MTB 1 Flashcards
Worst prognostic factor for Melanoma
Growing lesions
Most important prognostic factor
Tumor thickness
Best diagnostic test for melanoma
Full thickness BX
TX for melanoma
Surgical removal
IFN in widespread dz
Where does melanoma mets to
Brain
What determines the size of margin excised in melanoma
Tumor thickness
Risk factors for SQCC in derm
Sunlight
Organ transplant
Long term use of immunosuppressive drugs
Ulcer on lips that does not heal
SQCC
Presentation of Basal Cell Ca
Waxy lesion
Shiny like a pearl
TX for Basal CC
Shave BX
Mohs - esp eyelids, ear
Which virus ass’d with Kaposi
HHV-8
Presentation of Kaposi
Older men Mediterranean Reddish/purple GI tract, Lung Predominantly AIDS < 100 CD4
Is Kaposi Sarcoma treated w surgical removal
No
Tx for Kaposi Sarcoma
- AIDS - antiretrovirals
- Intralesional Vincristine or IFN
- Liposomal doxorubicin
Actinic Keratosis - risk of cancer?
Yes - premalignant
Small risk for SQCC
TX for actinic keratosis
Must remove w: Curettage Cryotherapy Laser Topical 5-FU Imiquimod
Imiquimod Tx for?
- Actinic keratosis
- Molluscum contagiosum
- Condyloma acuminatum
Seborrheic Keratoses Presentation
Elderly
Hyperpigmented
Stuck on appearance
Malignant potential for Seborrheic Keratoses?
TX?
No.
Tx: removal w cryotherapy, surgery, laser
Atopic Dermatitis Pathophys
Presentation
Mast cell overactivity
Asthma, allergic rhinitis, Fam Hx, onset before 5
Pruritis, scratching, scaly rough areas
TX for Atopic Dermatitis
- Topical Corticosteroids
- Tacrolimus and Pimecrolimus
- Antihistamines
Severe = doxepine - ABx - Cephalexin, mupirocin, repatamulim w impetigo
- UV light
Drugs ass’d with lymphoma
Tacrolimus and Pimecrolimus
Are psoriasis plaques itchy?
Not most of the time
Psych issue ass’d with psoriasis
Depression
TX for psoriasis - Local Disease
- Topical hi potency steroids
- Vit A and Vit D ointment (calcipotriene)
- Coal Tar
- Tacrolimus and Pimecrolimus on delicate areas - face and penis
TX for psoriasis - Extensive Disease
- UV light
- TNF Inhibitors
- MTX - last resort
Pityriasis Rosea Cause
Idiopathic
Presentation of Pityriasis Rosea
TX
Single lesion that disseminates
Spares palms and soles
TX: Steroids, UV light
Seborrheic Dermatitis Presentation
Areas w sebaceous glands
Scalp, face, chest, intertriginous areas
Pruritic, erythematous plaques w fine, loose yellow and greasy looking scales
Conditions w increased Seborrheic Dermatitis
- AIDS
2. PD
Presentation of Torus Palatinus
Benign bony growth - midline of hard palate
Fleshy immobile mass
Younger pts - 30 yoa, women, asians
Non-tender, ulcerates w trauma, heals slowly
Presentation Pemphigus Vulgaris
Bullae that rupture easily, + Nikolsky Mouth involved Fluid loss/Infxn Painful lesions Not pruritic Pts in 30's, 40's
Drug Causes of Pemphigus Vulgaris
ACE I
Penicillamine
Phenobarb
PCN
Autoabs to what in Pemphigus Vulgaris
Desmogleins
Most accurate test for Pemphigus Vulgaris
BX shows autoabs - IgG and C3 in epidermis
TX for Pemphigus Vulgaris
- Systemic steroids
- Azathioprine or mycophenolate
- Rituximab or IVIG = refractory
Presentation of Bullous Pemphigoid
Urticarial plaques
Pruritis
Mouth NOT commonly involved
70’s, 80’s
Most accurate test Bullous Pemphigoid
BX shows abs to dermo-epidermal junction/BM
IgG and C3 Linear along BM
Drug induced causes of Bullous Pemphigoid
Sulfas
NSAIDs
Fureosmide
Penicillamine
TX for Bullous Pemphigoid
Best initial - Prednisone
Mild - erythromycin, dapsone, nicotinamide
Presentation of Porphyria Cutanea Tarda
Blisterning sun dz
Back of hands and face involved
Porphyria Cutanea Tarda Causes/Assn’s
Liver Dz - Hep C, alcoholism,
Estrogen use = OCPs
Iron overload = hemochromatosis
Diabetes
Most accurate test Porphyria Cutanea Tarda
Increased uroporphyrins in 24 hour urine collection
What is deficient in Porphyria Cutanea Tarda
Uroporphyrin decarboxylase
TX for Porphyria Cutanea Tarda
- Correct underlying problem
2. Remove iron w phlebotomy
Impetigo causes GN and/or Rhematic fever?
GN
NOT RF
TX for Impetigo
Mild
- Mupirocin
- Bacitracin
- Repatamulin
TX for Community acquried MRSA Impetigo
Doxycycline
Clindamycin
TMP/SMZ
Presentation of Pilonidal cyst
Young males w body hair
Pain, swelling, purulent discharge in midline of post-sacral intergluteal region
TX of pilonidal cyst
Drain abscess and excise sinus tract