Dermatology Flashcards
Chronic relapsing skin disorder than begins in childhood – IgE mediated. Presents with red, scaly, crusted, pruritic lesions.
Atopic dermatitis
How do we treat atopic dermatitis?
Topical steroids and antihistamines
This is known as cradle cap in infants and dandruff in adults.
Seborrheic dermatitis
How do we treat dandruff?
Shampoos containing selenium or zinc and ketoconazole shampoo for acute flare-ups.
This often presents with edema, dermatitis, hyperpigmentation, fibrosis, and ulcerations.
Stasis dermatitis
How do we treat stasis dermatitis?
compression stockings, vascular bypass, stenting
This usually presents with pruritic vesicles over the palms, soles, and fingers. typically crack over a week or two.
Dyshidrotic eczema
This presents with patches that are usually raised, pink to red papules and plaques with distinct margins. Loosely adherent silvery scales. Mostly found on the scalp and exterior surfaces of the elbows and knees.
Psoriasis
What is Auspitz sign?
When you peel away a scale and it produces specks of bleeding from the capillaries
What type of psoriasis is most common and involves chronic recurring scaling papules and plaques.
Psoriasis vulgaris
This type of psoriasis is an acute eruption of typical and atypical lesions in a disseminated pattern (spares the palms and soles) and often appears after strep pharyngitis.
guttate psoriasis
This type of psoriasis is an abrupt, life threatening condition that is characterized by widespread pustules that coalesce to form lakes of pus, fever, malaise, and leukocytosis
Pustular psoriasis
How do we treat mild cases of psoriasis?
Topical corticosteroids and topical Vit D preparations
How do we diagnose a fungal skin infection?
KOH prep
What is a herald patch and what skin disorder is it associated with?
Herald patch is a solitary round or oval pink plaque with a raised border and fine adherent scales in the margin. Associated with pityriasis rosea.
What is the treatment for pityriasis rosea?
None – self-limiting (3-8 weeks)
This is caused by plugged follicles, retained sebum, bacterial overgrowth, and release of fatty acids.
Acne vulgaris
Open comedomes are usually white or blackheads?
Blackheads
This is a chronic skin disorder with facial flushing. Triggers include alcohol, sunlight, exercise, and extreme temps.
Rosacea
This type of rosacea is characterized by persistent flushing of central face, telangiectasis, roughness, scaling, and skin sensitivity.
Erythematotelangiectatic
This type of rosacea may look like acne due to papules/pustules.
Papulopustular rosacea
treat with topical metronidazole
This type of rosacea is characterizedd by tissue hypertrophy that distorts facial features
Phymatous
What type of rosacea consists of conjunctival hyperemia, blepharitis, hordeolum, and excessive tearing?
Ocular
How do you treat rosacea?
Avoid skin triggers, keep skin moisturized, sunblock and cleansing
This is commonly due to staph aureas – inflammation of hair follicles
Folliculitis
Is folliculitis painful?
Generally not – may burn
How do you treat folliculitis?
Gentle cleansing, mild compresses. Topical application fo clinda or erythro.
Small vesicles in a dermatomal pattern.
Herpes Simplex/Zoster
How can you confirm the diagnosis of herpes?
Tzank smear
How do you treat shingles?
Acyclovir + pain management
This presents with cough, coryza, conjunctivitis, and Koplik spots (buccal mucosa).
Measles
What virus causes measles?
paramyxovirus
This presents with a low grade fever and URI symptoms. Later develop parotid gland swelling and orchitis. Elevated amylase.
Mumps
This presents with occipital, post auricular, and post cervical lymphadenopathy. Forchheimer spots are seen on soft palate.
Rubella
This disease follows a URI by bright red rash over the cheek. “Slapped cheek” and lacey reticular rash.
Erythema Infectiousum (Fifths disease)
What virus causes fifths disease?
parvovirus B19
This presents with a very high fever. After the fever resolves, a maculopapular rash develops that starts on the trunk and spreads to face/extremities.
Roseola (exanthem subitum)
What virus causes Roseola?
herpes virus 6 and 7
Characterized by acute, spreading inflammation of the dermis and subcutaneous tissue.
Cellulitis
What is the most common cause of cellulitis?
Hemolytic streptococci and staph aureus
This typically presents around the mouth, nose and cheek. HONEY CRUST.
Impetigo
This disease is similar to cellulitis but has a raised, clear line of demarcation between infected and non-infected. Typically on face or ears.
Erysipelas
Does erysipelas come on gradually or suddenly?
Suddenly
This is typically found on obese people. It a disease of the apocrine gland.
Hydradentitis Suppurativa.
Is hydradentitis suppurativa related to hair follicles?
NOPE
How do you treat hydradentitis suppurativa?
I and D – excision of sinus tracts + PO abx for 2 weeks
How do we treat head lice?
1% premethrine rinse.
How is head lice spread?
By contact.
This presents with intense itching that spares the head and neck. Typically found between the fingers and other places there is no hair.
Scabies
How do we treat scabies?
5% premethrine cream
This type of spider bite will present with muscle cramps and aching
Black widow
What type of spider bite will present with necrosis of the skin?
Brown recluse
What type of skin neoplasm presents with a nodule appearance, pearly papule (that ulcerates), with a talangeictatic vessel. “Rolled borders”
Basal cell carcinoma
Does basal cell carcinoma typically metastasize?
No
This neoplasm presents with a scaly, erythematous papule or plaque + ulcer that fails to heal and continues to grow
Squamous cell
Do squamous cell carcinoma metastasize?
Yes – high risk
What is the most dangerous type of skin cancer?
Melanoma
These are a pre-cancerous squamous cell carcinoma. Present with an erythematous scaling macule or papule in sun exposed areas.
Actinic Keratosis
How do we treat vulvovaginitis?
Fluconazole
What is onychomycosis?
Fungal infection of the nail
How do we treat onychomycosis?
Terbinafine x 12 weeks
This presents with target-like lesions, fever, weakness, and malaise. Can be induced by drugs and infections.
Erythema multiforme.
This is characterized by a mucocutaneous blistering reaction most often caused by a drug reaction
Stevens-Johnson-Syndrome
What is the Nikolsky sign?
sloughing of skin
What is a severe variant of SJS?
Toxic epidermal necrolysis
What percentage of the body needs to be affected to be diagnosed with TEN?
30%
This presents most commonly from a food or drug allergy. Lesions are pruritic, may sting or burn, but should not be painful.
Urticaria
How do we treat urticaria?
Self-limiting, H1 antihistamines
What disease results in depigmented patches?
Vitiligo – destruction of melanocytes
What is vitiligo often associated with?
thyroid disease, pernicious anemia, DM, and addison’s disease
What type of burn is dry, red, painful, and does not blister?
Superficial
What type of burn is red, moist, painful, blanches and blisters?
Superficial partial thickness
What type of burn is white, and not painful?
Deep partial thickness
Do deep partial thickness burns blanch? can you feel pressure?
No blanching, can feel pressure
This type of burn is waxy white and leathery. Is completely painless.
Full thickness
What are some examples of burns that require a transfer to a burn unit?
Circumferential burns
burns crossing joints
burns that involve the hand, face, feet, genitalia, and perineum
what type of fluid do we give burn victims?
Lactated Ringers
What is the formula to determine how much LR to give to a burn victim?
4ml/kg x BSA% in 24 hours
Half is given in first 8 hours, remainder is given over the following 16
using the rule of 9’s, what percentage is each leg?
18 percent
using the rule of 9’s, what percentage is each arm (front and back)?
9 percent
