Dermatology

Question 1

Acute inflammation Tx

Answer 1

wet dressings to cool and dry the lesions
Then go to a powder, lotion aerosol, or spray
creams are for conditions that are more chronic and less inflamed
Ointments are for chronic inflammation such as lichenification, dryness, psoriasis and pruritis

Question 2

Two parts to each topical medicatoin

Answer 2

the medication

the substance that carries it

Question 3

Prednisone affects blood sugar

Answer 3

Be careful with it

Question 4

Changes in aging skin

Answer 4

descrease thickness, loss of elasticity, reduced sweat glands and vascularity

Question 5

Alopecia

Answer 5

telogen effluvium-
no baldness
4-6 weeks after an event (postpartum)
pull test

Question 6

Androgenic alopecia

Answer 6

male pattern baldness

Question 7

alopecia areata

Answer 7

autoimmune, recurrent patchy bald spots

Question 8

Vitiligo

Answer 8

Disappearance of pigment
related to autoimmune
use suncreen and makeup
Check thyroid, for SLE, B12, blood sugar

Question 9

Pruritis

Answer 9

desire to scratch
Is there a systemic cause (liver trouble)
check lymph nodes
Use topical trycyclic
Benedryl, antihistamines, capsacin cream,
emollients, cooling lotions, tepid water

Question 10

Vesicular rash

Answer 10

poison ivy
burrows solution to dry
topical medium to high corticosteroid, oral if over 20% of the body or on face or genitals. Taper 2-3 weeks IM corticosteroid is an alternative
antihistamine at night.

Question 11

Uticaria

Answer 11

Wheals, hives
Type I mediated.
PUPPS-Find trigger
H1 receptor antagonist with an H2 receptor antagonist
1st baby, third trimester, male babies
Claritin or Zyrtec
History by the 6 i’s-infection, ingestants, insects, inhalants, injectants, internal disease

Question 12

Parasites

Answer 12

lice or scabies? Itching, form burroughs (mites) Treat with 5% permethrin for mites. Put on Elimite at night wash off in am. repeat in a week. May still have itching from eggs, feces. 1% permethrin for lice.

Question 13

Fungal infection-intertrigo

Answer 13

Yeast, under breasts and in groin area. cool topical antifungal first (Lotrimin) bid then Oral fluconazole, keep dry, avoid talc and cornstarch powders. For moderate, use travacort to decrease inflammation 2x/7 days
Miconazole powder that absorbs is ok.

Question 14

Tinea Pedi

Answer 14

Athletes foot-topical lamisil, wash hands

Question 15

Tinea unguium

Answer 15

Nail fungus-Use oral itraconazole. Check liver enzymes. Take for 6 weeks and do labs 6 weeks fingers 12 weeks toenails

Question 16

bacterial cellulitis

Answer 16

acute skin infection. Comes after a wound or bite. Usually involves a lymph node. Fever? Staph or strep MRSA. Tx with dicolxacillin 7-10 days bactiban for impetigo and or erythromycin.
Orbital refer or hands. Those with DM need to be monitored closely. Monitor cellulitis closely.

Question 17

Herpes Labialis

Answer 17

Acyclovir 200 mg po 5x/7-10 days. for recurrent, 400 mg po 2x/for 5 days Only severe cases of recurrent herpes labialis should be tx’d.No cure, its a virus, Can pass with no lesions. safe sex. active herpes in preg mother requires c-section. vesicles on an erythematous base.

Question 18

Herpes Zoster

Answer 18

vaccine FDA for over 50 CDC for over 60
5th cranial nerve involved- trigeminal. refer to opthamologist
Acyclivor within 72 hours of rash. a neuralgia can happen so refer if so. Avoid contact with to someone who has never had chickenpox. Keep blisters covered.

Question 19

Atopic dermatitis

Answer 19

Is a type of contact dermatitis. Allergic is a type I reaction. A reaction to nickel and poison ivy is a type IV. Clean hands, stop scratching. Use protopic or elidel for chronic

Question 20

Contact dermatitis

Answer 20

cytotoxic. comes from something touching you. bracelet, new product on hands, etc. Use barriers and emollients.avoid handwashing. topical med-high corticosteroid

Question 21

Acne vulgaris

Answer 21

most common skin problem in US

Goal is to normalize keritazation.

Question 22

Acne Vulgaris-Tx

Answer 22

Classify to treat
family history, what exacerbates?, Takes 4-6 weeks to start working. Start with a wash, mild cleansers, benzyoil peroxide. If does not work can add an oral tetracycline, especially if inflamed. If nodularcystic refer.

Question 23

Acne inversa

Answer 23

Hyperkeratosis of the sebaceous glad follicle with secondary infection.
cell mediated
chronic
after 35 settles down
steroid and antibx

Question 24

Psoriasis

Answer 24

consistent home care. well circumscribed erythematous maculopapular lesions covered in silvery white scale. Pitting of nails. Treat with Triamcinilone for mild to moderate. Restore the skin barrier. cover in plastic. coal tar preparations., Vitamin D topical. Phototherapy. Oral retinoids are good for pustular psoriasis

Question 25

Seborrheic Dermatitis

Answer 25

cradle cap, nizoral shampoo. 2% ketocanazole Its a greasy erythematous scaling with an unknown cause.

Question 26

dry skin

Answer 26

manage with creams, fluids, tepid baths, etc

Question 27

warts

Answer 27

viral-treat with salicylic acid or liquid nitrogen. Aldara for genitals

Question 28

Seborrheic keratoses

Answer 28

look like candle wax drip moles. benign. not to worry

Question 29

skin cancer

Answer 29

open sore, mole that changes. early detection is key. Know the ABCDEs >6mm. caused from unprotected skin with UVA burning at young age.

Question 30

Basal cell carcinoma

Answer 30

normal flesh colored to slightly pigmented. Raised, shiny with pearly borders.

Question 31

Squamous cell carcinoma

Answer 31

roughened scaling that does not heal and bleeds when scraped

Question 32

ABCDE of cancer- these are usually malignant melanoma

Answer 32

A=asymmetrical
B=Borders (uneven)
C=color (two colors)
D=diameter >6mm
E=elevation (recently raised)