Dermatology Flashcards by Sharifa Avery

Kid has exfoliated lesions dx? Rx?

Scalded skin syndrome. Oxacillcin for MSSA.

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Kid has exfoliated lesions dx? Rx?

Scalded skin syndrome. Oxacillcin for MSSA.

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Flat scaly dry papules that can turn into squamous cell carinoma. Dx? Rx?

Actinic keratosis. Avoid sun.

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Kid has red macules and papular lesions with honey crusts. Dx? Rx?

Impetigo. Remove crust by soaking in warm water. Antibacterial washes (Benzyol peroxide). Bactroban/Bacitracin if dz is limited. Oxacillin if more severe (MSSA)

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Slow growing, rarely metastasizes dues to excessive sun exposure, located on sun exposed areas, Shiny, pearly, w/ central depression, overlying telengectasia and ulcerated. Dx? Test? Rx?

Basal cell carcinoma. Skin biopsy pallisading cells w/ retraction. Currettage, cryosurgery, radiation, excision. MOHS for lesions of face that are difficult to reconstruct.

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Sausage like finger, dactilitis, oncholysis and scaley silvery skin papules

Psoriatic arthritis.

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Alopecia, bullous and pustular lesions, impaired wound healing. What vitamin deficiency is this?

Zinc

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Rx for psioriasis?

1: Topical Steroid, topical, Vit D, topical Vit A. UVB, PUVA if UVB does not do it. Methotrexate, anti-TNF agents

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Eczema (Atopic Dermatitis) Rx?

Avoid scratching, lubricate skin, avoid wool, fragrances, harsh cleansers. 2. Low potency steroid cream (hydrocortisone), moderate to high potency (triamcilone and bethemesone), calcineurin inhibitors tacrolimus (good for face, eyelids) 3. Phototherapy or systemic immunosuppressants if severe.

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Erythematous rash w/ targetoid lesions on the palms and soles, back of hands that occur after HSV , drug iodpathic, rapidly progressive, associated with fever and malaise. Dx? Rx?

Erythema multiforme. Anti-histamines for itching. Steroids for 3 wks for severe form. Acylovir for HSV related lesions.

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Rash located on baby pelvic area.. Prolonged damnpness, interaction of urine (ammonia) and feces with the skin, reactions to medications/creams, type diaper. Dx? Rx?

Diaper Rash. Keep infant dry, change diapers often. Avoid harsh detergents, wipes with alcohol and plastic pants. Diaper ointments can reduce friction. Avoid powders.

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Scaly, Flaky, Greasy plaques on scalp, face, chest Chronic and recurrent occurs at sites with sebaceous glands activity. Dx? Rx?

Seborrheic Dermatitis. Antiseborrheic shampoo. topicla antifungals (ketacanazole, selenium sulfide) may need 1-2weeks retreatment, oral if severe, Topical steroids, topical calcineurin inhibitor (tacrolimus.)

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Pearly, shiny, umbilicated white papules. Dx? Test? Rx?

Molluscum Cantagious (Viral) SKin to skin contact. HIV testing may be indicated. Clinical. Cryotherapy.

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Strawberry tongue, sore throat, fever, sand paper like rash. Dx? Test? Rx?

Scarlet fever. Clinical. Acetominophen fever and pain. Abx (Penicillin) for the infection. Follow up recommended if hx of rheumatic fever.

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Multisystem dz with mucocutaneous lymph node syndrome, FEVER for 5 DAYs!, bilateral conjunctivitis, injected pharynx, cracked lips, strawberry tongue, edema, desquamation of extremities, polymorhic rash, cervical lymphadenopathy. Dx?

Kawasaki Dz

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Test and Rx for Pediculosis corporis, capitis, and pubis.

Lice (Nits) Detectable on hair/fibers. Hot water laundering, Boil or dispose implements. Comb hair. Premethrim rinse.

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Rx for pytiairis ? (Herald Patch, Christmas Tree)

Remits 6 to 12 weeks.

Older person with scattered dark purple areas on her hands and forearms without associated pain or itching. CBC, coagulation studies are all normal. Dx?

Senile purpura from perivascular connective tissue atropy.

16 yo girl with hx of SLE presents with progressively worsening acne. Just had an episode of SLE flare up and was given prednisone. Dx?

Steroid induced folicullits. (Cushionoid Syndrome Increased androgens/stress hormone)

Rx: 1. Comedal acne 2 .Inflammatory Acne? 3. Nodular (Cystic) Acne

Topical Retinoids 2. Add topical abx, oral if more severe 3. Add Oral isoretonin

Dental worker presents with vesicles on his index finger. Dx?

Herpatic Whitlow caused by Herpes 1 or 2.

Management of reccurent chalalzion (on the upper eye lid as oppose to stye? and why?

Biopsy for histopathalogical examination because it can develop into carcinoma.

Post injury pt develops purpulish discoloration of the leg. Dx? Management?

Necrotizing Fascitiis. 02, IVF, Broad spectrums and surgical debreidment.

Rx and prevention of poison ivy?

Washing 2 hrs after exposure, Oatmeal baths, Topical steroids or oral steroids if severe enough ( Oral prednisone Taper 14 or 21 days). Avoid the wooded areas is the best prevention.

Test and Treatment for Tinea Corporis, curis, pedis, capitis, facialis. Onconmycosis. Tinea versicolor.

Clinical then confirm with KOH Mount. (Septal Hyphae) Rx: Where ventilated clothes, dry well. Topical antifungal agents.

Skin cancer associated with organ transplant and long-term use of immunosuppressive drugs. Dx?

Squamous Cell Carcinoma.

Severe variant/progression of erythema multiform with widespread involvement. (Hypersensitvity Reaction) Prodrome of fever and flu like illness. Pt develops pruritis, pain, tenderness, and burning. Involves 10 to 20% of the surface body. Dx? What is the diagnosis if it involves >30%? Rx?

Steven Johnson Syndrome. >30 %TEN Toxic Epidermal Necrolysis. Removal and or treatment of causative agent. Hospitilzatin for severe dz. Fluid and electrolyte replacement. Common cause of death of TEN is sepsis.

Associated with HIV, Hep C, Hemacrhomatosis, Oral contraceptives. Pts develop nonhealing blisters in sun exposed areas. Dx? Test? Rx?

PTC (Porphyria Cutanea Tarda) Lack of uroporhyrinogen decarboxylase. Urinary uroporphyrins. Stop drinking alcohol and discontinue all OCPs. Sun protection. Defuroxime or phlebotomy to remove iron stores.

Can be idiopathic or caused by drugs. Bullae stay in tact. Negative Nikolsky Sign. First step in management?

Bullous Pemphigoid - antibodies against the basement membrane (of the dermal/epidermal region) proteins that lead to subepidermal bullae. Skin biopsy and serum assay of antibodies to confirm diagnosis hard to differentiate between, pemphigus, deramatitis hepatformis and linear igA. Topical Steroids, immunosuppresants.

Tender/Painful red/Violet nodules commonly occur in women associated with sarcoid and IBD. Dx? Rx?

Erythema nodosum. Treat underlying disease. NSAID because self limiting disorder.

Exposure to allergen, pattern of lesions often reflect mechanism of exposure weeping vesicles that ruptured and crust. Dx? What test can you do? Rx?

Contact dermatitis. Patch testing if etiology is not clear. cold compress, oat bath, avoidance of irritant. Steroids if no improvement.

Pink plaques w/ scale that spread to lymph nodes, actinic keratoses are pre-malignant. Dx? Test? Rx?

Squamous cell carcinoma. 2nd most common skin cancer. Skin biopsy. Surgical excision, MOHS.

Malignant proliferation of melanocytes Dx? Test? Rx?

Melanoma. Skin biopsy. Surgical excision, adjuvant therapy for advanced disease.

Can be idiopathic or caused by drugs (ACE-I). Pts develop bullae that easily rupture, involvement of the mouth, fluid loss and infection can occur if widespread. Positve Nikolsky Sign. Dx?Test? Rx?

Pemphigus Vulgaris auto-antibodies targeting desmoglein 3 and 1 in the desmosomal complex (Epidermal Region). Skin biopsy and serum assay of anti-bodies. Topical steroids, immunosuppressants.

Rx for psioriasis?

1: Steroid 2. Vit D (calcipotrene) derivative 3. Vitamin A derivative (tazarotene) PUVA, PUVB, Phototherapy. 4. Methotrexate, inflixiamb, cyclosporine (immumodulators)

1. Ulcer at the heel of the foot? 2. Ulcer above the medial malleous? 3. Ulcer at tip of toe and toe is blue Management of each?

1. Diabetic foot ulcer (regulate glucose, elevated foot eventual amputation) 2. Venous stasis ulcer (Doppler studies, UNA boot and compression stockings 3. Ischemic ulcer (Doppler and CT angio to check for revasculrization.)

Intensely puritic papules, vesicles in between fingers, wrist, elbows, axillae. Dx? Test? Rx?

Scabies. Primethrin. Orla ivermeticin for serious outbreaks. Skin scrapings. Rx of household contacts. Laundering of bedding and clothing.

Mutolptiple, coalescing, small circular masculae (white, pink, brown in color hypopigmented compared to baseline skin, more apparent spring and summer? Dx? Test? Rx?

Tinea Versicolor. KOH mount for yeast and hypea. Ketacanazole.

Painless blisters, increase fragility of skin on dorsal surfaces of the hands, facial hypertrichosis, hyperpigmentation, triggered by ingestion of ethanol, estrogens. Dx? Test? Rx?

Porphyria cutanea tarda. Deficicency of uroporphyrinogen decarboxylase. Confirm gisfnosis with elevagted Urinary uroporhyrins. Phlebotomy or hydroxychloroquine, interferon alpa if concomitant hep C.

Rx for shingles? What is

Oral valacyclovir x 7days to reduce w/ 72 hrs, transmisson, new lesions and post-herpatic neuralgia. > 72hrs then zinc oxide cream (supportive rx) HCP who have no immunity (previous infection or 2 dose vaccine) get varicella vaccine within 5 days of exposure. If pt immunocompromised then need immunoglobulin or anti-viral therapy.

After camping pt develops linear papules and vesicles that intensely painful and pruritic. Dx? Next step in management? Rx?

Poison ivy contact dermatitis type IV hypersensitivity reaction. Immediate removal of contaminated apparel. Gentle washing of exposed area. Topical steroid if mild, systemic/oral if severe.

Rx for chronic urticaria ?

1. Loratidine (claritin), Certirizine (zyrtec) 2. H1 blockers(hydroxzine), montelukast (luekotriene inhibitors 3. steroids, immunemodulators. Resolves spontaneously w/in 3-5 years.