Dermatology Flashcards
psoriasis usually presents on _____ surfaces
extensor
what other body part should you be sure to observe in a patient with psoriasis?
nails
commonly have nail pitting, oil spots, onycholysis
what is auspitz sign? what is it associated with?
bleeding when you peel the scales of psoriasis
what is koebner phenomenon? what is it associated with?
patients prone to psoriasis will often develop a plaque at the site of trauma
tiers of treatment for psoriasis, from mild to moderate?
1) mild = calcipotriene then topical steroids
2) moderate = UV light, methotrexate
3) severe = biologics like etanercept/enbrel, adalimumab/humiera, infliximab/remicade, ustekinumab/stelara
most common bacteria associated with acne vulgaris?
propionibacterium acnes
what psychiatric drug is associated with a lot of skin problems (like psoriasis, acne, etc.)?
lithium
what endocrine drug is associated with a lot of skin problems (psoriasis, acne, etc.)?
steroids
common topical antibiotics for acne?
clindamycin, erythromycin
common oral antibiotics for acne?
doxycycline, minocycline
oral medication for acne that carries black box warning for suicide and deformed babies?
isotretinoin
flushing and telangiectatias of the face in response to stressors?
rosacea
stressors = heat, ETOH, spicy foods
treatment of rosacea?
topical metronidazole OR oral tetracyclines
treatment of perioral dermatitis?
topical metronidazole OR oral tetracyclines
difference between contact dermatitis and atopic dermatitis?
contact = delayed type 4 hypersensitivity reaction
allergic = true type 1 hypersensitivity reaction
poison ivy, sumac, nickel are common triggers for contact dermatitis or atopic dermatitis?
contact dermatitis
treatment of both contact and atopic dermatitis?
topical steroids, antihistamines for itching
atopic triad?
eczema, allergic rhinitis, asthma
what condition often results from long-term atopic dermatitis?
lichen simplex chronicus w/ lichenification from scratching
treatment of lichen simplex chronicus?
STOP itch-scratch cycle, topical steroids
eruptions of small, fluid-filled vesicles on the hands that follow stress or hot, humid weather?
dyshidrotic eczema
“tapioca pudding” in a derm question should make you think what?
dyshidrotic eczema
treatment of dyshidrotic eczema?
burrow’s solution (domedoro astringent) or HIGH dose topical steroids
greasy, yellow scaly macules, papules, plaques on scalp and ears
seborrheic dermatitis
YEAST that causes seborrheic dermatitis?
pityrosporon ovale
treatment of of seborrheic dermatitis?
ketoconazole shampoo or tar/zinc containing shampoos
salmon herald patch followed by eruption in christmas tree distribution? what usually precedes?
pityriasis rosea
usually preceded by viral infection
treatment of pityriasis rosea?
self limited over 8-12 weeks; lotions, anti-pruritics
what are the four p’s of lichen planus?
purple, polygonal, pruritic, papule
lichen planus is often associated with what?
hepatitis C
treatment of lichen planus?
topical steroids lalala
“stuck on” warty plaque; dx and treatment?
seborrheic keratosis
cryotherapy or leave alone
autoimmune disorder in elderly with large, tense bullae? treatment?
bullous pemphigoid
TX with systemic prednisone +/- azithioprine (med given in organ transplant to prevent rejection)
red annular patch with distinct borders, central clearing, and fine scale usually meansssss what
tinea corporis (superficial fungal infection)
diagnosis and treatment of ringworm (tinea corporis)
DX with KOH – branching hyphae
TX is antifungals (topical clotrimazole)
another word for tinea infections are _____ infections
dermatophyte infections
hives are a type ___ hypersensitivity reaction involving which type of antibodies?
type 1 hypersensitivity involving IgE
erythema multiforme is often preceded by what?
oral herpes infection (think in question of child with cold sore, then bullseye rash on legs)
PCN or sulfa drugs
treatment of erythema multiforme?
systemic steroids
SJS is ____ or less percentage of body surfaces and involves ____ surfaces
SJS is less than 10 percent of BSA
involves mucosal surfaces!
TEN is over ____ percent of body surface areas
what drugs are commonly associated with SJS and TEN?
over 30 percent
PCN, sulfas, allopurinol, phentytoin
the autoimmune destruction of melanocytes is called what?
vitiligo
acanthosis nigricans should make you worry about what?
underlying diabetes, endocrine disorders
pregnancy and oral contraceptive use put you at risk for what skin condition?
melasma
treatment of melasma?
hydroquinone lightening cream, sunscreen
pruritic burrows, vesicles, excoriations in web spaces of hands
scabies
diagnosis and treatment of scabies?
DX = scraping, look under microscope
TX = lindane or permethrin cream over entire body and pretty much BURN EVERYTHING
thick, gold “honey crusted” lesions – DX and etiology?
DX = impetigo
etiology = staph more often than strep
treatment of impetigo?
topical mupirocin
two most common etiologies of folliculitis?
staph MC; pseudomonas if associated with hottub
well-demarcated, shiny, abrupt onset, superficial spreading cellulitis? diagnosis and etiology?
erysipelas
cause = group A strep
treatment of both erysipelas AND cellulitis?
penicillin, cephalosporin, or macrolide
acute fever, hypotension, diarrhea, generalized skin erythema with multiple organ failure is what?
toxic shock syndrome
what causes toxic shock syndrome? how do we treat?
staph aureus making toxin
TX = ICU admission, IV anti-staph ABX
6 month old presents with acute fever, hypotension, discrete macules, papules, petechiae, and purpura. what should you be worried about?
meningococcemia (caused by neisseria meningitides)
treatment of meningococcemia in an infant?
ICU, vancomycin and rocephin
complication is meningitis
hutchinson sign in regards to herpes simplex?
involvement of nasal tip suggests trigeminal involvement (also innervates cornea so we worry about blindness)
EMERGENT optho referral
herpetic whitlow most common in which populations?
boxers, nurses
most common type of skin cancer?
basal cell carcinoma
pearly, nodular papule with raised rolled borders and central depression and telangiectasias
basal cell carcinoma
actinic keratoses are precursors to what?
squamous cell carcinoma
erythematous scaling plaque with ulcerations and crust
squamous cell carcinoma
margins when excising melanomas should be at least how big?
1 cm
10 mm
