Dermatology Flashcards
Topical treatments for psoriasis.
Corticosteroids, vitamin D analogues, calcineurin inhibitors, tars, anthralin, tazarotine
Eosinophilic pustular folliculitis - timing, appearance, diagnosis (what NOT to miss), management
Timing = ~6 months, resolves by 3 years Appearance = itchy papules/pustules on red base, localized to scalp + brows Diagnosis = smear of pustule (eosino!), CBC (eosino!), r./o immunodeficiency (hyperIgE) Management = CC's, anti-histamine, anti-inflammatory
DDx for bruises
- Skin: Mongolian spots, hemaniomas, erythema multiforme, cultural (cupping)
- Coagulation d/o: hemophilia, vWD, ITP
- Autoimmune: Vasculitis, ITP, SLE
- ID: meningococcemia
- Onc: Leukemia, neuroblastoma
- Nutritional deficiency: Vitamin K
- Systemic illness: DIC
- Connect tissue d/o: Ehlers-Danlos, OI
Dermatological complication thought to be secondary to ischemic injury from perinatal complications + what test would you order?
Subcutaneous fat necrosis - hyperCa
DDx for dermatitis
- Atopic dermatitis
- Nummular dermatitis - circular
- Seborrheic dermatitis
- Irritant contact dermatitis
- Allergic contact dermatitis
- Scabies
- Immunodeficiency: Wiskott-Aldrich, Hyper-IgE Syndrome, SCID
Langerhans cell histiocytosis - what two features may they have that seborreic dermatitis does not
Petechiae/purpura, otorrhea
x3 causes of nail pitting
- Idiopathic
- Psoriasis
- Alopecia areata
Unique features of Pityriasis rosea
- Herald patch
- Christmas tree distribution
- Collarette scale
Treatment for Pityriasis rosea
- Should resolve by 3 months
- If symptomatic: topical steroids, anti-histamines
What area of the body does atopic dermatitis spare?
Groin + axilla
How does Guttate Psoriasis present + what is the treatment?
- Sudden onset multiple small papules
- Follows strep infection
- 10d penicillin
Psoriasis comorbidities
- Metabolic syndrome - cardiovascular disease, HTN, DM
- Autoimmune - IBD, arthritis
- Mental health
When do you check for uveitis in psoriasis?
If there is arthritis
What two derm conditions are related to each other in distribution + by Malassezia?
- Seborrheic dermatitis
- Pityriasis Versicolour
How to dx Pityriasis Versicolour
Clinical, can use wood’s lamp (yellow!)
Main difference between Pityriasis Versicolour, Pityriasis Rosea, and Tinea Corporis?
- PV: many colours, coalescing
- PR: collarette scale, Herald/Christmas
- TC: ring-shaped (aka ring worm)
How to tx Tinea Corporis?
- Scraping of lesion
- Topical anti-fungal BID until clear
- Avoid direct contact (e.g., wrestling)
What age group must you ALWAYS work up for acne?
1-7 year old
Oral Abx choice for acne + what must you also do
- Tetracyclines
- Erythromycin for <9 years
- ONLY to be used in combo with BPO
Side effects of isotretinoin
- Teratogenic!
- Labs - bHCG, lipids, LE’s
- CNS: night blindness, headache, pseudotumor cerebri
- MSK: myalgia, arthritis
- Skin: dryness, photosensitivity, acne fulminans
Tx for scabies including distribution of application
5% permethrin x8-14 hours, rpt 7 days later
-infant (scalp to toes), children (neck to toes)
Tx for scabies
(1) 5% permethrin x8-14 hours, rpt 7 days later
- infant (scalp to toes), children (neck to toes)
(2) prophylaxis for household members
(3) bedding/clothing
How does tinea capitis present?
- Single or multiple patches
- With or without partial alopecia
- Non-inflam = grey scale, black dots
- Inflam = erythema, scale, pustules, kerion
- Associated occipital LAD
Dx with occipital LAD + alopecia
Tinea capitis
Tx of tinea capitis
- Oral terbinafine x4-6 weeks
- Anti-fungal shampoo for pt + household
- Examine household members
Dx of tinea capitis
Scraping for KOH + fungal culture
DDx for alopecia
-Congenital
Focal:
- Alopecia areata
- Tinea capitis
- Trauma/traction
- Trichotillomania
Diffuse:
- Telogen effluvium*
- Anagen effuvium - chemo
- Androgenetic alopecia
- Alopecia areata - generalized type
- Hypothyroidism
- Lupus
- Iron deficiency anemia
What is telogen effluvium?
Diffuse alopecia develops 6 weeks to 4 months following an inciting event = severe emotional stress, surgery, medications, infection, or idiopathic
When is the most rapid growth for hemangiomas?
Between 1-3 months
When to consider treatment for hemangioma
- Cosmetically sensitive
- Risk of ulceration
- Impairment of function/vital structure
x4 situations when hemangiomas may be associated with systemic disease
- > 5 cutaneous IH’s = risk of visceral lesion (liver most common)
- Beard distribution = risk of airway lesion
- Segmental facial lesion = risk of PHACE
- Segmental lumbosacral/perineal lesion = LUMBAR
Work-up for PHACE
- Derm referral
- MRI/MRA head + neck
- Echo + ECG
- Optho
Classic three findings for Sturge Weber Syndrome
- Capillary malformation/Port wine stain (forehead)
- Glaucoma
- Leptomeningeal capillary-venous malformation
Most common cause of erythema multiforme
HSV
What group of conditions is vitiligo typically associated with?
Autoimmune conditions
Is there a prodrome for TEN/SJS?
yes - flu-like
What are you at risk for if there is a large congenital melanocytic nevus?
melanocytosis of the leptomeninges - increased risk of seizures
What derm condition can be thought of as mild atopic dermatitis and tends to be more pronounced in darker skin individuals?
Pityriasis alba
What is it - herald patch?
Pityriasis rosea
What class of medication to think of with photosensitivity skin reactions?
NSAIDs
What chronic derm condition can be triggered by strep?
Psoriasis
