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Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Scale

A

type of surface change resulting from excess stratum corneum (superficial layer of skin) that accumulates flakes or plates

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2
Q

Crust

A

hardened layer that results when serum, blood or exudate dries on skin surface

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3
Q

Pathophysiology of acne

A

Androgens in the circulation
Bacteria in the hair follicle
Follicular plugging
Sebum secretion

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4
Q

Rosacea

A

Rosacea is a common skin condition with characteristic symptoms and signs, including symmetric flushing, stinging sensation, inflammatory lesions (papules and pustules), and telangiectasias on the face.

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5
Q

Acrochordon

A

small, soft, common, benign, usually pedunculated neoplasm

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6
Q

AK definition

A

Actinic keratoses (AKs) are premalignant inflammatory skin lesions with the potential to transform into squamous cell carcinoma (SCC).

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7
Q

AK treatment

A

Liquid nitrogen (Cryosurgery) – freezing the affected tissue
5-Flurouracil (5-FU)
Aldara - has been approved in Canada and the US.
View the A-Detail™ on Aldara™.
Solaraze - Currently approved in the US only
Curettage / electro-desiccation
Excision – surgically removing the affected tissue (rare)
Photodynamic therapy

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8
Q

Lentigines description

A

A brown, sharply circumscribed macule resembling a freckle

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9
Q

AK description

A

a premalignant condition of thick, scaly, or crusty patches of skin
Ex: Well-circumscribed, 2cm, erythematous nodule with central ulceration and crust. The lesion is firm with palpation.

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10
Q

BCC

A
  • malignancy of the basal cells of the epidermis

- most common human malignancy

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11
Q

BCC RF

A
  • major risk factor is cumulative sun exposure, eighty-five percent occur on the head and neck, with the nose being the most common site
  • Usually in pt 40-80
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12
Q

BCC description (nodular)

A

translucent, waxy papule with a rolled, pearly border, telangiectasia, and often central ulceration.

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13
Q

Recurrence rates for surgical options for BCC

A

curettage and desiccation 10%
cryotherapy 10%
excision 2 - 5%
Mohs <1%

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14
Q

BCC superficial description

A

Superficial BCC occurs as irregularly shaped, slow-growing, circumscribed, round-to-oval, red, scaling plaque

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15
Q

Indications for TBSE

A

Personal history of skin cancer
Inc. Risk for melanoma - 2 first degree relatives, over 100 nevi
New rash on body
New patient with undiagnosed skin condition
F/u in patients with extensive skin conditions (ie psoriasis)

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16
Q

Frequently missed spots to look for skin problems

A

Medial canthi
Alar creases
Conchal bowl
Postauricular fold

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17
Q

Plaques

A

proliferation of cells in superficial dermis or epidermis

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18
Q

Acral distribution

A

distal aspects of the head (ears, nose) and the extremeties

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19
Q

Intertriginous distribution

A

in skin folds (axilla, crural, gluteal)

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20
Q

distribution pattern that follows sun exposed skin

A

Photodistributed

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21
Q

Random lesions in many body locations

A

scattered

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22
Q

superficial loss of the dermis

A

erosion

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23
Q

Erosion that involves the dermis

A

ulcer

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24
Q

Epidermis consists of

A

The epidermis is the topmost layer, and consists primarily of keratinocytes.

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25
Q

Dermis consists of

A

The dermis lies below the epidermis, and consists primarily of fibroblasts, collagen, and elastic fibers.

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26
Q

Beneath the dermis…

A

Subcutis

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27
Q

4 layers of epidermis

A 
Stratum corneum
Stratum granulosum (granular cell layer)
Stratum spinosum (spiny layer)
Stratum basale (basal cell layer)
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28
Q

Think of stratum corneum as a wall of bricks and mortar

A

Bricks: flattened keratinocytes filled with keratin and filaggrin
Mortar: lipid mixture, which surrounds the keratinocytes and provides the water barrier (lipids produced by granular layer)

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29
Q

Filagrin protein

A

retains water in the kerationocytes
- mutations cause atopic dermatitis, other
diseases of the skin

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30
Q

Psoriasis pathophysiology

A

rapid epidermal turnover (not enough time for differentiation at each level)

31
Q

3 types of cells that make up the epidermis

A

Keratinocytes Melanocytes Langerhans cells

32
Q

Melanocytes function

A

pigment producing cells, transfer their pigment to the keratinocytes in the basal cell layer

33
Q

Langerhans cells function

A

provide recognition, uptake procession and presentation of antigens to T cells for induction of delayed type hypersensitivity

34
Q

Dermis layers

A

Papillary and reticular

35
Q

Dermis function

A

support structure
contains blood and lymph vessels + nerves that supply the skin
contains sweat glands and hair follicles

36
Q

Cells of the dermis

A

fibroblasts and mast cells

37
Q

fibroblasts function

A

important for wound healing

38
Q

mast cells function

A

responsible for immediate type hypersensitivity reactions in the skin

39
Q

Sebaceous hyperplasia versus BCC

A

Yellow color, umbilication, and multiple similar papules help identify sebaceous hyperplasia
• BCC tends to be solitary and more friable (bleeds, scabs) – also more pearly translucent, often with telangiectasia

40
Q

Epidermal inclusion cyst

A

mobile subcutaneous nodule, often with an overlying punctum
- arise from hair follicles, not oil glands
Debris (dead skin cells, oil, etc.) collects within a sack

41
Q

Actinic keratosis differential

A 
Actinic keratosis 
Basal cell carcinoma 
Melanoma 
Seborrheic keratosis 
Squamous cell carcinoma 
Verruca vulgaris
42
Q

verruca vulgaris

A

Hyperkeratotic, exophytic (growing outward), dome- shaped papules or nodules
Punctateblackdots representing thrombosed capillaries

43
Q

type of wart morphologies

A

Verruca vulgaris: common warts
Verrucae planae: flat warts
Palmoplantar warts
Condylomata acuminata: external genital warts

44
Q

Side effect of cryotherapy

A

post inflammatory hyperpigmentation

45
Q

flat warts first line treatment

A

Cryotherapy
Salicylic acid (caution using on face)
Topical tretinoin

46
Q

external genital warts description

A

broad-based papules or large confluent plaques

HPV 11, 6

47
Q

molluscum contagiosum

A

smooth, dome-shaped papules with central umbilication

48
Q

Genital wart treatment

A

Cryotherapy
Imiquimod
Salicylic acid

49
Q

Classification of acne

A

Comedonal: open and closed comedones Inflammatory: papules and pustules Nodulocystic: nodules and cysts

50
Q

benzoyl peroxide MOA

A

antibacterial and comedolytic

51
Q

topical antibiotics

A

reduces P acnes and reduces inflammatory acne

Erythromycin 2% (solution, gel) Clindamycin 1% (lotion, solution, gel, foam)

52
Q

topical retinoids SE

A

dryness, pruritis, erythema, scaling, photosensitivity

53
Q

benzoyl peroxide SE

A

bleaching of hair, clothes, etc

54
Q

Topical agents for acne time of action

A

2-3 months

55
Q

Oral antibiotics for acne, uses

A

tetracycline, doxycycline, minocycline

Used for moderate to severe acne

56
Q

Tetracycline side effects

A

Are contraindicated in pregnancy and in children <8 years old
May cause GI upset (epigastric burning, nausea, vomiting and diarrhea can occur)
Can cause photosensitivity (patients may burn easier, which can be easily managed with better sun protection). Recommend sun block with UVA coverage for all acne patients on tetracyclines
tetracyclines DO NOT interfere with OCP
Takes 2-3 months for improvement

57
Q

Minocycline side effects

A

GI upset, vertigo, hyperpigmentation

58
Q

Acutane SE

A 
xerosis
cheilitis
elevated LFTs
hypertriglyceridemia
mood changes
pseudotumor cerebri
59
Q

seborrheic dermatitis

A

erythematous patches with greasy scale on the central face

60
Q

Tactuo

A

0.1% Adapalene (topical retinoid) and 2.5% benzoyl peroxide (60g), applied qHS or qAM

61
Q

Dovobet (Betamethasone dipropionate/Calcipotriol)

A

Psoriasis treatment

62
Q

tinea versicolor treatment

A

Ketoconazole 2% (Nizoral) Shampoo to skin x 5 minutes x 1 month
Topical 2.5% selenium sulfide solution (Selsun shampoo) x 10 min bid x 2 weeks
Canesten cream

63
Q

tinea capitis

A
  • Griseofulvin (Fulvicin U/F 15-20mg/kg) x 8wks

- Creams, Shampoos are ineffective, MUST have ORAL therapy

64
Q

Topical benzoyl peroxide with clindamycin

A

(BenzaClin® by Dermik)

65
Q

Topical benzoyl peroxide with erythromycin

A

(Benzamycin® by Dermik)

66
Q

Topical retinoid with erythromycin

A

(Stievamycin® by Stiefel

67
Q

Topical retinoid (tretinoin) plus erythromycin (Stievamycin® by Stiefel)

A

It should be applied to the affected areas once/day before bedtime after the skin has been thoroughly washed, rinsed and patted dry.

68
Q

Topical benzoyl peroxide plus erythromycin (Benzamycin® by Dermik)

A

A thin layer should be applied to the affected areas 1 to 2 times/day after the skin has been thoroughly washed, rinsed and patted dry. This product must be refrigerated and may bleach clothing.

69
Q

Topical benzoyl peroxide plus clindamycin (Clindoxyl® by Stiefel in Canada, Benzaclin® by Dermik)

A

It should be applied to skin that has been washed, rinsed and patted dry. This product does not need to be refrigerated.

70
Q

superficial basal cell carcinoma differential

A

basal cell carcinoma, nodular; eczema, nummular; tinea corporis

71
Q

dysplastic nevus differential

A

melanoma, superficial spreading; seborrheic keratosis

72
Q

nodular BCC differential

A

melanoma, amelanotic; nevus, intradermal; squamous cell carcinoma

73
Q

Eczema versus dermatitis

A

Eczema refers to an inflammatory process primarily involving the first layer of the skin. Dermatitis simply means inflammation of the skin by any cause.

Medicine (5 decks)

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