Dermatology Flashcards
Management of mild vs moderate vs severe acne
Mild: salicylic acid, benzoyl peroxide, retinoids, topical antibiotics (clindamycin or erythromcyin
Moderate: same plus oral antibiotics like minocycline or doxycycline
Severe: Oral isotretinoin
Management of moderate rosacea
Topical metronidazole
Most common cause of folliculitis and most common cause of hot tub folliculitis
Staph aureus and pseudomonas
Management of folliculitis
Topical mupirocin
Erythema multiforme vs stevens johnson syndrome vs toxic epidermal necrolysis
Erythema multiforme is characterized by type iv reaction to the skin following infection or medication exposure, has no fever or epidermal detachment (nikolsky sign) and is treated with symptomatic care
Stevens johnson syndrome is sloughing involving <10% of body surface involvement most often caused by medications like sulfa drugs and anticonvulsants, involves mucus membrane and has fever and uri prodrome, treated with discontinuation of causative agent and supportive therapy
Toxic epidermal necrolysis is like stevens johnson syndrome but involves >30% body surface area
Alopecia areata physical exam findings and how is it treated
Exclamation point hairs - short hairs broken off a few mm from the scalp with tapering near the proximal hair shaft
Treated with intralesional corticosteriods or topical corticoseroids and may resolve or progress to complete hair loss
Most common type of hair loss in men and women and treatmet
Androgenic alopecia, oral finasteride androgen inhibitor (advese effects can include decreased libido or sexual function)
Most sensitive test for onychomycosis
Periodic acid schiff test (even more sensitive than a koh wet mount!)
Most common causative agent in paronychia
staph aureus
Paronychia antibiotic treatment (2)
Cephalexin or dicloxacillin
Felon treatment
-I&D if fluctuant, if early without fluctuance then warm water or oral antibiotics like cephalexin
Eschar definition
Dry dark scab or falling away of dead skin
Erythema infectiosum definition
Fifth disease, caused by parvovirus b19, transmitted respiratory dropleets, manifests as nonspecific viral symptoms followed by erythematous malar rash with slapped cheek appearance followed by lacy reticular maculopapular rash on extremities, can see arthropaty or arthralgias, associated with fetal loss in pregnancy and can cause an aplastic crisis in patients with sickle cell or g6pd deficiency, primarily clinical diagnosis, self limited and treated supportive
Rubeola (measles) definition
Spread respiratory droplets or airborne causing URI prodrome with high fever and cough coryza and conjunctivitis followed by koplik spots (small 1-3 mm pale whitte or blue papules with an erythematous base on the buccal mucosa opposite the second molars and then a maculopapular rash beginning at the head and spreading caudally that lasts 7 days or so, primarily clinical diagnosis and supportive care mainstay of treatment
Most common cause of measles related deaths
Pneumonia
Hand foot and mouth disease definition
Caused by coxsackie virus spread primarily fecal oral or oral oral and presents in young children with mild fever, URI 3-5 days after exposure than an oral enanthem with painful oral vesicles surrounded by a thin halo of erythema followed by an exanthem often on the palms and soles that is usually not painful or pruritic, diagnosed mainly clinically and treated with supportive care
Herpangina definition
Caused by coxsackie virus especially type A that manifests as sudden onset high fever, small yellow white papulovesicular lesions on the posterior pharynx, clinical diagnosis, self limited and treated with supportive care
Most common causative agent of cellulitis and second most commoon
Group A strep, second is staph aureus
Lymphangitis
Streaking of skin representative of an infection of lymph vessels
Cat bite agent of concern and first line treatment and second line if allergic
Pasteurella multocida, augmentin, doxycycline if pcn allergic
Agents that cover mrsa (6)
- Clindamycin
- Doxycycline
- bactrim
- vancomycin
- Linezolid
- mupirocin
Most common cause of erysipelas
Group A strep strep pyogenes
Furuncle definition
Deep infection of the hair follicle most commonly caused by staph aureus treated with I&D most often
Most common causative agent of impetigo
Staph aureus
1st and 2nd line management of tinea capitis (scalp fungal infection)
Oral griseofulvin first line treatment, 2nd line oral terbinafine
1st line management of tinea cruris (jock itch)
clomitrazole topical antifungal
1st line management of tinea corporis (body fungal infection)
Topical antifungals like clotrimazole and ketoconazole
Intertrigo 1st line treatment
Topical antifungals like nystatin, clotrimazole or ketoconazole
Topical drug of choice for scabies and second line option
Permethrin or lindane
Topical drug of choice for lice and second line option
Permethrin or malathion
Kaposi sarcoma is most often seen in patients with HIV with a cd4 cound
100, presents as painless macular papular nodules palque like brown pink red or violaceous lesions, managed with chemotherapy or radiation for local disease
Diagnosis of a malignant melanoma
Full thickness wide excisional biopsy plus lymph node biopsy, shave biopsy discouraged
Malignant melanoma management
Complete wide surgical excision with sentinel lymph node biopsy
Most common type of skin cancer in the US
Basal cell carcinoma
Dyshidrotic eczema definition
Acute palmoplantar pruritic vesicular rash with small tense tapioca like vessicles on soles, palms, and fingers, treated with topcial corticoisteroids, don’t confuse for herpatic whitlow!!
Pityriasis rosea definition
Primarily seen in older children and young adults, mainfests as a herald patch (solitary salmon colored macule) on trunk followed by exanthem 1-2 weeks later, small very pruritic round or oval salmon colored papules with white circular scaling in a christmass tree pattern confined to trunk and proximal extremities, diaagnosed clinically and resolves on itst own, don’t confuse for tinea corporis
Pitriasis (tinea) versicolor first line treatment
Selenium sulfide
Infantile seborrheic dermatitis first line treatment
Ketoconazole if conservative observation does not resolve
Seborrheic dermatitis first line and second line management
Frist line selenium sulfide, second line ketoconazole shampoo
Vitiligo management
Topical corticosteroids
Melasma definition
Hyperpigmentation of sun exposed areas of skin, risk factors include increased estrogen exposure, sun exposure, family history, or darker complexion
Rule of 9’s burns
Head and neck =9 upper limb = 9 Trunk front = 18 Trunk back = 18 lower limb = 18 genitals = 1
1st-4th degree burn
1st degree manifests as erythema, pain, tenderness, dry appearance with no blistering
2nd degree has blistering, either very tender to touch or not painful with absent cap refill
3rd degree is full thickness characterized as painless, lack of blistering, lack of sensation
4th degree is to underlying fat muscle or bone
Most commonly used antimicrobial ointment on burns
Silver sulfadiazine or silver nitrate
ABG finding in carbon monoxide poisoning
increased carboxyhemoglobin level
Hydradenitis suppurativa maangement
Topical clindamycin first line
