Derm Review Flashcards

Question

folliculitis

Answer 1

-Inflammation/infection of hair follicle -Usually caused by bacterial or fungal infection -Papules, pustules common -Sweat (Staph or Pityrosporum) -Hot tubs (pseudomonas) -Shaving (pseudofolliculitis barbae) -tx: -Antibacterial soaps Antibiotics oral and topical Antifungals Mupirocin Warm compresses

Answer 2

Relatively common Commonly associated with a preceding Herpes simplex infection, Mycoplasma Pneumonia and respiratory infections Many other causes such as Infectious agents Allergens Drugs-sulfas/phenytoin/barbituates/PCN Connective tissue diseases X-ray therapy Pregnancy Internal malignancies Target Lesions-papules macules and sometimes vesicles Dusky red, round maculopapules appearing suddenly in symmetric pattern Backs of hands, feet, extensor surfaces of forearms and legs Target lesions “Iris” with centrifugal spread Unlike hives, lesions all mostly same sized Bullae and erosions may present in the oral cavity -tx: -Mild cases not treated -Topical steroids- no oral due to Herpetic factor -With Herpes infection, oral acyclovir may be given as prevention for reoccurring cases -May progress to SJS or TEN ****

Answer 3

Variants of the same condition Rare, acute serious and potentially fatal reaction to a medication Horrible blisters usually caused by drugs- antibiotics, anti-seizure meds and allopurinol and steroids Sheet like skin and mucosal loss Common in HIV infections 200+ medications associated -Clinical Features Fever >39*c Sore throat difficult swallowing Runny nose and cough Conjunctivitis Aches and pains Abrupt onset of tender painful red skin rash beginning on trunk Blisters form and merge to form sheets of skin detachment -tx: Stop Causative agent Transfer to burn center Other treatments –steroids, antibiotics IVIG all somewhat controversal

Answer 4

Males- Premature loss of hair in crown of scalp polygenic Gradual not abrupt Minoxidil Propecia blocks 5a reductase Decreased libido erectile disfunction Contra indicated in women Females diffuse hair thinning central scalp Polygenic Gradual not abrupt Minoxidil

Answer 5

Rapid onset of total hair loss in a sharply defined area (usually 1-4cm) MC found children and young adults Stress? Lab tests Thyroid, anemia, sex hormones, Biopsy -Treatment: Topical steroids Intradermal injections

Answer 6

Distal subungal MC type Many different species of fungus Fungus infiltrates and causes the nail to lift off the nail bed Trauma Trichophyton Mentagraphytes- White fungus Candida Albicans- yellow and brownish fungus In proximal nail fungus T Rubrum is MC cause (AIDS) -Treatment: Topical anti fungals - Ciclopirox Oral antifungals such as Lamisil, Sporonox, fluconazole -> worry about liver Keep nails short With orals, check liver function before and after treatment

Answer 7

-non necrotizing inflammation of the skin and sub cutaneous tissue -Breach in the skin- need a point of entry* Erythema Pain Swelling Warmth -Lymphangitic spread - streak up arm ** -Treatment: Cool compresses Elevation (if leg involment) Antibiotics aimed at staph and strep

Answer 8

Inflammatory form of Cellulitis Lymphatic involvement (streaking) More superficial Malaise, fever chills Well defined margins abrupt onset Causative agent is mostly Streptococci Also S. aurius, Pneumococcus organisms and Klebsiella TREAT WITH Penicillin

Answer 9

Common Contagious Superficial Strep or Staph aureus or combo*** After trauma or on normal skin Bullous and non bullous (crusted) Staph can colonize nose** MRSA -honey colored crust -tx:** Mupirocin (Bactroban) ointment Oral antibiotics Watch out for post Streptococcal Glomerulonephritis and nephritis Serious secondary infections (infants)

Answer 10

HSV 1: Most people have been exposed Skin to skin contact Viral shedding when there are no active sores Kissing, Sharing utensils… HSV 2: 20% sexually active adults carry Female Have other sexually transmitted Diseases Weakened immune system

Answer 11

Triggers Stress Illness Fever Sun exposure Menstruation Surgery -tx: Famvir Zovirax cream Valtrex For frequent infections you can prophalax with an antiviral Valtrex Cold sores 2 grams 2x a day for 1 day Genital Herpes 1 gram 2x a day for 10 days

Answer 12

Benign Lesions that appear anywhere on the body White, pink or flesh colored Umbilicated Itchy, red sore and swollen Highly contagious -pox virus* -tx: Cryotherapy (oweeeeeee) Cantharone Podophyllin Acids Retin A imiquimod -trigger inflammatory casade

Answer 13

Reactivation of the Chickenpox virus Virus lives in the dorsal nerve root and becomes activated Stress? Illness Imuno compromised Infection follows lines of Langer Rarely crosses midline! -tx: Famciclovir 500mg po q 8hrs x 7 days Acyclovir 800mg po q 4 hrs x 7-10 days Valacyclovir 1000mg po q3x a day x 7 days Pain meds prn PHN- Post Herpetic Neuralgia

Answer 14

Most common form of primary cutaneous malignancy Can occur at any age but primarily after 40 Rare in Asian and African Americans Variants- nodular, pigmented, superficial, morpheaform Pink or whitish pearly papule with underlying telangectasias

Answer 15

Goal of treatment is to eradicate tumor If criteria met, MOHS surgery is gold standard for removal EDC Topical chemotherapy Imiquimode- a topical immune-activating medication Risk factors include… Light skin Sunburns Radiation No genetic component but runs in families because of behaviorial practices

Answer 16

-Invasive primary cutaneous malignancy-can be deadly Primarily caused by accumulated UV light exposure Other factors include Radiation Chemicals- hydrocarbons, arsenic Tobacco Burns Hpv infections Spread within skin and lymph system Preceded by ACTINIC KERATOSES

Answer 17

MOHS surgery is most effective but not fool proof SCC’s can have “skip areas” Lymph node biopsy for invasive types Radiation therapy when surgical resection is not feasible Immunotherapy- Cetuximab

Answer 18

Increasingly common malignancy of melanocytes Incidence continues to rise at a faster rate than any other cancer Factors that increase risks Fair skin (Types I ans II) Atypical nevi Personal or family hx of Melanoma Hx of Blistering sunburns Early signs include: Change in existing mole size,shape and color Itching Tenderness Bleeding Ulceration No one size shape or color is diagnostic tx: Biopsy Biopsy Biopsy (Punch) Pathology will show Clarks Level or Breslow level The Thinner the Melanoma, better! Re excision of biopsy with appropriate margins Lymph node dissection Interferon-2a for stage II and III Targeted immunotherapy advances

Answer 19

-1-2 questions -body %