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Dermatology > Eczematous & Papulosquamous Disorders > Flashcards

Eczematous & Papulosquamous Disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

Types of Eczematous Disorders

A 
Atopic
Nummular eczema
Lichen simplex chronica
Dyshydrotic eczema
Contact
Diaper
Candidiasis
Perioral
Seborrheic
Stasis
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2
Q

Types of Papulosquamous Disorders

A

Lichen planus

Pityriasis rosea

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3
Q

Characteristics of Eczematous Lesions

A

Scaling
Crusting
Serous oozing

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4
Q

Define Dermatitis

A

Describes multiple types of skin disorders

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5
Q

Common Name for Atopic Dermatitis

A

Eczema

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6
Q

2 Theories of Atopic Dermatitis Pathogenesis

A

Impaired epidermal barrier function due to intrinsic structural & functional abnormalities in the skin
Immune function disorder in which Langerhans cells, T-cells, & immune effector cells modulate an inflammatory response to environmental factors

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7
Q

Clinical Manifestations of Atopic Dermatitis

A

Pruritus
Eczematous change & lichenification
Lesions ooze, crust & become purulent

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8
Q

Location of Atopic Dermatitis in Adults

A

Neck
Wrists
Behind ears
Antecubital & popliteal flexure areas

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9
Q

Location of Atopic Dermatitis in Children

A 
Neck
Wrists
Behind ears
Antecubital & popliteal flexure areas
Cheeks/face
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10
Q

Treatment of Atopic Dermatitis Treatment

A 
Eliminate exacerbating factors
Antihistamines used to treat pruritus
Hydration!!
Topical steroids
Burrow's solution for oozing lesions
Treat skin infections
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11
Q

Eliminating Exacerbating Factors for Atopic Dermatitis Treatment

A

Avoid triggers: heat, low humidity, perspiration

Treat stress & anxiety

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12
Q

Antihistamines Used in Atopic Dermatitis

A

Doxepin

Vistaril

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13
Q

Mild to Moderate Cases of Atopic Dermatitis

A

Topical steroids & emollients
Mild: low potency steroid cream or ointment
Moderate: medium to high potency steroids

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14
Q

Topical Steroids SE

A 
Atrophy
Telangiectasia
Purpura
Striae
Acneform eruption
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15
Q

> 3 weeks of therapy for the face or skin folds should use what class of medications

A

Topical calcineurin inhibitors

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16
Q

Black Box Warning for Topical Calcineurin Inhibitors

A

Increase the incidence of skin cancer & lymphoma with long term use

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17
Q

1st Line Treatment for Atopic Dermatitis

A

Hydration

Antidepressants

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18
Q

2nd Line Treatment for Atopic Dermatitis

A

Steroids

Topical calcineurin inhibitors

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19
Q

Define Nummular Eczema

A

Eczema that is described as coin shaped lesions

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20
Q

Where does nummular eczema usually occur?

A

Trunk

Lower extremities

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21
Q

What may be an alternative treatment for atopic dermatitis?

A

Phototherapy

Immunosuppressants: methotrexate, azithiorpine, cyclosporine, systemic steroids, IVIG

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22
Q

Describe Lichen Simplex Chronicus

A

What occurs as a result of chronic eczematous changes & scratching

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23
Q

Define Lichen Simplex Chronicus

A

Circumscribed plaque of thickened skin with increased markings with some scaling

24
Q

Describe Dyshydrotic Eczema

A

Vesicular eruption on the skin of the hand & feet marked by intense itching
Scaling, fissures, & lichenification may follow

25
Q

Treatment of Dyshydrotic Eczema

A

High potency topical steroids
May need to be given with occlusion
Hydration of the skin

26
Q

Define Contact Dermatitis

A

Dermatitis due to a direct exposure to a substance

From allergy or irritation

27
Q

Common Offenders of Contact Dermatitis in the U.S.

A 
Poison ivy
Poison oak
Poison sumac
Skin of mangoes
Gingko fruit
Nickel
Formaldehyde
Perfumes/cosmetics
Preservatives
Rubber & chemicals in shoes
Topical hydrocortison
Topical antibiotics
Topical benzecaine, thimersol
Laundry detergents
28
Q

Presentation of Contact Dermatitis

A 
Intense pruritus
Rash
Papular, erythematous lesions
Papule from fluid in epidermis
Vesicles & serous oozing
29
Q

Treatment of Plant Based Contact Dermatitis

A

Topical symptomatic therapy
Antihistamines
High potency topical corticosteroids
Systemic corticosteroids

30
Q

Topical Symptomatic Therapy for Contact Dermatitis

A 
Oatmeal baths
Cool, wet compresses
Calamine lotion
Burrow's or Domeboro solution for weeping lesions
Zanfel soap
31
Q

Treatment of Contact Dermatitis

A 
Remove offending agent
Topical symptomatic therapy
Medium to high potency topical steroids
Systemic steroids in severe cases
Burrow's solution for weeping blisters
Antihistamines for pruritis
Treat secondary bacterial infections
32
Q

What causes diaper dermatitis?

A

Combination of wetness, pH elevation, & friction

33
Q

Clinical Presentation of Diaper Dermatitis

A

Erythema in the diaper area

Determine if it’s from wetness, irritation from diaper, or a yeast infection

34
Q

Treatment for Diaper Dermatitis Without Yeast Infection

A

Frequent diaper changes

Barrier treatment with Vaseline or Desitin

35
Q

Treatment for Diaper Dermatitis with Yeast Infection

A

Topical antifungal: nystatin, miconazole, clotrimazole

Barrier lubricants such as Vaseline

36
Q

Treatment of Thrush

A

Nystatin

Clotrimazole

37
Q

Treatment of Cutaneous Candidiasis Infection

A

Nystatin powder
Clotrimazole (Lotrimin)
Ketoconazole
Oral fluconazole (Diflucan)

38
Q

Clinical Manifestations of Perioral Dermatitis

A

1-2 mm clustered erythematous papules, papulovesicles, or papulopustules
Most often around mouth
Spares vermillion border
Asymptomatic OR associated with burning or stinging

39
Q

Treatment of Perioral Dermatitis

A

May resolve on own
1st: Topical calcineurin inhibitor, topical erythromycin, topical metronidazole
Moderate to severe: systemic tetracyclines (adults), Erythromycin (kids)

40
Q

Describe Seborrheic Dermatitis

A

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

41
Q

Clinical Manifestations of Seborrheic Dermatitis

A 
Erythema (reddish or pink color)
Swollen/greasy appearance
White/yellow scales
Pruritis
Distribution
42
Q

Distribution of Seborrheic Dermatitis

A 
Lateral sides of the nose
Eyebrows
Glabella
Scalp
Chest
Upper back
Axillae
43
Q

Diagnosis of Seborrheic Dermatitis

A

Usually PE

Biopsy

44
Q

Treatment of Seborrheic Dermatitis on the Scalp

A

Antiproliferative shampoo

Antifungal shampoo

45
Q

Examples of Antiproliferative Shampoo

A 
T-Gel extra
Selenium sulfide (Selsun, Exelderm)
Zinc pyrithione (Head & Shoulders, Zincon, DHS zinc)
46
Q

Examples of Antifungal Shampoo

A

Ketoconazole 2%

Ciclopirox shampoo 1%

47
Q

Treatment of Non-Scalp Seborrheic Dermatitis

A 
Ketoconzole 2% cream or gel
Ciclopirox 1% cream
Tacrolimus 0.03% & 0.1%
Pimecromlimus 1% cream
Severe: low potency topical corticosteroid
48
Q

Define Stasis Dermatitis

A

Occurs from blood pooling due to chronic venous insufficiency
Increased pressure in capillaries
Extravasation

49
Q

Treatment of Stasis Dermatitis

A 
Prevent edema
Compression stockings
Elevation of legs
Skin cleansing
Emollients
Topical steroids for pruritis
Wet dressing for crusts or open lesions
50
Q

What areas can lichen planus effect?

A 
Skin
Oral cavity
Genitalia
Scalp (penile or vulvar)
Nails
Esophagus
51
Q

Clinical Manifestations of Lichen Planus

A

Shiny, flat, polygonal, violaceous papule or plaques with white lacy pattern
Intensely pruritic

52
Q

Diagnosis of Lichen Planus

A

Biopsy

53
Q

Treatment of Lichen Planus

A

Localized: High potency or super high potency topical corticosteroid
Hypertrophic: Intralesional corticosteroids
Widespread severe: phototherapy, systemic steroids acitretin

54
Q

Describe Pityriasis Rosea

A

“Herald patch”
Multiple new lesions appear centrally on trunk
Pruritic
Not contagious

55
Q

Treatment for Pityriasis Rosea

A

Self limiting
Pruritis: medium potency topical steroid
Severe: acyclovir or phototherapy

56
Q

Tinea Versicolor vs. Vitiligo

A

Both: hypopigmentation
TV: scaling
Vitiligo: no scaling

Dermatology (13 decks)

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