IM-Derma Flashcards
Erythematous papules
Open and closed comedones kn face, chest, back
Occasional pustules and post inflammatory macules
Diagnosis
Clinical hallmark
Drug of choice
Most common location
ACNE VULGARIS
Clinical hallmark: Comedones
Drug of choice:
- mild non inflammatory: topical retinoids
- mod to severe with prominent inflammation: + tetracycline and doxycycline
- severe nodulocystic unresponsive to other therapy: synthetic retinoid isotretinoin (teratogenic)
Most common location: face
Well demarcated, small and large erythematous plaques with adherent silvery scale
Pitting nails
Diagnosis Pathogenesis Most common variety Drug of choice Should not use?
PSORIASIS
Pathogenesis: Tcell mediated
Most common variety: plaque type
Drug of choice
- localized: mid potency topical steroids
- widespread: UV light
- should not be used: ORAL CORTICOSTEROIDS (life threatening pustular arthritis when discontinued)
- psoriatic arthritis: Methotrexate
IDENTIFY:
Traumatized area developing lesions of paoriasis
Removal of scale causes pinpoint bleeding
Predominant form of psoriatic arthritis
Present with sausage digits
Subtype that is severe and deforming, affects small joints of hands and feet
Collapse of soft tissues in fingers
Koebner phenomenon
Auspitz sign
DIP
Asymmetric arthritis
Arthritis mutilans
Telescoping fingers
Bronchial asthma
Pruritic rash, forearms, back of knee
Diagnosis Pathogenesis Characteristic Secondary lesion Drug of choice
ATOPIC DERMATITIS
Pathogenesis: impaired epidermal barrier, elevated IgE
Characteristic: pruritus
Secondary skin lesion: Lichenification
Drug of choice: low to mid potency glucocorticoids
Tacrolimus and Pimecrolimus (topical immunosuppressant) - reduce dependence to steroids
Vesicular, erythematous plaques arranged linearly with slight crusting
Intensely pruritic
No hx of eczema
Diagnosis: Pathogenesis: Common location: Definitive test: Treatment:
CONTACT DERMATITIS
Pathogenesis: type iv hypersensitivity
Location:
- ICD: hands, immediate, burning pain
- ACD: rest of the body, after 48h, pruritus
Definitive test: patch testimg
Treatment: avoidance
-severe: oral prednisone
Dishwasher
Fluid filled rash on hands
Deep seated vesicle on palms and fingers
DYSHIDROTIC ECZEMA
multiple, intensely pruritic, small papules and vesicles on thenar and hypothenar imminence and sides of fingers
Tx: protect hands, vinyl
Difference of seborrheic dermatitis from psoriasis
Beyond hairline: psoriasis
SEBORRHEIC DERMATITIS
Tx: topical antifu gal, antidandruff with zinc and pyrithione
STASIS DERMATITIS
typical location
Cause of hyperpigmentatiin
Therapy
Medial ankle
Hemosiderin
Leg elevation, compression stockings
Glucocorticoids for pruritus but not on the ulcer
Drugs that cause SJS/TEN
Most common drug cutaneous drug reaction
Diagnostic test
Sulfonamides Allopuri ol Anticonvulsants NSAIDS Lamotrigine Neviparine
Morbilliform / maculopapular > urticaria
Frozen section skin biopsy
Urticaria and angioedema
Mainstay of tx
Fixed drug rxn
Epinephrine
Topical steroids
IDENTIFY HYPERSENSITIVITY TYPE
Urticaria, angioedema, anaphylaxis
Type I
IgE
IDENTIFY HYPERSENSITIVITY TYPE
Drug induced hemolysis, thrombocytopenia
Type II
IgG
IDENTIFY HYPERSENSITIVITY TYPE
Vasculitis, serum sickness, drug induced lupus
Type III
Immune complex
Drug induced hypersensitivity syndrome, morbiliform eruption
Type IVb
Tcell mediated
Eosinophil inflammation
IDENTIFY HYPERSENSITIVITY TYPE
SJS/TEN, morbiliform eruption
Type IVc
Tcell mediated
Cytotoxic t lymphocyte inflammation
