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Clinical Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

mild non-inflammatory comedonal acne tx

A

topical retinoids

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2
Q

mild inflammatory acne tx

A

topical retinoid + BPO
if no response, add topical abx (clindamycin)

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3
Q

moderate inflammatory acne tx

A

topical retinoid + BPO w/ topical abx
add oral abx (doxycycline)

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4
Q

severe acne tx

A

isotretinoin

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5
Q

this condition is characterized by centrofacial erythema, flushing, telangiectasis, rhinophyma, and lack of comedones

A

rosacea

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6
Q

rosacea tx

A

avoid triggers, mineral based sunscreen
topical metronidazole, azelaic acid and ivermectin
mod-severe- oral tetracyclines
refractory cases- isotretinoin

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7
Q

this condition is hair follicle infection

A

folliculitis

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8
Q

MC pathogens of folliculitis

A

staph a
pseudomonas- “hot tub”

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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

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10
Q

Tx of perioral dermatitis

A

discontinue steroids or other irritants
topical calcineurin inhibitors, metronidazole, or erythromycin

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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

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12
Q

MC cause of erythema multiforme

A

HSV

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13
Q

tx of erythema multiforme

A

acyclovir if HSV and steroids

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14
Q

this condition is characterized by detachment of epidermis and extensive necrosis on <10% of body surface

A

SJS

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15
Q

this condition is characterized by detachment of epidermis and extensive necrosis on >30% of body surface

A

TEN

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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

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17
Q

SJS/ TEN managment

A

admit to ICU, discontinue offending meds
steroids
cyclosporine
IVIG or etanercept

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18
Q

tx for androgenic alopecia

A

topical minoxidil or oral finasteride

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19
Q

this type of alopecia is an increase of the number of hairs in the telogen phase

A

telogen effluvium

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20
Q

tx of telogen effluvium

A

reassurance

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21
Q

tx of alopecia areata

A

intralesional corticosteroids- triamcinolone acetonide
extensive- JAK inhibitors and oral steroids

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22
Q

tx of trichotillomania

A

NAC

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23
Q

tx of onychomycosis

A

systemic antifungals- griseofulvin
terbinafine for toenails

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24
Q

this is inflammation of the lateral or proximal nail folds

A

paronychia

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25
Q

paronychia tx

A

warm water and antiseptic soaks
oral abx- cephalexin or dicloxacillin
MRSA- trimethoprim-sulfamethoxazole
abscess- I&D

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26
Q

this is a space infection of fingernail pulp space

A

felon

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27
Q

felon tx

A

early abx- cephalexin or penicillin, I&D

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28
Q

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

A

digital myxoid cyst

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29
Q

tx of digital myxoid cyst

A

puncture and drainage
surgical removal

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30
Q

this is a brown discoloration in a band under the nail that is usually benign but must be investigated for melanoma

A

melanonychia

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31
Q

this is a painful infection of the finger caused by HSV

A

herpetic whitlow

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32
Q

tx of herpetic whitlow

A

antivirals

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33
Q

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

A

scabies

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34
Q

dx of scabies

A

microscopy via saline mount

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35
Q

tx of scabies

A

permethrin cream
ivermectin
diphenhydramine or hydroxyzine- pruritus
lidocaine

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36
Q

head lice tx

A

permethrin 1% cream or malathion lotion
ivermectin, benzyl alcohol, petroleum jelly

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37
Q

body lice tx

A

dispose/ wash infected clothing
hygiene measures

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38
Q

tx of pubic lice

A

permethrin rinse 1% for 10 min
permethrin cream 5% for 8 hrs

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39
Q

this tick disease is characterized by erythema migrans (target/ bulls eye rash)

A

lyme disease

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40
Q

lyme disease tx

A

doxycycline BID 21 days
or amox or ceftin

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41
Q

cause of lyme disease

A

borrelia

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42
Q

cause of rocky mountain spotted fever

A

rickettsia

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43
Q

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

A

rocky mountain spotted fever

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44
Q

tx of rocky mountain spotted fever

A

doxycycline or chloramphenicol

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45
Q

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

A

black widow

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46
Q

tx of black widow bite

A

usually self-limited
moderate- wound care, pain control, NSAIDs, analgesia, tetanus prophylaxis
severe- muscle relaxants
antivenom

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47
Q

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

A

brown recluse spider bite

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48
Q

tx of brown recluse spider bite

A

supportive- wound care and pain control
immobilization, ice, elevation, antihistamines, tetanus prophylaxis

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49
Q

this condition is spreading of infection of the deeper dermis and subcutaneous tissue (usually on lower leg)

A

cellulitis

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50
Q

MC pathogens of cellulitis

A

GAS
staph a

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51
Q

this condition is localized macular skin erythema, poorly demarcated, warm, tender, and will spread. typically on lower leg.

A

cellulitis

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52
Q

tx of mild cellulitis

A

oral abx- dicloxacillin, cephalexin, cefadroxil

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53
Q

tx of mod-severe cellulitis

A

IV abx- nafcillin, cefazolin, clindamycin

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54
Q

tx of cellulitis if PCN allergy

A

trimethoprim-sulfamethoxazole
clindamycin

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55
Q

this is a variant of cellulitis involving the upper dermis and superficial cutaneous lymphatics

A

erysipelas

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56
Q

this condition is characterized by sharply demarcated borders, intensely raised erythematous, warm, shiny/ glistening, and intense pain
*systemic symptoms are common

A

erysipelas

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57
Q

tx of erysipelas

A

oral penicillin V potassium, amox, or cephalexin
IV cefazolin or ceftriaxone

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58
Q

this is a superficial infection due to corynebacterium minutissimum

A

erythrasma

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59
Q

this condition is scaly, macerated moist skin in the toe web, is usually asymptomatic, mild pruritic, and has scaling and erythema

A

interdigital erythrasma

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60
Q

this condition is erythematous to brown macules or plaques that may coalesce into larger patches with sharp border and may resemble “cigarette paper”

A

intertriginous erythrasma

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61
Q

erythrasma dx

A

wood’s lamp
KOH

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62
Q

tx of erythrasma

A

clindamycin or erythromycin
(localized- topical; extensive- oral)

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63
Q

this is a highly contagious superficial vesiculopustular skin infection that has honey colored golden crusts

A

impetigo

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64
Q

tx of impetigo

A

mild- topical abx: mupirocin
extensive- oral abx: cephalexin
MRSA- trimeth-sulfa, doxy or clinda

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65
Q

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

A

hansen’s disease (leprosy)

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66
Q

dx of leprosy

A

acid fast bacillus smear
lepromin skin test

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67
Q

tx of leprosy

A

dapsone and rifampicin
add clofazimine for lepromatous type

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68
Q

tx of cutaneous TB

A

isoniazid and rifampin for 9 mo

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69
Q

in this type of cutaneous TB: papule occurs 2-4 wks after inoculation, progresses to ulcer, then crusts which may develop deeper abscess

A

PIT

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70
Q

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

A

TVC

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71
Q

this condition results in itching, burning, stinging, scales, erosion that are often between the toes/ web spaces and may have white maceration or peeling.

A

tinea pedis

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72
Q

this is tinea pedis that involves one hand and both feet

A

tinea manuum

73
Q

how to dx tinea pedis

A

KOH and culture

74
Q

tx of tinea pedis in the macerated stage

A

aluminum subacetate solution soaks
antifungal cream- imidazoles or ciclopirox
if fails… terbinafine

75
Q

tx of tinea pedis in dry and scaly stage

A

topical antifungal with urea lotion

76
Q

tx of tinea pedis in refractory cases

A

oral itraconazole or terbinafine

77
Q

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.

A

tinea corporis

78
Q

what is the MC organism that causes tinea corporis, pedis, and cruris?

A

T rubrum

79
Q

tx of tinea corporis

A

topical antifungals- terbinafine, burenafine, azoles
extensive- oral antifungals

80
Q

this condition is a fungal infection of the groin/ inner thighs and presents as annular hyperpigmented patches or plaques and are sharply demarcated.

A

tinea cruris

81
Q

what is the MC cause of tinea capitis in the US?

A

dermatophyte species trichophyton

82
Q

this fungal infection is infection of the scalp hairs that leads to patches of alopecia with black dots, scaly patches, yellow crusts, and lymphadenopathy

A

tinea capitis

83
Q

tx of tinea capitis

A

oral griseofulvin or terbinafine (take with fatty foods)
antifungal shampoo and topical antifungals

84
Q

what causes tinea versicolor?

A

overgrowth of malassezia furfur

85
Q

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.

A

tinea versicolor

86
Q

dx of tinea versicolor

A

KOH
Wood’s lamp

87
Q

tx of tinea versicolor

A

topical- selenium sulfide
systemic- oral fluconazole or itraconazole

88
Q

this condition is characterized by pruritus, burning, tingling, “beefy red” intertriginous areas with satellite lesions, erosions and scaling possible.

A

intertrigo/ candidiasis

89
Q

tx of intertrigo/ candidiasis

A

topical antifungals- azole creams
topical steroids- hydrocortisone 1%

90
Q

dx of intertrigo/ candidiasis

A

clinical, KOH, wood’s lamp

91
Q

what causes molluscum

A

poxvirus

92
Q

this condition presents as painless flesh colored to pearly white papules with a central umbilication

A

molluscum contagiosum

93
Q

dx of molluscum

A

clinical
test for HIV
histology- henderson-paterson bodies

94
Q

tx of molluscum

A

none required- self limitied
curettage, cryotherapy, cantharidin

95
Q

cause of condyloma acuminata

A

HPV (6 &11 MC)

96
Q

this condition presents as flat topped, painless raised papules, they may be large, soft, fleshy cauliflower like. may appear pink or red.

A

condyloma acuminata

97
Q

tx of condyloma

A

none required

98
Q

prevention of condyloma

A

gardasil vaccination

99
Q

this type of wart presents as firm hyperkeratotic papules with red brown punctuations (thromobosed capillaries)

A

common and plantar

100
Q

this type of wart is typically numerous, small, discrete flesh colored flat topped papules

A

flat

101
Q

tx of cutaneous warts

A

none required
common/plantar- topical salicylic acid, cryotherapy
flat- cryotherapy or topical agents (tretinoin, imiquimod)

102
Q

what causes erythema infectiosum/ fifth’s disease

A

parovirus B19

103
Q

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

A

erythema infectiosum

104
Q

tx of erythema infectiosum

A

supportive- NSAIDs

105
Q

what causes hand foot and mouth disease?

A

coxsackie virus A type 16

106
Q

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

A

hand foot and mouth disease

107
Q

tx of hand foot and mouth disease

A

supportive- antipyretics, hydration, topical lidocaine

108
Q

is rubeola or rubella more serious?

A

rubeola

109
Q

which condition has a URI prodrome with the 3 Cs- cough, conjunctivitis and coryza

A

rubeola

110
Q

which condition has koplik spots, brick red rash starting at hairline and neck, then spreads down and out, then darkens and coalesces?

A

rubeola

111
Q

tx of rubeola

A

supportive- antipyretics, hydration, tx of complications
vitamin A in children
prevention- MMR vaccine

112
Q

cause of rubeola

A

virus part of the paramyxovirus family

113
Q

cause of rubella

A

rubella virus- togavirus family

114
Q

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)

A

rubella

115
Q

in this condition, the exanthem is pink or light and non-confluent, lasts 3 days, does not coalesce and forchhemier spots may be present

A

rubella

116
Q

tx of rubella

A

supportive- antipyretics and hydration
*has less complications than rubeola

117
Q

what causes roseola/ sixth disease?

A

HHV-6 and HHV-7

118
Q

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.

A

roseola

119
Q

tx of roseola

A

supportive- antipyretics, rest, hydration
prevent febrile seizures

120
Q

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

A

chicken pox/ varicella zoster

121
Q

tx of varicella zoster (chicken pox)

A

healthy child: supportive- antihistamines, topical dressings
>12: acyclovir or valacyclovir

122
Q

this condition is caused by reactivation of latent VZV in older adults

A

shingles (herpes zoster)

123
Q

this condition is characterized by unilateral dermatomal rash that has erythematous papules followed by a painful eruption of vesicles, bullae and putusles

A

shingles

124
Q

tx of shingles

A

antivirals within 72 hrs of onset (without crusting)
analgesics

125
Q

tx of HSV-1 and HSV-2

A

oral valacyclovir or acyclovir
docosanol cream- HSV-1

126
Q

how to dx HSV

A

PCR
serology
viral cultures

127
Q

these are beige, brown or black papules or plaques with a velvety/ warty surface and have a “stuck on” appearance

A

seborrheic keratoses (SKs)

128
Q

what is the sign of leser-trèlat?

A

SKs, skin tags and acanthosis nigricans
associated with many malignancies

129
Q

tx of SKs

A

none required
liquid nitrogen

130
Q

this lesion presents as flesh colored, pink or hyperpigmented papules that feel like sandpaper, are tender to palpation and occur in sun exposed areas

A

actinic keratoses (AKs)

131
Q

tx of actinic keratoses

A

liquid nitrogen, photoprotection
topical fluorouracil cream or imiquimod

132
Q

this is a benign subcutaneous tumor that is soft, painless, and easily mobile

A

lipoma

133
Q

tx of lipomas

A

none required
may excise

134
Q

this is a benign growth that is freely moving, firm, and often has an overlying black comedone (punctum)

A

epidermal inclusion cyst

135
Q

tx of epidermal inclusion cyst

A

none required
excision or I&D

136
Q

this presents as a small raised papules that are pink, white, or flesh colored, pearly/ translucent, and have telangiectatic surface vessels. Is friable.

A

BCC

137
Q

tx of BCC

A

superficial- imiquimod and 5-FU
removal- Mohs, curettage, excision

138
Q

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.

A

SCC

139
Q

tx of SCC

A

exision w/ 4-6 mm margins
Mohs, nicotinamide cream, imiquimod or 5-FU, curettage, cryotherapy

140
Q

dx of melanoma

A

full thickness biopsy
Breslow’s level most important factor in prognosis

141
Q

tx of melanoma

A

complete excision
* <1 mm thick –> 1 cm margin
* >1 mm thick –> 2 cm margin

142
Q

Presentation:
* pruritus, dry, scaly skin
* MC in flexor creases
* erythematous ill-defined blisters, papules or plaques
* lichenification possible

A

atopic dermatits

143
Q

tx of atopic dermatitis

A

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
Q

tx of contact dermatitis

A
  1. topical steroids w/ emollients and moisturizers
  2. severe- oral steroids
  3. topical calcineurin inhibitors- tacrolimus or pimecrolimus
145
Q

this condition is the sudden eruption of highly pruritic symmetric vesicles on palms, lateral fingers or soles

A

dyshidrosis

146
Q

tx of dyshidrosis

A

self limiting
topical steroids, antihistamines, avoid allergens, dry hands, botox injections

147
Q

this is common in areas high in sebaceous glands and presents as erythematous plaques, patches or dry scales with white-yellow greasy scales

A

seborrheic dermatitis

148
Q

tx of seborrheic dermatitis

A

topical antifungals and low potency topical steroids

149
Q

Presentation:
* silvery scales on bright red plaques
* well-demarcated
* MC on flexural surfaces
* pruritus common

A

psoriasis

150
Q

what is aupitz sign?

A

bleeding with removal of plaque or scale
common in psoriasis

151
Q

what is koebner’s phenomenon?

A

lesions that occur at site of trauma
common in psoriasis and lichen planus

152
Q

this condition has:
* auspitz sign
* koebner’s phenomenon
* nail pitting
* guttate- teardrop papules that occur after strep

A

psoriasis

153
Q

mild- moderate psoriasis tx

A

mild-moderate
* topical high potency steroids w/ hydration and emollients
* topical vit D analogs- “calc”
* tar shampoo
* topical calcineurin inhibitors

154
Q

moderate- severe psoriasis tx

A

phototherapy

155
Q

severe psoriasis tx

A

systemic cyclosporine and retinoids
biologic agents- TNF, IL-17 and IL-23 inhibitors
methotrexate and topical tapinarof

156
Q

tx of lichen simplex chronicus

A

avoid scratching and occlusive dressings
topical high potency steriods and antihistamines
intralesional steroids for severe cases

157
Q

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

A

lichen planus

158
Q

tx of lichen planus

A

topical steroids
topical tacrolimus
oral antihistamines
generalized- phototherapy, retinoids, oral steroids

159
Q

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.

A

pityriasis rosea

160
Q

tx of piyriasis rosea

A

none required
topical steroids or antihistamines, emollients/ lotion and phototherapy are options

161
Q

this a reaction to a new drug that results in bright red erythematous macules or papules that form plaques and has no mucosal involvement

A

exanthematous drug eruption

162
Q

tx of exanthematous drug eruption

A

immediately stop medication
most self-limited
oral antihistamines and topical steroids, H2 blockers

163
Q

this condition is hyperpigmentation of sun exposed areas of the skin that presents as “mask-like” macules and patches, especially on face and neck.

A

melasma

164
Q

tx of melasma

A

sun protection
mild
* hydroquinone cream, azelaic acid, topical retinoids

mod-severe
* fluocinolone acetonide + hydroquinone + tretinoin

165
Q

this is skin depigmentation without inflammation due to autoimmune destruction of melanocytes

A

vitiligo

166
Q

tx of vitiligo

A

<20%- topical tacrolimus, toipcal steroids, JAK inhibitor
>20%- phototherapy, oral steroids

167
Q

this condition is due to insufficient venous flow, is typically on the lower left leg and results in hyperpigmentation, scaling, plaques or patches

A

stasis dermatitis

168
Q

tx of stasis dermatitis

A

increase venous return- compression stockings, elevation, exercise, treat underlying condition
itching- topical steroids
cellulitis- oral abx

169
Q

this condition presents as pruritus with eczematous or urticarial plaques followed by multiple tense large bullae that don’t rupture easily. Negative Nikolsky sign.

A

bullous pemphigoid

170
Q

dx of bullous pemphigoid

A

biopsy with immunofluorescence
ELISA

171
Q

tx of bullous pemphigoid

A

topical steroids and doxycycline
severe- systemic steroids

172
Q

this condition is life threatening, presents with mucosal involvement followed by painful flaccid skin bullae that rupture easily. Positive Nikolsky sign.

A

pemphigus

173
Q

tx of pemphigus

A

hospitalize–> IV abx
oral glucocorticoids (prednisone)
may add immune agents (rituximab, mycophenolate or azathioprine)

174
Q

acanthosis nigricans tx

A

treat underlying cause
keratolytic agents (tretinoin, topical vit D analog)

175
Q

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.

A

hidradenitis suppurativa

176
Q

tx of mild hidradenitis suppurativa

A

mild (hurley stage 1)- topical abx: clindamycin or doxycycline

177
Q

tx of mod- severe hidradenitis suppurativa

A

mod-severe (hurley stage 2)- oral tetracycline
* TNF inhibitors
* IL-17/12/23 inhibitors
* JAK inhibitors
* retinoids and rifampin

178
Q

this condition is an abscess or sinus tract in the upper part of the gluteal fold

A

pilonidal disease

179
Q

tx of pilonidal disease

A

acute- I&D (no abx unless cellulitis)
chronic- surgical excision

Clinical Medicine (8 decks)

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