DERMATOLOGY and OPTHALMOLGY Flashcards
Vitiligo tX
Limited disease: topical corticosteroids
Extensive/unresponsive disease: oral corticosteroids, topical calcineurin inhibitors, PUVA
UR Dx and define it
and ur Mx
Senile purpura (solar or actinic purpura) is a noninflammatory disorder that is most common in the elderly but can also be seen in middle-aged patients with extensive sunlight exposure. It is caused by loss of elastic fibers in perivascular connective tissue.
not a dangerous condition and requires no further investigation.
Blisters, bullae, scarring, hypopigmentation/hyperpigmentation on sun exposed skin (eg, back of hands, forearms, face)
Scarring & calcification similar to scleroderma
UR dx
Porphyria cutanea tarda
porphyria cutaneous tarda in early vs late enzyme defficiencies
remember triggered by ingestion of certain substances (eg, ethanol, estrogens) and is most common in patients with underlying hepatitis C.
early steps of porphyrin synthesis (eg, acute intermittent porphyria) cause abdominal pain and neuropsychiatric manifestations (eg, psychosis, neuropathy);
*** later steps (eg, PCT) lead to {photosensitivity }due to accumulation of porphyrinogens that react with oxygen on excitation by ultraviolet light
can be associated with hyperpigmintation
hashimoto thyroditis is associated with which skin disorder
vitilligo
Hair growth occurs in a cyclical pattern with 3 primary phases:
Anagen phase: Linear growth of the hair shaft associated with proliferation of hair follicle cells. At any given time, 80%-90% of follicles are in anagen phase, which lasts up to 5 years.
Catagen phase: Transition phase characterized by regression and apoptosis of follicular cells. The hair shaft may continue to be extruded from the follicle but is no longer growing. This phase lasts up to 2 weeks and typically accounts for <1% of follicles.
Telogen phase: Resting phase of variable duration. The hair shaft is shed during this phase in preparation for growth of a new hair.
just review it
read it again saw uuuuu
chemotheraputic agents can affect which phase and causes ———
but guess what its temporary, reversible
Impaired cellular reproduction can lead to cessation of hair growth and rapid shedding of hair shafts (anagen effluvium).
recall male and female hair loss patterns and Mx for both
Men: vertex, frontal hairline, temporal areas
Women: vertex, center of scalp (sparing of hairline)
Management
Men: minoxidil, finasteride
Women: minoxidil
urDX and Mx
alopecia areata
Mild/moderate hair loss: topical or intralesional corticosteroids{trimicnollone }
Extensive hair loss: topical immunotherapy (eg, diphenylcyclopropenone), oral corticosteroids
Loss of function in filaggrin gene
lead to —————charcterized by
ur Mx 3 and remeber the drugs
Ichthyosis vulgaris
1-Impaired epidermal barrier
2-Reduced skin moisturization
Therapy
Long baths to remove scales
Moisturization
Keratolytics (eg, urea,** alpha-hydroxy acid, salicylic acid)
palmerhype linearity is also common
ur DX
Acute, diffuse, noninflammatory hair loss
Scalp & hair fibers appear normal
Hair shafts easily pulled out (hair pull test)
ACUTE while tinia capitis more in children and its has more slow onset of time
so whats ur Mx
Telogen effluvium
Address underlying cause
Reassurance (self-limited disorder
uwrold fked up idea
ur Dx
can also occur on the scalp, hands, and trunk (eg, gluteal cleft) as small plaques.
Tetracyclines are an important cause of phototoxic drug eruptions.
give ex—–
doxycycline :>)
but remember its more common than benzyol peroxide to cause phototoxicity
common skin manifestations of lupus
discoid erythema
drug induced acne revise
remember normal drugs of acne dnt have any effect its worthless like ur brain <:)
read it again
Mild manifestations of a drug allergy (eg, urticaria and pruritus without systemic symptoms) Tx
while epniphrine is reserved for more severe anaphalctic reactions
e usually treated with antihistamines and discontinuation of the offending drug.
acute, painless, monocular vision disturbance accompanied by flashes of light and/or floaters.
ur DX
Retinal detachment
Commonly begins in the periphery, affecting peripheral vision first. Ophthalmoscopic examination typically shows an area of gray, elevated retina, often with a wrinkled appearance.
Anterior uveitis VS CONJUCTIVITIS
JUST ——–2 words
iritis and iridocyclitis) is characterized by a painful, red eye with tearing and decreased{ visual acuity. }
acute eye pain, headache, and nausea. Signs include conjunctival erythema, corneal opacification, and a mid-dilated pupil in eldery with no HX of trauma viral
ur Dx
gold standard test and best initial
acute angle closure glucoma \
Gonioscopy is the gold standard for diagnosis
tonometry if opthalmologist consultant isnt available
revise infectious keratitis
and remember cmv is painless with fluffy or granular retinal lesions near the vasculature as well as retinal hemorrhages
while the rest are painful
watery discharge its HSV
Central round infiltrate: This lesion is typically seen in bacterial keratitis (eg, Pseudomonas aeruginosa, Staphylococcus aureus)
Multiple ulcers with feathery margins: These findings are typical of fungal (eg, Candida) keratitis
angiofibroma is the hallmark of the disease ++++seizures
brain MRI is required to evaluate for associated CNS lesions (eg, hamartomas). Brain hamartomas can cause seizures (as seen in this patient’s mother) or manifest more subtly with behavioral/cognitive disorders (eg, attention-deficit hyperactivity disorder, intellectual disability), as seen in this patient. Diagnosis can be confirmed by genetic testing.
ash leaf spot
ur Dx
ur Mx remeber its an oldy disease
suberroickeratosis
stuck on appeareance
no Tx is required
ur Dx
Mx
Tx
bcc
punch r excisional biopsy
First-line:
Surgical excision with 4-mm margins
Mohs micrographic surgery (face/high-risk tumors)
Second-line:
Topical fluorouracil, topical imiquimod, C&E (low-risk tumors only)
ur Dx
Herpetic whitlow is a viral infection of the hand caused by herpes simplex virus. Most adult infections are acquired from contact with genital herpetic lesions or infected orotracheal secretions. Spontaneous resolution is the norm but recurrences are common.
ur Dx
usually on lower limbs associated with trauma and insect bites
dermatofibroma
Treatment (cryosurgery or shave excision) is usually not required unless the lesion is symptomatic, bleeds, or changes in color or size.
