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532 DERM > Dermatitis > Flashcards

Dermatitis Flashcards

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Dermatology Board Prep flashcards
1
Q

WHich dermatitis is called “the itch that rashes”?

A

Atopic Dermatitis

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2
Q

Which dermatitis is characterized by pruritic, erythematous, dry patches of skin, often with scale?

A

Atopic Dermatitis

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3
Q

Atopic dermatitis is associated with what findings?

A

Family/personal history of atopy
Xerosis or dysfunction of skin barrier
IgE reactivity

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4
Q

Which dermatitis is an immunological response due to cytokine production (not histamine)?

A

Atopic Dermatitis

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5
Q

Which dermatitis appears as dryness, patches and/or fissures on the palms of the hands and soles of the feet?

A

Dyshidrotic eczema

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6
Q

What are some triggers for dyshidrotic eczema?

A

metals

stress

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7
Q

What is the treatment for dyshidrotic eczema?

A

Moderate corticosteroids

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8
Q

What is the treatment for atopic dermatitis?

A

Mild to moderate topical corticosteroid - not >2wks

Topical calcineurin inhibitors (>2yo)

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9
Q

What does an atopic dermatitis superinfection look like?

A

Honey crusted lesions

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10
Q

What is the treatment for an atopic dermatitis superinfection?

A

Topical: mupirocin (Bactroban - also for impetigo)

Oral cephalexin or penicillin

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11
Q

Name an atopic dermatitis differential.

A

Herpes

Can do herpes culture to differentiate

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12
Q

Which dermatitis presents with single or multiple coin like plaques that occur anywhere on the body?

A

Nummular eczema

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13
Q

Which dermatitis is more common in cold weather?

A

Nummular eczema

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14
Q

What is the treatment for nummular eczema?

A

Hydration/emollient

Low-moderate topical corticosteroids

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15
Q

Name one differential for nummular eczema.

A

Tinea corporis (ringworm)

Tinea have sharply demarcated borders with scale at the edge and central clearing. Limited in number.
Do a skin scraping + KOH = hyphae

Eczema dx = xerosis + age + hx of atopy +early onset + relapsing

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16
Q

Which dermatitis reacts to metal from jewelry, leather from sandals or make up on the face?

A

Contact dermatitis

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17
Q

What is the treatment for contact dermatitis on the forehead?

A

Low potency TCS

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18
Q

What is the treatment for contact dermatitis on the back of the neck?

A

Moderate potency TCS

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19
Q

Which dermatitis presents with a vesicular rash in a linear fashion?

A

Contact dermatitis from poison ivy exposure.

This is a cell mediated reaction - the more they are exposed the more severe it gets.

20
Q

What is the treatment for poison ivy?

A

Moderate potency TCS (gel)
Antihistamine
Calamine lotion
Domeboro soaks for itching

21
Q

Which dermatitis is called the “lime and sunshine” rash?

A

Phytophotodermatitis

The oil in the lime gets on the skin and breaks out when exposed to the sun.

22
Q

What is the treatment for phytophotodermatitis?

A

Avoid sun exposure - will fade over time.

Hyperpigmentation can last for weeks

23
Q

Which dermatitis is chapped, shiny and parchment like and spares the skin folds?

A

Diaper dermatitis

24
Q

If diaper dermatitis appears with a rash in the inguinal folds what should you consider?

A

Fungal infection

Appears beefy red with satellite lesions

25
Q

What should you consider if treating dermatitis that does not improve?

A

Fungal infection

26
Q

What is the treatment for diaper dermatitis?

A 
Barrier/zinc oxide, Aquaphor
Avoid scented wipes
Frequent diaper changes
Air exposure
Hydrocortisone 0.5-1% thin layer 3x/d (5d max)
27
Q

Which dermatitis is known as cradle cap?

A

seborrheic dermatitis

28
Q

Which dermatitis presents as an erythematous rash with yellow flakey scales on the scalp, forehead, eyebrows and ears?

A

seborrheic dermatitis

29
Q

Which dermatitis peaks in infancy, again in adolescents and older patients with Parkinson’s’?

A

seborrheic dermatitis

30
Q

What is a complication of seborrheic dermatitis?

A

blepharitis

31
Q

What is the treatment for seborrheic dermatitis in infants?

A

Mineral oil 5-10 min before washing
Gentle brushing of scales
Frequent washing

32
Q

What is the treatment for seborrheic dermatitis in adolescents and adults?

A

Scalp
Tar, salicylic acid, ketoconazole, selenium sulfide
If severe, topical corticosteroid solution or foam

Face
Ketoconazole topical cream or shampoo
Intermittent low potency topical steroid

33
Q

A child has irritant contact dermatitis with lesions on the extremities and face. Which treatment is recommended for this patient?

a. Antihistamines
b. Medium- to high-potency topical corticosteroids
c. Oral corticosteroids
d. Topical calcineurin inhibitors

A

ANS: C
When periorbital regions or more than 20% of the body surface area is involved, the use of an oral steroid is appropriate. Antihistamines produce relaxation and improve sleep, but do not reduce the pruritus associated with contact dermatitis. Topical calcineurin inhibitors may be used in place of topical steroids, but oral steroids are indicated in this instance.

34
Q

A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient?

a. The rash is spreading through self-inoculation.
b. The vesicles may continue to develop for up to 2 weeks.
c. The rash may spread over the next 8 weeks.
d. The patient must have been re-exposed to the irritant.

A

ANS: B
Exposure to poison ivy resin results in vesicles and bullae that develop for up to 2 weeks. Once the resin is washed off, no further spread occurs. With insufficient treatment, the rash may persist, but not spread, for up to 8 weeks.

35
Q

Which is the primary symptom causing discomfort in patients with atopic dermatitis?

a. Dryness
b. Erythema
c. Lichenification
d. Pruritis

A

ANS: D

Itching is incessant, and patients usually develop other signs at the site of itching.

36
Q

A patient with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend?

a. Calcineurin inhibitors
b. Lubricants and emollients
c. Oral diphenhydramine
d. Prophylactic topical steroids

A

ANS: B
Emollients and lubricants are used long-term to reduce flare-ups. Calcineurin inhibitors can be helpful for managing chronic moderate to severe eczema. Oral diphenhydramine helps with symptoms of itching but is not used to prevent symptoms. Corticosteroids should be used sparingly to treat symptoms and stopped once the inflammation has subsided.

37
Q

A patient who has atopic dermatitis has recurrent secondary bacterial and skin infections. what will the provider recommend to help prevent these infections?

a. Bleach baths twice weekly
b. Frequent bathing with soap and water
c. Low-dose oral antibiotics
d. topical antibiotic ointments

A

ANS: A
Bleach baths and intranasal mupirocin have been shown to reduce bacterial superinfections of the skin. Frequent bathing with soap and water may increase flare-us and increase the risk for superinfections. Oral and topical antibiotic prophylaxis are not recommended.

38
Q

Which dermatitis is common in younger adults (20-40)?

A

Dyshidrotic eczema

39
Q

An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition?
Select all that apply.

a. Begin first-line treatment with a topical antifungal medication
b. Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo
c. Teach the patient that proper treatment is curative in most instances
d. Topical antibacterial medications may be used to prevent Malassezia proliferation
e. Use topical steroids for several weeks to prevent recurrence of symptoms

A

ANS: A, B
First-line therapy may include topical antifungals or corticosteroids. Adults with symptoms on the face or eyebrows are likely to have scalp lesions, since this is usually a “top-down” disorder. The condition is chronic and recurrent. Antibacterial medications are used for secondary bacterial infections but do not treat Malazessia, which is a fungus. Topical steroids should be used on a short-term basis.

40
Q

A patient with chronic seborrheic dermatitis reports having difficulty remembering to use the twice daily ketoconazole cream prescribed by the provider. What will the provider order for this patient?

a. Burrow’s solution soaks once daily
b. Oral corticosteroids
c. Oral itraconazole (Sporanox)
d. Selenium sulfide shampoo 2.5% as a daily rinse

A

ANS: C
Itraconazole is effective for moderate to severe symptoms and is an alternative for those who do not wish to use topical treatment. Burow’s solution and selenium shampoo rinses are not indicated. Oral corticosteroids are usually not given.

41
Q

An infant is brought to clinic with bright erythema in the neck and flexural folds after recent treatment with antibiotics for otitis media. What is the treatment for this
condition?

A. 1% hydrocortisone cream to affected areas for 1 to 2 days
B. Oral fluconazole 6 mg/kg on day 1, then 3 mg/kg/dose for 14 days
C. Topical keratolytics and topical antibiotics for 7 to 10 days
D. Topical nystatin cream applied several times daily

A

ANS: D

42
Q

A school­ age child has several annular lesions on the abdomen characterized by central clearing with scaly, red borders. What is the first step in managing this
condition?

A. Fluoresce the lesions with a Wood’s lamp.
B. Obtain fungal cultures of the lesions.
C. Perform KOH­ treated scrapings of the lesion borders.
D. Treat empirically with antifungal cream.

A

ANS: D

43
Q

A child has several circular, scaly lesions on the arms and abdomen, some of which have central clearing. The primary care pediatric nurse practitioner notes a smaller, scaly lesion on the child’s scalp. How will the nurse practitioner treat this child?

A. Obtain scrapings of the lesions for fungal cultures.
B. Order prescription­ strength antifungal creams
C. Prescribe oral griseofulvin for 2 to 4 weeks. Correct
D. Recommend OTC antifungal creams and shampoos.

A

ANS: C

44
Q

A child is diagnosed with tinea versicolor. What is the correct management of this disorder?

A. Application of selenium sulfide 2.5% lotion twice weekly for 2 to 4 weeks
B. Oral antifungal treatment with fluconazole once weekly for 2 to 3 weeks
C. Sun exposure for up to an hour every day for 2 to 4 weeks
D. Using ketoconazole 2% shampoo on lesions twice daily for 2 to 4 weeks

A

ANS: A

45
Q

An adolescent who had cradle cap as an infant is in the clinic with thick crusts of yellow, greasy scales on the forehead and behind the ears. What will the primary care pediatric nurse practitioner recommend?

A. Daily application of ketoconazole 2% topical cream
B. High ­potency topical corticosteroids applied daily
C. Mineral oil and shampoo on the affected areas
D. Selenium sulfide shampoo twice weekly to the face

A

ANS: A

532 DERM (8 decks)

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