Integumentary 5 Flashcards
RMSF is caused by
the bite of a dog tick/wood tick that is infected with the parasite Rickettsia rickettsii
first line treatment for RMFS
doxy
RMSF definitive dx is based on
antibody titers to R. rickettsii (by indirect fluorescent IgG antibodies or IFA assay)
what rash suggests RMSF
red spot like rash that starts on hands, palms, and feets/soles
RMSF classic symptoms
4
rash that starts on hands/palms and feet/soles
fever
HA
myalgia
after removing the tick, clean the area with
3
rubbing alcohol, iodine scrubs, or soap and water
light skinned adult or older patient that c/o small acne-like papules and pustules around nose, mouth, and chin; telangiectasias on nasal are and cheeks
rosacea
rosacea mild to mod disease tx
3
topical metronidazole, azelaic acid, or ivermectin
rosacea mod to severe disease tx
oral tetracycline or minocycline 4-12 weeks
pruritic rash located in the interdigital webs of the hands, axillae, breasts, buttock folds, waist, scrotum, and penis; severe itching at night
scabies
scabies lab
scrape burrow or scales with glass slide; use coverslip (wet mount) to look for mites or eggs
scabies tx
permethrin - wear for 8-14 hours, can repeat in 7 daysc
crusted scabies tx
combo permethrin and ivermectin
scabies - persons in the same household tx
treat everyone at the same time; any clothes/bedding used 3 days before and during tx should be washed and dried on hot settings
scabies - treat itching with
benadryl and topical steroids; can last up to 2-4 weeks
oral candidiasis - patient c/o
severe sore throat with white adherent plaques with a red base and hard to dislodge on the pharynx
thrush in healthy adults who are not on abx may signal what
immunodeficient condition
yeast infection - for skin infections do what in skin folds
nystatin powder and/or cream BID
yeast infection - OTC topical antifungals include
2
miconazole
clotrimazole
for mod to severe thrush or recurrent disease, what is preferred tx
oral fluconzaole systemic antifungal agent
tinea versicolor - KOH slide will show
hyphae and spores
lab test for tinea versicolor
KOH slide
tinea versicolor meds
topical selenium sulfide
topical azole antifungals like ketoconazole or terbinafine BID
fever, pharyngitis, malaise, then rash that starts on head and face then spreads to trunk, pruritis
chickenpox/varicella
elderly with papules and vesicles on red base that rupture and become crusted, pain and burning
shingles
shingles - cover lesions?
yes
the most sensitive test for VZV is
polymerase chain reaction PCR
varicella/chickenpox - antiviral therapy is recommended in who
immunocompetent individuals and pregnant patients
uncomplicated herpes zoster virus med
acyclovir 800 mg 5 x day or valacyclovir 1000 mg TID x 7 days
herpes zoster PHN - meds
3
tricyclic antidepressants
anticonvulsants
gabapentin
varicella vaccine age
2 dose
12-15 months
4-6 years
