Dermatology Flashcards
What are nail findings in psoriasis?
- *Nail pitting
- Onycholysis
- Yellow-brown colour
- Thickening
- Dystrophy
List some derm conditions that have nail pitting:
- Psoriasis
- Dermatitis (rough coarse pits)
- Alopecia Areata (transverse rows of fine pits)
What is incontinentia pigmenti?
Neurocutaneous disorder - association > derm > dental > ocular
Are skin lesions in incontinentia pigmenti at risk of malignant changes?
No- they are benign
List findings associated w/ incontinentia pigmenti:
> Derm: alopecia, coarse hair
Dental: late dentition, hypodontia, impaction
Ocular: neovascularization, micropthalmos, strabismus, optic nerve atrophy
CNS: seizures, DD, hemiplegia or hemiparesis
What is pseudoporphyria
Skin condition
- Look like porphyria BUT without porphyrin metabolism issue
- Usually from NAPROXEN/ NSAID
= photosensitive + small hypo pigment scars in areas of trauma
Most common cause of pseudoporphyria
Naproxen
Tx: D/C due to permanent scars risk.
List two RF for pseudoporphyria
- fair skin
- sun exposure area
What does pseudoporphyria look like?
- vesicles + easy bruising
- > small hypo pigmented depressed scars in areas of small trauma
what does incontenti pigmenti look like?
Initial linear streak or vesicles that blister.
Classic= pigmented strip following Blashko lines
*always affect axillae + groin
T or F: most people with acne have endocrine abnormalities.
False
Testing for hyperandrogegism (i.e. PCOS) if (+) signs
- pre puberty= acne, early odour, axillary or pubic hair, bone age ++, accelerated growth
- postpuberty= infreq menses, hirsutism, alopecia, infertility, PCOS, clitromegaly, truncal obesity etc.
T or F: routine microbiologic testing recommended for patients with acne?
False
Do any acne treatments alter course of acne?
None except isotretinoin (accutane)
Is there evidence that diet triggers acne flares?
No; limited evidence.
Which season improves acne and which worsens?
- Summer= improve
- Worsen= winter
What is the best routine cleansing regiment for people with acne?
Soap + water.
- agents w/ keratolytic agent, salicylic acid may temporarily remove sebum but no significant change
Single or combo therapy should be used in patients with acne?
Combo therapy
*Note topical retinoid can be mono therapy if comedonal.
How to treat comedonal versus mild versus severe papulopustrular or nodular?
**Generally= Retinoid -> BP or Abx -> Isotretinoin
Comedonal= topical retinoid (or salicylic acid)
Mild Papulopustular= suggest inflam
= Benzoyl peroxide w/ topical ABX (i.e. topical dapsone, tetracycline, doxycycline) or Retinoid
*usually BP in am + retinoid night
Severe Papulopust. or Nodular
= topical retinoid + benzoyl peroxide + PO Abx
OR isotretinoin 1mg/kg/day
What is the only treatment for severe nodulocystic acne?
Isotretinoin
T or F: limited evidence for benefit of physical modalities for routine tx of acne (i.e. pulsed dye laser, glycol acid peel, salicylic acid peel)
T
Is Pregnancy is contraindication to isotretinoin (accutane)?
yes
Highly teratogenic.
What is baseline monitoring for isotretinoin?
liver function lipid panel (cholesterol, TG) pregnancy test
What is the advantage of benzoyl peroxide over topical Abx?
Decreases P. acnes. resistance to Abx
How long do you have to wait for acne treatment until state ineffective?
6-8 weeks