Dermatology Precision

Question 1

Tinea Cruris

Answer 1

-Jock Itch
-Diffusely red rash on groin or scrotum
-Fungal skin infection caused by Trichophyton (T. Rubrum)
-Skin moisture (RF, Immunodeficiency, DM)
-KOH Smear
-Wood’s Lamp: Green Immunofluorescence if Microsporum

Question 2

Melasma

Answer 2

-Avoid risk factors such as increased estrogen (OCP’s, pregnancy), sun exposure
-More likely in women with darker skin
-use protective sunscreens, triple therapy ointment

Question 3

Wound, Open (Cat Bite)

Answer 3

-Use Augmentin (Amox-Clav)

Question 4

Vitiligo

Answer 4

-Acquired skin disorder characterized by skin depigmentation due to an autoimmune destruction of melanocytes

Question 5

Intertrigo

Answer 5

-Weight loss, weight control, proper hygiene, glycemic control, measures to reduce friction component of skin-skin contact
-Inflammatory condition of skin folds. Aggravated by heat, moisture, friction
-Candida infection worsens it –> satellite lesions, itching, burning, stinging

Question 6

After how many days do facial sutures need to be removed?

Answer 6

5 days

Question 7

Tinea Versicolor

Answer 7

-Due to yeast Malasezzia Furfur
-KOH prep: hyphae and spores (spaghetti and meatballs)
-Wood’s Lamp: yellow-green fluorescence
-2.5% Selenium Sulfide Shampoo or Imidazole cream
-PO Fluconazole

Question 8

Impetigo

Answer 8

-Staph Aureus (MC), GABHS (2nd)
-Vesicles, pustules with honey colored crusts
-Associated with regional LAD
-Primarily on surfaces of face
-Clinical diagnosis, gram stain and culture if atypical presentation
-Mupirocin (Bactroban) TID x 10 days (first line)
-Extensive or systemic disease: Cephalexin, Dicloxacillin, Clindamycin, E-mycin

Question 9

Dermatophytosis (Tinea)

Answer 9

First-line treatment: Topical Azoles x 4 weeks

Question 10

Scabies

Answer 10

-Often clinical diagnosis. Skin scrapings of burrows with mineral oil to identify eggs or mites under microscopy.
-Permethrin topical: Apply for 8-14 hours then shower and repeat in 1 week
-Lindane cannot be used after showers (teratogenic and seizures)

Question 11

Steven Johnson Syndrome (SJS)

Answer 11

-Begins with nonspecific symptoms –> blistering rash and erosions on face/trunk/limbs/mucosal surfaces
-Positive Nikolsky Sign (lateral pressure makes skin flake off)

Question 12

Dyshidrosis

Answer 12

High strength topical steroids and cold compresses; systemic steroids

Question 13

What is seen on exam if the patient is suspected of neurofibromatosis?

Answer 13

Cafe-au-lait spots, inguinal/axillary freckling, lisch nodules of the iris, optic pathway gliomas (afferent pupillary defect)

Question 14

Treatment for molluscum contagiosum

Answer 14

Cantharidin, topical retinoids

Question 15

Treatment for pressure ulcers

Answer 15

-Pressure redistribution, good hygiene, turn patient often, keep area clean

Question 16

Lichen planus is associated with other infection?

Answer 16

Hepatitis C

Question 17

What is xerosis?

Answer 17

Dry skin - may have scales or small cracks in patients who are in dry environments. If they frequently wash hands, have inadequate hydration, swim in chlorine pools.

-Usually worse during winter months

Question 18

Psoriasis is MC on _____ surfaces whereas eczema is on _____ surfaces

Answer 18

Extensor

Flexor

Question 19

Explain an adverse drug effect of warfarin on the skin

Answer 19

Can cause rare skin necrosis due to paradoxical blood clotting by inactivating vitamin K dependent factors (II, VII, IX, X, protein C and S)

Question 20

A patient who is receiving an infusion of Vancomycin develops symptoms such as pruritis, erythematous rash, hypotension, and angioedema. What is this called?

Answer 20

Red Man Syndrome