Dermatology Flashcards
_____ is an autoimmune disorder that arises typically in the 6th decade of life. Bullous formation occurs.
Bullous Pemphigoid
*There may be prodrome of urticarial or papular lesions
Behavior of bullae…
Typically they collapse and crust. At times bleeding erosions occur.
Where do lesions frequently occur in bullous pemphigoid?
Axillae, thighs, groin, and abdomen
How is bullous pemphigoid diagnosed?
Biopsy and immunofluorescence will confirm
Treatment of bullous pemphigoid is?
Systemic prednisone at high doses until remission then low doses for maintenance
*Mild cases can be treated with topical steroids
Most dangerous spider is the ______.
Brown recluse
Timing of symptom onset with spider bites:
Generally patient begins to feel pain 3 hours after bite
-Systemic symptoms begin 4-6 hours after the bite
_____ (type of spider) can cause neurologic overstimulation.
Black widows
*Muscle aches, spasms, rigidity
Reaction to a brown recluse involves:
Initial bite is painless. It evolves into a firm erythematous lesion that heals over several days to weeks.
-lesion becomes necrotic in 3-4 days and can extend to the muscle and be as large as the palm
Neurologic manifestations of black widow bites are treated with ____ and ____.
Diazepam and calcium gluconate
Brown recluse bites may be treated locally with:
Wound cleansing and analgesia. Usually wound decreases significantly in 5-10 days
*Update tetanus!
In viral exanthems (infections) rash is usually preceded by prodrome of:
Fever, malaise, sore throat, N/V, abdominal pain
The MC viral exanthems of childhood are:
o Rubeola (measles) o Rubella (German measles) o Varicella (chicken pox) o Roseola (sixth disease) o Erythema infectiosum (fifth disease)
Koplik’s spots (gray-white oral lesions on the buccal mucosa opposite the lower molars) are found in the prodromal phase of _____ (what disease state).
Measles- first disease
Clinical manifestation of measles rash-
Maculopapular rash in hairline and spreads to trunk, extremities (cephalad to caudal pattern)
-May also note cervical lymphadenitis, splenomegaly, and mesenteric LAD with abdominal pain. Otitis media, pneumonia, and diarrhea are common in infants.
How is Measles treated?
Self-limiting 7-10 days.
Rx–> symptomatic hydration and antipyretics. Otitis media is MC complication.
Characteristic signs of Rubella (German Measles) are:
Retroauricular, posterior cervical, and posterior occipital LAD accompanied by an erythematous, maculopapular, discrete rash that starts on the face and then spreads – it resolves in 3 days (rash is less prominent than with measles)
*Treatment- supportive
____ peaks between 6 months and 2 years. It’s known as Sixth disease. Rash follows 3-7 days of high fever.
Roseola
_____ is defined as lesions that appear in crops over 3-4 days. Can have up to 500. They crust in 3-5 days. There is a prodrome of fever, malaise, and anorexia.
Varicella
- Starts on trunk and spreads peripherally
- *DEW DROP ON ROSE PETAL
- **Contagious until lesions crust (usually 1 week)
Clinical dx of Varicella can be:
Tzanck smear for multinucleated giant cells
Treatment of Varicella involves:
Symptomatic
- Antihistamines for pruritus
- Acyclovir in teens
- IVIG if immunocompromised and exposed
- Administration of vaccine w/in 72 hours of exposure can prevent or lessen severity
____ is the reactivation of VZV.
Zoster/Shingles!
_____ is caused by human parovirus B19, with the class “slapped cheeks” appearance.
Erythema Infectiosum- Fifth Disease
*Not contagious with rash!
3 rashes with fifth disease:
- Slapped cheeks
- Maculopapular
- Lacy arms and legs
Pronounced pain at the site with a unilateral, dermatomal distribution is key for the diagnosis of _____.
Herpes Zoster
- Tzanck prep and viral PCR can confirm
- *Treat with Acyclovir or Valacyclovir
____ is a superficial cellulitis with lymphatic involvement caused mostly by GAS.
Erysipelas
- Onset is acute!!
- *S&S- painful macular rash with raised borders. Lymphangitis and lymphadenitis are common. Purpura, bullae, and necrosis may accompany the erythema.
- **Treat- parenteral Ceftriaxone or Cefazolin
Treatment of pilonidal sinus involves:
Surgical drainage, may be supplemented with abx
- Drain in ED and pack loosely with gauze
- F/u with sitz baths
- Follicle removal may be required with unroofing of sinus tracts
