Dermatology Flashcards
1
Q
mild non-inflammatory comedonal acne tx
A
topical retinoids
2
Q
mild inflammatory acne tx
A
topical retinoid + BPO
if no response, add topical abx (clindamycin)
3
Q
moderate inflammatory acne tx
A
topical retinoid + BPO w/ topical abx
add oral abx (doxycycline)
4
Q
severe acne tx
A
isotretinoin
5
Q
this condition is characterized by centrofacial erythema, flushing, telangiectasis, rhinophyma, and lack of comedones
A
rosacea
6
Q
rosacea tx
A
avoid triggers, mineral based sunscreen
topical metronidazole, azelaic acid and ivermectin
mod-severe- oral tetracyclines
refractory cases- isotretinoin
7
Q
this condition is hair follicle infection
A
folliculitis
8
Q
MC pathogens of folliculitis
A
staph a
pseudomonas- “hot tub”
9
Q
this condition is small inflammatory papules, papulopustules or scaling around the mouth, nose or eyes and that spares the vermillion border of the lips
A
perioral dermatitis
10
Q
Tx of perioral dermatitis
A
discontinue steroids or other irritants
topical calcineurin inhibitors, metronidazole, or erythromycin
11
Q
This condition is characterized by target lesions with 3 components: dusky central area, dark red inflammatory zone, outer pale ring of edema. Negative Nikolsky sign.
A
erythema multiforme
12
Q
MC cause of erythema multiforme
A
HSV
13
Q
tx of erythema multiforme
A
acyclovir if HSV and steroids
14
Q
this condition is characterized by detachment of epidermis and extensive necrosis on <10% of body surface
A
SJS
15
Q
this condition is characterized by detachment of epidermis and extensive necrosis on >30% of body surface
A
TEN
16
Q
this condition involves at least 2 mucosal membranes, has + Nikolsky sign, and has erythematous flat macules that may become vesicles, bullae, and erosions
A
SJS/ TEN
17
Q
SJS/ TEN managment
A
admit to ICU, discontinue offending meds
steroids
cyclosporine
IVIG or etanercept
18
Q
tx for androgenic alopecia
A
topical minoxidil or oral finasteride
19
Q
this type of alopecia is an increase of the number of hairs in the telogen phase
A
telogen effluvium
20
Q
tx of telogen effluvium
A
reassurance
21
Q
tx of alopecia areata
A
intralesional corticosteroids- triamcinolone acetonide
extensive- JAK inhibitors and oral steroids
22
Q
tx of trichotillomania
A
NAC
23
Q
tx of onychomycosis
A
systemic antifungals- griseofulvin
terbinafine for toenails
24
Q
this is inflammation of the lateral or proximal nail folds
A
paronychia
25
paronychia tx
warm water and antiseptic soaks
oral abx- cephalexin or dicloxacillin
MRSA- trimethoprim-sulfamethoxazole
abscess- I&D
26
this is a space infection of fingernail pulp space
felon
27
felon tx
early abx- cephalexin or penicillin, I&D
28
this condition is a shiny papule found close the the nail that is semi-translucent with smooth, shiny surface and a jelly-like fluid may be expressed
digital myxoid cyst
29
tx of digital myxoid cyst
puncture and drainage
surgical removal
30
this is a brown discoloration in a band under the nail that is usually benign but must be investigated for melanoma
melanonychia
31
this is a painful infection of the finger caused by HSV
herpetic whitlow
32
tx of herpetic whitlow
antivirals
33
this condition expresses linear burrows, vesicles or nodules on the scrotum or penis, erythematous papules with excoriations
in children, heavy involvement of hands and soles
scabies
34
dx of scabies
microscopy via saline mount
35
tx of scabies
permethrin cream
ivermectin
diphenhydramine or hydroxyzine- pruritus
lidocaine
36
head lice tx
permethrin 1% cream or malathion lotion
ivermectin, benzyl alcohol, petroleum jelly
37
body lice tx
dispose/ wash infected clothing
hygiene measures
38
tx of pubic lice
permethrin rinse 1% for 10 min
permethrin cream 5% for 8 hrs
39
this tick disease is characterized by erythema migrans (target/ bulls eye rash)
lyme disease
40
lyme disease tx
doxycycline BID 21 days
or amox or ceftin
41
cause of lyme disease
borrelia
42
cause of rocky mountain spotted fever
rickettsia
43
this tick disease is characterized by a macular rash that appears 3 days after bite on wrists and ankles first, then palms and soles, then generalized
rocky mountain spotted fever
44
tx of rocky mountain spotted fever
doxycycline or chloramphenicol
45
this type of spider bite results in a blanched circular patch with surround red perimeter and a central punctum. muscle pain, spasms and rigidity is common
black widow
46
tx of black widow bite
usually self-limited
moderate- wound care, pain control, NSAIDs, analgesia, tetanus prophylaxis
severe- muscle relaxants
antivenom
47
this type of spider bite is characterized by a red halo and blanching of affected area followed by hemorrhagic bulla that undergoes eschar formation and necrosis
brown recluse spider bite
48
tx of brown recluse spider bite
supportive- wound care and pain control
immobilization, ice, elevation, antihistamines, tetanus prophylaxis
49
this condition is spreading of infection of the deeper dermis and subcutaneous tissue (usually on lower leg)
cellulitis
50
MC pathogens of cellulitis
GAS
staph a
51
this condition is localized macular skin erythema, poorly demarcated, warm, tender, and will spread. typically on lower leg.
cellulitis
52
tx of mild cellulitis
oral abx- dicloxacillin, cephalexin, cefadroxil
53
tx of mod-severe cellulitis
IV abx- nafcillin, cefazolin, clindamycin
54
tx of cellulitis if PCN allergy
trimethoprim-sulfamethoxazole
clindamycin
55
this is a variant of cellulitis involving the upper dermis and superficial cutaneous lymphatics
erysipelas
56
this condition is characterized by sharply demarcated borders, intensely raised erythematous, warm, shiny/ glistening, and intense pain
*systemic symptoms are common
erysipelas
57
tx of erysipelas
oral penicillin V potassium, amox, or cephalexin
IV cefazolin or ceftriaxone
58
this is a superficial infection due to corynebacterium minutissimum
erythrasma
59
this condition is scaly, macerated moist skin in the toe web, is usually asymptomatic, mild pruritic, and has scaling and erythema
interdigital erythrasma
60
this condition is erythematous to brown macules or plaques that may coalesce into larger patches with sharp border and may resemble "cigarette paper"
intertriginous erythrasma
61
erythrasma dx
wood's lamp
KOH
62
tx of erythrasma
clindamycin or erythromycin
(localized- topical; extensive- oral)
63
this is a highly contagious superficial vesiculopustular skin infection that has honey colored golden crusts
impetigo
64
tx of impetigo
mild- topical abx: mupirocin
extensive- oral abx: cephalexin
MRSA- trimeth-sulfa, doxy or clinda
65
this disease manifests as nodular, plaque or papular skin lesions with symmetric nerve involvement, sharply demarcated hypopigmented lesions that may or may not be numb to the touch
hansen's disease (leprosy)
66
dx of leprosy
acid fast bacillus smear
lepromin skin test
67
tx of leprosy
dapsone and rifampicin
add clofazimine for lepromatous type
68
tx of cutaneous TB
isoniazid and rifampin for 9 mo
69
in this type of cutaneous TB: papule occurs 2-4 wks after inoculation, progresses to ulcer, then crusts which may develop deeper abscess
PIT
70
this type of cutaneous TB has an initial papule with violaceous halo that evolves to hyperkeratotic, warty firm plaque. Clefts and fissures may be seen
TVC
71
this condition results in itching, burning, stinging, scales, erosion that are often between the toes/ web spaces and may have white maceration or peeling.
tinea pedis
72
this is tinea pedis that involves one hand and both feet
tinea manuum
73
how to dx tinea pedis
KOH and culture
74
tx of tinea pedis in the macerated stage
aluminum subacetate solution soaks
antifungal cream- imidazoles or ciclopirox
if fails... terbinafine
75
tx of tinea pedis in dry and scaly stage
topical antifungal with urea lotion
76
tx of tinea pedis in refractory cases
oral itraconazole or terbinafine
77
this is a fungal infection of the trunk, legs, arms, or neck that presents as rings of erythema with raised scaly borders and a central clearing.
tinea corporis
78
what is the MC organism that causes tinea corporis, pedis, and cruris?
T rubrum
79
tx of tinea corporis
topical antifungals- terbinafine, burenafine, azoles
extensive- oral antifungals
80
this condition is a fungal infection of the groin/ inner thighs and presents as annular hyperpigmented patches or plaques and are sharply demarcated.
tinea cruris
81
what is the MC cause of tinea capitis in the US?
dermatophyte species trichophyton
82
this fungal infection is infection of the scalp hairs that leads to patches of alopecia with black dots, scaly patches, yellow crusts, and lymphadenopathy
tinea capitis
83
tx of tinea capitis
oral griseofulvin or terbinafine (take with fatty foods)
antifungal shampoo and topical antifungals
84
what causes tinea versicolor?
overgrowth of malassezia furfur
85
this condition is hyper or hypo pigmentation that is well demarcated. round or oval macules or thin plaques with small scaling are seen. MC on upper trunk and proximal extremities.
tinea versicolor
86
dx of tinea versicolor
KOH
Wood's lamp
87
tx of tinea versicolor
topical- selenium sulfide
systemic- oral fluconazole or itraconazole
88
this condition is characterized by pruritus, burning, tingling, "beefy red" intertriginous areas with satellite lesions, erosions and scaling possible.
intertrigo/ candidiasis
89
tx of intertrigo/ candidiasis
topical antifungals- azole creams
topical steroids- hydrocortisone 1%
90
dx of intertrigo/ candidiasis
clinical, KOH, wood's lamp
91
what causes molluscum
poxvirus
92
this condition presents as painless flesh colored to pearly white papules with a central umbilication
molluscum contagiosum
93
dx of molluscum
clinical
test for HIV
histology- henderson-paterson bodies
94
tx of molluscum
none required- self limitied
curettage, cryotherapy, cantharidin
95
cause of condyloma acuminata
HPV (6 &11 MC)
96
this condition presents as flat topped, painless raised papules, they may be large, soft, fleshy cauliflower like. may appear pink or red.
condyloma acuminata
97
tx of condyloma
none required
98
prevention of condyloma
gardasil vaccination
99
this type of wart presents as firm hyperkeratotic papules with red brown punctuations (thromobosed capillaries)
common and plantar
100
this type of wart is typically numerous, small, discrete flesh colored flat topped papules
flat
101
tx of cutaneous warts
none required
common/plantar- topical salicylic acid, cryotherapy
flat- cryotherapy or topical agents (tretinoin, imiquimod)
102
what causes erythema infectiosum/ fifth's disease
parovirus B19
103
this condition presents as an erythematous macular rash on face with "slapped cheek" appearance. may be followed by lacy maculopapular rash on trunk or extremities
erythema infectiosum
104
tx of erythema infectiosum
supportive- NSAIDs
105
what causes hand foot and mouth disease?
coxsackie virus A type 16
106
this condition starts as an oral enanthem with painful oral vesicles surrounded by a thin halo which undergo ulceration. then becomes a nonpruritic nontender exanthem on the distal extremities
hand foot and mouth disease
107
tx of hand foot and mouth disease
supportive- antipyretics, hydration, topical lidocaine
108
is rubeola or rubella more serious?
rubeola
109
which condition has a URI prodrome with the 3 Cs- cough, conjunctivitis and coryza
rubeola
110
which condition has koplik spots, brick red rash starting at hairline and neck, then spreads down and out, then darkens and coalesces?
rubeola
111
tx of rubeola
supportive- antipyretics, hydration, tx of complications
vitamin A in children
prevention- MMR vaccine
112
cause of rubeola
virus part of the paramyxovirus family
113
cause of rubella
rubella virus- togavirus family
114
in this condition, 1/2 are asymptomatic, the prodrome includes a low grade fever and lymphadenopathy. the exanthem starts on the face and spreads to the trunk and extremities (spares palms and soles)
rubella
115
in this condition, the exanthem is pink or light and non-confluent, lasts 3 days, does not coalesce and forchhemier spots may be present
rubella
116
tx of rubella
supportive- antipyretics and hydration
*has less complications than rubeola
117
what causes roseola/ sixth disease?
HHV-6 and HHV-7
118
the characteristic rash of this condition is rose-pink, blanchable, starts at the trunk, butt and neck and then spreads to the face. Has nagayama spots.
roseola
119
tx of roseola
supportive- antipyretics, rest, hydration
prevent febrile seizures
120
this describes what condition:
- prodrome: low grade fever, malaise, oral enanthem--> generalized exanthem
vesicular rash, pruritic, macules become papules, then vesicles and pustules, then crust over *dew drops on rose petals
rash starts on face and moves to trunk, then extremities, then other areas
chicken pox/ varicella zoster
121
tx of varicella zoster (chicken pox)
healthy child: supportive- antihistamines, topical dressings
>12: acyclovir or valacyclovir
122
this condition is caused by reactivation of latent VZV in older adults
shingles (herpes zoster)
123
this condition is characterized by unilateral dermatomal rash that has erythematous papules followed by a painful eruption of vesicles, bullae and putusles
shingles
124
tx of shingles
antivirals within 72 hrs of onset (without crusting)
analgesics
125
tx of HSV-1 and HSV-2
oral valacyclovir or acyclovir
docosanol cream- HSV-1
126
how to dx HSV
PCR
serology
viral cultures
127
these are beige, brown or black papules or plaques with a velvety/ warty surface and have a **"stuck on"** appearance
seborrheic keratoses (SKs)
128
what is the sign of leser-trèlat?
SKs, skin tags and acanthosis nigricans
associated with many malignancies
129
tx of SKs
none required
liquid nitrogen
130
this lesion presents as flesh colored, pink or hyperpigmented papules that feel like **sandpaper**, are tender to palpation and occur in sun exposed areas
actinic keratoses (AKs)
131
tx of actinic keratoses
liquid nitrogen, photoprotection
topical fluorouracil cream or imiquimod
132
this is a benign subcutaneous tumor that is soft, painless, and easily mobile
lipoma
133
tx of lipomas
none required
may excise
134
this is a benign growth that is freely moving, firm, and often has an overlying black comedone (punctum)
epidermal inclusion cyst
135
tx of epidermal inclusion cyst
none required
excision or I&D
136
this presents as a small raised papules that are pink, white, or flesh colored, **pearly/ translucent**, and have **telangiectatic surface** vessels. Is friable.
BCC
137
tx of BCC
superficial- imiquimod and 5-FU
removal- Mohs, curettage, excision
138
this lesion commonly presents as erythematous elevated nodules with white scaly or crusty bloody margins. Ulcerations and erosions may occur. Includes most lower lip cancers.
SCC
139
tx of SCC
**exision w/ 4-6 mm margins**
Mohs, nicotinamide cream, imiquimod or 5-FU, curettage, cryotherapy
140
dx of melanoma
full thickness biopsy
Breslow's level most important factor in prognosis
141
tx of melanoma
**complete excision**
* <1 mm thick --> 1 cm margin
* >1 mm thick --> 2 cm margin
142
Presentation:
* pruritus, dry, scaly skin
* MC in flexor creases
* erythematous ill-defined blisters, papules or plaques
* lichenification possible
atopic dermatits
143
tx of atopic dermatitis
acute
1. topical steroids w/ emollients and antihistamines
2. wet dressings and abx (if infected)
chronic
1. skin hydration with emollients
2. oral antihistamines- cetirizine, fexofenadine
3. trigger avoidance
144
tx of contact dermatitis
1. topical steroids w/ emollients and moisturizers
2. severe- oral steroids
3. topical calcineurin inhibitors- tacrolimus or pimecrolimus
145
this condition is the sudden eruption of highly pruritic symmetric vesicles on palms, lateral fingers or soles
dyshidrosis
146
tx of dyshidrosis
self limiting
topical steroids, antihistamines, avoid allergens, dry hands, botox injections
147
this is common in areas high in sebaceous glands and presents as erythematous plaques, patches or dry scales with white-yellow greasy scales
seborrheic dermatitis
148
tx of seborrheic dermatitis
topical antifungals and low potency topical steroids
149
Presentation:
* silvery scales on bright red plaques
* well-demarcated
* MC on flexural surfaces
* pruritus common
psoriasis
150
what is aupitz sign?
bleeding with removal of plaque or scale
common in psoriasis
151
what is koebner's phenomenon?
lesions that occur at site of trauma
common in psoriasis and lichen planus
152
this condition has:
* auspitz sign
* koebner's phenomenon
* nail pitting
* guttate- teardrop papules that occur after strep
psoriasis
153
mild- moderate psoriasis tx
mild-moderate
* topical high potency steroids w/ hydration and emollients
* topical vit D analogs- "calc"
* tar shampoo
* topical calcineurin inhibitors
154
moderate- severe psoriasis tx
phototherapy
155
severe psoriasis tx
systemic cyclosporine and retinoids
biologic agents- TNF, IL-17 and IL-23 inhibitors
methotrexate and topical tapinarof
156
tx of lichen simplex chronicus
avoid scratching and occlusive dressings
topical high potency steriods and antihistamines
intralesional steroids for severe cases
157
this condition presents as the 6 Ps:
1. purple
2. polygonal
3. planar
4. pruritic
5. papules
6. plaques
and has fine scales with irregular borders
lichen planus
158
tx of lichen planus
topical steroids
topical tacrolimus
oral antihistamines
generalized- phototherapy, retinoids, oral steroids
159
this condition starts as a herald patch then appears as smaller papules with "**cigarette paper**" scaling at the edges and a **Christmas tree pattern distribution**. Pruritus is common and the lesions are typically confined to trunk and proximal extremities.
pityriasis rosea
160
tx of piyriasis rosea
**none required**
topical steroids or antihistamines, emollients/ lotion and phototherapy are options
161
this a reaction to a new drug that results in bright red erythematous macules or papules that form plaques and has no mucosal involvement
exanthematous drug eruption
162
tx of exanthematous drug eruption
immediately stop medication
most self-limited
oral antihistamines and topical steroids, H2 blockers
163
this condition is hyperpigmentation of sun exposed areas of the skin that presents as "mask-like" macules and patches, especially on face and neck.
melasma
164
tx of melasma
**sun protection**
mild
* hydroquinone cream, azelaic acid, topical retinoids
mod-severe
* fluocinolone acetonide + hydroquinone + tretinoin
165
this is skin depigmentation without inflammation due to autoimmune destruction of melanocytes
vitiligo
166
tx of vitiligo
<20%- topical tacrolimus, toipcal steroids, JAK inhibitor
>20%- phototherapy, oral steroids
167
this condition is due to insufficient venous flow, is typically on the lower left leg and results in hyperpigmentation, scaling, plaques or patches
stasis dermatitis
168
tx of stasis dermatitis
increase venous return- compression stockings, elevation, exercise, treat underlying condition
itching- topical steroids
cellulitis- oral abx
169
this condition presents as pruritus with eczematous or urticarial plaques followed by multiple tense large bullae that don't rupture easily. Negative Nikolsky sign.
bullous pemphigoid
170
dx of bullous pemphigoid
biopsy with immunofluorescence
ELISA
171
tx of bullous pemphigoid
topical steroids and doxycycline
severe- systemic steroids
172
this condition is life threatening, presents with mucosal involvement followed by painful flaccid skin bullae that rupture easily. Positive Nikolsky sign.
pemphigus
173
tx of pemphigus
hospitalize--> IV abx
oral glucocorticoids (prednisone)
may add immune agents (rituximab, mycophenolate or azathioprine)
174
acanthosis nigricans tx
treat underlying cause
keratolytic agents (tretinoin, topical vit D analog)
175
this si a painful chronic inflammatory condition involving the skin due to hair follicle obstruction and leads to nodules, abscesses, draining sinus tracts, and hypertrophic scars.
hidradenitis suppurativa
176
tx of mild hidradenitis suppurativa
mild (hurley stage 1)- topical abx: clindamycin or doxycycline
177
tx of mod- severe hidradenitis suppurativa
mod-severe (hurley stage 2)- oral tetracycline
* TNF inhibitors
* IL-17/12/23 inhibitors
* JAK inhibitors
* retinoids and rifampin
178
this condition is an abscess or sinus tract in the upper part of the gluteal fold
pilonidal disease
179
tx of pilonidal disease
acute- I&D (no abx unless cellulitis)
chronic- surgical excision
