Dermatology Flashcards
Keloid scar tx
Intralesional glucocorticoids
- up to 70% of patients responding. Many keloids require serial injection for satisfactory response, and surgical excision is occasionally needed if glucocorticoids fail
- The earlier the lesion is treated, the greater the chance of improvement
Desmoid Tumors sx
- deeply seated painless or sometimes painful masses in the trunk/extremity,
intraabdominal bowel and mesentery, and abdominal wall. - They can cause intestinal obstruction and bowel ischemia and have a high rate of recurrence, even after aggressive surgery
Treatment of chronic urticaria :
- second-generation antihistamine (eg, foxofenidine, cetirizine, loratadine)
- If Refractory: H1 blocker, leukotriene receptor antagonist, H2 blocker, or a brief course of oral steroids.
actinic keratosis (AK)
- where is it?
- what does it look like?
- risk of cancer yes no?
- commonly occurs in areas of heavy sunlight exposure such as the face, scalp, ears, upper chest, and dorsal hands and forearms.
- characterized by small, rough, erythematous, and keratotic papules
- chronic photodamage such as dyspigmentation, wrinkling, thinning, and telangiectasia.
- Untreated AK has up to a 20% risk of progression to squamous cell carcinoma.
- should be removed or destroyed Individual lesions can be destroyed with liquid nitrogen cryosurgery or by surgical excision or curettage.
- field therapy w/ 5-FU
Tinea capitis
- what is it?
- tx?
Tinea corporis
- presentation?
Capitis: dermatophytosis that causes scaly, erythematous patches of the scalp with hair loss.
Firstline treatment is oral griseofulvin or oral terbinafine.
Tinea corporis is characterized by pink annular plaques with a scaly border and central clearing.
pigmented lesion has an increased risk of melanoma based on what size?
- what is the dx method?
(>6 mm in diameter)
- excisional bx
treatment of acne in women who may become pregnant, the preferred medications include
- topical erythromycin,
- clindamycin (inflammatory acne), or
- azelaic acid (comedonal acne)
Chronic allergic contact dermatitis (ACD):
- presentation?
typically excoriated, lichenified plaques at the beltline
- nickel allergy often presents near sites of frequently
- worn jewelry or clothing fasteners (belts),
- latex allergy often appears near clothing waistbands
- leather allergy typically appears on the feet
Lichen simplex chronicus (“neurodermatitis”): is characterized by thickened excoriated plaques caused by
persistent scratching and rubbing.
- It is associated with anxiety disorders and typically occurs in areas that are easy to reach (eg, arms, legs, neck).
seborrheic dermatitis
- presentation
- Increased incidence in ______ disorders
- possibility of ______ in patients with a new onset of severe or widespread seborrheic dermatitis, lesions in unusual sites (eg, extremities), or who fail to respond to appropriate treatment (topical antifungals selenium sulfide, topical ketoconazole
mildly pruritic, erythematous plaques with greasy scales.
- increased incidence in association with central nervous system disorders (especially Parkinson disease)
- HIV
_______ is also a superficial skin infection but presents with well-demarcated, bright red erythema, classically on the cheeks
Erysipelas
- GBS: PCN
- Staph: Cephalexin
- MRSA: TMP-SMX or doxyclycline
__________ staining of a skin sample can diagnose tinea infections by showing the characteristic segmented hyphae and arthrospores.
Potassium hydroxide staining of a skin sample can diagnose tinea infections by showing the characteristic segmented hyphae and arthrospores.
- Tinea infections usually present as pruritic, erythematous, circular, and scaly lesions with central clearing
Lichen Planus: classic skin lesions are
shiny, discrete, intensely pruritic, polygonal-shaped violaceous plaques and papules that are most frequent on the flexural surfaces of the extremities.
- Wrists are a common site of skin involvement.
- A characteristic whitish, lacy pattern, referred to as Wickham striae, is seen often on the lesion surfaces, especially on the tongue and buccal mucosa.
- Genital LP presents usually with intensely pruritic violaceous papules on the glans penis or vulva. - The diagnosis of LP is mainly clinical, based on classic skin lesions in a characteristic distribution. If it becomes necessary to confirm the diagnosis, a punch biopsy of the most prominent lesions should be performed and sent for histopathologic examination.
Screening for _____ should be considered in patients with LP, especially those with additional risk factors (eg, history of intravenous drug use).
Hep C
Rosacea is characterized by ________.
- Tx?
erythema in the central face and is often associated with flushing, telangiectasias, and pustules (occasionally).
- Patients with only erythema and telangiectasias may be managed with topical brimonidine and avoidance of factors which trigger flushing (eg, hot or spicy foods, alcohol, extreme temperatures, emotional distress).
- Patients with papular or pustular lesions are treated with topical metronidazole or azelaic acid. Oral antibiotics are considered for more severe or refractory cases.
