EM - Dermatology Flashcards
etiology of bullous pemphigoid
autoimmune disorder
autoimmune disorder
-prodrome: pruritus and urticaria
-large, firm topped bullae
-serous or hemorrhagic fluid
-negative nikolsky
Diagnosis of bullous pemphigoid
biopsy of the edge of the lesion
Treatment of bullous pemphigoid
prednisone
rule of 9s
Head and neck = 9%
Upper Ex = 9% each
Lower Ex = 9% each
Front trunk = 18%
Back trunk = 18%
management of burns
-pain control
-cath
-parkland formula for LR
-minor: clean with soap and water
-moderate-severe: cover with dry, sterile sheet and admit
etiology of cellulitis
MC staph aureus
s/s of cellulitis
-fever and chills
-swelling
-pain
-hot and tender
-ill defined borders
diagnosis of cellulitis
clinical
treatment of cellulitis
-MRSA oral: clinda
-MRSA parenteral: vanc
-no MRSA oral: keflex
-no MRSA parenteral: cefazolin
etiology of erysipelas
GABHS
s/s of erysipelas
-fever/chills
-pain
-hot and tender
-sharp borders
diagnosis of erysipelas
clinical
treatment of erysipelas
same as cellulitis
etiology of eczema
IgE
s/s of eczema
-itching
-dry patches
-asthma
-allergies
diagnosis of eczema
clinical
management of eczema
-avoid triggers
-topical steroids
-moisturize
-antihistamines
irritant vs allergic contact dermatitis
Irritant: One exposure causes dermatitis.
Allergic: repeat exposures causes dermatitis.
s/s of contact dermatitis
-erythema
-vesicles
-bullae
-scaling
diagnosis of contact dermatitis
clinical
treatment of contact dermatitis
-remove offending agent
-topical steroids
s/s of exanthematous drug reactions
-2-3 days after initiation of drug
-red, maculopapular rash
-pruritus
treatment of exanthematous drug reaction
-remove offending agent
-topical steroids
s/s of fixed drug eruption
-30 minutes to 8 hours after ingestion
-pruritus
-burning
-sharply demarcated macule
management of fixed drug eruption
-remove offending agent
-eroded: topical antibiotic
-noneroded: topical steroid
s/s of drug induces hypersensitivity eruptions
-onset 2-6 weeks after initiation
-fever,malaise
-facial edema
-maculopapular eruption
-oropharyngeal leions
treatment of drug induced hypersensitivity eruptions
topical steroids
s/s of pustular drug eruptions
-sterile pustules on an erytheatous base
treatment of pustular drug eruptions
self resolving after 2 weeks, then desquamation
s/s of herpes zoster
-paraesthesia prodrome
-dermatomal lesions
-papules -> vesicles -> pustules -> crusts
diagnosis of herpes zoster
PCR
treatment of herpes zoster
valacyclovir
supportive
etiology of impetigo
MSSA or MRSA
s/s of non-bullous impetigo
-honey crusted lesions
s/s of bullous impetigo
s/s of bullous impetigo
treatment of impetigo
-mupirocin ointment
-widespread: keflex
s/s of lice
scratching scalp, nits in hair
diagnosis of lice
-visualization of lice
-woods lamp
treatment of lice
Permethrin
etiology of pilonidal cyst
congenital disorder
congenital disorder
-pit near top of buttocks crease
-pus
treatment of pilonidal cyst
I&D of the abscess followed by sterile packing
staging of pressure ulcer
-Stage 1 - no broken skin; the area is reddened and non-blanchable
-Stage 2 - the skin is broken forming an ulcer; it may appear as a blister filled with clear fluid; the skin may become necrotic
-Stage 3 - the skin is broken and the wound is extending into the tissue beneath the skin; fat may be present in the wound bed and tunneling may occur
-Stage 4 - the pressure injury is very deep, possibly exposing muscle, tendon, and bone; there is typically extensive damage such as necrotic tissue and tunneling
-unstageable: full thickness skin and tissue loss obscured by slough or eschar
management of pressure injury
-redistribute pressure every 2 hours
-clean skin
-stage 1: cover with transparent film for protection
-stage 2: transparent or hydrocolloid dressing
-stage 3/4: debridement
s/s of scabies
-itching worse at night
-burrows
-black speck
(ROSH Q - in webs of fingers)
diagnosis of scabies
-scabies prep
-dermoscopy
treatment of scabies
Permethrin
treatment of crusted scabies
-permethrin + oral ivermectin
s/s of black widow bite
-HTN
-tachycardia
-palpitations
-SOB
-abd pain
-halo lesion around bite
s/s of recluse spiderm bite
-painless bite
-swelling, bullae, and ischemia
-ulcer and necrosis
-DIC
s/s of funnel web spider
-pain at bite site
-fatal
treatment of spider bite
-collection of spider
-wound irrigation
-rest, cold compress
-tetanus
-dapsone for necrosis
etiology of SJS/TEN
drugs
s/s of SJS/TEN
- positive nikolsky
-full thickness epidermal detachment
SJS vs TEN
SJS <10%
TEN >30%
diagnosis of SJS/TEN
biopsy
treatment of SJS/TEN
-fluids
-pain meds
-d/c med
-wound care
-steroids and IVIG
s/s of urticaria
-raised, erythematous wheals with central pallor
-dermatographism
treatment of urticaria
-acute: emergency department
-H1 +.H2 + steroid
-chronic: antihistamines
s/s of measles (Rubeola)
-low grade fever
-dry cough
-kopliks spots
-conjunctivitis
-rash
s/s of mumps
-parotitis
-fever
-HA
-muscle aches
s/s of rubella
-fine pink rash that begins on face and spreads to the trunk and limbs and then goes away in the same order
-arthralgias
s/s of erythema infectiosum
-slapped cheek rash
-fever
-rhinitis
-painful joints
s/s of roseola infantum
-high fever
-fever suddenly breaks and rash develops
