Dermatology Tuff Stuff

Question 1

What med should you NEVER use to tx seborrheic dermatitis?

Answer 1

lotrisone

Question 2

What is the tx for stasis dermatitis?

Answer 2

Leg elevation, exercise, weight reduction, support
stockings, moisturizers,

pulsed mid-topical corticosteroids:

• triamciniolone acetonide 0.5%
• or fluocinolone acetonide 0.025%

Question 3

What is the tx for hidradenitis suppurativa?

Answer 3

counseling: lifestyle, diet, smoking, no soap

MILD(stage 1):

• topical clindamycin
• oral antibiotics (doxycylcline/ minocycline, clindamycin)
• surgery
• intralesional cotricosteroids* (triamcinolone or kenalog) +

Moderate- Stage 3:
- oral antibiotics (first line- tetracyclines; Refractory cases-clindamycin and rifampin)
- hormonal therapy in females.
Adalimumab (HUMIRA)- day1: 40 mg injections, 2 weeks later 2 40 mg

Question 4

What meds cause psoriasis flares?

Answer 4

beta blockers, calcium channel blockers, lithium

Question 5

What is the tx for an exanthematous (morbilliform) drug eruption?

Answer 5

d/c med
antihistamine
topical steroids

Question 6

What is the tx for drug induced urticaria?

Answer 6

d/c medication
Antihistamine
SYSTEMIC steroids: (prednisone)

Question 7

What drugs cause drug induced urticaria?

Answer 7

PCN, radioactive contract, NSAIDS

within minutes/hours of administration

Question 8

What drugs cause SJS/TEN?

Answer 8

Sulfas
Ibuprofen
Carbamezapine
Cephalosporins
Allopurinal
Fluoroquinolone

Question 9

What dx is associated with lichen planus?

Answer 9

Hep C

Question 10

What is the tx for lichen planus?

Answer 10

topical high steroids

oral antihistamines

Question 11

What med should you NEVER use to tx psoriasis?

Answer 11

prednisone

Question 12

What is the tx for psoriasis?

Answer 12

First line: topical steroids
then get them to a dermatologist 
Heavy ointments
Antihistamines
Phototherapy
If joint involved then biologic
Topical vit A and D analogs

Question 13

What conditions in a pt’s hx should raise your index of suspicion for guttate psoriasis?

Answer 13

-beta-hemolytic 
Strepococci (streptococcus pyogenes)
-acute strep 
pharyngitis in adults
-perianal strep in kids

Question 14

What is the tx for erythema multiformi?

Answer 14

If herpetic, tx with antivirals (valicyclovir)

topical steroids, lidocaine if painful

Oral prednisone if extensive or refractory

Question 15

What is the tx for erythema multiformi major?

Answer 15

prednisone

Question 16

What is the tx for urticaria?

Answer 16

Drug induced: D/C medication,

• H1 antihistamine (cetirizine, loratidine, fexofenidine)
• systemic oral steroid (prednisone)

Question 17

What is the tx for angioedema?

Answer 17

• airway management (epi or intubation)
• medical management (H1 and H2 antihistamines, glucocorticoid)
• discontinue offending agent

Question 18

What tx would you try if topical therapy failed for impetigo?

Answer 18

oral abx: cephalosporins

Question 19

What is the tx for cellulitis?

Answer 19

Topical abx: Mupirocin

ALWAYS need oral abx: cephalosporins (ex. Keflex)

Warm antibacterial soaks and washes

Question 20

What is the tx for MRSA?

Answer 20

trimethoprim-sulfa or doxycycline

Question 21

What is the tx for lymphangitis?

Answer 21

Tx for stable adult/ kids 3+ that are nontoxemic (peeing drinking and well hydrated) → broad spectrum oral antibiotic until cultures are complete
(dicloxacillin, cephalexin)

analgesics, hot compress

3 and under/ systemically ill pts (fever chills myalgia enlarged lymph nodes)→ Parenteral antibiotics

analgesics, hot compress

Any children who do not improve within 48hrs → IV antistaph/antistrep therapy

Question 22

What is the tx for ecthyma?

Answer 22

Oral penicillin for strep

If S. aureus is present too → cephalexin/dicloxacillin

Hygiene: antibacterial soap, frequent sheets/towels/clothing
Topical warm compresses and topical antibiotic cream: (mupirocin oint)

Question 23

What are 3 common pathogens which cause dermatophytoses?

Answer 23

microsporum
trichophyton
epidermophyton