Dermatology Treatments Flashcards
1
Q
Seborrheic Keratosis
A
- Cryotherapy
- Electrodessication and curettage
- Don’t have to be treated if asymptomatic
2
Q
Acrochordons
A
- Scissor removal
- Electrocautery
- Cryotherapy (don’t recommend, causes too much collateral damage)
3
Q
Scars (hypertrophic, keloid)
A
- Scar massage
- Intralesional steroid injection
- Pulse dye laser
- Silicone products
4
Q
Dermatofibroma
A
- Cryotherapy (usually need more than 1x)
- Punch biopsy
- not recommended to treat
5
Q
Sebaceous Hyperplasia
A
- Not necessary unless irritating
- Electrocautery (tell patient they have a high chance of growing back)
6
Q
Syringoma
A
-Electrocautery
7
Q
Milium/Milia
A
- Retinoids (treat and prevent)
- Incision and extraction
- Light electrodessication
8
Q
Epidermal Cyst
A
- Excision
- Incision and drainage not effective (the entire capsule has to be excised)
9
Q
Pilar Cyst
A
-Excision
-Incision and drainage not effective
(same as epidermal cyst)
10
Q
Myxoid Cyst
A
- Surgically excised
- Incision and drainage followed by firm compression dressing for weeks
- Injection of sclerosing solution
- Triamcinolone injection
11
Q
Pilonidal Cyst
A
- Incision and drainage
- Pack the wound if deep with frequent dressing changes in the office
- Antibiotics generally not needed
- Pain relief
- Recurrent cysts = general surgery
12
Q
Lipoma
A
-Excision
13
Q
Pyogenic Granuloma
A
-Shave biopsy with cauterization
14
Q
Stork Bite
A
- Not necessary on posterior neck
- Facial ones do fade over time
15
Q
Port Wine Stain (Nevus Flammeus)
A
- Send to pediatric dermatologist
- Pulsed dye laser treatment
- Make up can be used to camouflage
16
Q
Infantile Hemangiomas
A
- Send to pediatric dermatologist
- Pulse dye laser or continuous wave laser
- Intralesional and systemic high-dose glucocorticoid
- Propranolol (worry about hypotension, hypoglycemia, bronchospasm, hyperkalemia)
- Interferon-alpha
- Cryosurgery
- Excision
17
Q
Cherry Angiomas
A
- Electrocautery
- Laser/intense pulse light
18
Q
Spider Angioma/Telangiectasia
A
- Electrocautery
- Laser surgery
19
Q
Angiokeratomas
A
- No tx needed
- Uncertain of diagnosis –> biopsy it
20
Q
Venous Lake
A
- Electrosurgery
- Laser
- Rarely, excision
21
Q
Acquired Melanocytic Nevus
A
- Shave biopsy
- Punch biopsy/removal
- Elliptical excision
- Dermascope can help aid in deciding to remove lesion or monitor
22
Q
Congenital Melanocytic Nevus
A
- Have to monitor on a regular basis by derm
- If it looks abnormal = biopsy
- Any changes = biopsy
- Educate about sun protection measures
23
Q
Becker’s Nevus
A
-None needed unless for cosmetic reasons
24
Q
Nevus Spilus
A
- None
- Cosmetic reason: surgical excision, laser
25
Nevus Sebaceous
-Excise - refer to dermatology
26
Halo Nevus
- Need to evaluate skin for vitiligo and suspicious nevi
- Biopsy
- Refer to dermatology for monitoring/rule out melanoma
27
Blue Nevus
-Excise, send to derm
28
Spitz Nevus
- Excision
| - Send to dermatology for skin evaluation
29
Café au lait spot
-None if there is no suspicion of another disorder
30
Freckles/Lentigines
- Bleaching agents
- Laser/IPL
- Sun protection-prevention works best
31
Actinic Damage-Photoaging
- Derm for evaluation and monitoring
- Topical retinoids
- Antioxidant serums
- Sun protection measures can prevent AND treat
- Discourage intentional tanning
32
Actinic Keratosis
- Cryotherapy
- Topical 5-fluorouracil 5% cream
- Imiquimod 5% cream
- Aminolevulinic acid activated by intense pulse light
- Skin checks by derm every 6 months
- Skin protection
33
Basal Cell Carcinoma
- Superficial BCC's can be treated via ED&C (electrodessication and curettage) or imiquimod or photodynamic therapy if not a surgical candidate
- All other's require excision (Moh's micrographic surgery)
- If here are mets, vismodegib is used
- Skin cancer checks twice a year by dermatology
34
Squamous Cell Carcinoma
- Excision (Moh's micrographic surgery)
- Skin cancer checks at least twice a year
- Lymph node palpation
- High risk tumors may require imaging studies
- Radiation therapy for high risk tumors, systemic chemo for regional/distant mets
35
Bowen's Disease (variant of SCC)
- Excision
- Electrodessication and curettage
- Crysurgery
- Topical 5-fluorouracil
- Imiquimod
- Skin cancer checks at least twice a year
36
Keratoancanthoma
- Excision
- Electrodesiccation and curettage
- Every 5 month skin evaluations
37
Melanoma
- Not sure --> excise it
- Send patient to dermatology
- At dermatology --> re-excise it per guidelines +/ SLNM, total body skin checks, check lymph nodes, spleen and liver, CXR, LFT's, new treatment options available
- Watch skin tattoos closely
38
Merkel Cell Carcinoma
- Surgical excision
- Radiation
- Chemotherapy
39
Kaposi Sarcoma
- Treat HIV is that is present
- Patients on immunosuppressants, can you tweak them?
- Local lesions --> cryotherapy, radiotherapy, excision, laser, injection of chemo agents
- Wide spread lesions --> photodynamic therapy, isotretinon, cytokine inhibitor, ganciclovir, foscarnet
40
Atopic Dermatitis
- Topical steroids
- Topical calineurin inhibitors
- Oral antihistamines (for itching)
- Antibiotics if secondary infection
- Home care --> moisturizing, avoid bathing in hot water, avoid triggers/irritants
41
Pityriasis Alba
- Prevent dryness in winter with moisturizers
| - Topical steroid if itchy
42
Nummular Eczema
-High potency topical steroids
43
Asteototic Eczema
-Humidifier, emollients, medium potency steroid, avoid hot bath and soap
44
Dyshidrotic Eczema
-Mid-high potency steroid
45
Ichthyosis Vulgaris
- Moisturize
- Keratolytics --> topical agents containing one or a combination of the following: Lactic acid, urea, salicylic acid, alpha-hydroxy acids
- Retinoids --> Adapalene (Different), Tretinoin (Retin A)
46
Keratosis Pilaris
- Moisturize
- Keratolytics --> topical agents containing one or a combination of the following: Lactic acid, urea, salicylic acid, alpha-hydroxy acids
- Retinoids --> Adapalene (Different), Tretinoin (Retin A)
47
Lichen Simplex Chronicus
- STOP the itch scratch cycle!
- Mid to high (3 weeks) potency topical steroids to thick lesions (+/- occlusion)
- Low potency steroids or pimecrolimus (Elidel) to vulva, scrotum, axilla, face
- Oral antianxiety or sedating meds may be beneficial to some patients (day/night)
- If lesions are infected consider topical or oral abx
- Ling-term therapy: daily use of low-potency topical corticosteroids
48
Prurigo Nodularis
-Intralesional steroid, occlusion
