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ECN > Derma > Flashcards

Derma Flashcards

1
Q

Germs en DHBN-FN: polymicrobienne et monomicrobienne

A

polymicrobienne: anaerobi, coc G+, Bacils n-
Monomicrobienne: Strep. pyogenes ++, S. Aureus

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2
Q

Germs pour myosite

A

souvent monomicrobienne: Clostridium perfringes

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3
Q

Quelles FN sount toujours plymicrobiennes?

A

perineales- gangrene de Fournier

cervicofaciales

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4
Q 
Porte entre germs en:
DHBN perineale
DHNB cervicogaciales
Myonecrose
pyomyosites
A

DHBN perineale- origine perineal, chirurgie
DHNB cervicogaciales- dentaire, amygdale, gl. salivaire
Myonecrose: chirurgie ou traumatisme
pyomyosites: traumatisme + S. aureus ou strep

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5
Q

Fdr pour DHBN-FN

A 
age
DZ
imunosuprimee
cancer
insufficience veineuse
lymphoedeme chronique
IRC
chirrhose
arteriopathie
alcoolisme
obesite

CT
AINS

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6
Q

Fdr pour DHBN avec SARM

A 
hospitalisation recente
contact
institution
atcd 
hemodyalise chronique
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7
Q

Signes de gravite eryzipele

A 
Locaux- extension rapide
Bulles hémorragiques 
Douleur intense
Hypoesthesie
Indurence
Livedo
Necrose
Creptitations

Systhemique: tachycardie, hypoTA, confusion, tachypnee, oligurie, paleur
(PAS FIEVRE)

Dz, imunodeprime, precarite

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8
Q

Jambe rouge aigue- suspicion erysipele- cat

A

Hemocultures- pas specifiques
Prelevement derma oui
Imagerie- sans delai le ttt: rx, eco, irm
Eco-doppler MI: recherce insuffisance veineuse
Nfs: hyperleucocyt
Iono, cpk, creat

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9
Q

Si on voit bulles aeroqies a rx de membre en suspicion de DHBN, ca dire anaerobie?

A

Non

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10
Q

Eryzipel dz- germs

A

Pseudomonas aeruginosa
S. Aureus
Anaerobies

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11
Q

On cherche quoi si on trouve de DHBN chez un diabetique?

A

Osteite et décompensation dz

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12
Q

Germs DHBN chez imunodeprime

A

Pseudomonas aeruginosa

E. Coli- si neutropenie

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13
Q

Erysipel cause a quelle bacterie si notion de morsure de chat ou chien et mane ration d’ os de porc?

A

Chien ou chat: pasteurellose d’ inocullation

Os de porc: rougte de porc: erysipelotrix rhusopathie

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14
Q

Dermo-hypodermite inflamatoire: panicullite MI- caracteristiques

A

Nodules et plaques inflamatoires hypodermiques

Cuisses ++, abdomen et bras

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15
Q

TTT erysipele- AB + autres

A

amoxicilline pour 10-15 J
ou prystinamicine, clyndamicine, macrolide

Bandes de contention
AC si thrombo-embolique

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16
Q

TTT si erysipele recidivant

A

a tous les 2-3 SA:
amoxi 0,5-1 g
prystinamicine 0,5-1 g
benzathine-penicilline- Extencilline

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17
Q

TTT si DHBN

A

Chirurgie en urgence- chirurgie large: des tissus nécrosés : peau, aponévrose superficielle, muscle
clyndamicine + penicilline a spectre elargie (tazocilline) ou cephalosporine +- aminoside +- metronidazol

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18
Q

Causes d’erythrodermie

A
  1. VIH
  2. Lichen plan
  3. medicaments
  4. psoriazis
  5. gale
  6. eczema
  7. lymphome cutane
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19
Q

Localisation typiques de psoriazis

A

coudes, genoux, jambes (mais pas PLIS)
région lombo-sacrée
cuir cevelou

20
Q

Localisation eczema du nourrison

A

convexites des membres, visage
tronc
cuir chevelu

21
Q

Def. eczema atopique

A

anomalies structurelles de la barriere cutanee

+ predisposition genetique

22
Q

TTT eczema atopique

A

dermocorticoides quotidiennes

23
Q

Hypersensibilite Ig-E type 1- maadies

A

urticaire

oedeme de Quincke

24
Q

Eczeme- hypersensibilite de quel type?

A

type 4

25
Q

Pyoderma gangrenosus- maladies associes

A

imuno:
Chron
PR

26
Q

Dif. entre pyoderma gangrenosum et angiodermitis necrosis

A

Pyoderma gangrenosum:

  • faxe extenseru de jambe
  • rouge
  • douloureuse
  • origine immuno
  • tt: corticoides

Angiodermitis:

  • noir, en carte geographique
  • douloureuse
  • origine arteriollaire
27
Q

Germs plus souvent DHBN

A

strep B hemolitique groupe A

28
Q

3 formes de rosacee

A
  1. papulo-pustuleuse
  2. vasculaire
  3. hypertrophique
29
Q

ttt rosacee: mineurs et diffueses

A

tt supresif
mineure: Métronidazole, Acazélaique, Ivermectinetopique pdt 3 mois

diffuse: Cyclines +/-topiques pdt 3 mois
+ photoprotection, larmes artificiales

30
Q

TTT pustulose exanthemique aigue general

A

dermocorticoides

stop medicaments

31
Q

pustulose exanthemique aigue generalise- en ? j ca apparait apres medicament? caracteristiques

A

< 4 J apres medicaments

  • fievre, AEG
  • plis, membres, tronc
  • sy. inflamateur
32
Q

Erythem polymorphe:

  • comment ca semble
  • association de..
  • localisation
  • causes plus frequante
A
  • lesions “ en cocarde” ou “ cibles” (3 circles concentriques: au millieu il y a parfoi une bulle)
  • associe: erosions des muqueuses
  • distribution acrale: pieds, mains, coudes, genoux, visage
  • herpes virus, Mycoplasma pneumonie
33
Q

Melanome: >= 2 criteres

A 
A: asymetrie
B: borders
C: colour
D: diametre > 6 mm
E: evolution
34
Q

Clasif. ancee

A 
G0: hyperpigmentation ou erytheme
G1: qqe. comedones et papules
G2: < 1/2 face
G3: > 1/2 face
G4: toute la face
G5: nodule, acnee vraiment inflamatoire
35
Q 
TT acnee 1er intention
G1
G2
G3
G4
A 
G1: peroxyde benzoil (PB) ou retinoides
G2: PB+retinoides 
G3: PB+retinoi ou cyclines po + retinoides ou PB
G4: cyclines po + PB+ R
G5: Izotretinine
36
Q

TT acnee 2eme intention (apres 3 M de tt initial)

A

G1: peroxyde benzoil + retinoizi
G2: 1. aug. tt initial. 2. AB local + Ret ou Ac. azaleic ou cycline po + BP + ret
G3: izotretionine po
G4: izotretionine po

37
Q

TT de mentainance acnee (G0)

A

adapalene
ou
adapalene + PB

38
Q

Evolution HSV

A
  1. vesicules: uniques ou multiples
  2. erosions: “en bouquet” ou simples + croutes
  3. cicatrisation
39
Q

TT HSV

A

acyclovir 200 mg X 5- 10 J ou

8 mg/kg pour 5-10 J

40
Q

l’hpv donne 3 types des verrues:

A

plantaire: HPV 1
plane: HPV 3
vulgaire: HPV2

41
Q

tt verrues

A

disparition sontanee
keratolytic: ac. salicilic, colloidon
TT agresif: cryoablation, CO2 (CI enfants)

42
Q

TT zona zoster: + antialgique
non-immunodeprime
immunodeprime

A

non-immunodeprime:
<50 ans sans att. conjonctival: pas TT
le rest: VALCICLOVIR 1gx3/J

Immunodeprime: ACICLOVIR IV
Antialgique palier II
- gabapentine, pregabaline, amitriptiline, patch lidocaine

43
Q

descrition urticaire

A

papule oedemateuses

44
Q

Gale- clinique

A

prurite intense, insomniant, epargant la visage
lesions interdigitales
vesicules perles, sillons scabieux, nodule

45
Q

tt gale

A 
Ivermetacine systhematique: 1 prise pui renuveller de 7a 14 J
Benzoat benzyl: topic
Permehirat: topic
Lavage a 60 d
- tt. la famille, partenaires sex

ECN (29 decks)

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