Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical medicine > Dermatology 2 > Flashcards

Dermatology 2 Flashcards

1
Q

Acne

A

disease of pilosebaceous unit, appears near puberty; more sever in males, more persistent in females, dismissed as minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Classification of acne

A

5 cysts, comedones >100, inflammatory> 50 or >125 total- severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Etiology of acne

A

sebum is the pathogenic factor in acne, it is irritating and comedogenic, begins when sebum production inc, propionibacterium acne proliferates in sebum, and the follicular epithelial lining becomes altered and forms plugs called comedones, testosterone is a factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pathogenesis of acne

A

inc sebum production, hyperkeratosis of sebaceous duct, propionibacterium acnes, blocked or plugged pilosebaceous follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment of mild acne

A

benzoyl peroxide, topical antibiotic or combo and retinoid applied on alternate evenings; oral antibiotics if no response in 6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of moderate acne

A

topical antibiotic and benzoyl peroxide, oral antibiotics, topical retinoid can be introduced if inflammation subsides, oral abx should be continued until no new lesions develop and then taper gradually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of severe acne

A

requires aggressive tx, reassuree about effectiveness, I&D for cysts w/ thin roofs, intra lesional injection of kenalog, oral antibiotics, oral prednisone to control inflammation, rapid introduction of accutane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hormonal acne

A

increased facial oiliness, premenstrual acne, inflammatory acne on mandibular line and neck, adult acne, worsening in adult, treatment failure w/ accutane, h/o irregular menses, hirsutism, alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hormonal tx for acne

A

oral contraceptives, spironolactone, and prednisone/dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Steroid acne

A

uniform size and symmetric distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

neonatal acne

A

seb glands stimulated by maternal androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acne conglobata

A

double comedones, papules, cysts and abcesses, mainly black, no systemic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acne fulminans

A

ulcerative, necrotic acne w/ systemic sx, fever, wt loss, leucocytosis, arthralgia, muscle pain, elevated esr, treat w/ steroids followed by accutane, abx not effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

other types of acne

A

occupational, acne cosmetica, excoriated acne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Perioral dermatitis

A

occurs in young women, resembles acne, lesions confined to chin and nasolabial folds, pustules on cheek adjacent to nostril are characteristic, pathogenesis unknown (prolonged use of fluorinated steroids? cosmetics?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of perioral dermatitis

A

abx, 2-3 weeks or oral tetracycline and erythromycin are mainstay tx, doxy also effective, long term maintenance therapy w/ oral abx may be required, tacrolimus ointment, topical abx are not effective, avoid other topicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long does treatment for perioral dermatitis take

A

2-3 months w/ proper treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rosacea primary features

A

flushing, non-transient erythema, papules and pustules, telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rosacea secondary features

A

burning or stinging, dry appearance, edema, ocular manifestations, peripheral location, phymatous changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rosacea pearls

A

unknown etiology, EtOH may worsen, sun exposure, heat, hot drinks, a mite “demodex folliculorum”, after age 30, celtic origin,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rosacea clinical features

A

erythema, edema, pappules, pustules and telangiectasia, eruptions on forehead, cheeks, nose and occasionally around the eyes, chronic deep inflammation around the nose –> irreversible hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rhinophyma

A

whisky nose, common in rosacea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ocular rosacea

A

common, 58% w/ rosacea, mild conjunctivitis, soreness, foreign body sensation and lacrimation, maybe dry eyes, dec visual acuity may result from long standing disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment of oral antibiotics

A

doxycycline, tetracycline, minocycline or metronidazole, severe refractory cases can be treated w/ accutane, first line is metronidazole cream, sulfa prep (Sulfacet-R), mirvaso controls erythema for 12 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hidradenitis Suppurativa
chronic suppurative and scaring disease of the skin and subcutaneous tissue in axilla, anogenital regions, under breasts and body folds, mild is misdiagnosed as recurrent furunculosis
26
Pathogenesis of hidranenitis suppurtiva
now believed to be a disease of follicle instead of apocrine appartatus, bac infection prop a major cause of exacerbation, not appear until puberty
27
Clinical presentationof hidrandenitis suppurtiva
double comedone, communicating under skin, progressive and self perpetuating, extensive, deep, dermal inflammation results in large, painful abcesses, healing process permanentlly alters the dermis, cordlike bands of scar tissue criss cross
28
Management of hidradenitis suppurtiva
abx, long term oral, tetracycline, erythromycin, doxy, and minocycline, accutane in selected cases, large cyst should be incised and drained to intralesional injection of kenalog, get bac culture, wt loss and stop smoking
29
Psoriasis
1-3% pop, genetic, unknown origin, chronic, recurrent exacerbation and remission that are emotionally and physically debilitating
30
Pathology of psoriasis
epidermis contains a large number of mitoses, epidermal hyperplasia and scale, dermis contains enlarged and tortuous capillaries that are very close to the skin surface and impart the characteristic erythematous hue, bleeding
31
Auspitz's sign
bleeding when capillaries rupture as scale is removed, see pin point hemorrhages w/ scaly skin
32
Variations of morphology of psoriasis
chronic plaque psoriasis, guttate psoriasis, pustular psoriasis, erythrodermic psoriasis, HIV induced psoriasis, light sensitive
33
Variationin location of psoriasis
scalp, palms and soles, pustular psoriasis of palms and soles, psoriasis inversus, nail psoriasis, psoriatic arthritis
34
Guttate and pustular psoriasis
destinctive lesions, begin as red scaling papules, coalesce to form round oval plaques, Auzpitz's sign, scale is adherent, silvery white reveals bleeding when removed, koebner's phenomenon, affects extensors
35
Koebner's phenomenon
lesions develpp at site of trauma, scratching, sunburn, surgery
36
Drugs that precipitate psoriasis
lithium, beta blockers, antimalarials, systemic steroids
37
Chronic plaque psoriasis
most common, evolve into erythrodermic, chronic, well-defined plaques w/ silvery white scales, enlarge to certain size and remain stable for months, temporary brown, white or red macule remains when plaque subsides
38
Guttate psoriasis
strep pharangitis or viral URI may precede eruption by 1-2 weeks, scaling papule may appear on trunk and extremities, mm-1 cm, may resolve spontaneously in weeks to months, responds to abx
39
Generalized pustular psoriasis
rare form, sometimes fatal, erythema suddenlly appears into flexural areas and migrates to other surfaces, numerous tiny, sterile pustules from an erythemmatous base, lakes of pus, leukocytosis, febrile, relapse common
40
Treatment of generalized pustular psoriasis
w/drawal both topical and systemic steroids (may precipitate flares), wet dressings and group V steroids, for severe cases systemic therapy w/ acitretin methotrexate and cyclosporine
41
Erythrodermic psoriasis
severe, unstable, highly labile disease, mainly in pt w/ chronic disease, rarely initial presentation, precepitating factors: systemic steroids, topical steroids, phototherapy, stress, infection, other topical therapies
42
Treatment of erthrodermic psoriasis
bed rest, avoid UV light, compresses, liberal use of emollients, inc protein and fluid intake, antihistamines and hospitalization; methotrexate, cyclosporine, acitretin, biologics
43
Psoriasis of the scalp
may be only site affected, plaques similar to skin but scales are anchored by hair, extension of plaques onto the forehead is common, even in most severe cases the hair is not permanently lost, tx topical steroids
44
Psoriasis of nails
pitting best known abnormality, oil spot lesion, localized separation of the nail, cellular debris accumulates, brown yellow color; onycholysis- separation of nail from the nail bed in irregular manner, like fungal infection, fragmentation
45
Psoriatic arthritis
5-8% in psoriatic pts, higher among pt w/ more severe cutaneous disease, 53% suffer from arthralgia, RF neg, 80% nail involvement, progressive arthritis
46
Diagnosis of psoriatic arthritis
to exclude other arthritis disease: ANA, ESR, WBC, uric acid, ESR is best lab to disease activity, RF levels typically normal
47
Five presentations of psoriatic arthritis
asymmetric arthritis, symmetric, distal interphalangeal joint disease, arthritis mutilans, ankylosing spondylitis
48
Asymmetric arthritis presentation
most common pattern involving one or more joints, sausage finger, continued inflammation promotes soft tissue swelling on either side of the joint
49
Symmetric arthritis presentation
polyarthritis resembling RA occurs but the RA factor is neg
50
Distal interphalangeal joint disease
Most characteristic presentation of arthritis w/ psoriasis is involvement of DIP, chronic but mild, 5% pts
51
arthritis mutilans
most severe form, involves osteolysis of any of the small bones of hands and feet, leads to digital telescoping producing the opera glass deformity
52
ankylosing spondylitis
may occur as an isolated phenomenon
53
Treatment of psoriatic arthritis
NSAIDs 1st line, intralesional injections w/ corticosteroids, methotrexate- 2nd line, biologics- embrel, humira, remicade, antimalarials, cyclosporine, acitretin, photochemotherapy, steroid creams
54
When to stop treatment of psoriatic arthritis
when the plaque cannot be felt by drawing the finger over the skin surface
55
Seborrheic dermatitis
common, chronic inflammatory disease w/ characteristic pattern for different age groups, pityrosporum ovale is cause, genetic and environment influence, many pt have oily complexion, remission and exacerbation common
56
Infants, cradle cap
infants develop greasy adherent scales on vertex of the scalp, scales may accumulate and become thick and adherent and can be removed w/ shampooing, secondary infection can occur
57
Treatment of cradle cap
serum and crust are treated w/ antistaph abx, erythema and scaling- group VI or VII steroid, dense scale removed w/ warm mineral oil or olive oil then wash detergent after sseveral hours, remission can be prolonged w/ salicylic acid and tar shampoos
58
Tinea amiantacea
1-several patches of dense scale anywhere on scalp, persist for months before parent notices area of some hair loss and yellow white plates of scales, 2-10 cm
59
Treatment of tinea amiantacea
warm 10% liquor carbonis detergens in nivea oil, apply over night and shampoo in morning, can use tar shampoo for maintenance, topical steroid lotion too
60
Adult or classic SD
fine, dry, white scaling w/ minor itching, should wash hair everyday w/ antidandruff shampoo; scalp and margins, eyebrows etc, on ears could be eczema or fungus, varying degrees
61
Treatment of adult SD
shampoos, zinc soaps, selenium, tar, salicylic acid, topical steroids, V-VII creams, anti yeast meds- ketoconazole or ciclopirox olamaine, also sulfacetamide, metrogel, protopic and elidel creams
62
Pityriasis rosea
common, binign, asymptomatic eruption, unknown etiology, `23 yo, 2% recur, 20% have h/o acute infection w/ fatigue, HA or sore throat
63
Clinical features of pityriasis rosea
2-10 cm round lesions~17% pt, mainly on trunk or proximal extremities, d-w enters eruptive phase, smaller lesions appear and inc in num, long axis of oval plaques oriented along skin lines "christmas tree pattern", collarette scale
64
Treatment of pityriasis rosea
spontaneously clears in 1-3 months, oral erythromycin, group V steroids for itching, UVB
65
Lichen planus
unique inflammatory cutaneous and mucous membrane rxn pattern of unknown etiology, 40 yom, 46yof, 10% have fam hx, associated w/ Hep-C!
66
Primary lesions
pruriitic, planar, polygonal, purple papules, heal w/ pigmentation, 2-10 mm papule/plaque, close inspection of surface shows lacy reticular pattern, criss-cross, whitish lines "Wickham striae" accentuated by immersion oil, focal epidermal thickening, koebner's phenomenon
67
Types of lichen planus
localized papules, hypertrophic lichen planus, LP of palms and soles, oral mucous membrane LP, Nail
68
localized pupule LP
most commonly located on flexor surfaces of wrist/forearms, legs/above ankles, 20% do not itch, chronic, last >4 years
69
hypertrophic LP
pretibial and ankles, reddish brown or violaceous plaques w/ rough or verrucose surface, heal w/ dark pigmentation, average 8 yrs, intalesional steroids
70
LP of palms and soles
papules are larger and aggregate into semi translucent plaques w/ globular waxy surface
71
Follicular LP
lichen planopilaris, may cause scarring alopecia
72
Oral mucous membrane LP
asymptomatic dendritic, branching or lacy, shite network pattern seen on buccal mucosa, seen in >50% of the pts w/ cutaneous disease, twice more common in women
73
Nails LP
proximal to distal linear grooves and depressions
74
Treatment of LP
topical steroids I-II, intralesional steroids, systemic steroids, acitretin, azathioprine, cyclosporin, dapsone, antihistamines, steroids in orabase for mucous membranes

Clinical medicine (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions