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Clinical Medicine > Dermatology Treatments > Flashcards

Dermatology Treatments Flashcards

1
Q

Seborrheic Keratosis

A
  • Cryotherapy
  • Electrodessication and curettage
  • Don’t have to be treated if asymptomatic
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2
Q

Acrochordons

A
  • Scissor removal
  • Electrocautery
  • Cryotherapy (don’t recommend, causes too much collateral damage)
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3
Q

Scars (hypertrophic, keloid)

A
  • Scar massage
  • Intralesional steroid injection
  • Pulse dye laser
  • Silicone products
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4
Q

Dermatofibroma

A
  • Cryotherapy (usually need more than 1x)
  • Punch biopsy
  • not recommended to treat
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5
Q

Sebaceous Hyperplasia

A
  • Not necessary unless irritating

- Electrocautery (tell patient they have a high chance of growing back)

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6
Q

Syringoma

A

-Electrocautery

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7
Q

Milium/Milia

A
  • Retinoids (treat and prevent)
  • Incision and extraction
  • Light electrodessication
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8
Q

Epidermal Cyst

A
  • Excision

- Incision and drainage not effective (the entire capsule has to be excised)

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9
Q

Pilar Cyst

A

-Excision
-Incision and drainage not effective
(same as epidermal cyst)

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10
Q

Myxoid Cyst

A
  • Surgically excised
  • Incision and drainage followed by firm compression dressing for weeks
  • Injection of sclerosing solution
  • Triamcinolone injection
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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
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12
Q

Lipoma

A

-Excision

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13
Q

Pyogenic Granuloma

A

-Shave biopsy with cauterization

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14
Q

Stork Bite

A
  • Not necessary on posterior neck

- Facial ones do fade over time

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15
Q

Port Wine Stain (Nevus Flammeus)

A
  • Send to pediatric dermatologist
  • Pulsed dye laser treatment
  • Make up can be used to camouflage
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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
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17
Q

Cherry Angiomas

A
  • Electrocautery

- Laser/intense pulse light

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18
Q

Spider Angioma/Telangiectasia

A
  • Electrocautery

- Laser surgery

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19
Q

Angiokeratomas

A
  • No tx needed

- Uncertain of diagnosis –> biopsy it

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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
Q

Nevus Sebaceous

A

-Excise - refer to dermatology

26
Q

Halo Nevus

A
  • Need to evaluate skin for vitiligo and suspicious nevi
  • Biopsy
  • Refer to dermatology for monitoring/rule out melanoma
27
Q

Blue Nevus

A

-Excise, send to derm

28
Q

Spitz Nevus

A
  • Excision

- Send to dermatology for skin evaluation

29
Q

Café au lait spot

A

-None if there is no suspicion of another disorder

30
Q

Freckles/Lentigines

A
  • Bleaching agents
  • Laser/IPL
  • Sun protection-prevention works best
31
Q

Actinic Damage-Photoaging

A
  • Derm for evaluation and monitoring
  • Topical retinoids
  • Antioxidant serums
  • Sun protection measures can prevent AND treat
  • Discourage intentional tanning
32
Q

Actinic Keratosis

A
  • 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
Q

Basal Cell Carcinoma

A
  • 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
Q

Squamous Cell Carcinoma

A
  • 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
Q

Bowen’s Disease (variant of SCC)

A
  • Excision
  • Electrodessication and curettage
  • Crysurgery
  • Topical 5-fluorouracil
  • Imiquimod
  • Skin cancer checks at least twice a year
36
Q

Keratoancanthoma

A
  • Excision
  • Electrodesiccation and curettage
  • Every 5 month skin evaluations
37
Q

Melanoma

A
  • 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
Q

Merkel Cell Carcinoma

A
  • Surgical excision
  • Radiation
  • Chemotherapy
39
Q

Kaposi Sarcoma

A
  • 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
Q

Atopic Dermatitis

A
  • 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
Q

Pityriasis Alba

A
  • Prevent dryness in winter with moisturizers

- Topical steroid if itchy

42
Q

Nummular Eczema

A

-High potency topical steroids

43
Q

Asteototic Eczema

A

-Humidifier, emollients, medium potency steroid, avoid hot bath and soap

44
Q

Dyshidrotic Eczema

A

-Mid-high potency steroid

45
Q

Ichthyosis Vulgaris

A
  • 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
Q

Keratosis Pilaris

A
  • 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
Q

Lichen Simplex Chronicus

A
  • 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
Q

Prurigo Nodularis

A

-Intralesional steroid, occlusion

Clinical Medicine (2 decks)

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