Dermatology Flashcards
mild non-inflammatory comedonal acne tx
topical retinoids
mild inflammatory acne tx
topical retinoid + BPO
if no response, add topical abx (clindamycin)
moderate inflammatory acne tx
topical retinoid + BPO w/ topical abx
add oral abx (doxycycline)
severe acne tx
isotretinoin
this condition is characterized by centrofacial erythema, flushing, telangiectasis, rhinophyma, and lack of comedones
rosacea
rosacea tx
avoid triggers, mineral based sunscreen
topical metronidazole, azelaic acid and ivermectin
mod-severe- oral tetracyclines
refractory cases- isotretinoin
this condition is hair follicle infection
folliculitis
MC pathogens of folliculitis
staph a
pseudomonas- “hot tub”
this condition is small inflammatory papules, papulopustules or scaling around the mouth, nose or eyes and that spares the vermillion border of the lips
perioral dermatitis
Tx of perioral dermatitis
discontinue steroids or other irritants
topical calcineurin inhibitors, metronidazole, or erythromycin
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.
erythema multiforme
MC cause of erythema multiforme
HSV
tx of erythema multiforme
acyclovir if HSV and steroids
this condition is characterized by detachment of epidermis and extensive necrosis on <10% of body surface
SJS
this condition is characterized by detachment of epidermis and extensive necrosis on >30% of body surface
TEN
this condition involves at least 2 mucosal membranes, has + Nikolsky sign, and has erythematous flat macules that may become vesicles, bullae, and erosions
SJS/ TEN
SJS/ TEN managment
admit to ICU, discontinue offending meds
steroids
cyclosporine
IVIG or etanercept
tx for androgenic alopecia
topical minoxidil or oral finasteride
this type of alopecia is an increase of the number of hairs in the telogen phase
telogen effluvium
tx of telogen effluvium
reassurance
tx of alopecia areata
intralesional corticosteroids- triamcinolone acetonide
extensive- JAK inhibitors and oral steroids
tx of trichotillomania
NAC
tx of onychomycosis
systemic antifungals- griseofulvin
terbinafine for toenails
this is inflammation of the lateral or proximal nail folds
paronychia
paronychia tx
warm water and antiseptic soaks
oral abx- cephalexin or dicloxacillin
MRSA- trimethoprim-sulfamethoxazole
abscess- I&D
this is a space infection of fingernail pulp space
felon
felon tx
early abx- cephalexin or penicillin, I&D
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
tx of digital myxoid cyst
puncture and drainage
surgical removal
this is a brown discoloration in a band under the nail that is usually benign but must be investigated for melanoma
melanonychia
this is a painful infection of the finger caused by HSV
herpetic whitlow
tx of herpetic whitlow
antivirals
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
dx of scabies
microscopy via saline mount
tx of scabies
permethrin cream
ivermectin
diphenhydramine or hydroxyzine- pruritus
lidocaine
head lice tx
permethrin 1% cream or malathion lotion
ivermectin, benzyl alcohol, petroleum jelly
body lice tx
dispose/ wash infected clothing
hygiene measures
tx of pubic lice
permethrin rinse 1% for 10 min
permethrin cream 5% for 8 hrs
this tick disease is characterized by erythema migrans (target/ bulls eye rash)
lyme disease
lyme disease tx
doxycycline BID 21 days
or amox or ceftin
cause of lyme disease
borrelia
cause of rocky mountain spotted fever
rickettsia
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
tx of rocky mountain spotted fever
doxycycline or chloramphenicol
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
tx of black widow bite
usually self-limited
moderate- wound care, pain control, NSAIDs, analgesia, tetanus prophylaxis
severe- muscle relaxants
antivenom
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
tx of brown recluse spider bite
supportive- wound care and pain control
immobilization, ice, elevation, antihistamines, tetanus prophylaxis
this condition is spreading of infection of the deeper dermis and subcutaneous tissue (usually on lower leg)
cellulitis
MC pathogens of cellulitis
GAS
staph a
this condition is localized macular skin erythema, poorly demarcated, warm, tender, and will spread. typically on lower leg.
cellulitis
tx of mild cellulitis
oral abx- dicloxacillin, cephalexin, cefadroxil
tx of mod-severe cellulitis
IV abx- nafcillin, cefazolin, clindamycin
tx of cellulitis if PCN allergy
trimethoprim-sulfamethoxazole
clindamycin
this is a variant of cellulitis involving the upper dermis and superficial cutaneous lymphatics
erysipelas
this condition is characterized by sharply demarcated borders, intensely raised erythematous, warm, shiny/ glistening, and intense pain
*systemic symptoms are common
erysipelas
tx of erysipelas
oral penicillin V potassium, amox, or cephalexin
IV cefazolin or ceftriaxone
this is a superficial infection due to corynebacterium minutissimum
erythrasma
this condition is scaly, macerated moist skin in the toe web, is usually asymptomatic, mild pruritic, and has scaling and erythema
interdigital erythrasma
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
erythrasma dx
wood’s lamp
KOH
tx of erythrasma
clindamycin or erythromycin
(localized- topical; extensive- oral)
this is a highly contagious superficial vesiculopustular skin infection that has honey colored golden crusts
impetigo
tx of impetigo
mild- topical abx: mupirocin
extensive- oral abx: cephalexin
MRSA- trimeth-sulfa, doxy or clinda
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)
dx of leprosy
acid fast bacillus smear
lepromin skin test
tx of leprosy
dapsone and rifampicin
add clofazimine for lepromatous type
tx of cutaneous TB
isoniazid and rifampin for 9 mo
in this type of cutaneous TB: papule occurs 2-4 wks after inoculation, progresses to ulcer, then crusts which may develop deeper abscess
PIT
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
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