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Therapeutics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

dry skin with severe pruritis

A

eczema (AD)

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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

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3
Q

first line for mild eczema

A

low potency topical steroid BID 2-4 weeks

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4
Q

first line for mod eczema

A

high potency topical steroid 1-2 weeks tapered to low potency

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5
Q

first line for eczema on face or flexures

A

low potency steroids x5-7 days

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6
Q

alternative topical CIs used for >2years and older with mild/mod eczema or in face/flexures

A

tacrolimus, pimecrolimus

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7
Q

alternative for mild/mod eczema in 3 months and older when steroids cannot be tolerated

A

crisaborole ointment (eucrisa) BID

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8
Q

alternative for >12 years in mild/mod eczema when other therapies ineffective

A

ruloxitinib cream (opzelura)

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9
Q

maximum amount of ruloxitinib cream (opzelura) that can be used in a week

A

60g/week
100g/2weeks

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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)

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11
Q

BBW for abrocitinib/cibinqo and upacitinib/rinvoq

A

serious infection, mortality, malignancy, MACE, thrombosis

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12
Q

SC MoAbs used for mod/sev eczema when topicals do not work/not advised

A

dupilumab (dupixent)
tralokinumab (adbry)

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13
Q

immunosuppressive options for mod/sev eczema

A

cyclosporine, methotrexate, azathioprine

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14
Q

this class blocks cytokine transcription and inhibits T-cell activation

A

topical calcineurin inhibitors

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15
Q

PDE-4 inhibitor oinment for eczema

A

crisaborole (eucrisa)

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16
Q

JAK inhibitors for eczema

A

ruloxitinib cream (opzelura)
abrocitinib tabs (cibinqo)
upacitinib tabs (rinvoq)

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17
Q

erythematous, indurated, scaly plaques caused by contact with an allergen

A

allergic contact dermatitis

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18
Q

type of allergic contact dermatitis with redness, itching, swelling, and blisters 4 hours-4days after exposure to urushiol oil

A

toxicodendron dermatitis

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19
Q

first line treatment for ACD

A

topical corticosteroids up to 2 weeks
high or medium potency depending on whether on face/flexures

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20
Q

alternative for ACD that is localized or involves the face/intertriginous areas

A

topical calcineurin inhibitors

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21
Q

topical calcineurin inhibitors do not work for what type of ACD

A

urushiol rash

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22
Q

alternative for ACD >20% of BSA or on face/hands/feet/genitalia

A

systemic corticosteroids

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23
Q

drying and soothing agents for ACD/ToxicoDerm

A

dry- aluminum acetate soak
sooth- oatmeal bath, calamine

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24
Q

preventative option for toxicodendron dermatitis

A

bentoquatam

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25
Q

what does not help toxicodendron dermatitis

A

antihistamines do not help itch
TCIs not effective

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26
Q

2 treatment options for toxicodendron dermatitis

A

high potency topical corticosteroids
systemic corticosteroids if severe, or face/genitals (prednisone taper 2-3 weeks, medrol not long enough)

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27
Q

chronic relapsing condition with well-demarcated erythematous plaques, greasy/yellow scales, usually distributed in areas rich in sebaceous glands

A

seborrheic dermatitis

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28
Q

asymptomatic accumulation of greasy scales that are dark/yellow on infants between 2 weeks and 12 months old

A

cradle cap

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29
Q

topical antifungals than can be used for seborrheic dermatitis (4)

A

selenium sulfide
zinc pyrithione
ketoconazole
ciclopirox

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30
Q

AEs of selenium sulfide

A

discoloration of blonde, gray, or dyed hair

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31
Q

application of selenium sulfide

A

BIW to wet hair, leave for 10 mins, rinse
if using RX strength, decrease to once a week after 2 weeks of use

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32
Q

what ages can use selenium sulfide and zinc pyrithione

A

2 and older

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33
Q

application of ketoconazole

A

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

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34
Q

AEs of ketoconazole

A

hair loss, skin irritation, abnormal hair texture, and dry skin

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35
Q

AEs of ciclopirox

A

ventricular tachycardia, contact derm, hair discoloration

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36
Q

application of ciclopirox shampoo and gel

A

shampoo: BIW x 4 weeks with at least 3 days between each treatment, leave in hair for 3 mins
gel: BID x 4 weeks

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37
Q

alternative options for treating seborrheic dermatitis

A

coal tar, topical steroids, topical CIs, systemic antifungals (severe cases)

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38
Q

AEs of coal tar

A

stains hair, skin, linens, photosensitivity, irritant contact derm

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39
Q

application of coal tar

A

QD at bedtime, bath in morning to remove tar and loosen scales

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40
Q

treatment of cradle cap

A

baby shampoo, soft brush to remove scales

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41
Q

chronic autoimmune disorder with lesions that may be itchy and/or sore and may bleed

A

psoriasis

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42
Q

most common type of psoriasis, irregular red plaques , lesions covered in scales, Auspitz sign with bleeding after scale removal

A

plaque psoriasis

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43
Q

categories of plaque psoriasis

A

mild: BSA <3-5%
mod: BSA 3-10%
sev: >10%, affects emotion, hands, feet, scalp, or genitals

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44
Q

3 first line options for MILD plaque psoriasis

A

topical corticosteroids- match potency to severity
calcipotriene (dovonex)
calcitriol (vectical)

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45
Q

dosing & max of calcipotriene for plaque psoriasis

A

BID, max of 100g/week to avoid hypercalcemia

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46
Q

alternative options for plaque psoriasis (5)

A

tazarotene (tazorac), TCIs, anthralin, coal tar, salicylic acid

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47
Q

1st line option for mod/sev plaque psoriasis dosed once weekly

A

methotrexate

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48
Q

PDE4i used as an alternative in mod/sev plaque psoriasis for those who prefer oral without risk of immunosuppression

A

apremilast (otezla)

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49
Q

vit A derivative used as an alternative in mod/sev plaque psoriasis in combo with other agents, effect takes 3-6 mos

A

acitretin (soritane)

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50
Q

IL-12/23 inhibitors (2) MoAbs used as an alternative in mod/sev plaque psoriasis, not most effective

A

risankizumab (skyrizi)
guselkumab (tremfya)

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51
Q

IL-17A inhibitors (2) MoAbs used as an alternative in mod/sev plaque psoriasis, most effective biologic options

A

brodalumab (siliq)
ixekizumab (taltz)

52
Q

tnf-a blocker MoAb with least efficacy used as an alternative in mod/sev plaque psoriasis

A

adalimumab (humira)

53
Q

conjunctivitis type with morning crusting and thick pus in eyes

A

bacterial

54
Q

treatment for bacterial conjunctivitis (2)

A

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
Q

conjunctivitis type with burning/sandy/gritty feeling, watery discharge

A

viral

56
Q

treatment option for both viral and allergic conjunctivitis

A

-vasoconstrictor/antihistamine: naphazoline/pheniramine
-mast stabilizing antihist: azelastine (optivar), ketotifen (zaditor), olopatadine (patanol)

57
Q

conjunctivitis type with itching, hyperemia, tearing, chemosis, eyelid edema

A

allergic

58
Q

conjunctivitis type with direct damage to ocular tissue causing redness, edema, mucous discharge, swollen/thickened eyelids

A

toxic

59
Q

treatment for toxic conjunctivitis

A

loteprednol or other minimally preserved topical steroid for short course BID to QID

60
Q

treatment for fleas

A

calamine, oral antihistamines, topical corticosteroids, ice packs, wash area, avoid scratching

61
Q

treatment for bedbugs

A

low/med potency topical steroids, systemic antihistamines, avoid scratching

62
Q

how to use nix (permethrin)

A

2 months and older
wash hair, towel dry so damp
apply and leave for 10 minutes
only retreat if needed

63
Q

how to use rid

A

2 years and older
apply to dry hair, leave for 10 mins
second treatment must be done in 7-10 days

64
Q

AEs of lindane (alternative for lice)

A

neurotoxicity, human carcinogen

65
Q

alternative for resistant cases of lice

A

oral bactrim + topical permethrin

66
Q

treatment for pubic lice

A

topical permethrin or pyrethrins/piperonyl butoxide

67
Q

non medication option for lice

A

wet combing

68
Q

main treatment option for scabies

A

permethrin (elmite) cream

69
Q

application of permethrin for scabies

A

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
Q

treatment for resistant scabies

A

ivermectin x 1 then repeat in 14 days

71
Q

alternative for scabies, treatment failure common

A

crotamiton (crotan) cream or lotion

72
Q

treatment for chiggers

A

topical antipruritic, topical steroids, oral antihistamines, repel with DEET

73
Q

treatment for mosquito bites

A

antihistamine, topical or oral glucocorticoid

74
Q

how old to use DEET

A

2 months and older

75
Q

AEs of DEET

A

rare dermatitis, allergic reaction, neurotoxicity

76
Q

what to use/application for bites

A

local anesthetics or counterirritants TID-QID up to 7 days if 2 years and older

77
Q

oral treatment for alopecia

A

finasteride 1 mg

78
Q

AEs of finasteride

A

orthostatic hypotension, dizziness, decreased libido, breast tenderness, impotence
hazardous for females of childbearing age

79
Q

topical treatment for alopecia and application

A

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
Q

AEs of minoxidil

A

hypotension, dizziness, tachycardia, HA

81
Q

pH of healthy skin

A

4.7-5.7

82
Q

common drugs that cause acne

A

lithium, valproic acid, phenytoin, isoniazid, GCs, OCs, cyclosporine, azathioprine, disulfiram, phentermine, iodides, bromides, androgens, danazol, high dose B and D vitamins

83
Q

names of topical retinoids

A

tretinoin, adapalene (differin), tazarotene

84
Q

AEs of topical retinoids

A

irritation, dryness, flaking, transient worsening of acne, photosensitivity

85
Q

how long to see improvement with topical retinoids

A

8-12 weeks

86
Q

topical antimicrobials

A

benzoyl peroxide, clindamycin, erythromycin, dapsone, minocycline

87
Q

topical antimicrobials are most effective in combination with

A

a topical retinoid

88
Q

AE of topical clindamycin

A

risk of pseudomembranous colitis

89
Q

AE of benzoyl peroxide

A

bleaching of hair/clothing, erythema, scaling, xerosis, stinging

90
Q

when are benefits seen with benzoyl peroxide

A

minimum 3 weeks
maximum 12 weeks

91
Q

oral antibiotics used for acne

A

tetracycline, doxycycline, minocycline, sarecycline, erythromycin, bactrim, azithromycin

92
Q

which hormonal agents can and cannot be used for acne treatment

A

CHC- ethinyl estradiol + progestin
CANNOT USE PROGESTIN ONLY

93
Q

inhibit androgen binding, used for acne treatment

A

spironolactone, drosperinone

94
Q

dosing of isotretinoin
duration of course

A

0.5 - 1 mg/kg/day in divided doses with food
increase to 2 mg/kg/day BID
course given 15-20 weeks

95
Q

micronized isotretinoin dosing

A

0.4-0.8 mg/kg/day in divided doses with or without food

96
Q

contraception requirements for isotretinoin

A

2 forms simultaneously for 1 month before, during, and 30 days after treatment
abstinence acceptable if for religious reasons

97
Q

dispensing of isotretinoin according to ipledge must be

A

not later than the do not dispense date before being reversed
-30 days for men
-7 days for women

98
Q

AEs of isotretinoin

A

night blindness, PSYCHIATRIC, skin photosensitivity, eczema-like rash, dry lips, dry eyes, HA, etc…

99
Q

contraindications to isotretinoin

A

pregnancy
underlying psychiatric conditions
concomitant use w/ tetracyclines, doxycycline, or minocycline (pseudotumor cerebri risk)

100
Q

AEs of azelaic acid

A

burning, itching, redness, hives

101
Q

storage of clascoterone cream

A

2-8C before dispensing
patients store at room temp
discard 180 days after dispensing or 30 days after opening

102
Q

which medications work for post-inflammatory hyperpigmentation

A

hydroquinone cream, retinoids, azelaic acid, chemical peels

103
Q

treatment for acne conglobata

A

isotretinoin, systemic antibiotics, intralesional steroids

104
Q

types of exanthematous drug reactions

A

maculopapular rash, DRESS

105
Q

drugs that cause maculopapular rash

A

penicillins/cephalosporins, sulfonamides, anticonvulsants

106
Q

onset of maculopapular rash

A

7-10 days after drug

107
Q

onset of DRESS

A

1-6 weeks after drug

108
Q

drugs that cause DRESS

A

allopurinol, sulfonamides, anticonvulsants, dapsone

109
Q

signs of DRESS

A

FEVER, exanthematous eruption, eosinophilia, organ involvement (esp. liver)

110
Q

treatment of dress given organ involvement

A

yes–> systemic corticosteroids for 8-12 weeks
no –> high potency topical steroid BID-TID x1 week

111
Q

types of urticarial drug reactions

A

urticaria
serum sickness-like

112
Q

onset of urticaria

A

minutes to hours, minor

113
Q

drugs causing urticaria

A

penicillins & related, sulfonamides,, aspirin, opiates, latex

114
Q

onset of serum sickness-like reaction

A

1-3 weeks after drug

115
Q

drugs causing serum sickness-like reaction

A

penicillins/cephalosporins, sulfonamides

116
Q

types of blistering drug reactions

A

fixed drug eruption
SJS/TEN

117
Q

onset of fixed drug eruption reaction

A

minutes to days, minor

118
Q

drugs causing fixed drug eruption

A

tetracyclines, barbiturates, sulfonamides, codeine, phenolphthalein, APAP, NSAIDs

119
Q

onset & presentation of SJS/TEN

A

within 7-14 days
fever, bullous formation, mucous membrane involvement, epidermal necrosis & sloughing

120
Q

risk factors for SJS/TEN

A

HIV INFECTION, lupus (SLE), malignancy, UV light or radiation therapy, genetic

121
Q

drugs causing SJS/TEN

A

sulfonamides, penicillins, anticonvulsants, NSAIDS (oxicams), allopurinol

122
Q

topical antiseptic wound options for SJS/TEN

A

chlorhexidine, silver nitrate, silver SULFAdiazine, gentamicin

123
Q

treatment options for SJS/TEN
which is preferred?
which is absolutely contraindicated

A

steroids
IVIG – preferred
cyclosporine
thalidomide – CI

124
Q

drugs that cause skin photosensitivity

A

sulfonamides, tetracyclines, amiodarone, coal tar

125
Q

drugs that cause skin hyperpigmentation

A

phenytoin, tetracyclines, silver, mercury, antimalarials, amiodarone

126
Q

aminopenicillins (amoxicillin, ampicillin) have higher cross reactivity with…

A

cefadroxil, cephalexin, cefaclor, and cefprozil

Therapeutics (29 decks)

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