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PANCE > Dermatology - 5% > Flashcards

Dermatology - 5% Flashcards

1
Q

Acanthosis Nigricans

A

Velvety thickening

Hereditary, DM, obesity, Drugs (nicotinic acids), Gi/GU malignancy

Gray-brow, black thickend plaques

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2
Q

Acne Vulgaris

Acneiform Eruptions

A

Open comedones (blackheads) vs closed comedones (whiteheads)

Pilosebaceous unit, hyperkeratinization of follicle

Sxs

  • comedones, papules, pustules
  • nodules, cysts

Tx

  • water based products, milk and stress
  • Step wise
    • topical retinoid -retin-a
    • Benzoyl peroxide
    • topical antibiotics (clinda, azithro,
    • PO Abx - Minoxycine, tetracyclines - doxycycline, can cause photosensitivity)
    • Isoretinoin - preg test q 4 wk
    • OCPs
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3
Q

Rosacea

Acneiform Eruption

A

W, 30-50yo facial pilosebaceous unit

Sxs

  • facial erythema, telangiectasias, papules, rhinophyma
  • triggered by heat, etoh, spicy foods

Tx

  • Redness - Topical Metronidazole, azelaic acid, topical ivermectin
  • Prim papules/pustules - PO abx - tetracycline - doxy, minocyxline - failed topical
  • Telangiectasia/Rhino - derm consult
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4
Q

Actinic Keratosis

A

Long, repetitve sun exposure; 60% of SCC from AK

Sxs

  • single, or multp lesions
  • red papules/plaques in coarse adherent scales
  • feel like sandpaper

Tx

  • Prevention
  • Cryo
  • Topical fluoroucacil/Efudex)
  • Topical Imiquimod/Aldara
  • bx
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5
Q

Alopecia

A

Tinea capitis - 2/2 fungal infection

  • tx with selenium sulfide or ketoconazole shampoo

Alopecia Areata

  • oval shaped well demarcated hair loss, exclamation point hair
  • autoimmune - attack hair follicles
  • no tx - hair regrowth but not native hair

Telogen effluvium

  • scalp disorder - thinning or shedding hair d/t hair into telogen phase
  • after psychologically stressful event
  • self limiting

Androgenic alopecia

  • male pattern baldness; autosomal dominant
  • topical minoxidil
  • PO finasteride
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6
Q

Atopic Dermatitis aka Eczema

A

Chronic relapsing skin disorder

Type I IgE hypersensitivity reaction

a/w Allergic triad

  1. Asthma
  2. Allergic Rhinitis
  3. Atopic dermatitis

Sxs:

  • Pruritic rash
  • Dry, scaly skin - lichenification, fissures, worsening rash
  • usu flexor surfaces for adults (neck, eyelids, forehead, face, wrists)
  • facial & extensor surfaces for children (elbows, behind knees)

Tx:

  • Moisturizers, and emollients - Cetaphil or Eucerin
  • Topical CS for flare ups
  • Topical Calcineurin inhibitors - mod to sev dz
    • ​Tacrolimus and Pimecrolimus
  • UV photo therapy for refractory
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7
Q

Bullous Pemphigold

Vesiculobullous Dz

A

Rare, acq’d autoimmune subepidermal blistering skin disorder = autoantibodies (IgG) against hemidesmosomes

Sxs:

  • Large bullae and crust on axillae, thighs and abd
  • more tense, less fragile, deeper than pemphigus vulgaris
  • Negative Nikolsky skin (bleeding when scratched)

Dx:

  • skin bx - direct immunofluorescence exam
    • deposits of IgG and C3 basement membrane

Tx:

  • Self limited
  • Systemic CS - high doses until remission
  • Azathioprine? - immunosuppressive agents
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8
Q

Burns - Degrees and Rule of 9s

A

Rule of 9s (pic)

1st degree - sunburn

  • erythema involved tissue
  • skin blanches w/ pressure
  • skin may be tender

2nd degree - partial thickness

  • skin is red and blistered
  • skin very tender

3rd degree - full thickness

  • burned skin is tough and leathery
  • skin non-tender

4th degree - Into bones and muscles

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9
Q

Burns - minor/major, tx

A

Minor

  • < 10TBSA adults
  • < 5 TBSA young/old
  • <2% full thickness
  • not involve face, hands, perineum, feet, cross major joints or be circumferential

Major

  • > 25% TBSA adults
  • >20% TBSA young/old
  • >10% full thickness burn
  • Burns w/ face, hands, perineum, feet, cross major joints/circumferential

Tx:

  • monitor ABCs, fluid repletion, topic abx
  • cleans w/ mild soap and water, no direct ice
  • Irrigate chemical burns w/ running water x 20 ms
  • topic abx for superficial burns
  • fingers and toes wrapped individually to prevent maceration and gauze placed btwn them
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10
Q

Candidiasis

A

Moisture, warmth, breaks in barrier

intial papules

beefy red eroded patches w/ satelitte regions

Tx - nystatin, azole cream

PO flucanozole

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11
Q

Cellulitis

A

Acute bacterial skin infection from portal entry

MCC - GA Strep or S. aureus; animal bites via P. multicida or human bites E. corrodens

Sxs:

  • Pain, warmth, swelling
  • Spreading erythema (mark w/ pen) - non blanching
  • flat margins and not well demarcated

Dx:

  • would culture f/u in 48 hrs

Tx:

  • Mild cellulitis - MSSA
    • Cephalexin or Dicloxacillin
  • ​Cat bite - Augmentin or doxy if PCN allergic
  • Puncture wound - Cipro
  • MRSA
    • ​Bactrim 1 DS tab PO BID
    • Clindamycin 300-450 mg PO
    • Doxycyclin 100 mg PO BID
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12
Q

Contact Dermatitis

A

Irritant Dermatitis

Chemic irritant - topic steroids - sharply demarc erythema, edema, oozing, crusting

Contact Dermatitis

Allergic Contact Dermatitis - reexposure to allergic substance 10-14 sensitization

MC - urushiol resin (poison ivy), neomycin, nickel

Pruritic, well demarcated erythema

Topic CS

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13
Q

Contact Dermatitis: Allergic vs Irritant

A

Allergic Contact Dermatitis - MCC poison ivy (Rhus dermatitis)

  • delayed Type IV hypersensitivity reaction
  • 10-14 days
  • re-exposure appears w.in 12-48 hrs

Irritant Contact Dermatitis - MCC chemical Irritants or diaper rash

  • Cleaners, solvents, detergents, urine, feces

Sxs:

  • Acute - well demarcated erythema and exudative lesions
  • Burning, itching, erythema
  • Eczematous eruptions
  • Chronic - plaque and scaling - lichenification

Dx - patch gesting

Tx:

  • Localized - mid or high potency CS
    • Triamcinolone 0.1% or Clobetazol 0.05%
  • >20% BSA - systemic CS
    • Prednisolone 0.5-1mg/kg/d
    • should resolve w/in 12–24 hrs
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14
Q

Dermatophytes - Tinea

A

Fungus

Tinea corporis, pedis, cruris

Trichomycosis - hair and hair follicles

Onychomycosis - nails

Sxs

  • Annular patches w/ peripheral scaling - active on periphery w/ central clearning

Dx

  • KOH microscopy

Tx

  • Micanozole, clotrimazole
  • Terbinafine - fungicidal
  • PO Terbinafine if extensive involvement
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15
Q

Drug Eruptions

A

adversed cutaneous reaction to admin of a drug; usu w/in past 6 wks

Sxs:

  • skin reactions are MC
  • can be mild to severe (multiorgan damage)
  • Pruritus, mild fever => systemic sxs fever, malaise, HA

Dx

  • clinical - bacterial, viral or underlying skin dz (cutaneous lymphoma)

Tx

  • withdraw offending agents
  • monitor for sxs of CV collapse - anaphylaxis, DRESS, SJS/TEN, extensive bullous rx, generalized erythroderma
  • Don’t rechallenge w/ drugs causing urticaria, bullae, angioedema, DRESS, anaphylaxis
  • anaphylaxis or widespread uritcaria => epinephrine 0.2-0.5mg & prednisone to prevent recurrence
  • Antihistamines
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16
Q

Drug Eruptions

Exanthematous

A

MC of all skin eruptions

Typically 7-10 days after starting drugs, MC abx (amoxicillin)

Sxs

  • Morbilliform (measles like) on trunk and spread to extremities, pruritic

Tx

  • Topical Steroids
  • PO antihistamines
  • dc abx
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17
Q

Drug Eruptions

Fixed

A

Sxs

  • Single, few, dusky red, violaceous
  • occurs in the same place each time med taken, occurs more quickly each time
  • 30-8 hrs; end of extremities
  • MCC - tetracyclines, metronidazole, NSAID, salicylate

Tx

  • DC med
  • topical CS
  • antimicrobial ointment
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18
Q

Eczema

A

Chronic superficial inflammation of skin

Atopic Dermatitis

exposed to irritative factor - allergic triad (eczema, allergy, asthma), doesn’t hold water well

Sxs

  • pruritis, chronic, dry erythematous skin w/ papules
  • scaling skin eruptions
  • vesicles, crusting
  • Infancy - extensor (back of elbow), front of knees, scale face
  • childhood - flexor surfaces
  • adult - flexors hands/foot

Tx

  • Emollients*** - vaseline
  • Steroids - affected areas lowest strength
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19
Q

Erysipelas

A

Form of Cellulitis = MC d/t Group A Strep (pyogenes)

Sxs:

  • Usu face or LE
  • Pain, warmth
  • Superficial, well demarcated erythema
  • fever, chills
  • +/- bullae

Dx - culture

Tx:

  • mild - Pencillin G (or erythromycin/clinda if PCN allergic)
  • Mod - bactrim or PCN/Cephalexin
  • Severe - IV Vanco
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20
Q

Erythema Infectiosum (Fifth Disease)

Viral Exanthems

A

Parvovirus B19 - “Slapped cheek” rash on face

Sxs:

  • Low grade fever
  • sore throat
  • bright rash on cheeks -> spreads to trunk, arms, & legs
    • ​maculopapular w/ central clearing
    • lacy reticular rash

Dx: clinical

Tx: Rash lasts a few days to several weeks

pruritic rash

symptomatic tx

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21
Q

Erythema Multiforme

A

Acute, self limited skin rx - Type IV hypersensitivity rx

a/w HSV**, sulfa drugs, oral mucosal lesion uncommon

Sxs

  • extremities - hands, feet, mucosa
  • Target like shape, raised, blanching
  • NOT itchy

Dx

  • Major - widespread skin lesions & 2 mucosal sites
  • Minor - limited skin region and 1 type of mucosal (oral)
  • Negative Nikolsky sign
  • Target lesions, concentric zomes - dusky center

Tx

  • PO antihistamines, tylenol, cool compresses
  • EM major - CS, opthal consult
  • EM minor - supportive care
  • Acyclovir - if recurrent
22
Q

Hand Foot Mouth Disease

Viral Exanthems

A

Coxsackie type A virus

Children < 10 yo; very contagious in 1st week - spread via direct contact w/ saliva and mucus

Herpangina Is blister located to just the mouth

Sxs:

  • Small, tender, erythematous papules or vesicles on pharynx, mouth, hands, feet
  • Punched out, cratered
  • Irritability
  • Loss of appetite
  • General irritability
  • Feeling unwell

Dx - clinical

Tx

  • clears up in 10 days
  • pain meds for sxs relieve
  • Good hand hygiene
23
Q

Herpes Zoster

A

Varicella (chickenpox) - reactivation causing maculopapular rash along one dermatome

Dx - Tzanck Smear - multinucleated giant cells

Zoster Opthalmicus

  • shingles w/ CN V - dendritic lesions on slit lamp

Zoster Oticus (Ramsay-Hunt Syndrome)

  • facial n CN 7, otalgia
  • lesion on ears, auditory canal and TM
  • facial palsy auditory symptoms
  • ddx Bell’s palsy

Tx:

  • Acyclovir, valacyclovir, famciclovir - given w/in 72 hrs to prevent post-herpetic neuralgia
  • Post herpetic Neuralgia pain > 3 mos- parethesias or decreased sensation
24
Q

Hidradenitis Suppurativa

A

Genetic, env factor (DM, PCOS, Obestiy)

sxs

  • Inflammed, v painful nodules
  • sinus tract, scarring, from repeated
  • Double comedones*** pathogno

Tx

  • derm
  • Topical or PO abx
  • TNF
  • Surgery
25
Q

Impetigo

A

Highly contagious bacterial skin infx - MCC S aureus, S pyogenes or both

Children or adults

Begins as papules -> vesicles -> ruptured to form thick, adherent, golden crust

Sxs:

  • Red sores form around nose and mouth
  • Yellow-brown/golden crust
  • Non-painful and pruritic = honey colored and weeping

Dx - Gram stain and culture

Tx:

  • Topical Mupirocin, dicloxacillin or cephalexin for more severe illness
  • MRSA - Doxy, Clinda or Bactrim
  • Abx x 7 d
26
Q

Lice

A

Sxs:

  • pruritic scalp, body (corporis), or groin (pubis)
  • Small white specs on hair shafts

Dx:

  • observation of nits and lice - nits are ovoid, grayish white eggs

Tx:

  • Permetherin topical 1% - shampoo and cream
  • Launder fomites aka sheets in > 131 F or 55C
  • Seal toys in bag for 72 hrs
  • PO Ivermectin for resistant cases
27
Q

Lichen Planus

Papulosquamous Disorders

A

Inflammatory dermatosis unkn eti

Sxs - 5 Ps

  • Pruritic
  • purplish
  • polygonal
  • plain topped papules
  • Flexor surface of extremities
  • Wickham’s striae - white lines on plaques
  • Koebner phenomenon is common

Tx -

  • topical steroids, UV therapy, retinoids
  • antihistamines (hydroxyzine)
  • long lasting lesions = Hep C testing
  • Oral LP - risk of Oral SCC
28
Q

Measles (Rubeola)

A

Paramyxovirus via respiratory droplets

Sxs:

  • 10-12 days incubation
  • Prodrome
    • 1-3 d; 3 C’s
      • Cough, Coryza, Conjunctivitis
  • Enanthem
    • 4 8 hrs before Exanthem
    • Koplik’s spots - red/white/blue spots In mouth
  • Exanthem
    • 4 days after fever onset
    • Morbilliform - maculopapular, blanching rash
    • Cephalocaudal - head to extremities spread

Dx: Clinical, Measles IgM abs

Tx:

  • supportive, anti-inflammatories, isolate 1 wk after rash onset
29
Q

Melasma

A

Hyperfunctional melanocytes - usu in pregnant or on OCP; worse with sun exposure

Macular, splotchy, hyperpigmentated in sun exposure

Tx

Sunscreen, SPF >30

epidermal melasma - hydroquinone, tretinoin

30
Q

Basal Cell Carinoma

Neoplasms

A

Basal cell cancer - new skin as old one dies; younger ind 2-40yo

RF - heavy sun exposure

Sxs

  • White waxy lump, translucent
  • raised pearly and rolled borders, telangiectasis
  • central ulcer on sun exposed areas - hand and neck

Dx

  • Shave or punch biopsy

Tx

  • Surgery w/ margins - Moh’s sx
  • limited potential for mets
  • Fluorouracil or imiquimod to affected areas
31
Q

Kaposi Sarcoma

Neoplasms

A

HHV-8; AIDS defining cancer; angioproliferative disorder

Sxs

  • nt swts, wt loss
  • multiple, well demarcated red/purple firm nodules and plaques on head, neck, and mouth
  • ulcerate and bleed

Dx - biopsy

Tx

  • Cryotherapy, excision,
  • radiation tx
  • HAART**
32
Q

Melanoma

Neoplasms

A

Cancer of melanocytes (skin pigment); UVB/UVA; young women

Superficial spreading is MC type of melanoma

Sxs

  • ABCDE
    • Asymmetry
    • Border - irregular
    • Color
    • Diameter - increasing or > 5mm
    • E elevation/raised

Dx - excisional biopsy - with margins

Tx

  • Excision and wide margins
  • Depth of lesion
    • Clarks anatomical depth
    • Breslow’s total depth
  • Stage I-III = surgical excision is curative
  • Stage IV = chemo
  • avoid sunburns, SPF30
33
Q

Squamous Cell Carcinoma

Neoplasms

A

2nd MCC, Epidermal keratinocytes;

UV or chemical exposure

Sxs

  • erythematous, indurated scaly/ulcerated papules
  • skin exposed on elerly
  • faster growing thatn BCC
  • can become tender or painful

Dx - biopsy - carcinoma until proven otherwise

Tx - surgical excision +/- Mohs

  • good prognosis w/ immediate tx
34
Q

Onychomycosis

A

Fungal infection of toes and fingernails

Yellow, thickened nails

Dx - fungal culture, wet mount of KOH

Tx - PO Antifungal

  • Terbinafine 250 mg/d PO x 12 wks for toenails
  • Itraconazole pulse x1 wk on and 3 wks off vs continuous
35
Q

Paronychia

A

MCC S aureus; superficial inflammation of lateral and posterior fold of skin around nails

Tx

  • I&D of abscess
  • warm compresses
  • abx - PO cephalexin (MRSA coverage)
    • topical not effective
36
Q

Pemphigus Vulgaris

Vesiculobullous Dz

A

Potentially fatal - autoimmune blistering dz; MC Mediterranean or Jewish descent 40-60 yo

Sxs

  • painful mucocutaneous lesions
  • Nikolsky sign - sloughing of skin w/ pressure
  • non-healing ulcers for at least 1 mo, extremely painful
  • fragile blisters mouth to elsewhere

Dx

  • Immunofluorescence - intercellular deposition of IgG or C3
  • Biospy - acantholysis

Tx

  • PO Prednisone
  • Immunosuppressive agent (azathioprine, or methotrexate)
  • Dapsone, gold, cyclophosphamide for refractory
37
Q

Pilonidal Disease

A

abn skin growth at tailbone/natal cleft that contain hair and skin

MC teens/20s, Males, Obese, sedentary, local trauma

eti - sinus tract, abscess

Sxs:

  • pain, discomfort
  • swelling above anus or near tailbone
  • drainage of pus and blood

Dx - clinical

Tx:

  • I&D with wound debridement - look for sinus tract
  • Abx to prevent cellulitis
    • Cefazolin + metronidazole
    • Augmentin
38
Q

Pityriasis Rosea

Papulosquamous Disorders

A

Older teens and young adults; can follow URI

Sxs

  • Herald patch - salmon red, ONE plaque
  • oval scaly lesions line up against folds (Langer lines)
  • Christmas tree distribution

Tx

  • self limiting - 3-8 wks
  • anti-pruritics
  • RPR ro syphilis
39
Q

Pressure Sores

A

Sacrum and hip most often affected; resposition every 2 hrs

Stage 1 - erythema of localized area, usu non-blanching over bony surfaces

  • Aggressive preventative measures, thin-film dressings for protection

Stage 2 - partial loss of dermal layer, resulting in pink ulceration

  • Occlusive dressing to maintain healing
  • transparent films, hydrocolloids

Stage 3 - full dermal loss often exposing subcutaneous tissues and fat

Stage 4 - full thickness ulceration exposing bone, tendon, or muscle. Osteomyelitis might be present

  • debridement of necrotic tissue
  • Exudative ulcers - will benefit from absorptive dressings - calcium alginates, foams, hydrofibers
  • Dry Ulcers - occlusive dressing to maintain moisture, hydrocolloids, hydrogels
40
Q

Psoriasis

Papulosquamous Disorders

A

Psoriasis Vulgaris MC; skin and joint hyperproliferation; 20s and 50s (bimodal)

Sxs

  • Pruritic, well demarcated, erythematous plaques
  • silvery scaling
  • EXTENSOR - elbows and knees
  • Auspitz’s sign - bleed when scale is picked
  • Koebner’s phenomenon - minor trauma cause new lesions

Dx - clinical

Tx

  • emollients
  • phototherapy
  • severe - methotrexate or immunologics
41
Q

Roseola (6th Disease)

A

Caused by HHV 6 and 7

Between 6mos-2yo

Sxs:

  • Sudden high fever (102-104)
  • Red rash appears as fever subsides
  • blanching maculopapular rash - neck/trunk -> face -> extremities
  • rash lasts for 1-2 days

Dx - clinical

Tx - bed rest, fluids, antipyretics

42
Q

Rubella (German’s Measles)

A

Rubella virus - spreads through sneezing/coughing

Contagious 1-2 wks before sxs

Teratogenic in 1st Trimester

Sxs:

  • Erythematous, discrete maculopapular exanthem
  • First on face, spreads to trunk and extremities; generalized w/in 24 hrs spares palms and soles**
  • lasts for 3 days
  • Fever
  • Lymphadenopathy

Dx -

  • EIA
  • Serological assays
  • Rubella specific IgM abs remain + for > 1 year.
43
Q

Scabies

A

Skin infestation by mite - Sarcoptes scabiei

Sxs:

  • Pruritic papules - S shaped or linear burrows on skin
  • MC web spaces in intertriginous regions - hands, wrists, finger webs
  • Severe itching, @ night

Dx:

  • clinical
  • definitive Skin scrape - microscopic observation of mite, egg or feces

Tx

  • Topical Permetherin 5%, wash off 8-14 hrs, repeat 1 week
  • Wash all bedding/clothes
  • PO Ivermectin 200 mcg/kg PO once, then repeat In 2 wks
    • C/I in pregnant/breast feeding
44
Q

Seborrheic Dermatitis

A

Sebaceous gland are most active; MC in newborns 2-12 mos

D/t Malassezia yeast

Sxs:

  • Infants - thick, white, yellow greasy scale on scalp aka cradle cap
  • Adults - flaky, greasy, erythematous patches on scalp found behind ears - body folds

Tx:

  • Ketoconazole 2% shampoo - baby
  • Antifungal shampoo - Selenium sulfide - selsun blue
45
Q

Seborrheic Keratosis

A

MC benign cutaneous; genetic, later in life

Sxs

  • Sharply, demarcated “greasy”, waxy, “stuck on”
  • verrucous or papillomatous growth
  • face, neck or trunk, no palm or soles

Tx

  • no tx req’d
  • cryosx, curettage, or flat excision
46
Q

Steven Johnson Syndrom / Toxic Epidermal Necrolysis

A

Extensive necrosis and detachment of epidermis and mucosal surfaces ;

SJS <10% of BSA; TEN - older pts and > 30% of BSA

Uus occurs 8 wks after drug exposure

Eti:

  • Sulfa
  • Anticonvulsants (Phenytoin or carbamazepine)
  • Tetracyclines
  • Allopurinol or
  • Abx - bactrim, B-lactam, FQs, penicillin**
  • NSAIDs

Sxs

  • Fever, HA, rhinitis + myalgias preced lesions by 1-3 days
  • Rash rapidly extends to rest of body
  • Flaccid blisters spreads and break with pressure
  • + Nikolsky’s sign – lateral pressure

Tx

  • EMERGENCY - stop offending drugs
  • BURN UNIT
    • IV fluids
    • pain control
  • systemic steroids
  • OPTHAL
    *
47
Q

Spider Bite - Black Widow

A

Red hourglass on Abdomen

Sxs:

  • Neurologic manifestations - toxic rx,
    • nausea, vomiting,
    • HA
    • fever
    • syncope
    • convulsions

Tx

  • wound care, symptomatic tx
  • treat with anti-venom in elderly and kids
  • Benzos, opioid
48
Q

Spider Bite - Brown recluse

A

Brown Violin on Abd

  1. Necrotic wound - local tissue reaction
  2. local burning at site for 3-4 hrs
  3. blanched area - d/t vasoconstriction
  4. Central Necrosis erythematous margins around Ischemic center “red halo”
  5. 24-7 hrs after hemorrhagic bullae w/ Eschar formation
  6. Necrosis “blue” center

Sxs:

  • Pain
  • Erythema
  • ecchymosis
  • ulceration and necrosis

Tx:

  • wound care, delayed excision
  • Abx erythro, cepholosporin
  • Tetanus prophy
49
Q

Tinea Versicolor

A

Superficial yeast infx - Malessezia furfur, humid lipid rich env

Round oval, sharply marginated scaling macules

trunk and chest

Dx - KOH, woods-lamp blue green fluores

Tx - selenium sulfide or ketoconazole shampoo or lotion

50
Q

Urticaria

A

skin rash triggered by rx to certain foods, medications, stress or other irritants

Eti - Infection, Insect/Infestations (younger)

Ingestion, Inhalation, Injection (older)

Sxs:

  • Blanchable, pruritic, raised, red or skin colored papules, wheels or plaques
  • disappears within 24 hrs
  • + Darier’s sign - localized urticaria appearing where skin Is rubbed (histamine release)
  • Angioedema - painless, deeper form of urticaria affecting lips, tongue, eyelids hands and genital

Dx - clinical

Tx:

  • Self limited
  • Antihistamine meds
    • 2nd gen antihistamine H1 blockers - 1st line
      • ​Allegra, claritin, Zyrtec
    • 1st gen AHs - sleep disturbances
      • ​Hydroxyzine/diphenhydramine
    • H2 AHs - as adjuvants
      • Cimetidine, ranitidine
    • Steroids for exacerbations, avoid chronic use
  • IF anaphylaxis - epinephrine 0.3 to 0.5mg IM route
    *
51
Q

Vitiligo

A

Autoimmune rx against melanocytes; precipitating factor - stress, illness, trauma, severe sunburn

Sxs - chalky pigment, will not fluorescence (ddx tinea versicolor)

Tx

  • sunscreen
  • cosmetic cover up
  • repig - topical glucocorticoid
  • skin graft

PANCE (15 decks)

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