Dermatology Flashcards
Male Pattern Baldness
tx?
post-pubertal androgens(5DHT) causes baldness in circular pattern at the crown.
tx: Topical Minoxidil or PO Finasteride(5a reductase inhib)
Alopecia Areata
tx?
Ai disorder against hair = well defined bald spot anywhere! assoc w/ “exclamation point sign” = hair folicle is thick at end but narrow at base w/loss of pigment
tx: steroids
Tinea Capitis
sx? dx? tx?
fungal infection causing circular balness w/all hairs at equal lengths
dx: KOH prep only! will now show up on wood lamp
tx: ORAL Griseofulvin
Traction Alopecia
permanent scarring due to hair being pulled tight = xtream braiding. stop or will be permanent.
Dacryocystitis
infection of the lacriminal sac under hte eye in the inner aspect. presents with pain, redness + swelling and when pushed may produce pus. tx w/abx
in Antiphospholipid syndrome why do you have a prolonged PTT but still cause thrombosis?
PTT is prolonged bc it is part of the intrinsic pathway and the AP’s get in the way of the tests measurements. Its not actually prolonged it just appears that way bc of how the test is performed. this is why you actually get thrombosis but a long PTT but normal PT(measured idfferently.)
what is thrombocytosis?
high platelet count
ab to desmoglein
pemphigus vulgaris
+nikolsky sign
pemphigus vulgaris
tx of pemphigus vulgaris? age group seen in?
steroids! seen in 30-50 yo
ab to hemidesmosomes?
bullous pemphigoid
vesicles/bullea in oral mucosa + bullea all over body in 35 yo. dx?
pemphigus vulgaris +nikolsky sign. only PV involves oral mucosa
tx of bullous pemphigoid?
steroids
Dermatitis Herpetiformis
sx? tx?
cuntenous manifestions of celiac dz = IgA ab to Transglutaminase or Endomysial Ab = dx by looking for these ab!
- presents as ag-ab complex build up under skin = neutrophilic abscess = pruritic rash on butt, legs or extensor surfaces
tx: avoid gluten
tx of Porphyria Cutanea Tarda?
avoid the sun
dx of Porphyria Cutanea Tarda?
coral red urine under wood lamp
enzyme deficiency in Porphyria Cutanea Tarda?
uroporphyrinogen decarboxylase
sx of Porphyria Cutanea Tarda?
bullae on sun exposed skin may be tirggered by: OCP, Alcohol, hepC, hemochromatosis
triggers of Porphyria Cutanea Tarda?
OCP, Alcohol, hepC, hemochromatosis
tx of psoriasis?
- UV light 2. mild topical anti-steroidals
pt w/”dandriff” on scalp, eyebrows and forehead. dx? tx?
seborrheic DERMATITIS(no keratosis thats old ppl splatter)
tx: selenium shampoo bc this is due to a fungus
pt w/ pink rash that spares the palms or soles that then turns scaly. syphilis -. dx? tx?
pityriasis rosea. tx with steroids
tx of contact dermatitis?
avoid + topical diphenhydramine or aloe creams
purple papules with a lacy netowrk of white lines, itchy. seen in a person with hep C. dx? tx?
Lichen plantus
white lines = wickham striae
tx: topical steroids
kid w/ dry, red, itchy vesicles w/crusted lesions around face + at diaper line. dx? tx?
atopic dermatitis = eczema
- may look like impetigo but found at other places
tx: avoid + topical steroids
adutl w/dry red lichenification around fossa’s. dx? tx?
eczema
tx: avoid + topical steroids
contact dermatitis hsr type…
4
What is Stasis dermatitis?
edema, erythema, brown disccoloration, scales = seen in areas fluid sits for long periods of time = tx cause
pt w/annular, blanching red papules of varying size comes in after working outside in yard. dx? cause? tx?
urticaria = hives due to IgE mast cell activating causeing histamine to be released = T1 HSR.
tx: 1. antihistamine +steroids (if anaphylax add epi) 2. RAST to ID antigen so it can be avoided
may be caused by: bee sting, pressure, heat, food, contact dermatitis
How long before you would see a drug reaction rash? how would you treat? sx?
7-14 d later see widespread, symmetric and pruritic rash. stop agent and give diphenhydramine
What is Erythema-Multiforme? sx?
cutaneous IC depo due ot reaction wiht some drug. looks like target shaped lesion on skin +/- palms and soles and is self limitied. tx cause or stop drug.
ddx: syphilis vs SJS vs ErthMf.
Steven johnson syndrome vs toxic epidermal necrolysis
both: +nikolsky +oral mucosa
SJS: <10% body fx, bx: basel cell degeneration
TEN: >30% body fx, bx: total thickness epidermal necrosis
**do not confuse w/PV
Pt w/ negative hx presents with 1week pain in ankles w/ multiple pink to red nodules below the knee. What’s the next best test?
This is ERYTHEMA NODOSUM. Mc in lower legs.
Assoc: strep, sarcoidosis, TB, coccidio, IBD.’c etc
Initial workup: CBC, LFT, RFT, Antistrep O ab test, TB skin and CHEST X-RAY to look for infectious cause
Ichthyosis Vulgaris sx? Tx?
Chronic skin disorder with diffuse dermal scaling due to inability of dead skin to fall off. Skin looks super dry like “fish scales”. Worse in winter and not helped by lotion.
Tx: keratolytics(tar, salicylic acid) & topical retinoids for sx control
68 yo women with hx HA for 2 months now has LOV in R eye w/ swollen pale disc, ESR 85 + subclavicular bruit. Dx? Tx?
Pt has Giant cell arthritis! This is the most common presentation of GCA! Tx this with HD IV steroids to prevent further dmg.
Dermatofibroma
Hyper pigmented nodule with center dimpling known as butt hole sign with a fibrous component. This is more common in women and often appears on the legs more than the arms. Canby itchy and painful but not always. Treatment is cryosurgery
Patient describes what sounds like a SCC on skin but says it grew fast then randomly dissapearted. Dx?
Keratoacanthoma! Sometimes goes away on its own, if not remove with surgery as it is pre malignant
Erythematous lesion with a sandpaper like brown to yellow scale. Dx? Early tx? Disseminated tx?
Actinic keratosis = early SCC!!
Tx w/ cryosurgery or 5FU
Ash leaf spot
Single area of hypopigmentation that is positive on wood lamp. Pathognomic for tuberous sclerosis(GI polyps, seizures, shagreen patch(CT hamartoma on the back), sebaceum adenomas)
