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PANRE > Dermatology > Flashcards

Dermatology Flashcards

1
Q

skin cancer

risk factors

A

RF: fair complexion, h/o blistering sunburn as a child, increased sun exposure, fhx.

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2
Q

actinic keratosis

A
  • small , light pigmented scaly spots
  • sun exposed areas

tx: cryotherapy for isolated lesions( SE: hypo pigmentation)
- 5-fu- Efudex- applied bid and make skin red and angry and apply until lesions crust over

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3
Q

squamous cell carcinoma

A
  • presentation varied
  • ulceration or sore that bleeds and does not heal
  • rare for mets
  • Bowens dz–> SCC in situ

dx: biopsy
tx: excision, treat thoroughly with Mohls’ surgery to check margins

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4
Q

basal cell carcinoma

A

slowly enlarging nodule with central depression or ulceration with surface telangiectasis

mets rare

tx: same as squamous cell

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5
Q

Melanoma

A
  • ABCs of mole evaluation
  • Asymmetry
  • border irregular
  • colore mottled
  • diameter > 6 mm
  • elevation common, irregular
  • leading cause of death
  • appear flat or raised
  • h/ o dysplasia nevi –> incr risk
  • px r/t thickness of melanoma
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6
Q

seborrheic keratoses

A

benign, age-related plaques
-beige to brown to black
no tx needed
-waxy appearance

tx: curettage and freezing
- sudden eruption –> underlying malignancy

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7
Q

atopic dermatitis

A

pruritic, leads to scratch/itch cycle
– seen with fix with asthma or allergy

  • tends to grow out
  • seen in arm and flexural folds

s/s: denny’s lines -inftraorbital darkness

tx: avoid triggers, topical steroids, protonic, elderly
systemic steroids only for extensive dz,
oral histamines.

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8
Q

contact dermatitis

A

irritant- chemical exposure

  • erythema, scaling
  • industrial and detergents

allergic: poison ivy and nickle
- confined to area of contact and later can spread beyond

tx: avoid irritants
-topical steroids
-burrow solution for wheeling solution
- tacrolimus
severe > 20% - use oral steroids

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9
Q

diaper dermatitis

A

d/t prolonged exposure to urine/ feces
- get with yeast

  • tx: topical antifungals
  • nystatin
  • clotrimazole
  • miconazole
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10
Q

nummular eczema

A

coin-like lesions on LE
seen in older or younger adults
-older male/ETOH abuse

  • mild to sever pruritus

tx: hydration and systemic anti-histamines
- topical steroids
- phototherapy

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11
Q

perioral dermatitis

A
  • seen in women of child bearing age
  • h/o topical steroid use
  • tx: topical metronidazole, erythromycin,
    avoid steroids,

severe: oral tetracycline, doxycycline, minoclycline
taper meds

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12
Q

seborrheic dermatitis

A
  • seen in Males with oily skin
  • seen in nasal folds, eyebrows, eyelids
  • tends to recur
  • scales with background erythema

tx: cleaning the area
- shampoos with selenium sulfide, ketoconazole,
- mild topical steroids
- maintenance tx required

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13
Q

stasis dermatitis

A

inflam reaction to leaky serum from varicose veins

brownish-purplish skin with weepiness
tx: improve blood flow to area

avoid neomycin ( neosporin)
wear compression stocking and wrap
-burrows solution
-abx for infection

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14
Q

dyshidrosis

A
  • bubbling of tapioca-like vesicle–> scale and leas to fissures
  • seen in hands and fingers
  • outgrow it
    dx: clinical

tx:topical steroids
burrows solution
only systemic steroids for systemic cases

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15
Q

lichen simplex chronicus

A
  • intense itching caused by self-perpetuating scratch-itch
  • lichenified lesions
  • Neck and extremities common
  • tx: cessation of itch-scratch cycle
  • topical steroids
  • occlusion to prevent further trauma
  • pt educ.
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16
Q

lichen planus

A
  • purple violaceous, polygonal, papular or planar
  • Wickhams striae on surface - fine lacy white lesions
  • oral and nail manifestations
  • tx: often resistant
  • topical steroids w/ occlusion
  • oral steroids in severe cases
  • UVA therapy

can be caused by drugs

  • koebner’s phenomna- lesions seen in previous area of trauma
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17
Q

pityriasis rosea

A

benign, seen in young adults

  • spring and Fall
  • oval erythematous to fawn colored discrete lesion with collarette scale
  • Herald patch 2 weeks prior to the rash
  • christmas tree pattern
  • self- limiting, resolved in 6 weeks
  • topical steroids
  • consider STI testing
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18
Q

drug eruptions

A
  • varied presentations
  • occurs day to week from tx
  • PCN and sulfa are common
  • self-limited

tx: d/c drug
- supportive care

fixed drug eruption- reintroduce drug and manifest in the same exact way and place

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19
Q

erythema multiforme

A

target lesions

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20
Q

Steven Johns and TEN ( toxic epidural necrolysis)

A 
fever, HA, arthralgia, 
-confluent, asymmetric area of dusky erythema 
- shedding full sheets of skin
-mm affected
- taken to burn unit 
-causes:  abx, anticonvulsant, NSAIDS
- life-threatening 
Nikolksy sign- sloughing of skin and shear epidermis

tx:

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21
Q

bulls pemphigoid

A

pruritic tense blisters

  • abrupt onset
  • oral leions
tx: months--> years
topical potent steroids 
-oral steroids 
dapsone 
negative Nikolsky

immune suppression

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22
Q

psoriasis

A

chronic, papulosquamous dz, genetic

silvery scales on bright red

Ausptiz sign, Koebner’s phenom a

worse in winter

  • gutate - associated with strep throat, class tear drop salmon plaques
tx; depend on extent of sz
localized- topical steroids
dovonex
duodenum
tazorac
tar based products 
avoid stress and ETOH

generalized dx: phototherapy
methotrexate
oral retinoids

23
Q

tine corporis

A
  • round, oval, semicircular
  • central clearing

mild contagious

tx; topical anti fungal( azoles)
systemic: itraconazole

24
Q

tine pedis

A

seen in young adult males

  • mocassin type

hype on KOH exam

management: prevention- use show shoes
dry, scaly- anti fungal txt
macerate: burrow wet dressing

25
tinea veriscolor
- fair skin- hyppigmented - overgrowth of year tx; topical selenium sulfide lotion / shampoo - topical or systemic ketoconazole
26
folliculitis
inflame of hair - pustules in hair follicles pseudo folliculti: beard area from ingrown hairs tx; depend on etiology
27
cellulitis
GAS and S. aureus tx: oral abx severe: admit for IV abx
28
erysipelas
superficial - fatal - prodrome sx: rash - LE more common - shiny bright red rash dx: clinical tx; IV abx first 48 hours and support therapy
29
impetigo
kids - staph auteurs - site of bug bite - vesicle, homy-colored crust tx; bactroban oral abx for larger area
30
viral warts
HPV- 100 serotypes tx; OTC salicylic acid cryotherapy co2 laser therapy surgical excision
31
viral condylomata acumiat
genital area HPF 6, 11 highly infectious cauliflower, fleshy growth tx: podofilox, imiquimod cryotherapy
32
herpes simplex
hsv 1- labials hsv 2- genital prodrome at site giant cell on Tzanck tx: valtrex, famvir, pt education
33
shingles
pain ful rash from parcel -thoracic/ lumbar root trigeminal nerve- blindness tx: anti-viral s, oral steroids in immunocompromised help reduce pain
34
molluscum contagiosum
- central umblication - self limited -benign seen on trunk and extremities viral in origin
35
acne vulgaris
- common adolescent and young adults - comedones, papules, pustules, cysts - improves in summer midl: topical- retinoids, benzoyl peroxide moderate inflame: add oral abx ( mine or doxy) severe inflame: isotretinon, intralesional, injeciton
36
rosacea
- seen in women middle age - no comedones - worse w/ heat, exercise - papulres and telangecasia tx; avoid of flushing with sunscreen topical flail, oral mino, doxy severe: isotretinoin
37
vitiligo
autoimmune disorder? no pigment tx; depend on extent and disfiguration - topical steroids, UVB/ PUVA cosmetic are, protective sunscreen
38
acanthuses nigrican
adenoma ca of GI tract -bening type- seen with overweight, insulin resistant mangement: loose weight - control BS - cosmetic care
39
Burns
ABCs rule of 9's , dictate who goes to burn center 1st degree: redness w/o change in texture 2nd degree; blister 3d degrees: area is white, leathery myoglobinuria ( electrial ) look or exit wound from lighting strike no ice, check for harness
40
hidradenitis suppurative
``` obesity,acne - tender inflame nodule in axilla males- groin, button tx: weight reduction, loose garments, clean area, drysol, tetra/ erythromycin ``` check for access
41
urticaria
self -limited chronic: > 6 weeks in duration angiogema tx: anti-histamin maintain short course of steroids avoidance of identified triggers
42
melasma
hyperpigmenation of un exposed area seen in young women OTC cause ``` difficult to treat: hydroquino tretioin azelaic acid slow to resolve ```
43
lipomas
bening tumors of fat cell - just monitor - check for lip sarcoma( more fixed) FNA
44
epidermoid cyst
firm, mobile, young no tx triamcinola if inflamed I and D , oral abx if infected
45
Kaposi sarcoma
AIDs indicative purple nodules anywhere -tx: antiviral therapy
46
decubitus ulcers
bed sores press over bone prominence Stage 1-intact skin, warmth Stage 2: patial thickness stage 3- full thickness stage 4: full thickness and extension into mm bone and mm move often wound dressing sharp debridement
47
pediculosis ( lice)
``` overcrowding dwelling -schools tx: all intimate contacts seen in hair and body topical premetharin ( NiX shampoo) clean/ dispose of infections clothing, linen ```
48
scabies
arachnid mite spares head and neck pruritic vesicle in web spaces of hand groin - confirm under microscopy tx: tx all contact clean clothing and bedding permethrin 5% cream- resistance rare, use 2X one week apart
49
spider bites
black widow- bite if disturbed mm pain, mm spasm tx: parental opioids, mm relaxers brown recluse: more active in spring and fall progressive local necrosis, possible, fever, chills, n/v excision of bite see oral steroids, dapsone, colchicine
50
alopecia area
patchy loss of hair - small hairs that are broken off ( exclamation point hairs) tx: intralesional triamcinolone topical and systemic steroid PUVa phot therapy minoxidil
51
androgenic alopecia
``` hair will not grow back M> F males- receding hairline at temples and vertex females: loss of hair over central scalp tx: finasteride and minoxiidil ```
52
oncyomycosis
fungus of toenail and fingernails - older age, low immune system tx; topical generally ineffective newer oral anti fungal regrowth slow
53
paronychia
soft tissue infection around the nail - acute: I and d and abx chronic: occupational - candida keep dry, topical, anti fungals

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