Final Exam Flashcards
Atopic Dermatits Tx
Tx includes long term use of emollients & short-term Rx for flares
Acute inflammation:
Topical steroid
(low potency for face- hydrocortisone 0.25%)
Eyelid- Topical Desonide
Antihistamines for pruritus
Chronic form of Eczema
pruritic, inflammatory skin Dz w/ wide range of severity
red, non clearing circle.
Hand & eyelid
Atopic Dermatitis
well demarcated erythematous plaque w/ silvery scale & no central clearing
Extensor Surfaces
Psoriasis
scaly, erythematous patches, papules
most common form of the skin condition
Plaque Psoriasis
Plaque Psoriasis 1st line Tx (Class)
high intensity (II) topical steroid Desonide 0.05%
Plaque Psoriasis Tx Trunk/Extrem (Class)
high potency (II) topical corticosteroid clobetasol, halobetasol, betamethasone, dipropionate
Plaque Psoriasis Tx Face (3) (class)
LOW potency topical steroid (VI-VII)
desonide 0.05%
hydrocortisone butyratem
triamcinolone 0.025%
Severe Psoriasis Systemic Tx (3)
Oral Steroids?
Systemic Tx should be supplemented w/Topical Tx
No oral steroids
- phototherapy
- Oral Rx/Traditional Agents
- methotrexate, acitretin, cyclosporin, apremilast - Select Biologic Agents- TNF inhibitors, IL inhibitors
Guttate Psoriasis Triggers & Tx
Strep infections
Tx: ABX
Psoriasis & FHx
1/3 of psoriasis pts have 1st degree relative
Most common form of Psoriasis
Plaque Psoriasis
well-demarcated/self-limiting
Hyper or hypopigmented patches (salmon/tan)
Hot climates
Exercise, sweat
chest, groin
Tinea Versicolor
Tinea Versicolor Dx test (finding)
KOH (hyphae & small,round spores)
Spaghetti & meatballs
Tinea Versicolor duration?
Lifelong
Tinea Versicolor Tx
1st line
1. Antifungal Shampoo (selenium sulfide, Ketoconazole, zinc pyrithione)
satellite macules around patches of erythema
Candida Intertrigo
Candida Intertrigo Tx
Topical Antifungal Tx
Cream: Clomitazole or Miconazole
Powder: Nystatin
Ointment: Desonide
Tinea Pedis (4)
Tinea Corporis
Tinea Cruris
Presentation
Pedis-athletes foot 1. Interdigital 2. Moccasin 3. Vesicolor 4. Ulcerative Corporis-Skin, trunk & limbs Cruris- jock itch
Tinea Pedis
Tinea Corporis
Tinea Cruris
Tx (3) in 2 forms
Terbinafine
Naftifene
Butenafine
(Cream or gel)
Erythematous patches w/overlying scale
common inflammatory rxn to
Seborrheic Dermatitis
Seborrheic Dermatitis Tx
Ketoconazole cream
Pityrias Alba Definition & Tx
Mild, often asymptomatic form of AD on the face
1st line Tx- emollients & sun protection
Atopic March
progression from AD to other allergic Dz (food intolerance, allergic rhinitis, & asthma)
% of pt’s w/food allergies who have Atopic Dermatitis
30%
Classes of Steroid (low to high)
Low (Class VI-VII)
- Fluocinolone 0.01%
- Desonide 0.05%
- Hydrocortisone (1% or 2.5%)
Medium (Class III-V) - Triamcinolone: ointment 0.01% cream 0.01% lotion 0.01%
High (II)
Fluocinonide 0.05%
Super High (I) Clobetasol 0.05%
Contact Dermatitis & Types (2)
& sensitivity type
Delayed type IV hypersensitivity
- Allergic Contact Derm
- Irritant Contact Derm
When does ACD occur?
contact w/ a particular substance elicits type IV hypersensitivity rn
Allergen test for ACD?
Patch test
latex allergy hypersensitivity type?
delayed
Tx for minor & major cases of ACD
minor- low dose topical steroids- desonide 0.09%
major-oral steroids- prednisone
Most common type of ACD
Tx? (class)
Rhus dermatitis:
Poison ivy, poison oak, poison sumac all contain causative resin (urushiol)
Tx: Low potency Topical Steroid (desonide) esp on face
Atopic Triad
Atopic Triad:
Asthma
Atopic Dermatitis
Seasonal Allergic Rhinitis
Low (VI-VII) Steroids (3)?
- Fluocinolone 0.01%
- Desonide 0.05%
- Hydrocortisone (1% or 2.5%)
Medium (III-VI) Steroid (1) & forms (3)?
- Triamcinolone:
ointment 0.01%
cream 0.01%
lotion 0.01%
High (II) Steroid?
Fluocinonide 0.05%
Super High (I) Steroid?
Clobetasol 0.05%
Name the condition:
Molecule turned on by strep infection**
found in younger pop
Psoriasis in tiny droplets over the body.
Can beitchy
Guttate Psoriasis
Seborrheic Dermatitis Bug?
Cure?
Malassezia yeast that thrives on seborrheic skin
No cure
Extremely common in young
“Christmas tree distribution’**
light pink patches
Asymptomatic
Commonly follows virual URI***
Pityrias Rosacea
pityriasis Rosacea Tx
Doxycycine
Prepubescent girls & postmenstrual women
‘fine cigarette paper’
3% risk of squamous cell carconima**
Lichen Sclerosus et Atrophicus
super itchy 5 P's ( classic lichen 'lace' & found in mouth as well Nails as well
Lichen Planus
Lichen Planus Tx (2)
Prednisone
Steroid Mouth wash
Shorts & tshirt pattern (under shorts & tshirt)
Not found >30yo
Not contagious
Pityrias Rosacea
Is there a cute for Keratosis Pilaris? Sx Tx (3)?
No cure
Salicylic acid (low [ ]) scratch- topical ABX (mupirocin) Vinegar water soaks (teaspoon vinegar, pint of H2O)
Contact Dermatits Tx (3 levels)
Topical Steroids
Hydrocortisone 2.5% (light)
Triamsenolone or hydroxyzine (antihistamine) (medium)
Betamethasone (stronger)
Psoriasis Tx?
Check for what 1st?
Skyrizi
check for TB
Bellybutton type papule ***
kids & sexually active adults
Mulloscum contagiosum
arms & buttocks
contaigous but don’t make them stay home
Liquid nitrogen if necessary
Mulloscum Contagiosum
dew drop on a rose petal**
one size vesicles
Varicella Zoster
What tx do you add to Doxycylcine (or other oral ABX) for Acne Tx?
also use benzol peroxide!
“ugly duckling” rule
Flast=more concerning
Melanoma
Precursor to Squamous Cell Carcinoma
Actinic keratosis
telangiectasia
acne pimples
chronic, no cure
Rosacea
Rosacea Tx?
Doxycycline
dry, angry red, rashy
lichenified
red, open, weapy
travel to humid area
Eczema
Eczema Tx (steps)
Wet skin w/H2O, then steroid, then non fragrance cream Dupixant maybe Prednisone is last resort or if waiting for prior auth for dupixant.
