Dermatology Flashcards
Acute inflammation Tx
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
Two parts to each topical medicatoin
the medication
the substance that carries it
Prednisone affects blood sugar
Be careful with it
Changes in aging skin
descrease thickness, loss of elasticity, reduced sweat glands and vascularity
Alopecia
telogen effluvium-
no baldness
4-6 weeks after an event (postpartum)
pull test
Androgenic alopecia
male pattern baldness
alopecia areata
autoimmune, recurrent patchy bald spots
Vitiligo
Disappearance of pigment
related to autoimmune
use suncreen and makeup
Check thyroid, for SLE, B12, blood sugar
Pruritis
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
Vesicular rash
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.
Uticaria
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
Parasites
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.
Fungal infection-intertrigo
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.
Tinea Pedi
Athletes foot-topical lamisil, wash hands
Tinea unguium
Nail fungus-Use oral itraconazole. Check liver enzymes. Take for 6 weeks and do labs 6 weeks fingers 12 weeks toenails
bacterial cellulitis
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.
Herpes Labialis
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.
Herpes Zoster
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.
Atopic dermatitis
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
Contact dermatitis
cytotoxic. comes from something touching you. bracelet, new product on hands, etc. Use barriers and emollients.avoid handwashing. topical med-high corticosteroid
Acne vulgaris
most common skin problem in US
Goal is to normalize keritazation.
Acne Vulgaris-Tx
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.
Acne inversa
Hyperkeratosis of the sebaceous glad follicle with secondary infection. cell mediated chronic after 35 settles down steroid and antibx
Psoriasis
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
Seborrheic Dermatitis
cradle cap, nizoral shampoo. 2% ketocanazole Its a greasy erythematous scaling with an unknown cause.
dry skin
manage with creams, fluids, tepid baths, etc
warts
viral-treat with salicylic acid or liquid nitrogen. Aldara for genitals
Seborrheic keratoses
look like candle wax drip moles. benign. not to worry
skin cancer
open sore, mole that changes. early detection is key. Know the ABCDEs >6mm. caused from unprotected skin with UVA burning at young age.
Basal cell carcinoma
normal flesh colored to slightly pigmented. Raised, shiny with pearly borders.
Squamous cell carcinoma
roughened scaling that does not heal and bleeds when scraped
ABCDE of cancer- these are usually malignant melanoma
A=asymmetrical B=Borders (uneven) C=color (two colors) D=diameter >6mm E=elevation (recently raised)
