Dermatology 5% Flashcards
Vesicular lesions on palms that break and then crack. Tapioca Pudding appearance
Dishydrotic eczema. Tx: corticosteroids
Pruritic, sharply demarcated, coin shaped lesions on back of hands, feet, and extensor surfaces
Nummular eczema
Lichen Planus is associated with what condition?
Clinical manifestation:
Hepatitis C
5 Ps: purple, polygonal, planar, pruritic, papules w/ fine scales
What conditions are associated with erythema nodosum?
Pregnancy, sarcoidosis, TB
Can mimic syphilis so do PRP if pt is sexually active with this skin manifestation.
Pityriasis Rosea
Keratin hyperplasia (proliferating cells in stratus basale + stratum spinosum) d/t ______ =
T-cell activation and cytokine release
Psoriasis
Auspitz sign =
Seen in ___
Punctuate bleeding w/ removal of plaque
Psoriasis, actinic keratosis
Pityriasis versicolor caused by ___
Dx w/:
Tx:
Malassezia furfur
KOH prep: hyphae + spores “spaghetti and meatball” appearance
Wood’s lamp: yellow-green fluorescence
Tx: Selenium sulfide*
Sodium sulfacetamide
Azole antifungals
Type I Hypersensitivity Reaction
IgE mediated
Ex: Urticaria, angioedema
Type II Hypersensitivity Reaction
Cytotoxic, Ab-mediated
Ex: drugs + cytotoxic abs –> cell lysis
Type III Hypersensitivity Reaction
Immune antibody-antigen complex
Ex: drug-mediated vasculitis, serum sickness
Type IV Hypersensitivity Reaction
Delayed (cell mediated)
Ex: Erythema Multiforme
MC causes of Exanthematous/Mobiliform Rash include all of the following EXCEPT: A. Abx B. NSAIDs C. Colchicine D. K+ sparing diuretics
C, D
Allopurinol
Thiazide diuretics
MC causes of Erythema Multiforme include all of the following EXCEPT: A. Sulfonamides B. Macrolides C. Phenobarbital D. Dilantin
B. Penicillins
What’s the difference between Erythema multiforme MAJOR and MINOR?
Minor: No mucosal membrane lesions
Major: >1 mucous membrane involvement
No epidermal detachment
Erythema multiforme = Type ___ Hypersensitivity
4
Urticaria/angioedema = Type ___ Hypersensitivity
1
Sloughing > ___% = Toxic Epidermal Necrolysis
30%
<10% = Steven-Johnson Syndrome
4 main pathophysiologic factors in Acne Vulgaris
- increased sebum production ( increased androgen in puberty)
- Blogged sebaceous glands
- Proprionibacterium acne overgrowth
- Inflammatory response
SE of Isotretinoin
- Highly teratogenic: 2 pregnancy tests before starting + monthly while on it
- Hepatitis
- Increased triglycerids/cholesterol
Tx of severe Acne Vulgaris
1st line treatment of Rosacea =
___ may be used for flushing.
Topical metronidazole
Clonidine
PainLESS, soft, fleshy, cauliflower like lesion in genital region =
Caused by ___
Condyloma acuminata
HPV
Dx of mucosal HPV infection (warts)
whitening of lesion w/ acetic acid application
Painful, erythematous inflammatory nodules seen on anterior shins =
Etiologies include (4)
Erythema Nodosum
- Estrogen exposure (OCP, pregnancy)
- Sarcoidosis
- Infection: strep, TB, sarcoid, fungal (Coccidioidomycosis*)
- Inflammatory d/o: IBD, leukemia, Behcet disease
Kaposi Sarcoma = connective tissue cancer caused by ___.
Seen in ___.
Tx:
HHV-8
HIV/immunosuppressive patients
HAART therapy
Tx of Impetigo
Mupirocin (bactroban)** TID x 10 days
Systemic abx: Cephalexin Dicloxacillin Erythromycin/azithromycin Clindamycin
Tx of cellulitis
Cephalexin, Dicloxacillin x 7-10 days
PCN allergies: Erythromycin, Clindamycin
Cat bite pathogen =
Tx:
Pasteurella multocida
Tx: Augmentin
PCN allergy: Doxycycline
Puncture wound through shoe should have tx that covers for ____. Tx =
Pseudomonas
Ciprofloxacin
Paronychia =
infection of nail margin
Tx of choice for pediculosis
(lice)
Permethrin topical
Red itchy pruritic papules or nodules on scrotum, glans, or penile shaft, body folds =
scabies
Tx of choice for scabies
Permethrin topical
Lindane
Cheaper tx for scabies
Do NOT use p bath/shower –> may cause seizures d/t increased absorption through open pores
CI: Teratogenic, do not use in breastfeeding women, < 2 y/o
Autoimmune d/t secondary to desmosome disruption =
Type ___ Hypersensitivity.
(+/-) Nikolsky sign
Biopsy shows ___.
Tx:
Pemphigus vulgaris
Type II HSN
POSITIVE Nikolsky sign
IgG throughout epidermis
Tx: Systemic corticosteroids
Autoimmune attack on basement membrane causing SUBEPIDERMAL blistering =
Type ___ Hypersensitivity.
(+/-) Nikolsky sign
Tx:
Bullous pemphigoid
(elderly)
Type II HSN
NEGATIVE Nikolsky sign
Tx: corticosteroids
Tx of brown recluse spider bite
Dapsone
What degree of burn?
- Red, yellow, pale, white
- Dry
- blistering
- not painful
- ABSENT capillary refill
2nd degree: Deep partial thickness
What degree of burn?
- Moist, weeping
- +blistering
- MOST PAINFUL
- PRESENT capillary refill
2nd degree: superficial partial thickness
Parkland Formula =
Used for ____.
= 4 x mass (kg) x area of burn (% TSA)
Give 1/2 in 1st 8 hrs
Rest in last 16 hrs
Used in burn IV fluid resuscitation
Rule of 9s
9% head 9% each arm 18% each leg 18% anterior torso (chest + abdomen) 18% posterior torso 1% perineum 1% hand
Silvadene used for ____.
CI:
Burn management: abx
CI: sulfa allergies, pregnancy, < 2 months
Do NOT use on face d/t discoloration
Keloid = excess production of ____ during wound healing.
Type III collagen
Coxackie A causes
- Hand, foot, mouth disease
- Herpangina –> sudden onset of high fever, Stomatitis
Coxackie B causes
Pericarditis (MC cause)
Myocarditis (MC cause)
Pleurodynia = severe pleuritic chest pain w/ swelling over diaphragm, HA
Dermatitis Herpetiformis is strongly associated w/ ___.
_____ deposition in ____.
Tx:
Celiac disease
IgA immune complex deposition in dermal papillae
Tx: Gluten free diet, Dapsone*
MC cause of acute pancreatitis in children
Mumps
Mumps caused by ____ pathogen.
Paramyxovirus
MMR vaccine given ____
12-15 months
4-6 y/o
Paramyxovirus causes
Mumps
Rubeola (Measles)
Solitary glistening friable red nodule or papule that may bleed or ulcerate MC in children/young adults after trauma.
Tx:
Pyogenic granuloma (misnomer)
Topical Imiqod, alitretinoin gel
Pyoderma gangrenosum associated w/ ____.
Tx:
Inflammatory disease: RA, IBD, spondyloarthropathies , etc.
Topical steroids
Tacrolimus
ulcerative skin lesion 2ndary to immune dysregulation +/- preceded by trauma
Pyoderma gangrenosum
“3 day rash” caused by Togavirus
Rubella (German Measles)
Recurrent erythema multiforme is MC d/t ____.
recurrent herpes simplex virus outbreak
1st line treatment of hidradenitis suppurativa
Intralesional triamcinolone
Trichophyton rubrum is the most common cause of ___
athlete’s foot
