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X Clin Med Exam 1 > L6 Rosacea, Acne, Insects etc > Flashcards

L6 Rosacea, Acne, Insects etc Flashcards

1
Q

Acne vulgaris

A

Common skin disorder of adolescents and young adults, disease of the pilosebaceous unit

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2
Q

Microcomedo

A

Precursor for clinical lesions of acne vulgaris due to follicular hyperkeratinization

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3
Q

Follicular hyperkeratinization

A

When follicle is producing an excess number of dead skin cells and more are sloughing off

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4
Q

Closed comedo/ whitehead

A

Accumulation of sebum due to increased sebum production and keratinous material in this step after a microcomedo

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5
Q

Open comedo/blackhead

A

Follicular orifice opened with continued distenstion, oxygen oxidized tip and makes it black

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6
Q

Pimple

A

Follicular rupture contributes to development of inflammatory lesions, bacterial byproduct causes inflammation and infection in surrounding skin

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7
Q

Factors contributing to acne

A

Androgens stimulate growth/secretory function of sebaceous glands, mechanical trauma, stress or diet

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8
Q

Presentation of acne vulgaris

A

Face/neck/chest/upper back/upper arms, sinus tracts can form

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9
Q

Other considerations when diagnosing acne

A
  1. Hyperandrogenism workup when female has signs of androgen excess
  2. Rapid appearance with virilization could be underlying adrenal or ovarian tumor
  3. Could be acne-inducing drugs
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10
Q

Tx for comedonal lesions of acne vulgaris

A

Topical retinoids

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11
Q

Tx for inflammatory lesions of acne vulgaris

A

Topical antimicrobial therapies

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12
Q

Tx for severe inflammatory acne

A

Oral antibiotics

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13
Q

Tx for abx resistant bacteria in acne vulgaris

A

Benzoyl peroxide

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14
Q

Tx for mild papulopustular and mixed acne

A

Benzoyl peroxide, topical abx (erythromycin, clindamycin) and topical retinoid

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15
Q

Tx for moderate acne

A

Topical retinoid + oral abx (tetracycline)+ benzoyl peroxide

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16
Q

Tx for severe acne

A

Retinoid, oral abx and benzoyl peroxide OR oral isotretinoin monotherapy

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17
Q

Teratogenic meds

A

Cause birth defects, retinoids are super contraindicated in pregnancy

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18
Q

Safe acne regimen for pregnancy

A

Oral erythromycin, topical clindamycin, topical azelaic acid

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19
Q

Acne rosacea

A

Chronic skin disorder of the central face (nose, cheeks, chin and forehead), usually emerges in 30s

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20
Q

Pathogenesis of acne rosacea

A

Abnormalities in immunity, UV damage, vacular dysfunction or inflammatory reactions to cutaneous microorganisms

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21
Q

4 subtypes of acne rosacea

A

Erythematotelangiectatic, papulopustular, phymatous, ocular

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22
Q

Erythematotelangiectatic rosacea

A

Chronic redness of central face, flushing, skin sensitivity, dry appearance, telangiectasias

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23
Q

Papulopustular rosacea

A

Papules and pustules of central face, inflammation can be confluent, no comedones

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24
Q

Phymatous rosacea

A

Tissue hypertrophy causing irregular contours, mostly nose but can be cheeks/forehead/chin, mostly men

25
Q

Ocular rosacea

A

Often coincides with other types, can precede/coincide/follow them, dry eyes/ pain/itching/blurry vision/photosensitivity etc.

26
Q

Tx for erythematotelangiectatic rosacea

A

First line is behavior modification, second line is laser and pulsed light therapies or topical brimonodine (vasoconstriction)

27
Q

Tx for papulopustular rosacea

A

First line for mild/moderate: metronidazole (abx) or azelaic acid while second-line is ivermectin, severe disease is oral (tetracyclines/macrolides)

28
Q

Tx for phymatous rosacea

A

Early is isotretinoin, advanced is surgical debulking/laser ablation

29
Q

Scorpion stings

A

Cause major neurological toxicity by injecting venom via tail

30
Q

Scorpion venom

A

Potent neurotoxin inactivated sodium channels causing membrane hyperexcitability (excessive neuromuscular activity and autonomic dysfunction)

31
Q

Grade I scorpion stings

A

Produce local pain and paresthesias at sting

32
Q

Grade II scorpion stings

A

Produce local symptoms as well as remote pain and paresthesias (often radiate proximally up affected extremity but may be in remote sites)

33
Q

Grade III scorpion stings

A

Produce EITHER cranial nerve OR somatic skeletal neuromuscular dysfunction

34
Q

Grade IV scorpion stings

A

Both cranial nerve dysfunction and somatic skeletal neuromuscular dysfunction

35
Q

Tap sign

A

Sign of envenomation seen when there is local pain exacerbated by tapping near the sting site

36
Q

Cranial nerve dysfunction in scorpion stings

A

Hypersalivation, abnormal eye movements, blurred vision, slurred speech and tongue fasiculations

37
Q

Somatic skeletal neuromuscular dysfunction in scorpion stings

A

Fasiculations, shake and jerk extremities, opisthotonos, emprosthotonos, fever up to 104

38
Q

Opisthotonos

A

Arching of back

39
Q

Emprosthotomos

A

Tetanic forward flexion of body

40
Q

Severe scorpion envenomations admitted to monitor

A

Respiratory compromise, MI, hyperthermia, rhabdo, multiple organ failure

41
Q

Tx for severe scorpion envenomation

A

IV fentanyl for pain, IV benzos unless there is antivenom

42
Q

Bee sting rxn

A

Most often is local with swelling, erythema and lasts for few hours to 1-2 days

43
Q

Large local reaction to bee sting

A

Exaggerated erythema and swelling, gradually enlarges over 1-2 days, resolves in 5-10, use prednisone, antihistamines or NSAIDs

44
Q

Black widows

A

Black with red hour-glass shaped marking on abdomen

45
Q

Black widow bite

A

Causes small local rxn, blanched circular patcch, surround red perimeter and central punctum, venom causes catecholamine release

46
Q

Presentation of black widow bite

A

Intermittent radiating pain, abdominal/chest/back pain and muscle spasm, diaphoresis, HA, NV

47
Q

Brown recluse

A

Violin-shaped marking

48
Q

Recluse bite

A

Often initially painless and progresses to severe pain, usually a red plaque or papule with central pallor, imght see 2 small puncture marks in erythema, can have vesiculation

49
Q

Rare complication of recluse bite

A

Ulcerative necrosis where see dark, depressed center after 1-2 days, malaise symptoms and sometimes renal failure, hemolytic anemia, hypotension, DIC, rhabdo

50
Q

Vitiligo

A

Acquired skin depigmentation due to autoimmune process directed against melanocytes

51
Q

Vitiligo presentation

A

Milk white macules with homogenous depigmentation and well-defined borders, slowly progressive

52
Q

Skin biopsy in vitiligo

A

Epidermis devoid of melanocytes

53
Q

Hidradenitis suppurativa

A

“Acne inversa,” chronic inflammatory skin disorder of the hair follicle, see in axillary, inguinal and anogenital regions

54
Q

Reason for hidradenitis suppurativa

A

Cycle of follicular occlusion, rupture and associated immune response (might be genetics, mechanical stress, obesity, smoking or diet)

55
Q

Presentation of hidradenitis suppurativa

A

Begins with single, deep-seated inflammatory nodule that progresses, might become an abscess with purulent drainage

56
Q

Skin changes in hidradenitis suppurativa

A

Sinus tracts, comedones, scarring, destroy pilosebaceous unit and can no longer grow hair there

57
Q

Most important tx for hidradenitis suppurativa

A

Lifestyle modification

58
Q

Tx for hidradenitis suppurativa

A

Local: topical clindamycin or intralesional corticosteroids, systemic abx (doxycycline or minocycline), anti-androgenic agents, surgery and then TNF inhibitors and oral retinoids in severe cases

59
Q

Complications of hidradenitis suppurativa

A

Fistulae, stricutures/contractures, lymphatic obstruction, infectious complications, SCC, malaise, depression, suicide

X Clin Med Exam 1 (7 decks)

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