Dermatology Surgery Flashcards
Most common type of skin cancer
Basal cell carcinoma
Nodular BCC
Typical translucent, pearly papule
Telangiectasias
Well-defined borders
Ulcerating BCC
Pearly, smooth, and firm
Telangiectasias
Central ulcer
Sclerosing BCC
Plaque, scar-like lesion
White or pink
Superficial multicentric BCC
Thin plaque or patch
Pink or red
May have scaling
Pigmented BCC
Globules of dark pigment
Smooth surface
Diagnosis of BCC
Biopsy
Treatment of BCC
Mohs or surgical excision
Erivedge (vismodegib) for patients who are not surgical candidates
How to describe burns
Rule of 9s
Burn degrees
1st: epidermis only
2nd: epidermis and superficial dermis
3rd: entire dermis and epidermis
4th: entire dermis and epidermis as well as bone, muscle, or fat
Management of large burns
IV opiates for pain
Fluids (LR)
Catheter to monitor Is and Os
How to calculate fluid dose for burn patients
Parkland formula
Management of minor burns
Clean wound and apply topical Silvadene
Acidic vs. alkalotic burns
Acid: coagulation necrosis leading to eschar formation
Alkali: liquefaction necrosis
Etiology of cellulitis
MC staph aureus
S/S of cellulitis
Fever, chills
Erythema
Pain, hot, tender
Indistinct borders
Diagnosis of cellulitis
Clinical
Treatment of cellulitis
MRSA: clinda, vanc, bactrim
Non-MRSA: keflex
Dog bite: augmentin
Immediate vs. delayed drug reactions
Immediate: < 1 hour after last dose
Delayed: after 1 hour
S/S of exanthematous drug reactions
Bright red, maculopapular rash
Starts on trunk and spreads to extremities
Drugs common for exanthematous drug reactions
PCN
Carbamazepine
Allopurinol
Sulfonamides
Gold salts
Treatment of exanthematous drug reaction
D/c offending agent
Topical steroids and antihistamines
Fixed drug reaction
Patch or plaque that will recur at the same site if re-exposure of offending agent occurs
Treatment of fixed drug reaction
Eroded: antibiotic ointment
Non-eroded: topical steroid ointment
MC drugs resulting in drug-induced hypersensitivity syndrome
Antiepileptic drug
Sulfonamides
S/S of drug-induced hypersensitivity syndrome
Onset 2-6 weeks after drug initiation
Fever, malaise
Facial edema
Maculopapular eruption
Organomegaly
Lymphadenopathy
Abnormal labs
Treatment of drug-induced hypersensitivity syndrome
Mild: topical steroids
Severe: oral steroids
S/S of melanoma
Asymmetry
Irregular borders
Dark color
Large size
Changing over time
Diagnosis of melanoma
Full thickness/punch biopsy
Treatment of melanoma
Excision with wide-margins
Margins for melanoma
In situ: 0.5 cm
Less than 1-2 mm: 1-2 cm
2-4 mm: 2 cm
> 4 mm: 2 cm
MC location of pressure ulcers
Sacrum/hip
Rating of pressure ulcers
1: intact skin
2: loss of epidermis with exposed dermis
3: full-thickness skin loss
4: exposed muscle, tendon, or bone
Precursor to SCC
Actinic keratosis
S/S of SCC
Hard, firm papule or plaque
Keratotic scale
Diagnosis of SCC
Biopsy
Treatment of SCC
Mohs or excision with narrow margins
Topical Imiquimod or 5-FU
Keratocanthoma
Volcano-like, rapid growing, SCC
