Dermatology #4 (Clean Up) Flashcards
What is the first line treatment for all patients with more than mild acne vulgaris? (2 things)
Topical retinoid plus a topical antimicrobial agent
another form of noninfectious folliculitis, is caused by ingrown hairs in the beard area from shaving in the direction against the grain of hair growth
Pseudofolliculitis barbae (razor bumps)
First-line treatment for folliculitis
Mupirocin ointment and topical benzoyl peroxide cream
What is the first line treatment if persistent or recurrent hot tub folliculitis (due to pseudomonas)
Fluoroquinolones (Ciprofloxacin orally)
First-line treatment for rosacea
- Topical metronidazole, azelaic acid, or topical ivermectin (first line)
- Clonidine may be used for flushing
- Orał tetracyclines if patient fails topical treatment
What characterizes the rash of erythema multiforme?
Target lesions with a dusky central area or blister, surrounded by pale ring of edema, and erythematous halo on extreme periphery of lesion
Causes of erythema multiforme
- HSV virus MC
- Mycoplasma spp (in kids)
- Sulfa drugs, beta lactams, Phenytoin, Phenobarbital
Although treatment for erythema multiforme is symptomatic in most cases, what drug, if given early, may reduce the number and duration of cutaneous lesions?
Acyclovir
What is the key androgen leading to androgenetic alopecia?
Dihydrotestosterone (DHT)
Describe molluscum contagiosum
Single or multiple firm dome-shaped flesh-colored waxy papules with central umbilication
Molluscum Contagious is most common in who?
Children, sexually active adults, and patients with HIV
Management of Molluscum Contagiosum
- No treatment needed in most cases (resolves in 3-6 months)
- Curettage (first line when therapy indicated)
What is seen on histology if it is performed for molluscum contagiosum?
Henderson-Paterson bodies (keratinocytes containing eosinophilic cytoplasmic inclusion bodies)
However, what is one common medication that is used in the treatment of molluscum?
Cantharidin (topical blistering agent)
Describe a squamous cell carcinoma
- Erythematous, elevated thickened nodule with white scaly or crusted, bloody margins
- Nonhealing ulceration or erosion
- On lips, hands, neck, or head
Treatment for squamous cell carcinoma
- Surgical excision with clear margins (MC used)
- Electrodessication and curettage for small superficial lesions
- Mohs Surgery: recurrent and sensitive areas
What is a Kaposi Sarcoma?
Vascular cancer associated with HH8 infection
Kaposi Sarcoma is MC seen in immunosuppressed patients, such as HIV with a CD4 < ____ or post-transplant. What is the treatment if associated with HIV?
CD4 < 100
HAART therapy
Treatment for Kaposi Sarcoma
Chemotherapy or radiation for local disease
HAART therapy if associated with HIV
MCC of skin cancer-related death
Malignant Melanoma
Malignant melanoma most commonly mets to
regional lymph nodes, skin, liver, lungs, and brain
MC type of malignant melanoma
Superficial spreading (trunk on men and legs in women)
What type of malignant melanoma is seen in darker-skinned individuals? Most commonly seen on palms, soles, and nail beds?
Acral lentiginous
Explain what ABCDE means in malignant melanoma terms?
A: Asymmetry B: Borders (irregular) C: Color (Variation) D: Diameter (> 6 mm) E: Evolution
Diagnostics for malignant melanoma
-Full-thickness wide excisional biopsy + lymph node biopsy
DO NOT DO SHAVE BIOPSY
MC type of skin cancer in the US
Basal cell carcinoma
What is true about basal cell carcinoma?
Slow growing, locally invasive but low incidence of metastasis
Describe a basal cell carcinoma
- Small, raised, translucent pearly or waxy papule with raised, rolled borders and central ulceration with overlying telangiectasic vessels. Often easily friable.
- MC on face, nose, neck, or trunk
Diagnostic for basal cell carcinoma
- Punch or shave biopsy
- Or excisional biopsy
Surgical management for basal cell carcinoma
- Mohs micrographic surgery for facial involvement
- Electrodesiccation and curettage for non-facial tumors
Lichen Planus is associated with
Hepatitis C in adults
Describe lichen planus (6 P’s)
- Purple
- Polygonal
- Pruritic
- Papules or Plaques with fine scales
- Planar
What else can be seen in Lichen Planus?
Wickham Striae (fine white lines on the skin or on oral mucosa)
What is Koebner’s Phenomenon in regards to Lichen Planus?
New lesions at sites of trauma
Treatment for lichen planus
- Topical corticosteroids with occlusive dressings
- Antihistamines for pruritus
- The rash usually resolves in 8-12 months spontaneously
