Eczematous and Papulosquamous Disorders

Question 1

Hallmark of disease is pruritus. Scratching leads to eczamatous change and lichenification. Lesions may ooze, crust, become purulent

Answer 1

atopic dermatitis (eczema)

Question 2

Two very common locations for atopic dermatitis

Answer 2

antecubital and popliteal flexure areas

Question 3

Antihistamines used to treat pruritus of atopic dermatitis

Answer 3

doxepin or vistaril

Question 4

Solution used to dry up oozing lesions

Answer 4

Burows (Domeboro)

Question 5

Corticosteroid treatment for mild to moderate cases of atopic dermatitis

Answer 5

desonide 0.05% or hydrocortisone 2.5%

Question 6

High potency corticosteroid treatment for moderate atopic dermatitis

Answer 6

fluocinolone 0.025%, triamcinolone 0.1%, betamethasone dipropionate 0.05%

Question 7

Used for patients who require therapy to the face or skin folds for more than three weeks

Answer 7

Topical calcineurin inhibitors

Question 8

Name the Topical calcineurin inhibitors

Answer 8

tacrolimus (protopic) and pimecrolimus (Elidel)

Question 9

Black box warning of Topical calcineurin inhibitors

Answer 9

increase the incidence of skin cancer and lymphoma with long term use

Question 10

Coin shaped lesions that usually occur on the trunk and lower extremities. Tx is the same as for atopic dermatitis

Answer 10

nummular eczema

Question 11

occurs as a result of chronic eczematous changes and scratching. Circumscribed plaque of thickened skin with increased markings with some scaling

Answer 11

lichen simplex chronicus

Question 12

Vesicular eruption on the skin of the hands and feet marked by intense itching (vesicles are deep). Scaling, fissures and lichenification may follow

Answer 12

dyshydrotic eczema

Question 13

Caused by direct exposure to a substance as far back as 2 weeks ago or may develop rxn to products that have been used for yrs. Intense pruritis, rash, papular erythematous lesions

Answer 13

contact dermatitis

Question 14

Common plant substance in north america found in poison ivy/oak/sumac, mango skin, or gingko fruit, that is responsible for contact dermatitis

Answer 14

oleoresin urushiol

Question 15

Systemic corticosteroids that can be used for plant based contact dermatitis that covers a large area (>10% BSA), face, or genitals

Answer 15

prednisone 2-3 wks

Question 16

Topical corticosteroids for contact dermatitis

Answer 16

clobetasol 0.05% crm

Question 17

Helpful for treating pruritus of allergic contact dermatitis but not plant based

Answer 17

antihistamines

Question 18

Caused by a combination of wetness, pH elevation and friction. Erythema in diaper area

Answer 18

diaper dermatitis

Question 19

When should you suspect candidal infection secondary to diaper dermatitis?

Answer 19

predominately in creases and there are satellite lesions

Question 20

Treatment for diaper dermatitis without secondary yeast infection

Answer 20

frequent diaper changes, vaseline or desitin

Question 21

Treatment for diaper dermatitis with secondary yeast infection

Answer 21

topical antifungal (nystatin, miconazole, clotrimazole), vaseline. No steroids

Question 22

Treatment of candidiasis if failure of topical therapy

Answer 22

oral fluconazole (diflucan)

Question 23

1-2 mm clustered erythematous papules, paulovesicles or paulopustules with or without scale. Occurs most often around the mouth sparing the vermillion border

Answer 23

perioral dermatitis

Question 24

What is perioral dermatitis strongly correlated with?

Answer 24

topical steroid use

Question 25

First line treatment for perioral dermatitis

Answer 25

topical calcineurin inhibitors***, topical erythromycin, or topical metronidazole

Question 26

What diseases may have widespread seborrheic dermatitis?

Answer 26

HIV and Parkinson's

Question 27

Erythematous scaling patches develop in areas of sebaceous glands (scalp, face, trunk)

Answer 27

seborrheic dermatitis

Question 28

What is thought to be the pathogen responsible for seborrheic dermatitis?

Answer 28

saphrophyte Malessezia (pityrosporum ovale)

Question 29

In addition to erythema, some pruritus, and distribution involving nasolabial folds and central face, what characterizes clinical manifestation of seborrheic dermatitis

Answer 29

swollen and greasy appearance

Question 30

Treatment of seborrheic dermatitis if located on the scalp

Answer 30

T-gel, selenium sulfide, zinc pyrithione, or ketoconazole shampoo

Question 31

Treatment of non-scalp seborrheic dermatitis

Answer 31

ketoconazole, ciclopirox, tacrolimus, or pimecrolimus crm.

Question 32

What can be added on to treatment of non-scalp seborrheic dermatitis in severe cases?

Answer 32

low potency topical corticosteroid for 1-2 weeks

Question 33

Medications that may cause lichen planus

Answer 33

ACE inhibitors and beta blockers

Question 34

Shiny, flat, polygonal, violaceous papules or plaques with white lacy pattern that is a clinical manifestation of lichen planus

Answer 34

Wickham's striae

Question 35

How is lichen planus diagnosed?

Answer 35

biopsy

Question 36

In addition to Wickhan's striae, symptoms include White reticulate lesions occur on mucosal surfaces that are intensely pruritic

Answer 36

lichen planus

Question 37

Initial tx of localized cutaneous lichen planus on trunk or extremities

Answer 37

high potency corticosteroids

Question 38

Treatment for patients with widespread lichen planus

Answer 38

phototherapy, acitretin, systemic glucocorticoids

Question 39

Occurs from blood pooling due to chronic venous insufficiency. Hemosiderin from the blood cells stain the skin

Answer 39

stasis dermatitis

Question 40

Treatment of stasis dermatitis

Answer 40

compression stockings and elevation of legs

Question 41

What is the first sign of pityriasis rosea?

Answer 41

herald patch

Question 42

Salmon colored lesions that are often oval with long axis paralleling the lines of skin stress (christmas tree distribution). Resolves in 6-10wks.

Answer 42

pityriasis rosea

Question 43

Treatment for severe cases of pityriasis rosea

Answer 43

acyclovir or phototherapy

Question 44

manifestation of the mildest form of seborrheic dermatitis

Answer 44

dandruff

Question 45

What is the likely etiology for a lesion that is small, starts to grow with steroids and has central clearing?

Answer 45

fungal

Question 46

What combination of treatments for skin conditions should be avoided?

Answer 46

steroid and antifungal

Question 47

Difference between tinea versicolor and vitaligo

Answer 47

tinea versicolor has scaling