Dermatology Flashcards
1
Q
dry skin with severe pruritis
A
eczema (AD)
2
Q
categories of eczema
A
mild- infrequent itching, little effect on life
mod- frequent itching, mod effect on life, disturbed sleep
seve- incessant itch, widespread, affects life, lose sleep
3
Q
first line for mild eczema
A
low potency topical steroid BID 2-4 weeks
4
Q
first line for mod eczema
A
high potency topical steroid 1-2 weeks tapered to low potency
5
Q
first line for eczema on face or flexures
A
low potency steroids x5-7 days
6
Q
alternative topical CIs used for >2years and older with mild/mod eczema or in face/flexures
A
tacrolimus, pimecrolimus
7
Q
alternative for mild/mod eczema in 3 months and older when steroids cannot be tolerated
A
crisaborole ointment (eucrisa) BID
8
Q
alternative for >12 years in mild/mod eczema when other therapies ineffective
A
ruloxitinib cream (opzelura)
9
Q
maximum amount of ruloxitinib cream (opzelura) that can be used in a week
A
60g/week
100g/2weeks
10
Q
oral option for mod/sev eczema in those >12 years when other systemic therapies do not work or cannot be ussed
A
abrocitinib (cibinqo)
upacitinib (rinvoq)
11
Q
BBW for abrocitinib/cibinqo and upacitinib/rinvoq
A
serious infection, mortality, malignancy, MACE, thrombosis
12
Q
SC MoAbs used for mod/sev eczema when topicals do not work/not advised
A
dupilumab (dupixent)
tralokinumab (adbry)
13
Q
immunosuppressive options for mod/sev eczema
A
cyclosporine, methotrexate, azathioprine
14
Q
this class blocks cytokine transcription and inhibits T-cell activation
A
topical calcineurin inhibitors
15
Q
PDE-4 inhibitor oinment for eczema
A
crisaborole (eucrisa)
16
Q
JAK inhibitors for eczema
A
ruloxitinib cream (opzelura)
abrocitinib tabs (cibinqo)
upacitinib tabs (rinvoq)
17
Q
erythematous, indurated, scaly plaques caused by contact with an allergen
A
allergic contact dermatitis
18
Q
type of allergic contact dermatitis with redness, itching, swelling, and blisters 4 hours-4days after exposure to urushiol oil
A
toxicodendron dermatitis
19
Q
first line treatment for ACD
A
topical corticosteroids up to 2 weeks
high or medium potency depending on whether on face/flexures
20
Q
alternative for ACD that is localized or involves the face/intertriginous areas
A
topical calcineurin inhibitors
21
Q
topical calcineurin inhibitors do not work for what type of ACD
A
urushiol rash
22
Q
alternative for ACD >20% of BSA or on face/hands/feet/genitalia
A
systemic corticosteroids
23
Q
drying and soothing agents for ACD/ToxicoDerm
A
dry- aluminum acetate soak
sooth- oatmeal bath, calamine
24
Q
preventative option for toxicodendron dermatitis
A
bentoquatam
25
what does not help toxicodendron dermatitis
antihistamines do not help itch
TCIs not effective
26
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)
27
chronic relapsing condition with well-demarcated erythematous plaques, greasy/yellow scales, usually distributed in areas rich in sebaceous glands
seborrheic dermatitis
28
asymptomatic accumulation of greasy scales that are dark/yellow on infants between 2 weeks and 12 months old
cradle cap
29
topical antifungals than can be used for seborrheic dermatitis (4)
selenium sulfide
zinc pyrithione
ketoconazole
ciclopirox
30
AEs of selenium sulfide
discoloration of blonde, gray, or dyed hair
31
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
32
what ages can use selenium sulfide and zinc pyrithione
2 and older
33
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
34
AEs of ketoconazole
hair loss, skin irritation, abnormal hair texture, and dry skin
35
AEs of ciclopirox
ventricular tachycardia, contact derm, hair discoloration
36
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
37
alternative options for treating seborrheic dermatitis
coal tar, topical steroids, topical CIs, systemic antifungals (severe cases)
38
AEs of coal tar
stains hair, skin, linens, photosensitivity, irritant contact derm
39
application of coal tar
QD at bedtime, bath in morning to remove tar and loosen scales
40
treatment of cradle cap
baby shampoo, soft brush to remove scales
41
chronic autoimmune disorder with lesions that may be itchy and/or sore and may bleed
psoriasis
42
most common type of psoriasis, irregular red plaques , lesions covered in scales, Auspitz sign with bleeding after scale removal
plaque psoriasis
43
categories of plaque psoriasis
mild: BSA <3-5%
mod: BSA 3-10%
sev: >10%, affects emotion, hands, feet, scalp, or genitals
44
3 first line options for MILD plaque psoriasis
topical corticosteroids- match potency to severity
calcipotriene (dovonex)
calcitriol (vectical)
45
dosing & max of calcipotriene for plaque psoriasis
BID, max of 100g/week to avoid hypercalcemia
46
alternative options for plaque psoriasis (5)
tazarotene (tazorac), TCIs, anthralin, coal tar, salicylic acid
47
1st line option for mod/sev plaque psoriasis dosed once weekly
methotrexate
48
PDE4i used as an alternative in mod/sev plaque psoriasis for those who prefer oral without risk of immunosuppression
apremilast (otezla)
49
vit A derivative used as an alternative in mod/sev plaque psoriasis in combo with other agents, effect takes 3-6 mos
acitretin (soritane)
50
IL-12/23 inhibitors (2) MoAbs used as an alternative in mod/sev plaque psoriasis, not most effective
risankizumab (skyrizi)
guselkumab (tremfya)
51
IL-17A inhibitors (2) MoAbs used as an alternative in mod/sev plaque psoriasis, most effective biologic options
brodalumab (siliq)
ixekizumab (taltz)
52
tnf-a blocker MoAb with least efficacy used as an alternative in mod/sev plaque psoriasis
adalimumab (humira)
53
conjunctivitis type with morning crusting and thick pus in eyes
bacterial
54
treatment for bacterial conjunctivitis (2)
erythromycin 5mg/g ointment 1/2 inch QID x 5-7 days
trimethoprim/polymyxin B 0.1%-10,000 U/g drops 1-2 drops QID x 5-7 days
55
conjunctivitis type with burning/sandy/gritty feeling, watery discharge
viral
56
treatment option for both viral and allergic conjunctivitis
-vasoconstrictor/antihistamine: naphazoline/pheniramine
-mast stabilizing antihist: azelastine (optivar), ketotifen (zaditor), olopatadine (patanol)
57
conjunctivitis type with itching, hyperemia, tearing, chemosis, eyelid edema
allergic
58
conjunctivitis type with direct damage to ocular tissue causing redness, edema, mucous discharge, swollen/thickened eyelids
toxic
59
treatment for toxic conjunctivitis
loteprednol or other minimally preserved topical steroid for short course BID to QID
60
treatment for fleas
calamine, oral antihistamines, topical corticosteroids, ice packs, wash area, avoid scratching
61
treatment for bedbugs
low/med potency topical steroids, systemic antihistamines, avoid scratching
62
how to use nix (permethrin)
2 months and older
wash hair, towel dry so damp
apply and leave for 10 minutes
only retreat if needed
63
how to use rid
2 years and older
apply to dry hair, leave for 10 mins
second treatment must be done in 7-10 days
64
AEs of lindane (alternative for lice)
neurotoxicity, human carcinogen
65
alternative for resistant cases of lice
oral bactrim + topical permethrin
66
treatment for pubic lice
topical permethrin or pyrethrins/piperonyl butoxide
67
non medication option for lice
wet combing
68
main treatment option for scabies
permethrin (elmite) cream
69
application of permethrin for scabies
apply to body onto skin from neck to soles of feet including finger and toenails
remove by washing after 8-14 hours
reapply 1-2 weeks later
70
treatment for resistant scabies
ivermectin x 1 then repeat in 14 days
71
alternative for scabies, treatment failure common
crotamiton (crotan) cream or lotion
72
treatment for chiggers
topical antipruritic, topical steroids, oral antihistamines, repel with DEET
73
treatment for mosquito bites
antihistamine, topical or oral glucocorticoid
74
how old to use DEET
2 months and older
75
AEs of DEET
rare dermatitis, allergic reaction, neurotoxicity
76
what to use/application for bites
local anesthetics or counterirritants TID-QID up to 7 days if 2 years and older
77
oral treatment for alopecia
finasteride 1 mg
78
AEs of finasteride
orthostatic hypotension, dizziness, decreased libido, breast tenderness, impotence
hazardous for females of childbearing age
79
topical treatment for alopecia and application
minoxidil- apply 2 hours prior to sleep
solution 1 mL to bald area BID
foam 1/2 cap BID for males, QD for females
80
AEs of minoxidil
hypotension, dizziness, tachycardia, HA
81
pH of healthy skin
4.7-5.7
82
common drugs that cause acne
lithium, valproic acid, phenytoin, isoniazid, GCs, OCs, cyclosporine, azathioprine, disulfiram, phentermine, iodides, bromides, androgens, danazol, high dose B and D vitamins
83
names of topical retinoids
tretinoin, adapalene (differin), tazarotene
84
AEs of topical retinoids
irritation, dryness, flaking, transient worsening of acne, photosensitivity
85
how long to see improvement with topical retinoids
8-12 weeks
86
topical antimicrobials
benzoyl peroxide, clindamycin, erythromycin, dapsone, minocycline
87
topical antimicrobials are most effective in combination with
a topical retinoid
88
AE of topical clindamycin
risk of pseudomembranous colitis
89
AE of benzoyl peroxide
bleaching of hair/clothing, erythema, scaling, xerosis, stinging
90
when are benefits seen with benzoyl peroxide
minimum 3 weeks
maximum 12 weeks
91
oral antibiotics used for acne
tetracycline, doxycycline, minocycline, sarecycline, erythromycin, bactrim, azithromycin
92
which hormonal agents can and cannot be used for acne treatment
CHC- ethinyl estradiol + progestin
CANNOT USE PROGESTIN ONLY
93
inhibit androgen binding, used for acne treatment
spironolactone, drosperinone
94
dosing of isotretinoin
duration of course
0.5 - 1 mg/kg/day in divided doses with food
increase to 2 mg/kg/day BID
course given 15-20 weeks
95
micronized isotretinoin dosing
0.4-0.8 mg/kg/day in divided doses with or without food
96
contraception requirements for isotretinoin
2 forms simultaneously for 1 month before, during, and 30 days after treatment
abstinence acceptable if for religious reasons
97
dispensing of isotretinoin according to ipledge must be
not later than the do not dispense date before being reversed
-30 days for men
-7 days for women
98
AEs of isotretinoin
night blindness, PSYCHIATRIC, skin photosensitivity, eczema-like rash, dry lips, dry eyes, HA, etc...
99
contraindications to isotretinoin
pregnancy
underlying psychiatric conditions
concomitant use w/ tetracyclines, doxycycline, or minocycline (pseudotumor cerebri risk)
100
AEs of azelaic acid
burning, itching, redness, hives
101
storage of clascoterone cream
2-8C before dispensing
patients store at room temp
discard 180 days after dispensing or 30 days after opening
102
which medications work for post-inflammatory hyperpigmentation
hydroquinone cream, retinoids, azelaic acid, chemical peels
103
treatment for acne conglobata
isotretinoin, systemic antibiotics, intralesional steroids
104
types of exanthematous drug reactions
maculopapular rash, DRESS
105
drugs that cause maculopapular rash
penicillins/cephalosporins, sulfonamides, anticonvulsants
106
onset of maculopapular rash
7-10 days after drug
107
onset of DRESS
1-6 weeks after drug
108
drugs that cause DRESS
allopurinol, sulfonamides, anticonvulsants, dapsone
109
signs of DRESS
FEVER, exanthematous eruption, eosinophilia, organ involvement (esp. liver)
110
treatment of dress given organ involvement
yes--> systemic corticosteroids for 8-12 weeks
no --> high potency topical steroid BID-TID x1 week
111
types of urticarial drug reactions
urticaria
serum sickness-like
112
onset of urticaria
minutes to hours, minor
113
drugs causing urticaria
penicillins & related, sulfonamides,, aspirin, opiates, latex
114
onset of serum sickness-like reaction
1-3 weeks after drug
115
drugs causing serum sickness-like reaction
penicillins/cephalosporins, sulfonamides
116
types of blistering drug reactions
fixed drug eruption
SJS/TEN
117
onset of fixed drug eruption reaction
minutes to days, minor
118
drugs causing fixed drug eruption
tetracyclines, barbiturates, sulfonamides, codeine, phenolphthalein, APAP, NSAIDs
119
onset & presentation of SJS/TEN
within 7-14 days
fever, bullous formation, mucous membrane involvement, epidermal necrosis & sloughing
120
risk factors for SJS/TEN
HIV INFECTION, lupus (SLE), malignancy, UV light or radiation therapy, genetic
121
drugs causing SJS/TEN
sulfonamides, penicillins, anticonvulsants, NSAIDS (oxicams), allopurinol
122
topical antiseptic wound options for SJS/TEN
chlorhexidine, silver nitrate, silver SULFAdiazine, gentamicin
123
treatment options for SJS/TEN
which is preferred?
which is absolutely contraindicated
steroids
IVIG -- preferred
cyclosporine
thalidomide -- CI
124
drugs that cause skin photosensitivity
sulfonamides, tetracyclines, amiodarone, coal tar
125
drugs that cause skin hyperpigmentation
phenytoin, tetracyclines, silver, mercury, antimalarials, amiodarone
126
aminopenicillins (amoxicillin, ampicillin) have higher cross reactivity with...
cefadroxil, cephalexin, cefaclor, and cefprozil
