Exam 1 Bolded Words Only Flashcards
1
Q
Dermatitis means
A
inflammation of the skin
2
Q
Atopic dermatits: “the itch…”
A
that rashes
3
Q
Atopic triad
A
atopic dermatitis, allergic rhinits, asthma
4
Q
Atopic dermatitis occurs where in children and adults
A
children - cheeks, scalp, extensor surfaces
adults - feet, hands, flexural surfaces
5
Q
Essential features of Atopic Dermatitis
A
pruritis, eczema - morphology, chronic or relapsing history
6
Q
First line of treatment for atopic dermatitis
A
hydrate skin with emollients
7
Q
Where should you avoid putting high potency steroids?
A
on face, in skin folds
results in skin atrophy
8
Q
Side effects of topical steroids
A
pigment changes, atrophy, striae, bruising, telangiectasias
9
Q
Second line of treatment for atopic eczema
A
topical calcineurin inhibitors for face
10
Q
Tapioca like
A
dyshidrotic eczema
11
Q
Dyshidrotic eczema is
A
intensely pruritic
12
Q
Tx for dyshidrotic eczema
A
reassurance, topical steroids
13
Q
Allergic contaxt dermatitis
A
delayed type (type 4)
14
Q
Irritant contact dermatitis
A
hands in water, detergents, etc; 80% of all contact dermatitis
15
Q
Alleric contact derm main symptom
A
itch
16
Q
Poison ivy, oak, sumac
A
allergic contact derm
17
Q
Allergens for contact derm
A
nickel, rubber, latex, perservatives, neomycin
18
Q
Drug eruptions
A
morbilliform or exanthematous (95%)
Uticaria or angioedema (5%)
most are type 4
19
Q
Drug eruptions develop within how many days of exposure?
A
5-14 days
20
Q
Drug eruptions are:
A
morbilliform; red macules, papules
21
Q
Drug hypersensitivity syndrome
A
high fever, rash - morbilliform, internal organs affected
22
Q
SJS
A
life threatening
mucocutaneous reactions
23
Q
SJS is:
A
medication induced
24
Q
SJS total body surface area
A
less than 10%
25
TEN total body surface area
greater than 30%
26
SJS?TEN has a positive ____ sign.
Nikolsky
27
How to estimate TBSA?
Rule of 9s
28
SJS/TEN tx
discontinue offending medication
29
Complications of SJS/TEN
acute phase - fatal complications
| long-term sequelae - cutaneous, mucosal, ocular, pulmonary complications
30
Species responsible for seborrheic dermatitis
Malessezia fur fur
31
Characteristics of seborrheic dermatitis?
mild dandruff to more extensive inflammatory dermatitis
32
Cradle cap
seborrheic dermatitis; yellow greasy scales
33
Adult seborrheic dermatits
erythematous coalescing macules, patches or plaques with yellow greasy looking scales
34
treatment for blepharitis and cradle cap
olice oild, warm H2O
35
treatment for scalp seborrheic dermatitis
antifungal agents and topical corticosteroids
36
tx for face seborrheic dermatitis
low potency topical corticosteroid cream, antifungal, or combo
37
Pityriasis Rosecea characteristics
christmas tree pattern, viral skin exanthem, common in teens and young adults, herald patch with secondary rash 1-2 weeks later, cigarette paper on some plaques, collarette scale
38
Tx for pityriasis rosecea
goes away on own
39
Lichen planus is ______-______.
immune mediated
40
Licehn planus is usually
idiopathic
41
Koeber phenomenon is associated with what skin diseases
lichen planus
| psoriasis vulgaris
42
Koebner phenomenon is what
development of lesions in sites of trauma
43
4 Ps of Lichen Planus
pruritic, purple, polygonal papules
44
Wickham's striae
tiny white lines running through papules
45
What disease is wickham's striae associate with?
lichen planus
46
Tx for lichen planus
topical steroids/intralesional - triamcinolone
| high potentcy on trunk/extremities
47
Characteristics of Psoriasis
thickened, dry rasied patches covered in silveru white scale
48
chronic plaque psoriasis - aka:
| most common
psoriasis vulgaris
49
Clinical presentation of psoriasis?
well-demarcated, red violent plaque covered with thick adherent white silvery scale
50
Auspitz is what? What disease is it associated with?
specks of blood; psoriasis
51
_____ proceeds guttate psoriasis.
Strep
52
Can you use oral steroids to treat psoriasis?
No. it will get better but will worsen upon discontinuation
53
Tx of psoriasis?
group 1/2 corticosteroids, synthetic vit D, coal tar, topical retinoids, topical calicneurin inhibitors
54
Limited disease of psoriasis tx:
less than 5%, does not affect hands feet or genitials is typically tx with super high potency steroids
55
Steroid sparing ages may be used in _____ with topical steroids
combination
56
Psoriatic arthritis
inflammatory arthritic associated with psoriasis
57
Moderate to severe psoriasis should be treated by whom?
derm - requires phot therapy or systemic therapy
58
Prevalence of psoriatic arthritis?
30% of pts with psoriasis
59
____ joints and spine are affected in half the cases of Psoriatic arthritis?
DIP
60
Psoriatic arthritis lab findings
Elevated sedimentation rate and leukocytoris, positive HLA-B27 association
61
Tx for psoriatic arthritis
coordination with rheumatologist and derm
62
Acne vulgaris is a disease of:
the pilosebaceous unit
63
_____ is considered the precursory for the clinical lesions of acne vulgairs
microcomedo
64
Accumulation of sebu and kertinous material converts ____ into a _____.
microcomedo, closed comedo
65
Follicular orifice is opened with continued distension forming
open comedo - black head
66
Follicular rupture contribues to development of
inflmmatory lesion
67
Immune system sends white blood cells to fight infection and creates pus in pore
white head
68
Tx for comedonal and inflammatory lesions?
topical retinoids
69
Tx for inflammatory lesions
topical antimicrobial
70
Tx for severe inflammatory acne
oral antibiotics
71
What does benzoyl peroxide do
decreases emergency of antibiotic resistant bacteria
72
Some acne meds are
teratogenic
73
Acne rosacea
chronic skin disorder of central face
74
four types of rosacea
erythematotelaniectatic
papulopustular
phymatous
ocular
75
First line treatment for erythematotelangiectatic rosacea?
behavior modification - avoid triggers, sun protection, gentle skin care
76
First line tx/second line tx for midl to moderate papulopustular rosacea
metrondiazole, azelaic acid
tentra/mio/doxy cyclines
77
Tx for phymatous rosacea?
isotretinoin, surgical debulking
78
Scorpion stings/venom works how?
complex mixtures which includes potent neurotoxin that inactivates sodium channels causing membrane hyperexcitability --> excessive NT activity and autonomic dysfunction
79
Grade 1 envenomation produce
local pain and paresthesias
80
Grade 2 envenomation produce
local symptoms and remote pain and paresthesias
81
Grade 3 envenomations produce either
cranial nerve or somatic skeletal neuromuscular dysfunction
82
Grade 4 envenomations produce
both cranial nerve and somatic skeletal neuromuscular dysfunction
83
Bee stings most commonly result in
local reaction
84
Bee stings anaphylactic reaction
treated with IM epinephrine
85
Widow causes ____ release
catecholamine
86
Vitiligo
acquired skin depigmentation via an autoimmune process directed against melanocytes
87
Vitiligo characteristics
milk-white macules with homogenous depigmentation and well-defined borders
88
Hidradenitis Suppurativa is
chronic skin disorder involving hair follicle
89
Hidradenitis Suppurativa results from cycle of
follicular occlusion, rupture, associated immune response
90
Hidradenitis Suppurativa starts with
.... then what happens
single, deep-seated inflammatory nodule
more nodules form as disease progresses
may form abscess that opens to skin
purulent drainage occurs if ruptured
91
Lymphangitis
inflammation of lymphatic channels due to inflammation/infection
tender, red streaks extending proximally
92
Folliculitis caused by
staph aureus
93
Hot tub folliculitis caused by
pseudomonas
94
Folliculitis symptoms
itching, occasional pain
95
How can folliculitis progress
furuncle --> carbuncle
96
Tx for folliculitis - staph
self-limited usually
if moderate/severe: mupirocin, cephalexin
MRSA: sulfa, clindamycin, doxy
97
Tx for folliculitis - pseudomonas
self-limited
98
Impetigo - three kinds
nonbullous - more common
papules --> vesicles --> pustules --> honey colored crusting
bullous - vesicles enlarge and form flaccid bulla
ecthyma - punhced out ulcers with overlying crust
99
Impetigo tx
nonbullous/bullous:
mild: topical antibiotics
moderate/severe: oral antibjotics covering staph and step dicloxicillin, cephalexin
ecthyma - always tx with oral therapy - ducloxicilin, cephalexin
100
Cellulitis - two types
nonpurulent - cellulitis, erysipelas
| purulent - cellulitis, abscess
101
Erysipelas is caused by
B hemolytic streptococci
102
Characterisitcs of erysipelas
sharply demarcated border/well-defined margin
103
SLE: consider what possibility?
drug-indeuced cutaneous lupus
104
Erythema Multiforme
target-like lesions
105
Cause of erythema multiforme
herpes simplex
106
Erythema multiform major and minor differences
major - mucous membranes
107
Dermatitis herpetiformis
gluten sensitivity autoimmune skin condition
108
Pemphigus - mucosal involvement
flaccid bullae begin in oropharynx
109
Pemphigus - Nikolsky sign
gentle application of lateral pressure in an uninvolved area causes superficial layer to slough
110
Hallmark finding of pemphigus
acantholysis
111
Pemphigus perilesional biopsy
direct immunofluorescence
112
How to treat pemphigus
systemic corticosteroids, immunosuppressive agents are mainstay
113
Pemphigoid - two kinds
bullous pemphigoid, mucous membrane pemphigoid
114
Pemphigoid - what kind of bullae
tense bullae
115
Pemphigoid dx
direct immunoflourescence is gold standard
116
Pemphigoid tx
topical and or systemic corticosteroids
117
Pressure injury stages:
1 - redness, intact skin
2 - exposed dermis, no fat
3 - full loss of skin, rolled edges, adipose
4 - fat, thickness, full exposure, bone, muscle, tendon, fascia
118
Bull's eye appearnance
erythema migrans - lyme's
119
Pathogen - erythema migrans
borrella burgdorferi
120
Pathogen - rocky mountain spotted fever
rickettsia rickettsia
121
Measles etiology
Paramyxovirus
122
How long is measles incubation period?
| What are symptoms?
2-3 weeks
| Asymptomatic
123
Measles prodrome
anorexia, malaise, fever of over 105 followed by 3 Cs
124
3 Cs associated with which disease?
Measles
125
What are the three Cs of Measles
couch, coryza, conjunctivitis
126
What are Koplik spots and what disease are they associated with
Measles.
| "Grains of salt" inside mouth
127
What is the enanthem of Measles?
| How long before the rash do they appear?
Koplik spots; 48 hours
128
Exanthem of measles
rash: blanching, maculopapular
129
Spreading pattern of measles rash
Head to toe, spares palms and soles
130
How long are you infectious with measles before and after rash?
5 days before, 4 days after
131
What complications are associated with measles?
diarrhea and otitis media are the most common
pneumonia - common cause of death in childlren
encephalitis
Subacute scierosing Panencephalitis - 7-10 years later - FATAL
132
Can you get MMR when pregnant?
No.
133
How to treat measles?
symptomatic tx only
134
Another name for erythema infectiosum
fifth disease
135
Etiology of erythema infectiosum/fifth disease?
parvovirus B-19
136
When does fifth disease usually occur? How does it spread?
school-aged children; respiratory secretions
137
How long do symptoms of fifth disease last?
weeks, months, or years; new occurence of rash following heat, exercise, hot bath
138
Clinical stages of fifth disease?
incubation: 7-14 days
prodrome - non-specific, flu-like, low-grade fever
Rash: "slapped cheek"; malar rash
Body rash follow facial rash 2-3 days later
139
Description of body rash
lacy pink macular rash of trunk and extremeties (extensor surfaces)
140
Tx of fifth's disease
symptomatic/reassurance
141
Rubella - German Measles - etiology
Rubella virus
142
Clinical stages of german measles
Incubation: 12-23 days
Prodrome (maybe) - 1-5 days prior to rash but also may be concurrent with rash
Low grade fever, enlarged lymph nodes
Rash
143
What does German Measles rash look like?
3-day measles
pinpoint pink maculopapules
head to to progression
contagious 7 days before and after rash
144
German Measles complications
encephalitis, thrombocyctopenic purpura, GI hemorrhage
birth defects in pregnant women - congenital rubella syndrome - LETHAL
145
What is blueberry muffin associated with?
German measles
146
Tx of Measles?
Symptomatic tx only
147
Roseola infantum etiology
herpes virus 6
148
Typical progression of roseola infantum
high fever of 102-105 --> resolves abruptly --> rash appears
149
Clinical presentation of roseola infantum
incubation: 9-10 days
prodrome: febrile phase - high fever
rash: blanching pink/erythematous maculopapular
150
How does roseola infantum spread around the body?
from neck/trunk initially then to face/extremity
151
Describe roseola infantum itch and appearance?
nontoxic, nonpruritic except in immunocompromised
152
How to treat roseola infantum?
supportive tx only
153
Hand foot and mouth disease etiology?
Cozsackle A16 virus
154
Clinical presentation of hand foot and mouth
incubation: 3-5 days
155
Clinical presentation of hand foot and mouth
incubation: 3-5 days
prodrome: 12-24 hours - typically absent, fever, fussiness, emesis, abdominal pain
oral enanthem/exanthem: sore throat, vesicles on buccal mucosa, tongue (ENANTHEM) and vesicles on hands, feet, and butt - vesicles may create ulcers
156
Tx for hand foot and mouth
symptomatic relief only
157
Molluscum Contagiosum seen in what population
children and adults/immunocompromised
158
Self-spreading of molluscum contagiousum
self-spreading by touching, scratching shaving
159
Etiology of molluscum contagiosum?
poxvirus
160
Molluscum contagiosum presentation
lesions - umbilication, flesh-colored, pearly papulas, 2-5mm, located everywhere but palms and soles
161
Tx for molluscum contagiosum?
none
162
Mucosal HPV name
condyloma acuminata
163
HPV presentation
cauliflower-like lesions, perianal growth, pruritis
164
HPV Common Warts
common in children, young adults, transmitted by skin to skin contact, spontaneous resolution in 1-2 years; reoccurence common
165
HPV Common warts may have _____ capillaries
pigmented, black "seeds"
166
Treatment required for common warts
none
167
Varicella etiology
Varicella Zoster virus
168
Varicella transmission
contagious
169
Clinical stages of Varicella
incubation period of 10-21 days
prodrome: 2-5 days - fever malaise, pharyngitis, anorexia
Rash - generalized vesicular rash
Very itchy
Lesions occur at different stages over 4 days and are typically crusted over by 6 days. Look for lesions at different stages in healing in dx.
170
Another name for herpes zoster
shingles
171
How does shingles reoccur?
reactivation of latent VZV from dorsal root ganglia
172
Pathogenesis of herpes zoster (shingles)
virus dormant in sensory ganglia --> immunity to VZV diminishes --> virus travels along sensory nerve --> skin lesions appear
173
Shingles usually on:
trunk
174
Clinical stages of shingles/herpes zoster?
prodrome: acute neurotic pain precedes eruption by 3-5 days - throbbing, stabbing, burning + pruritis, fever, headache, allodynia
Active disease: Rash - dermatomal, unilateral, thoracic distribution most common
175
What nerve does herpes zoster ophthalmicus affect?
trigeminal nerve
176
Hutchinson's sign:
vesicles on nose; can lead to vision loss due to retinal necrosisand link to trigeminal ganglion activation
177
Tx with shingles
START EARLY within 72 hours
| Antiviral! Valcyclovir is preferred
178
Types of Herpes Simplex Virus
HSV-1 and HSV-2
