

Local Anesthetics - Can be

Answer 1

Can be applied topically to relieve pain and itching associated with skin disorders
Benzocaine
Lidocaine
Pramoxine

Question 2

Urticaria - 20%

Answer 2

20% prevalence in general population

Question 3

Urticaria - intensly

Answer 3

Intensely pruritic, erythematous plaque

Question 4

Urticaria - sometimes with

Answer 4

Sometimes with angioedema (swelling deeper in skin)

Question 5

Urticaria - trigger

Answer 5

Acute (<6 weeks); chronic (>6 weeks)

Question 6

Urticaria - acute

Answer 6

Acute (<6 weeks); chronic (>6 weeks)

Question 7

Urticaria - Prefered

Answer 7

H1 anithistimines
Second-generation (preferred*)
First-line
Minimally sedating
Some patients requiring higher than standard doses

First gen can also be used

Question 8

Urticaria - Glucocorticoids

Answer 8

Glucocorticoids – do not appear to be necessary in isolated urticaria
Brief course (one week or less) of systemic glucocorticoids could be added to anti-histamine therapy – patients with prominent angioedema or if symptoms persist past a few days
Suppress a variety of inflammatory mechanisms

Question 9

Drug-induced exanthems

Answer 9

most common cutaneous reactions to drugs (90% of all drug rashes)a
Exanthems, morbilliform, and macular and popular eruptions

Question 10

Pruritis - Can be due to

Answer 10

Can be due to a distinct dermatological condition or an occult underlying systemic disease.

Question 11

Pruritis - Can contribute to

Answer 11

Can contribute to a high burden, decreased quality of life

Question 12

Pruritis - Acute - Less than

Answer 12

less than 6 weeks

Question 13

Pruritis - Chronic

Answer 13

6 weeks or greater

Question 14

Identify underlying

Answer 14

dermatologic or systemic cause

Question 15

Non-pharmacological interventions

Answer 15

Stop medications that cause pruritis
Cool environment
Avoidance of skin irritants
Stress reduction

Question 16

Puritis managment

Answer 16

Topical and intralesional corticosteroids
Treatment inflammatory skin disease with outcome of relief of associated pruritis.
NOT indicated if no evidence of skin inflammation.
Systemic therapy – H1 antagonists (1st and 2nd)
TCA – doxepin (Sinequan) 25mg at night up to 150mg daily (divided doses)
Gabapentin (Neurotonin) 200 to 300mg nightly – dialysis patient, neurogenic pruritis.

Question 17

Irritant contact dermatitis (ICD) (80%

Answer 17

occupational) – direct cytotoxic action of an agent on the cells of the epidermis and dermatitis.

Question 18

Allergic contact dermatitis (ACD)

Answer 18

type 4 delayed hypersensitivity reaction (exposure to nickel, neomycin, fragrances).

Question 19

Atopic dermatitis (AD) –

Answer 19

pruritic inflammatory skin disorder, exacerbations and remissions of dry, itchy, red skin.

Common at 3 to 6 months of age
Associated with other atopic disorders (asthma, AR, urticaria, food allergy)

Question 20

Contact Dermatitis Management -

Answer 20

Avoidance of the offending agents
Handwashing to a minimum
Emollients
Medium-high potency corticosteroids (choice based on thickness, surface involved). Ointments often preferred
Topical calcineurin inhibitors

Question 21

ACD involving >20% of the body, involving face, hands, feet or genitalia

Answer 21

Prednisone

Question 22

Poison iv dermatitis severe

Answer 22

(involving face or genitlia) – 1m/kg/day tapered over 2 to 3 weeks

Question 23

Antihistamines – use in

Answer 23

ACD, unsure beneficial in contact dermatitis

Question 24

Atopic Dermatitis Management

Answer 24

Patient education
Eliminate exacerbating factors
Moisturization, control of inflammation, prevention of scratching.
Antihistamines
Emollient moisturizer
Bathing practices 
Controlling pruritis
Topical corticosteroid ointment
Calcineurin inhibitors
Prevent secondary skin infections
Systemic corticosteroids – extreme cases

Question 25

Herpes Zoster - unilateral

Answer 25

Unilateral within one dermatome (20%, adjacent dermatome)

Question 26

Herpes Zoster - prodrome

Answer 26

Prodrome – pain (stabbing, burning, aching, or excruciating), dysesthesia, or pruritis

Question 27

Herpes Zoster erythematous

Answer 27

Erythematous and maculopapular, becomes cluster of clear vesicles

Question 28

Herpes Zoster low

Answer 28

Low-grade fever, lymphadenopathy

Question 29

Herpes Zoster zoster

Answer 29

sine herpete

Question 30

Herpes Zoster - Uncomplicated – symptomatic treatment

Answer 30

prevention secondary infection

Question 31

Herpes Zoster Antiviral

Answer 31

Antiviral therapy
< 72 hours after onset
Greatest benefit in patients older than 50 years of age
> 72 hours after onset
New lesions are appearing
Choice based on cost, dosing
Acyclovir – 800mg five times daily x 7 days
Valacyclovir – 1000mg three times day x 7 days
Famciclovir – 500mg three times day x 7 days
Analgesics – narcotics
Topical cool moist compresses, Lidoderm patches
Adjunct therapies – gabapentin, TCA, oral steroids

Question 32

Pediculosis Capitis - Common condition

Answer 32

Common condition caused by infestation of the hair and scalp by Pediculus humanus capitis (the head louse)

Question 33

Pediculosis Capitis - Treatment

Answer 33

Multiple topical pediculicides

Wet combing – very young infants/want to avoid pediculides