Derm JB Flashcards
basal cell carcinoma dx
punch/shave bx
basal cell carcinoma tx
electrodesiccation/ curettage MC in nonfacial
Mohs for recurrent or face
surgical excision
small superficial, nonfacial: imiquimod and 5FU
basal cell carcinoma description
translucent, pearly, waxy papule
central ulceration
raised/rolled borders
telangiectasia, bleed easily
bullous pemphigoid PE
- nikolskys sign
Tense bullae
bullous pemphigoid tx
high potency topical CS (clobetasol)
systemic CS, antihistamines, immunosuppressants
cutaneous anthrax PE
group of small bumps/blisters that may itch
swelling around sore
painless skin sore w/ black center (eschar)
cutaneous candidiasis tx
head/nails: oral “azole”
everywhere else: topical antifungals
dengue fever sx
biphasic rash (erythematous mottling, –> maculopapular rash that spares Palms and soles –> petechiae on extensor surfaces of limbs)
dermatophytes (tinea) tx
topical azole 1st line
dyshidrosis tx
high strength topical steroids
cold compress
systemic steroids
Erythema multiforme major sx
prodrome to SJS/TEN
looks like bad ringworm: target lesion w/ involvement >1 mucus membranes
type IV hypersensitivity rxn
hx of HSV or mycoplasma pneumonia
Med hx (sulfa drugs, b lactam, phenytoin)
erythema toxicum tx
spontaneously resolves in 1-2w
guttate psoriasis sx
hx of psoriasis in the past: nail pitting, oil spots, auspitz sign, koebners phenomenon, psoriatic arthritis)
small erythematous papule w/ fine scales
sausage digits
Extensor surfaces
Herpes type 3 (zoster) tx
acyclovir, valacyclovir famciclovir
give w/in 72h to prevent postherpetic neuralgia
impetigo sx
vesicles, pustules w/ honey colored crust
regional lymphadenopathy
on surfaces of the face
MCC impetigo
S. aureus
impetigo dx
clinical dx
gram stain and culture if atypical presentation
impetigo tx
mupirocin topically TOC
bacitracin
Extensive/systemic (fever): systemic abx (cephalic, dicloxacillin, clindamycin, erythromycin, azithromycin, clarithromycin)
intertrigo sx
aggravated by heat, moisture, friction
candida: satellite lesions
itching, burning, pain, stinging
lichen Planus sx
purple, polygonal, planar, pruritic, papules w/ fine scales and irregular borders
may develop koebners phenomenon
molluscum contagiosum sx
single or multiple dome shaped flesh colored to pearly white, waxy papules w/ central umbilication
curd like material may be expressed if squeezed
molluscum contagiosum tx
cantharidin
topical retinoids
benign neoplasm of axilla tx (seborrheic keratosis/lipoma)
seborrheic keratosis: no tx, cosmetic management
lipoma: no tx, cosmetic management
neurofibromatosis sx
> 6 cafe au lait spots, inguinal/axillary freckling, lisch nodules on the iris seen on slit lamp exam
soft fleshy skin tumors
optic pathway gliomas (afferent pupillary defect)
increase incidence of oral lichen planus with
HCV infection
pedunculosis pubis tx (crabs)
topical permethrin or pyrethrin
lindane 2nd line
ivermectin in refractory cases
pemphigus vulgaris sx
oral mucosal erosions/ulcerations –> painful flaccid bullae
+ nikolsky sign
bullae ruptures easily, leaving painful denuded skin erosions that bleed easily
pityriasis rosea dx
clinical dx
confirm w/ KOH to look for hyphae
pityriasis rosea tx
2.5% selenium sulfide shampoo
imidazole cream
PO fluconazole
psoriasis tx
mild/mod: high dose topical steroids 1st line
mod-sev: phototherapy, systemic tx (methotrexate, cyclosporine, retinoids, biologic agents)
scabies dx
often clinical dx
skin scraping of the burrows with mineral oil to ID mites/eggs in microscopy
scabies tx
permethrin topical head to toe for 8-14h
shower and repeat in 1wk
clothing/bedding should be placed in plastic bag for 72h then wash/dry in heat
melanoma tx
complete wide surgical excision w/ lymph node bx or dissection
+/- adjunct therapy” alpha IF, immune therapy, radiotherapy
SJS sx
fever and URI sx for 1-3d
painful oral and skin erythematous macule w/ purpuric centers
+ nikolskys sign
tinea capitis tx
PO griseofulvin 1st line
PO terbinafine, itraconazole, or fluconazole 2nd line
tinia cruris sx
“jock itch”: diffusely red rash on groin or scrotum
trichophyton infects keratinized tissues of skin, hair, nails
tinea cruris dx
KOH
woods lamp: green fluorescence if due to microsporum
tinea versicolor dx
KOH: hyphae and spores (spaghetti and meatballs)
woods lamp
cat bite, open wound tx
augmentin
