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Derm1 > Dermatitis - others > Flashcards

Dermatitis - others Flashcards

1
Q

Seborrheic Dermatitis Peak incidence pop

A

Infancy
Maternity
Teens - high hormones

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2
Q

Seborrheic Dermatitis Flares what time frame

A

Dry winter
Stress
Change hygiene - field

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3
Q

Seborrheic Dermatitis Is very serious in what pop?

A

Old w/ neuro issues

-dementia,stroke,parkinsons

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4
Q

Seborrheic Dermatitis Is very common when ass/w what dz process?

A

Aids

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5
Q

Seborrheic Dermatitis Morphology

A

Fine white/yellow greasy flakes
Inflamed base
Red papules
Annular w/ raised edge

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6
Q

Seborrheic Dermatitis Can cause

A

Cradle cap
2ndy staph inf if chronic
Prurituc

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7
Q

Seborrheic Dermatitis Distribution

A 
Scalp + margins
Eye brows/lashes
Nasolabial folds
Ext ear canals
Others - hair areas
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8
Q

Seborrheic Dermatitis etiology

A

Hereditary, environment, yeast.

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9
Q

Seborrheic Dermatitis Pathophys

A

Hyperprolif like CPP

Glandular issue - oily skin

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10
Q

Seborrheic Dermatitis management - shampoo

A
  • otc antidandruf (supfur/zinc for inflam areas)
  • selenium sulfide - dry flake
  • tar based - if like CPP
  • ketaconazole - yeast
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11
Q

Seborrheic Dermatitis management - topical steroids/others

A
  • Face - 1% HC
  • chest/back - triamcinolone spray
  • ears - fluocinolone sol
  • Dense scalp scaling - flucinolone C-IV
  • fungus - itraconazole
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12
Q

Atopic dermatitis is?

A

Chronic pruritic eczematous disease

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13
Q

Atopic dermatitis Pop it begins in?

A

Childhood - improves w/ age (remit/recur)

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14
Q

Hx correlated w/ Atopic dermatitis?

A

Atopy triad, sinusitis

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15
Q

Atopic dermatitis Morphology

A 
Erythema progressing to patchy/confluent papules/plaques w/...
-flaking
-xerosis
-excoriations
-fissures
Lichen/staph Inf 
Dermatographism
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16
Q

Atopic dermatitis Distribution adults

A

Bilat flexor creases
Hands, wrist, ankles
Neck, waist
Eyelids on face only

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17
Q

Atopic dermatitis Distribution children

2-12yo

A

Flexural areas
Face/scalp (honey crust)
Patchy or generalized body eczema

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18
Q

Atopic dermatitis Distribution infants

0-2yo

A

3rd month
Dry, red, scaling on cheeks
Progress to child distro

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19
Q

Atopic is AKA

A

Itch that rashes

-that itch causes eruptiveness

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20
Q

Eczematous essentially is

A

Dry > cracking > itch > rash

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21
Q

What are another two forms of atopic dermatitis

A

Ichthyosis vulgaris

Keratosis pilaris

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22
Q

Atopic dermatitis triggers

A 
Temp/sweat
Dry humidity
Excess washing
Irritative substances
Contact allergy
Aeroallergens
Foods/stress
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23
Q

Atopic dermatitis Management goals

A

Stop inf/inflam/triggers
Restore stratum corneum w/ emollients/anti-itch
Hydrate skin
Mild soap

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24
Q

Atopic dermatitis Inflam txt (adults/children)

A

Adults - Mid-high top CCS = triamcinolone

PEDs - C-V fluticasone propionate cream

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25
Q

Atopic dermatitis Txt inf

A

Abx- 1 for 10xD
Dicloxacillin
Erythromycin
Cephalexin

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26
Q

Atopic dermatitis Txt pruritus

A

Break itch-scratch cycle w/ hydroxyzine or benadryl

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27
Q

Atopic dermatitis Main txt creams/ointments (short/long term)

A

Pimecrolimus cream - no burn

Tacrolimus ointment - failed everything else burning sensation

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28
Q

MC inflammatory skin dz?

A

Eczema (not a dermatitis)

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29
Q

Eczema general attributes

A

Erythema

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30
Q

3 stages of eczema

A

Occurs in any order
Acute
Subacute
Chronic

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31
Q

Eczema acute appearance

A

Intense erythema/itch, vesicles, bullae

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32
Q

Eczema acute Etiology

A

Contact allergy
Acute nummular eczema
Stasis derm
Pomphylox

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33
Q

Eczema acute Txt

A

Cold/wet compress
(PO)/top CCS
AH
ABX -2ndy inf

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34
Q

Eczema subacute appears

A

Erythema, scaling, fissuring, parched look, scaling

Itch,pain,burn

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35
Q

Eczema subacute Etiology

A 
Contact allergy 
Irritant
Atopy
Nummular eczema
Asteatotic eczema
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36
Q

Eczema subacute Txt

A

Top CCS - prn occl.
Emollients after
AH or ABX

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37
Q

Eczema chronic appearance

A 
Thickened skin
Accentuated skin lines
Excoriations
Fissuring
Mod-intense itch
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38
Q

Eczema chronic Etiology

A 
Atopy
Habitual scratch
Lichen
Nummular ecz
Asteatotic ecz
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39
Q

Eczema chronic Txt

A

Top steroids w/ occl = best

AH, ABX, emollients

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40
Q

Another name for dyshidrotic ecz?

A

Pompholyx

41
Q

dyshidrotic ecz is/distro

A

Distinct rxn pattern w/ symmetric bilat vesicular hand/foot dermatitis localized laterally
W/ mod-sev itching prior to vesicles
+- hyperhidrosis (sweat)

42
Q

Dyshidrotic ecz MC pop?

A

1st - teens, then middle aged

43
Q

Dyshidrotic ecz Morphology

A

Multiple tiny deep seated vesicles (tapioca lesions) on palms/soles

44
Q

Dyshidrotic ecz May present w/

A

Red/wet pruritic palms/soles

45
Q

Dyshidrotic ecz Progression

A

Vesicles resolve 3-4wks
Become scales > lichen > cracking > peeling > fissuring
1st pruritis > pain

46
Q

Dyshidrotic ecz Management

A 
Lifestyle mod (avoid h2o irritants, diet)
CCS potent steroids then wean
ABX bacterial inf
-dicloxacillin
-erythromycin
-cephalexin
Itch - hydroxyzine
PUVA
Fail - low dose methotrexate
47
Q

Asteatotic ecz AKA

A 
Eczema craquele or
Winter itch (more itch than rash)
48
Q

Asteatotic ecz Etiology

A

Cold/dry weather

Long hot showers

49
Q

Asteatotic ecz morphology

A

Anterolat Low legs dry/scaly w/ xerosis
-can occur anywhere
Red plaques, w/ thin long horizontal superficial fissures (cracked porcelain)
Excoriation w/out other lesions.

50
Q

Asteatotic ecz Management

A 
Mods to skin care
-decrease baths/temp
-less/mild soap
Emollients often esp after bath
CCS- short term C-III-IV ointments 
Severe - wet dress/Abx
51
Q

Asteatotic ecz Severe presentation

A

Oozing, crusts, infection

52
Q

Nummular Ecz pop

A

Middle age-old

53
Q

Nummular Ecz Distro

A

Recur same spot every winter - MC back of hand

-also low legs, forearms, flanks/hips

54
Q

Nummular Ecz Presents w/

A

Intense itching > habitual > lichenification

55
Q

Nummular Ecz Morphology

A

Discrete, round, coin-shaped red plaque 1-5 cm diameter.
Intense erythema
Thin, sparse scales +- flakes
+- thick w/ vesicles on top

56
Q

Nummular Ecz Management

A

C III-V potent steroids 4-6wks (TAC MC) depends on thickness
Correct dryness
PRN antipruritic

57
Q

Lichen Simplex Chronicus aka

A

LSC or

Localized/circumscribed nuerodermatitis

58
Q

LSC is

A

Nerve entrapment ass/w Eczematous eruption from habitual scratching which is very satisfying.

59
Q

LSC is precipitated by

A 
Seborrheic Dermatitis
Atopic Dermatitis 
Nummular Eczema 
Irritant/contact dermatitis 
Other lichenification
60
Q

LSC pop

A

Any age - adults MC

61
Q

LSC Morphology

A 
Red papules coalesce to red scaly thick plaques w/ accentuation of skin lines
Lichen 2/2 excoriation/chronic rubbing
Cracks/fissures +-
Hyperpigmented 
Nodules - prurigo nodularis
62
Q

LSC Distro

A

Convenient areas to scratch/rub

63
Q

LSC basic Management

A

Long term therapy goal - soften/break lichen
Break itch-cycle
Emollients for dryness

64
Q

LSC rx management

A

Thick area - C-I clobetasol prop or betamethasone diprop
Nodules - intralesion TAC
Scratch in sleep - AH
Flurandrenolide - w/ plastic occl.

65
Q

Another name for LSC nodules

A

Prurigo Nodularis

66
Q

Pityriasis Rosea Pop

A

Young adults 10-35yo

67
Q

PR incidence higher when

A

Winter

68
Q

Pityriasis Rosea Pathogen ass/w

A

HHV 6
Or Hx - URI
Consider 2/2 syphillis

69
Q

Pityriasis Rosea S/S

A 
Asymp to very pruritic
Sudden onset (harold patch)
70
Q

Pityriasis Rosea Outcome

A

Self limiting
Resolves 6-8wks
Recurrent

71
Q

Pityriasis Rosea Morphology

A

Herald patch 2-10cm
1st/lrgst lesion - pt thinks ringworm?
Next lesion is during eruptive phase - macules/papules peak # 1-2wks
-round-oval 1-2cm plaques

72
Q

Pityriasis Rosea Distro

A

Christmas tree lesions/drooping skin lines on back
Herald patch or eruptive lesions- trunk/prox extremities
Eruptive conc on low Abd

73
Q

Reverse Pityriasis Rosea

A

Uncommon, affects neck, face, arms, legs, palm soles

74
Q

Pityriasis Rosea basic Management

A

Benign, self limited

Itch - top C-V CCS or AH

75
Q

Pityriasis Rosea Severe management

A

PO prednisone
UVB 2wks
PO acyclovir

76
Q

Lichen planus is

A

Unique inflam cutaneous/mucocutaneous membrane rxn

77
Q

Lichen planus Pop

A

20-60yo

78
Q

Lichen planus Presents

A

+- intensly pruritic
Flaring lesions - no cause or Rx/chem/transplant
Persists then fades
Can koebnerize

79
Q

5 P’s to Lichen planus

A 
Pruritic
Planar
Polygonal
Purple
Papules/plaques
(And persists - 6)
80
Q

Whats Wickhams straie? is ass/w?

A

Lichen planus - white lacy pattern crisscrossed lines on lesion

81
Q

Lichen planus Morphology

A

Primary lesion 2-10mm
Flat topped papules w. Irregular angulated polygonal borders
-wickhams straie
New lesions = pink-white progress to violaceous/purpke hue w/ waxy look

82
Q

Lichen planus Distro

A 
Acral - hands/feet/ankles/wrist
Extensor or flexor
Oral lesions- white/lacy painful erosions
Nail splitting
Scalp - scarring hair loss
Genital lesions
83
Q

Lichen planus Dx

A

Clinical - or Bx to confirm

84
Q

Lichen planus Localized Management

A 
Localized LP 
- top C I-II
- Intralesion inj
Mucous membranes
-CCS + adhesive base
-resist - Azathioprine
85
Q

Lichen planus Mucous membrane Management

A

Mucous membranes

  • CCS + adhesive base
  • resist - Azathioprine
  • Tacrolimus/pimecrolimus
86
Q

Lichen planus Generalized Management

A

PO CCS steroids 2-4wks

Bx - R/O SCC

87
Q

Contact Dermatitis Is a form of?

A

Eczematous dermatitis from irritants/allergies

88
Q

Contact Dermatitis Due to irritant patho?

A

Damages barrier (non-immunologic)

89
Q

Contact Dermatitis Due to allergic patho?

A

Antigen absorption (sensitized) > eruption (immunologic process)

90
Q

Dx of Contact Dermatitis?

A

Patch testing

91
Q

MC Irritant dermatitis

A

Occupational - hands

Diaper dermatitis

92
Q

Irritant dermatitis Morphology

A

Damage to stratum corneum
Inflamed, cracked, fissures skin, vesicular, exudative (acute-subacute)
Chronic - scaly, flaky, lichenified w/ less eryrhema

93
Q

Which is more common of the two contact dermatitis

A

Irritant dermatitis

94
Q

Irritant dermatitis Management

A 
Avoidance
Emollients as protective barrier
Cool compress - acutely
Severe - top CCS 
Wash cool water
95
Q

Allergic contact dermatitis MC

A

1 MC - Nickel

2 MC - Poison ivy

96
Q

Allergic dermatitis Morphology

A

Acute eczematous eruption
Red, swollen, vesicular bullous
Exudative > crusty
Intense pruritic

97
Q

Allergic dermatitis Distro

A

Usually well defined w/ The contact

98
Q

Allergic dermatitis Mangement

A 
Minimize avoid allergen 
Wet compress
Potent PO/top CCS 2-3w
AH
Triamcinolone spray

Derm1 (7 decks)

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