Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

STEP2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

flat spot less than 1cm (non-palpable, just visible)

ex:freckles, tattoos

A

macule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

flat spot>1cm

ex:port wine stain

A

patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

solid, elevated lesion

A

papule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

same as papule but >!cm and flat-topped

ex: psoriasis

A

plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

palpable, solid lesion >1cm, not flat-topped
ex: small lipoma
erythema nodosum

A

nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

elevated circumscribed lesion

A

vesicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

same as vesicle but >5mm (large blister)

ex. contact dermatitis, pemphigus

A

bulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Itchy, transiently edematous area

ex:allergic reaction

A

wheal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

erysipelas

A

upper dermis
superficial lymphatics

may appear raised with clear line of demarcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cellulitis

A

deeper dermis

subcutaneous fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

risk factors for erysipelas and cellulitis

A 
chronic skin problems
diabetes mellitus
chronic swelling of LE
IV drug use
immunocompromiased state
penetration of skin (surgery/trauma)
previous cellulitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnosis and labs in cellulitis and erysipelas

A

Clinical diagnosis
increased WBC count, ESR, CRP
blood cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common organisms in cellulitis

A
  1. beta- hemolytic strep
    s. pyogenes, group B strep
  2. s. aureus common in abscesses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do we treat cellulitis

A

non-purulent cellulitis:
PO- dicloxacillin
cephalexin
clindamycin

IV- cefazolin
nafcillin
clindamycin

purulent cellulitis:
PO- clindamycin
TMP-SMX
Doxycycline
Linezolid

IV abx-
vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Skin abscesses

A

collection of pus within dermis and deeper skin tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Furuncle (boil):

A

infection of hair follicle
purulent material extends through dermis into subQ tissue

often drains spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Carbuncle

A

coalescence of several inflamed follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diagnosis of abcess, furuncle, carbuncle

A

clinical

culture is indicated for bacterial idenfication
-s.aureus in 75% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment of skin abscess

A

let the pus out

if large,
incision and drainage
for patients at risk of endocarditis: vancomycin 1hr prior to incision and drainage

oral: clindamycin, tmp-smx, doxycycline, linezolid

IV: vancomycin

antibiotics are often unsuccessful because you need to get the pus out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hidradenitis suppurative

A

recurrent infection/occlusion of apocrine glands

MC site: axilla

Tx:
-general measures: avoid skin trauma, gentle cleansing, smoking cessation, weight loss

-mild disease: topical clindamycin daily, punch debridement

second line: clindamycin with rifampin

severe disease: oral doxycycline or minocycline, more invasive surgical debridement
-alternative treatments: intralesional steroids, anti-adrenergic drugs, TNFa inhibitors, oral retinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

necrotizing fasciitis

A

infection spreading along fascial plane

polymicrobial- anaerobes, gram +, gram -
GAS
often in the setting of some systemic disease

H and P:
unexplained, excrutiating pain in the absence of or beyond areas of cellulitis

bulla, necrosis, crepitus

Dx: surgical exploration is the only way to definitively diagnose, as well as to treat

rapidly worsening cellulitis with severe pain

Xray: crepitus, subcutaneous air can be seen with plain film on an xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fournier gangrene

A

perineal cellulitis with abrupt onset and rapid spread

this is a urological emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the general treatment for necrotizing fasciitis?

A

immediate aggressive surgical debridement

abx:
1. carbapenem (imipenem or meropenem)
or beta-lactam plus beta-lactamase inhibitor (piperacillin +tazobactam)
PLUS
2. clindamycin
PLUS
3. vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gangrene

A

significant amounts of body tissue necrosis

a chronic condition compared with necrotizing fasciitis

dry gangrene (chronic, distal, severe ischemia) treat with revascularization or allow auto-amputation

wet gangrene: bacterial infection in moist tissue: debridement, possible amputation

gas gangrene: caused by clostridium perfringens

  • debridement
  • hyperbaric oxygen
  • antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Impetigo

A

contagios skin infection among young children

s. aureus is MCC (MSSA)
s. pyogenes

vesicles that form and rupture to form thick crust, most commonly on the face

Treatment:
mild- mupirocin

moderate-severe: dicloxacillin, cephalexin

MRSA: clindamycin, TMP-SMX, doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Acne vulgaris

A
  1. hyperkeratosis
    - retinoic acid (tretinoin)
    - isotretinoin is PO, potent
  2. sebum overproduction
    - isotretinoin
    - tretinoin
    - spironolactone (anti-androgen, decreases testosterone and cortisol)
    - OCP
  3. propionibacterium acnes proliferation
    - erythromyicin PO
    - tertracycline PO
    - doxycycline PO
    - minocycline PO
    - clindamycin PO
    - topical clindamycin
    - benzoyl peroxide
  4. inflammation
    - steroids

affecting areas that have hormonally- sensitive sebaceous glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

isotretinoin side effects

A 
hepatotoxicity
teratogenic
drying and cracking of skin and lips
depression
elevated TG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Acne drugs that can cause photosensitivity

A

tetracycline
doxycycline
tretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Rosacea

A

cause is not understood
inflammation, UV damage, vascular damage

middle- aged patient
facial erythema with telangiectasias starting at nose and cheeks
recurrent facial flushing provoked by various stimuli including hot/spicy foods, alcohol, temperature extremes, emotional reactions

no comedones, but otherwise looks a little like acne

ocular blepharitis, conjunctivitis, keratitis

bumpy nose (sebaceous gland hyperplasia)- rhinophyma

Topical treatment:

  • metronidazole
  • azeleic acid

Systemic treatment:

  • tetracycline, doxycycline, minocycline
  • isotretinoin for severe refractory cases
  • laser therapy for rhinophyma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

HSV

A

recurrent viral infection of mucocutaneous surfaces

HSV1- oral disease
viral genetic disease in sensory areas

cold sores every month, every 5 years

small painful vesicles around the mouth, lasting several days

eyes, esophagus

Herpetic whitlow- cutical, painful

Dx:
Tzanck smear on a q-tip
viral culture
serology

Tx: treats symptoms, can’t be cured
acyclovir
famciclovir
valacyclovir

contagious even when you don’t see lesions

Vertical transmission can cause disseminated disease

Newborns can get herpes temporal lobe encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Varicella

A

primary disease- chickenpox

secondary- shingles

clinical features:
prodrome of malaise, fever, pharyngitis, HA, myalgia for 24 hours prior to rash onset

pruritic evolving rash with teardrop vesicles, crusting over

face, trunk, extremities, spreads over 2-4 days, crusted over by 6 days

superinfection may occur (s. pyogenes)

adults may develop PNA or encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatments for children with chickenpox?

A

antihistamines for pruritis
cut fingernails closely to avoid excoriations leading to bacterial superinfections
acetaminophen for fever
no need for acyclovir in otherwise healthy children younger than 12

acyclovir if:

  • > 12yo
  • hx of chronic cutaneous or cardiopulmonary disorders
  • taking intermittent oral or inhaled steroids
  • chronic salicylates

prevention:
varicella vaccina now given at 1 year and 4 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Shingles

A

reactivation of herpes zoster virus

painful, grouped vesicles in a dermatomal distribution

postherpetic neuralgia possible

transmission through direct contact with active lesion (not as transmissible as chickenpox)

treatment: 
antivirals if presenting within 72 hours
-valacyclovir
-famciclovir
-acyclovir: high dosing frequency but low cost

Analgesia with opioids
Corticosteroids (prednisone tapered over 7 days) only if severe symptoms and no contraindications. Usually the high risk of side effects outweighs the only modest benefits.

ppx: shingles vaccine for everyone over 50 year
do not give to pregnant women, or immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Treat postherpetic neuralgia

A

months, years, fades over time

gabapentin
pregabalin
TCAs
lidocaine patches
capsaicin cream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Acne treatment

A 
benzoyl peroxide
topical retinoid or antibiotic
oral antibiotic
OCPs
spironolactone
isotretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Rosacea treatment

A

topical metronidazole or azeleic acid

laser therapy

systemic treatment:

  • tetracycline
  • doxycycline
  • minocycline
  • isotretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Warts

A

benign epithelial growths caused by HPV 1-4 (skin)

Genital warts HPV 6 and 11

Treatment options for cutaneous warts:

  • 2/3 resolve spontaneously within 2 years
  • salicylic acid (first line)
  • liquid nitrogen
  • 5-FU and imiquimod
  • curettage, trichloroacetic acid, cantharidin (blister juice from beetles), surgical excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Molluscum contagiosum

A

seem most commonly in children

adults with HIV, perineal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

tinea versicolor

A
  • malassezia furfur
  • hypopigmented or light brown or pink macules often found on back and shoulders
  • hyphae and spores (spaghetti and meatballs) seen microscopically

will scale when scraped

Treatment:
ketoconazole 2% shampoo
topical antifungal (terbinafine)
selenium sulfide
PO antifungal for extensive disease (ketoconazole, fluconazole, itraconazole)
dandruff shampoo can also be affective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tinea

A 
capitis (scalp)
corporis (body)
cruris (groin)
pedis (foot)
unguium (nails)

caused by microsporum, trichophyton, epidermophyton

pruritic, erythematous, blisters, scaly plaques, central clearing

diagnose with KOH, hyphae present

Treatment:
SKIN- topical (clotrimazole, terbinafine, nystatin)
PO- (terbinafine, itraconazole, fluconazole)

Scalp: PO (griseofulvin, terbinafine, itraconazole, fluconazole)
Nails: PO (terbinafine, itraconazole, fluconazole); topical (cilcopirox, efinaconazole)

check LFT before starting these meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Intertrigo

A

candida albicans
looks like diaper rash
common in skin creases

irritant dermatitis by contrast, won’t have satellite lesions, and won’t be as much in the folds
KOH shows pseudohyphae

Treat with topical clotrimazole or terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Scabies

A

RF: crowded living conditions
poor hygiene

Severe pruritis with burrows and papules located on extremities and between fingers and toes

Skin scrapings will show mites and eggs under microscope

treat with permethrin cream
diphenhydramine and corticosteroids help with itching

wash everything in hot water

infection of close contacts is a common complication

43
Q

lice and crabs

A

diagnosis by direct visualization

all cause pruritis

Pediculosis capitis:

  • treat with permethrin cream or shampoo, rinse after 10 minutes, then comb out lice and nits
  • alternatives: topical malathion or ivermectin

Pediculosis corporis: body louse
-treat with permethrin cream and leave on for 8-10 hours

Pediculosis pubis: groin lice

  • Treat with permethrin or pyrethrin cream and rinse out after 10 minutes, and then comb
  • Alternatives: topical malathion and ivermectin
  • sexually transmitted
44
Q

Hypersensitivity reactions in the skin (mainly 1 and 4)

A

Type 1: mast cell degranulation: IgE, immediate allergy

Type 4: delayed type, cell-mediated immune memory response
Morbilliform rash days after 2nd exposure to allergen

Common causes: plants, nickel, soaps, latex

Stop offending agent 
remove contact with allergen
topical steroids
oral antihistamines
oral corticosteroids
IM epinephrine
45
Q

Erythema multiforme

A

erythema multiforme: deposition of immune complexes into superficial microvasculature and mucous membranes
often a drug reaction (PCN, sulfonamides, NSAIDs, PO contraceptives, anticonvulsant medications)
HSV and mycoplasma pneumoniae are common infectious causes that can lead to erythema multiforme

Appearance: skin lesion, target, pale zone, darker outer ring
can be anywhere

lesions develop over 10+ days:
macule> papule> vesicles/bullae in the center of the papule

common sites:
hands/forearms, sole/feet, elbows and knees, penis and vulva

Severe form (EM major) always involves the mucuous membranes and can become SJS/TEN

46
Q

Treatment for erythema multiforme

A

stop inciting medication
symptomatic treatment with antipruritics
if severe- systemic glucocorticoids (although no proven effectiveness)

if patient also has history of HSV, then antiviral such as acyclovir or valacyclovir

47
Q

SJS and TEN

A

SJS is severe EM, always involves mucous membranes

skin sloughs,

48
Q

TEN

A

> 30% of BSA
full-thickness epidermal necrosis

treat in a burn unit
IV fluids

Labs:
decreased H/H
increased ALT, AST

IV hydration
acyclovir

49
Q

Seborrheic dermatitis

A

chronic relapsing dematitis a/w sebacious glands

possible cause is malassezia furfur

erythematous plaques with greasy- looking, yellowish scales

Treatment:
scalp: medicated shampoo (ketoconazole, selenium sulfide, ciclopirox); alternative is tar- containing shampoo

skin: low-potency topical steroids or topical antifungal cream (ketoconazole)

50
Q

What diseases are a/w increased incidence of seborrheic dermatitis?

A

Parkinson, HIV, psoriasis, immunocompromised patients (transplant patients)

Exacerbations are common in emotional stress and hospitalizations

Severe intractable seborrheic dermatitis may point to HIV infection

51
Q

Seborrheic keratosis

A

various presentations, variable size, pasted on
no treatment needed

dark
warty

52
Q

Actinic keratosis

A

precancerous lesion a/w sun exposure

53
Q

Atopic dermatitis

A

oozing, crusty
often found in children
asthma allergies

dry vesicles

treatments:
skin hydration: emollients
topical steroids
calcineurin inhibitors: tacrolimus or pimecrolimus
severe or resistant cases: UV light therapy, systemic steroids, immunosuppressants (methotrexate, cyclosporine, azathioprine)
antibiotics for open lesions (cover s.aureus and streptococcus)

54
Q

side effects a/w calcineurin treatment

A

lymphoma

keep duration short

55
Q

psoriasis

A

immune- mediated
red plaques on knees and elbows

pustules
silvery scales

clinical diagnosis
skin biopsy: thickened epidermis
absent granular layer
nucleated cells in stratum corneum

are you having joint pain as well? check for arthritis

56
Q

psoriasis treatment

A

mild to mod disease:

  • topical steroids and emollients
  • alternatives: tar-nased products, topical retinoids (tazarotene); topical vitamin D (calcipotriene), anthralin, calcineurin inhibitors (tacrolimus, pimecrolimus)

Severe disease:

  • phototherapy
  • oral retinoids
  • immunosuppressants (methotrexate, cyclosporine)
  • adalimumab, etanercept and infliximab
57
Q

Pityriasis rosea

A

benign, self- limited inflammatory disease, in children or young adults with possible viral association, seen on trunk

herald patch: 2-5 cm, precedes christmas tree, pink, confirm lack of hyphae with KOH prep

clinical diagnosis

Treatment: 
self- limiting
moderate-potency topical steroid for pruritis
severe disease:
UV therapy
acyclovir
erythromycin
58
Q

Erythema nodosum: cause

SPUD BITS

A

shins, trunk, etc
delayed immunologic reaction to drugs, infection, IBD

Streptococcal infection
Pregnancy
Unknown (idiopathic)
Drugs
Behcet disease
Inflammatory bowel disease
Tuberculosis
Sarcoidosis
H and P:
malaise
arthralgia
tender erythematous nodules (pretibial)
fever

Labs:
possible +ASO
increased ESR
Bx: fatty infiltration

Treatment:
self- limited
NSAIDs
potassium iodid
corticosteroids
59
Q

Lichen planus

A

pruritic
purple
polygonal plaque, shiny and flat, commonly on the flexor surface (wrist, etc)

Wickham’s striae is a white, lace-like pattern on the surface of the papules/plaques

Mucous membrane involvement: Wickham’s striae in the lateral buccal mucosa and possibly erosive lesions that may become infected with Candida

Genital involvement: usually limited to violaceous papules on the glans penis in men, vulva of women

RF:
HIV
Hep C

Treatment:
corticosteroids of medium to high potency (topical or intralesional, oral if topical is unsuccessful)

acitretin (oral retinoid)

60
Q

Decubitus ulcers

A

stage 1: pressure-related, change in color, skin intact

stage 2: superficial ulcer

stage 3: full thickness with damaged tissue

stage 4: full thickness with damage to muscle, etc

Treatment:
good nutrition and hydration
remove pressure on ulcer
debridement
wound care
antibiotics
61
Q

Stasis dermatitis

A

RF: chronic venous insufficiency. LE
eczematous, inflammatory papules, increased pigmentation, stippling, old hemorrhages

clinical diagnosis
venous reflux is confirmed using duplex ultrasound

62
Q

Treatment for stasis dermatitis

A 
weightloss
compressive dressings of stocking
leg elevation
topical steroids
vein ablation
63
Q

Medications most commonly associated with erythema multiforme

A 
penicillins
sulfonamides
OCPs
NSAIDs
anticonvulsants
64
Q

EM vs. SJS vs. TEN

A

EM:
milder disease
no sloughing of skin

SJS:
skin-sloughing limited to 30% of BSA

65
Q

Psoriasis- what does it look like?

A

red plaques with silvery scales
extensor surfaces
Auspitz sign

66
Q

classic presentation of erythema nodosum

A

pretibial nodules within subcutaneous fat

-painful and erythematous

67
Q

classic presentation of pityriasis rosea

A

herald patch, followed by rash in Christmas tree patten

no treatment needed

68
Q

classic presentation of lichen planus

A

pruritic, purple, polygonal, plaques and papules on flexor surfaces of extremities

69
Q

Pemphigus vulgaris

A

flaccis, easy to rupture blisters, +Nikolsky

almost always with oral lesions

antibodies in epidermis

anti-desmosome antibody

Tx: high dose systemic steroids, azathioprine or mycophenolate mofetil (steroid-reducing adjuvant)
antibiotics for 2ndary infection

fatal without treatment

70
Q

Bullous pemphigoid

A

tense bullae
rare oral lesions (10-30%)
antibodies found at dermal- epidermal junction

antihemidesmosomes, with better prognosis than pemphigus

topical steroids (clobetasol)

PO steroids (prednisone) if topical steroids aren’t possible

chronic management: mycophenolate mofetil
azathioprine
methotrexate

71
Q

Porphyria cutanea tarda

A

deficiency in uroporphynogen decarboxylase

porphyrin accumulates

acute porphyria
-nervous system:neuropathy, abd pain, mental disturbances

cutaneous porphyria:
-excess porphyrins near the surface of the skin

risk factors: hepatitis C, alcohol abuse, excess iron

classic presentation: blistering lesions

chronic skin thickening on sun-exposed areas, hyperpigmentation, calcification, facial hypertrichosis

diagnosis:
elevated urinary porphybilinogen

diagnosis: elevated plasma porphyrins

treatment:
phlebotomy
hydroxychloroquine
avoidance of sun, alcohol, estrogens, iron supplements

72
Q

Actinic keratosis

A

precancerous skin lesion
RF: sun exposure
erythematous papule with rough, yellow-brown scales
biopsy: dysplasia

Treatment: topical 5-FU, imiquimod, cryotherapy

0.1%/year risk of squamous cell carcinoma

73
Q

Squamous cell carcinoma

A

skin cancer of squamous cells of epithelium

RF:sun exposure, arsenic exposure, fair complexion, radiation- especially UVB

painless, well-demarcated, scaly patch or plaque, erythematous, scaling

Treatment: surgical excision (Mohs), radiation

5-10% metastesize

74
Q

Basal cell carcinoma

A

mc skin cancer
least likely to metastesize
pearly papule
rolled edges

treatment: surgical excision (Mohs), radiation, cryotherapy

75
Q

Melanoma

A

malignant melanocyte tumor
RF: sun exposure, fair complexion, family history, numerous nevi

Types:
-superficial spreading is most common, grows laterally before vertically (back on men, legs on women)
-nodular: only grows vertically and becomes invasive rapidly
-acral lentiginous: least common, found on palms, soles, and nail beds
lentigo maligna: slow growth, 10-50 years before vertical growth

Labs: excisional biopsy shows atypical melanocytes and possible invasion into the dermis (>.76 mm is associated with increased risk of metastasis)

Treatment:
0.5 cm margin if in situ
1cm margin if 2mm thick +/- lymph node dissection

chemotherapy and radiation if metastasis

Most commonly mets to brain, lung, GI tract

periodic skin checks if history of sun exposure or family history of melanoma

76
Q

ABCDE of melanoma

A 
Asymmetry
Border irregularity
Color
Diameter >6mm
Evolving

Do not shave; excisional biopsy

77
Q

Most important prognostic indicator in melanoma

A

depth of lesion

78
Q

BCC appearance

A

pearly papule
telangiectasias

rolled edges if ulcerated

79
Q

Squamous cell carcinoma appearance

A

papule or ulcer
scaling or keratinization
irregular or disorderly appearance
either painless or painful

80
Q

split-thickness graft

A

graft composed of epidermis and part of the dermis

abdomen, thighs, buttocks

extensive, large surface areas

81
Q

full-thickness graft

A

face and hand defects

82
Q

composite graft

A

fat, nailbed, etc, site-speficit reconstructions are the indication

83
Q

fasciocutaneous flap

A

skin+subQ tissue+vascular supply
donor sites: forehead, groin, deltopectoral region, thighs

indicated for large defects

84
Q

muscle flap

A

may include skin (myocutaneous)

donors: TFL, gluteal muscle, lat
indications- deep tissue injury, radiation injury

85
Q

Melasma

A

dark skin discolration common in pregnant women and those taking OCPs or hormone replacement therapy

Tx by minimizing sunlight exposure and sunscreen
titanium and zinc oxide

Triple combo cream: tretinoin, hydroquinone, mid-potency topical steroid (flucinolone)

86
Q

What are characteristic features of vitiligo

A

sharply demarcated patches of complete depigmentation (due to loss of melanocytes)

  • borders are hyperpigmented
  • more common at acral areas and around body orifices

Skin is of normal texture (excludes morphea and lichen sclerosis)

Associated with thyroid disease in 30% of patients (especially women)
mo

most common age 20-30

87
Q

Autoimmune disorders associated with vitiligo

A 
GRaves
autoimmune thyroiditis
pernicious anemia
type I DM
primary adrenal insufficiency
hypopituitarism
alopecia areata
autoimmune hepatitis
88
Q

Treatment for vitiligo

A

sunscreen to minimize tanning of normal skin, which would increase the contrast

dyes and make-up to camofluage depigmented area

topical corticosteroids (first line)

Tacrolimus or pimecrolimus (calcineurin inhibitors)

Psoralens (topical or oral) + UV light (PUVA or UVB) for extensive disease

surgical mini-grafting is an option when medical therapy fails

hydroquinone for depigmentation of normal skin to match regions of vitiligo (ast resort)

89
Q

Acanthosis nigricans

A

velvety hyperpigmentation

most commonly seen on lateral folds of axilla, neck, groin

associated with hyperinsulinemia and visceral maligancies

Treat underlying disorder:
diabetes
weightloss
discontinuation of medication (glucocorticoids, OCPs), or treatment of malignancy

Tretinoin (topical)
Calcipotriene (Vit D topical analog)

90
Q

blue mass that does not regress

A

cavernous hemangioma (venous malformation)

91
Q

Treatment for infantile hemangioma

A

uncomplicated infantile hemangiomas will gradually resolve within the frist 2 years of life, therefore observation is usually the best treatment

Complicated infantile hemangiomas: oral propanolol, systemic glucocorticoids, vincristine, interferon alpha

92
Q

Clinical features of alopecia areata

A

asymptomatic, inflammatory, non-scarring areas of complete hair loss

may be precipitated by stress

regrowth after 1st affack in 30% by 6 months, in 50% by 1 year, in 80% by 5 years

10-30% will not regrow hair
5% progress to total hair loss

obtain syphilis screen
CBC
BMP
ESR
TSH
ANA (to rule out pernicious anemia, chronic active hepatitis, thyroid disease, SLE, Addison)

Rule out trichotillomania (pulling out one’s hair): look for broken hair shafts of different lengths, consider shaving a small patch oand observe over a few weeks for growth

Treatment:
intralesional steroid injection
topical corticosteroids
minoxidil topical
topical immunotherapy
anthralin cream (children)
oral steroids
93
Q

What name is given to diffuse stress-related hair loss?

What is the treatment?

A

Telogen effluvium
self- limited
reassurance, stress relief

94
Q

androgenic alopecia

A

causes are both hormonal and genetic

dihydrotestosterone causes follicular miniturization leading to replacement of terminal hairs by short, thin hairs

inheritance involves both paternal and maternal factors

Treatment:
Finasteride (5alpha-reductase inhibitor)
Minoxidil (topical)

95
Q

Caused by complete lack of melanocytes

A

vitiligo

96
Q

Hair loss associated with effects of dihydrotestosterone on hair follicles

A

androgenic alopecia

97
Q

Most common co-morbidity in vitiligo

A

TSH

98
Q

purple-red lesion on face that does not regress with age

A

port wine stain

99
Q

infant with bright red lesion that regresses over months-years

A

strawberry hemangioma

100
Q

benign, small papule that appears on skin with age

A

cherry hemangioma

101
Q

bright red papule with radiating blanching vessls

A

spider angioma

102
Q

blue, compressible mass that does not regress

A

cavernous hamengioma

103
Q

red-pink nodule on a child that is often confused with melanoma

A

Spitz nevus

104
Q

anti-centromere abs

A

CREST scleroderma

STEP2 (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions