Final Exam - Dermatology Flashcards
what patients are at highest risk for dry skin (xerosis)
a. kids under 5
b. kids from 5-10
c. adults aged 20-30
d. elderly patients
d. elderly patients
emollients are the ____ line for itching associated with dry skin (xerosis)
first
4 agents to reduce itching for dry skin
-menthol and camphor
-pramoxine
-aluminum acetate
-hydrocortisone
true or false: aluminum acetate alters C-fiber nerve transmission
true
dermatitis occurs ____ to ____ hours after exposure to poison ivy
24 to 48
treatment of acute dermatitis: avoid ___ _____ because they do not provide tx for long enough period of time
dose packs
true or false: for acute dermatitis we should start with prednisone 10-20 mg per day
false (40-60 mg)
atopic dermatitis is the most common form of _____
eczema
what is the atopic triad?
-atopic dermatitis
-asthma
-allergic rhinitis
2 common triggers for atopic dermatitis (they were in bold)
detergents
infections
for moderate to severe atopic dermatitis, we can use ____-potency TCS BID for up to 3 days beyond clearance of lesions
medium
what is occlusion?
blockage or closing of an opening, blood vessel, or hollow organ
true or false: topical corticosteroids can cause tachyphylaxis
true
betamethasone dipropionate OINTMENT is in which class of topical corticosteroids?
very high potency (class 1)
betamethasone dipropionate CREAM is in which class of topical corticosteroids?
high potency (class 2)
betamethasone dipropionate LOTION is in which class of topical corticosteroids?
mid potency (classes 3-5)
(mid potency is where most patients start therapy)
why shouldn’t you use betamethasone dipropionate ointment on the face?
due to vasoconstriction
topical calcineurin inhibitors MOA
blocks pro-inflammatory cytokine genes
(can be used on any area)
topical calcineurin inhibitors are now consideted ____-line tx, and long-term use can cause risk of respiratory infection in children < ____ years old
2nd; 2
crisaborole 2% ointment is an alternative to TCS and TCIs. What is its MOA?
PDE-4 inhibitor (non-steroidal)
dupilumab (dupixent) MOA for mod-severe atopic dermatitis
human monoclonal antibody against IL-4 receptor alpha; inhibits signaling of IL-4 and IL-13
upadacitinib (Rinvoq) MOA
JAK inhibitor
how should Rinvoq be dosed?
15 mg to 30 mg PO once daily
ruxolitinib (Opzelura 1.5% cream) is for mild to moderate atopic dermatitis. What is its MOA?
JAK inhibitor
____ have more severe acne during puberty
a. males
b. females
a. males
____ have more severe acne during adulthood
a. males
b. females
b. females
acne affects ___% of the adolescent population which corresponds to increased _____ production
90; androgen
what is comedone?
hair follicle plugged with sebum, keratin & dead skin
first choice for comedonal, noninflammtory acne (mild)
a. adapalene + benzoyl peroxide
b. oral isotretinoin
c. topical retinoids
c. topical retinoids
(especially adapalene)
first choice for mild-moderate papulopustular inflammatory acne (2 of them)
adapalene + benzoyl peroxide
clindamycin + benzoyl peroxide
first choice tx for severe papulopustular or moderate nodular acne, and for nodular or conglobate acne
oral isotretinoin
MOA for adapalene (2)
-retinoid
-regulate epithelia cell growth
MOA for tazorotene and tretinoin topical
retinoid
MOA for azelaic acid topical therapy (2)
-antibacterial
-keratolytic
(azelaic acid is adjunct)
MOA for benzoyl peroxide (3)
-antibacterial
-comedolytic/keratolytic
-anti-inflammatory
MOA for clindamycin, erythromycin, and clindamycin + BP topical therapy
topical antibiotic
true or false: we need to worry about tolerance for topical antibiotics
false
(only have to worry about tolerance for oral antibiotics)
oral antibiotics for acne such as minocycline, doxycycline, erythromycin, azithromycin, and SMX/TMP are most effective when ______ is present
inflammation
limit treatment of oral antibiotics for acne to ___-___ weeks, if possible
6-8 weeks
oral hormone treatment for acne
spironolactone 100-150 mg per day
(suppresses androgen production)
clascoterone 1% cream is an androgen receptor inhibitor for acne and is applied how often per day?
BID
isotretinoin is a vitamin ___ derivative
A
isotretinoin can only dispense a ___ day supply with no refills
30
what is telangiectasia? (common in rosacea)
small widened blood vessels on the skin (permanent dilation of the blood vessels)
who is more likely to have rosacea, men or women?
women
hydralazine is a ____ that can be a trigger for rosacea
vasodilator
topical meds for rosacea should be allowed to penetrate the skin for ___-___ min before applying makeup
5-10
example of a topical antibiotic for mild rosacea
metronidazole
(apply BID)
for rosacea, patients should minimize ___ exposure
sun
psoriasis results from rapid skin growth that is ___ times faster than normal
7
3 major types of psoriasis
plaque
scalp
psoriatic
severe psoriasis classification is > ____% BSA
10
how do keratolyics such as salicylic acid 2% treat psoriasis?
causes slothing of the very dry scales
true or false: completely avoid sun exposure to treat psoriasis
false (can be beneficial, but not up to the point where it causes burns)
calcipotriene/calcitriol are both vitamin ___ analogs
D
high/very-high potency topical corticosteroids for psoriasis should be limited to no more than ____ grams per week
50
phototherapy for psoriasis is for ____ and ____ plaques
limited; resistant
which penetrates thicker lesions better in phototherapy for psoriasis: UVA or UVB
UVA
apremilast MOA for psoriasis
PDE-4 inhibitor
azothiaprine, methotrexate, and mycophenolate mofetil MOA for psoriasis
immunosuppressants
cyclosporine MOA for psoriasis
calcineurin inhibitor
tofacitinib MOA for psoriasis arthitis
JAK inhibitor
avoid use of ____ vaccines in treatment with biologic agents for psoriasis
live
