DERMA Flashcards
Which treatment is appropriate in order to avoid overuse of topical corticosteroids and minimize likelihood of flares in atopic dermatitis?
EMOLLIENTS
A 31/M, known to have asthma and allergic rhinitis, complains of difficulty sleeping due to pruritus of eczema. Which drug can benefit the patient?
Diphenhydramine
May be used as prophylactic treatment for AD
Tacrolimus Ointment
Systemic therapies used for wide spread and nonresponsive AD are
1. Cyclosporine 3-5 mg/kg/day (first line for refractory AD) 2. Mycophenolate mofetil 2 g/day 3. Methotrexate 10-22.5 mg/week 4. Azathioprine 1.5-2.5 mg/kg/day
What are the most common causes of irritant contact dermatitis?
either “wet,” such as detergents, organic solvents, soaps, weak acids and alkalis,
or
“dry,” such as low humidity air, heat, powders and dusts
Mainstay of diagnosis in allergic contact dermatitis. It has a sensitivity and specificity of 70-80%. Reproduces allergic contact dermatitis in an individual sensitized to a particular allergen.
Patch testing
The optimum timing of readings is day ___. An additional reading at day 6 or 7 will pick up a ~10% more positives that were negative at days 2 and 4.
2 and 4
A patient with chronic spontaneous urticaria reports persistent symptoms despite treatment with Cetirizine 10 mg tablet OD for the last 2 weeks. What should you do next?
Continue Cetirizine 10 mg tablet OD for another 2 weeks
- Which antihistamine is a standard treatment of acute spontaneous urticaria?
Loratidine
Cutaneous expression of the atopic state (family hx of asthma, allergic rhinitis or eczema)
Dermatitis
Characteristic defect in atopic dermatitis
Impaired epidermal barrier
Mutation of this protein in the stratum corneum is responsible for Impaired epidermal barrier in atopic dermatitis
FILAGGRIN
Clinical criteria for the diagnosis of atopic dermatitis
- Pruritus and scratching
- Course marked by exacerbations and remissions
- Lesions typical of eczamatous dermatitis
- Personal or family history of atopy (Asthma, AR, FOOD ALLEGIES, OR ECZEMA)
- Clinical course lasting longer than 6 weeks
- Lichenification of skin
- Presence of dry skin
Cutaneous stigma of AD
Perioral pallor
Extra fold of skin beneath lower eyelid ( DENNIE MORGAN FOLDS)
Increased palmar skin markings
Increased of cutaneous infections (esp STATUS AUREUS)
Macrolide immunosuppressants derived from soil fungi for AD
Tacrolimus ointment
Pimecrolimus cream
Preferred systemic antibiotics for secondary infections that exacerbates AD
DICLOXACILLIN (penicillinase resistance penicillines)
Cephalosporins (CEPHALEXIN)
Preferred systemic antibiotics for secondary infections that exacerbates AD if Dealing MRSA 7-10days
TMP SMX
Minocycline
Doxycycline
Clindamycin
May represent the end stage of a variety of pruritus and eczematous disorders.
Well circumscribed plaques with lichenified skin due to chronic scratching.
Lichen simplex chronicus
Common areas involved in Lichen simplex chronicus
Posterior nuchal region
Dorsum of the feet or ankles