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DERM > Inflammatory Dermatoses > Flashcards

Inflammatory Dermatoses Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the key clinical features for allergic contact dermatitis?

A
  • Linear or geometric shape
  • Erythematous papules/plaques with or without vesicles or crusting
  • Intense Itching
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2
Q

If you see a child with facial crusting and 1 eye closed shut, what do they most likely have?

A

Poison ivy

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3
Q

If you see someone with a pink plaque below their belly button, what is the most likely diagnosis?

A

nickel allergy to belt buckle

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4
Q

How should you work up a patient with allergic contact dermatitis?

A

Don’t do anything! (if the allergen is easily identifiable)

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5
Q

When should you do patch testing on a patient with allergic contact dermatitis?

A

Chronic contact dermatitis

Unknown allergy

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6
Q

What does patch testing help you do in allergic contact dermatitis?

A

Helps to identify and avoid allergens in chronic ACD

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7
Q

What are some common causes of allergic contact dermatitis?

A 
Neomycin (topical antibiotics)
Metals
Rhus (poison ivy)
Fragrances
Preservatives
Formaldehyde
Rubber
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8
Q

How do you treat allergic contact dermatitis?

A

Topical Steroids

Stop contact allergen

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9
Q

When would you give oral steroids to a patient with allergic contact dermatitis?

A

if it was widely diffused–be sure to give for 2-3 weeks!! (or rebound can occur!)

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10
Q

Where do older children have atopic dermatitis?

A

Flexural surfaces (behind knees, behind neck)

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11
Q

Where do infants and toddlers have atopic dermatitis

A

Extensor surfaces: cheeks, ???

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12
Q

What are the common symptoms of atopic dermatitis? (the “must haves”)

A

Xerosis and pruritis

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13
Q

What is follicular prominence?

A

rough feeling–very close together bumps (very very hard to treat)

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14
Q

What is the most appropriate treatment for atopic dermatitis?

A
  • Topical steroids
  • Emollients (Vasalene)+ wrapping
  • Eliminate staph aureus contamination (makes them more itchy!)
  • Topical Calcineurin inhibitors (second line–steroid sparing)
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15
Q

Why do you not give oral steroids with atopic dermatitis?

A

works very well at first, but TERRIBLE rebound

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16
Q

How do you eliminate staph aureus contamination with atopic dermatitis?

A

bleach baths

17
Q

What is a fairly common complication of atopic dermatitis (if they come into contact with herpes)?

A

eczema herpeticum

18
Q

How do you treat eczema herpeticum?

A

IV Acyclovir

19
Q

What are the key diagnostic features of urticaria?

A

No surface change (scale)
Erythematous, edematous papules and plaques (wheals)
Individual lesions last < 24 hours

20
Q

What are the most common causes of acute urticaria?

A

Medicine or food allergy

21
Q

How do you treat acute urticaria ?

A

1st and 2nd generation H1 antihistamines

22
Q

If you see a patient with urticaria, what else must you consider?

A

anaphylaxis! (give epinephrine)

23
Q

What are the clinical keys to fixed drug eruption?

A
  • Very round “target-looking” mark with a central dusky purple area (that can become a blister)
  • Usually comes every time patient takes the drug
  • Heals with hyperpigmentation
24
Q

What is the classic drug that gives you a fixed drug eruption?

A

laxatives
tetracyclines
NSAIDs

25
Q

How do you treat DRESS?

A

Get CBC, LFTs, BUN/Creatinine, complete drug history

26
Q

What drugs cause DRESS?

A 
Anti-epilectics**
Allopurinol
Sulfas
Anti-TB drugs
Anti-HIV drugs
NSAIDs
27
Q

What are the key features of DRESS?

A
  • Morbilliform eruptions
  • Facial edema
  • Fever, lymphadenopathy, malaise
  • > 70% eosinophilia
  • Internal organ involement
28
Q

What is the most important treatment for SJS/TEN?

A
  • Stop the causitive agent is the most important method of care
  • IVIg is also given
  • Possible transfer to burn unti
  • Multidisciplinary care with opthalmology, gynecology, urology

DO NOT GIVE IV STEROIDS!

29
Q

How much body coverage is SJS?

A

<10% BSA

30
Q

How much body coverage is TEN?

A

> 30%

31
Q

What are the key features to SJS/TEN?

A
  • Erythematous/dusky macules which coalesce to form flaccid bullae
  • Positive Nikolsky sign (pressing on normal skin will cause blister)
  • mucosal involvement (occular, oral, and genital)
32
Q

How is erythema multiforme different than SJS?

A

Erethyema multiforme is almost always caused by a herpes (target lesions on body, hands, and feet and lesions in mouth)–NO widespread skin sloughing!

DOES NOT PROGRESS TO SJS

33
Q

True or False: erythema multiforme and SJS cannot be differentiated in biopsy.

A

TRUE! They are morphologically the same!

34
Q

What drugs cause SJS/TEN?

A 
SATAN
Sulfas**
Allopurinol
Tetracyclines
Anticonvulsants
NSAIDs

DERM (17 decks)

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