Dermatology Flashcards
Most common form of skin CA
Basal cell CA-
Pearly, red papules or plaques with Rolled borders and Telangiectasias
sun exposed areas
Langerhans cells (can exit epidermis to travel to lymph nodes and present antigens) play a prominent role in
Allergic contact dermatitis, like
Poison ivy
Merkel cells
associated with touch, found more densely in touch-sensitive areas
discrimination of fine spatial details
Merkel cell Carcinoma
Rare, aggressive form of skin CA
Deep pink or Red nodule, may mimic a furuncle or inflamed cyst
Dermis includes:
- Support
- Collagen
- Elastic fibers
- Blood vessels
- Lymph vessels
- Nerves
- Glands
- Hair follicles
Apocrine glands found ONLY in
Axillary
Anogenital areas
These glands open DIRECTLY into hair follicle
Eccrine sweat glands
do NOT INVOLVE hair follicle.
Instead, open directly onto the skin
Present throughout body surface
Function of Eccrine sweat glands
all over body, open directly onto skin
Regulate body temp
Fibroblasts (resp for keloids, scarring) and Mast cells are found in the:
Dermis
Function of Subcutis
Fat layer that separates dermis from Underlying fascia and muscles
made of: Adipocytes and Connective tissue
Fx:
insulation, energy supply, cushion/protect skin, allow for skin’s mobility
If person is missing subcutis
Skin may be bound down, contractures to some limbs
Erythema Nodosum (a disorder of the Subcutis)
inflammation of subcutis. Appears as deep-seated red nodules, often on shins
Assoc w: GI infections, Sarcoidosis, Crohn’s dz
Epidermis (4 layers) from base up
Basal
Spinous
Granular
Corneum (top)
Common tx for Atopic Dermatitis and Psoriasis
Topical Steroid
Super high potency steroid
Class I
Steroids within any class are equal in strength
Strength is based on the molecule, not the concentration
Super high strength Steroid
Clobetasol propionate cream
Medium strength steroid
Mometasone
Triamcinolone
Low strength steroid
Desonide
Hydrocortisone
When deciding on the strength of a steroid, what is more important to look at?
CLASS
not the %
Class I is strongest, Class VII is weakest
Class I steroids are used for:
Scalp, palm, sole, thick plaque on extensor surface
Med-high potency, Class 2-5 steroids are used for
Mild-mod NONFACE and NONintergriginous areas
Low potency steroids (Class 6-7) are used for
Face, eyelid, genital, intertriginous
Ointments are more or less potent than creams/lotions
MORE potent
allow better drug absorption
How long to use Super high potent steroids
<4 weeks
How long to use High and Medium potency steroids
<6-8 weeks
How long to use Low potency steroids on face and other sensitive areas?
1-2 weeks
Body Surface Area
1 Palm=
1% BSA
Fingertip Unit. (FTU)
on pad of finger from Tip to DIP joint
500 mg= treats 2% BSA
Steroid cream; It takes 30 grams to cover an average adult body
for one application
Common Topical Retinoids to treat Acne Vulgaris
Tretinoin
Adapalene
Tazarotene
Topical Abx to tx Acne Vulgaris
Erythromycin 2% (solution, gel)
Clindamycin 1% (lotion, solution, gel, foam)
1st line tx for Mild Acne
Topical Retinoid
OR
Peroxide
1st line tx for Moderate Acne
COMBO:
Topical Retinoid, Peroxide
+/- Topical Abx
1st line tx for Severe Acne
COMBO:
Topical Retinoid,
Peroxide,
Oral Abx
+/- Topical Abx
Nystatin
Better for candida, not dermatophytes
Tinea Pedis tx
Terbinafine OR
Miconazole
(topical)
BID 4-6 wks
Tinea Corporis (body) tx
Terbinafine
2nd line: Miconazole
BID daily until resolution, then continue for 2 more weeks
1st line tx for Psoriasis
High potency topical steroid
+/- topical vit D
Super high potency steroid
Clobetasol prop
High potency steroid
Fluocinonide cream
Mometasone ointment
Medium potency steroid
Mometasone cream
Triamcinolone acetonide
Low potency steroid
Fluocinolone ACETONIDE cream
Desonide
Hydrocortisone
Desonide
Hydrocortisone
Low potency
Clobetasol propionate
HIGH potency
Triamcinolone acetonide
Medium potency
Use on Scalp, palm, sole, and thick plaques on extensor surfaces
Clobetasol prop
HIGH potency
Use on mild-mod NON facial and NON intertriginous
Medium potency
Triamcinolone acetonide
Use on Face, eyelid, genital, and intertriginous area
Desonide
Hydrocortisone
(LOW potency)
AK
Actinic Keratoses
Dry, scaly
Pre-CA
Fair skinned pts
Later in life (after 40s) after repeated sun exposure
AK can progress to
Sq Cell CA
Basal cell CA
most common type
Pearly, flesh colored or pink, rolled borders
Sq Cell CA
2nd most common type of skin CA
Sq Cell CA
Red firm bump, scaly patch, or sore that Re-opens
Melanoma
Can be deadly
Melanoma
often develop in MOLE or new DARK SPOT
Melanoma
A-asymmetry B-borders C-color D-diameter (>6 mm concerning, pencil eraser) E- evolving
