Dermatology Flashcards
dry skin with severe pruritis
eczema (AD)
categories of eczema
mild- infrequent itching, little effect on life
mod- frequent itching, mod effect on life, disturbed sleep
seve- incessant itch, widespread, affects life, lose sleep
first line for mild eczema
low potency topical steroid BID 2-4 weeks
first line for mod eczema
high potency topical steroid 1-2 weeks tapered to low potency
first line for eczema on face or flexures
low potency steroids x5-7 days
alternative topical CIs used for >2years and older with mild/mod eczema or in face/flexures
tacrolimus, pimecrolimus
alternative for mild/mod eczema in 3 months and older when steroids cannot be tolerated
crisaborole ointment (eucrisa) BID
alternative for >12 years in mild/mod eczema when other therapies ineffective
ruloxitinib cream (opzelura)
maximum amount of ruloxitinib cream (opzelura) that can be used in a week
60g/week
100g/2weeks
oral option for mod/sev eczema in those >12 years when other systemic therapies do not work or cannot be ussed
abrocitinib (cibinqo)
upacitinib (rinvoq)
BBW for abrocitinib/cibinqo and upacitinib/rinvoq
serious infection, mortality, malignancy, MACE, thrombosis
SC MoAbs used for mod/sev eczema when topicals do not work/not advised
dupilumab (dupixent)
tralokinumab (adbry)
immunosuppressive options for mod/sev eczema
cyclosporine, methotrexate, azathioprine
this class blocks cytokine transcription and inhibits T-cell activation
topical calcineurin inhibitors
PDE-4 inhibitor oinment for eczema
crisaborole (eucrisa)
JAK inhibitors for eczema
ruloxitinib cream (opzelura)
abrocitinib tabs (cibinqo)
upacitinib tabs (rinvoq)
erythematous, indurated, scaly plaques caused by contact with an allergen
allergic contact dermatitis
type of allergic contact dermatitis with redness, itching, swelling, and blisters 4 hours-4days after exposure to urushiol oil
toxicodendron dermatitis
first line treatment for ACD
topical corticosteroids up to 2 weeks
high or medium potency depending on whether on face/flexures
alternative for ACD that is localized or involves the face/intertriginous areas
topical calcineurin inhibitors
topical calcineurin inhibitors do not work for what type of ACD
urushiol rash
alternative for ACD >20% of BSA or on face/hands/feet/genitalia
systemic corticosteroids
drying and soothing agents for ACD/ToxicoDerm
dry- aluminum acetate soak
sooth- oatmeal bath, calamine
preventative option for toxicodendron dermatitis
bentoquatam
what does not help toxicodendron dermatitis
antihistamines do not help itch
TCIs not effective
2 treatment options for toxicodendron dermatitis
high potency topical corticosteroids
systemic corticosteroids if severe, or face/genitals (prednisone taper 2-3 weeks, medrol not long enough)
chronic relapsing condition with well-demarcated erythematous plaques, greasy/yellow scales, usually distributed in areas rich in sebaceous glands
seborrheic dermatitis
asymptomatic accumulation of greasy scales that are dark/yellow on infants between 2 weeks and 12 months old
cradle cap
topical antifungals than can be used for seborrheic dermatitis (4)
selenium sulfide
zinc pyrithione
ketoconazole
ciclopirox
AEs of selenium sulfide
discoloration of blonde, gray, or dyed hair
application of selenium sulfide
BIW to wet hair, leave for 10 mins, rinse
if using RX strength, decrease to once a week after 2 weeks of use
what ages can use selenium sulfide and zinc pyrithione
2 and older
application of ketoconazole
BIW x 4 weeks with at least 3 days between each treatment, leave in hair for 3 mins, once controlled use once a week for maintenance
AEs of ketoconazole
hair loss, skin irritation, abnormal hair texture, and dry skin
AEs of ciclopirox
ventricular tachycardia, contact derm, hair discoloration
application of ciclopirox shampoo and gel
shampoo: BIW x 4 weeks with at least 3 days between each treatment, leave in hair for 3 mins
gel: BID x 4 weeks
alternative options for treating seborrheic dermatitis
coal tar, topical steroids, topical CIs, systemic antifungals (severe cases)
AEs of coal tar
stains hair, skin, linens, photosensitivity, irritant contact derm
application of coal tar
QD at bedtime, bath in morning to remove tar and loosen scales
treatment of cradle cap
baby shampoo, soft brush to remove scales
chronic autoimmune disorder with lesions that may be itchy and/or sore and may bleed
psoriasis
most common type of psoriasis, irregular red plaques , lesions covered in scales, Auspitz sign with bleeding after scale removal
plaque psoriasis
categories of plaque psoriasis
mild: BSA <3-5%
mod: BSA 3-10%
sev: >10%, affects emotion, hands, feet, scalp, or genitals
3 first line options for MILD plaque psoriasis
topical corticosteroids- match potency to severity
calcipotriene (dovonex)
calcitriol (vectical)
dosing & max of calcipotriene for plaque psoriasis
BID, max of 100g/week to avoid hypercalcemia
alternative options for plaque psoriasis (5)
tazarotene (tazorac), TCIs, anthralin, coal tar, salicylic acid
1st line option for mod/sev plaque psoriasis dosed once weekly
methotrexate
PDE4i used as an alternative in mod/sev plaque psoriasis for those who prefer oral without risk of immunosuppression
apremilast (otezla)
vit A derivative used as an alternative in mod/sev plaque psoriasis in combo with other agents, effect takes 3-6 mos
acitretin (soritane)
IL-12/23 inhibitors (2) MoAbs used as an alternative in mod/sev plaque psoriasis, not most effective
risankizumab (skyrizi)
guselkumab (tremfya)