Papillosquamous d/o

Question 1

tinea versicolor looks like

Answer 1

well-dermacated round or oval patches or macules w/ fine scaling upon scraping on upper trunk (raining pattern) and proximal arms

Question 2

how tinea versicolor is diagnosed

Answer 2

KOH scraping

Question 3

3 tx for tinea versicolor

Answer 3

Topical anti-dandruff shampoo
Topical imidazole cream
Oral fluconazole or itraconazole if widespread or failed tx

Question 4

what causes other tinea conditions

Answer 4

genetic predisposition + environment exposure to fungus (moist, immunosuppressed)
doesnt invade skin unless host is immunocompromised

Question 5

4 ways to diagnose other tineas

Answer 5

annular appearance w/ central clearing & peripheral scale
obvious fungal infxn on 2 feet & 1 hand or 2 hands & 1 foot
scraping scale for KOH shows branching hyphae
culture (takes weeks)

Question 6

first line tx for tinea pedis, corporis or cruris

Answer 6

topical terbinafine

Question 7

2nd line tx for tinea pedis, corporis or cruris

Answer 7

Imidazole creams (clotrimazole or miconazole)

Question 8

when can you use systemic therapy for other tineas (3)

Answer 8

in hair follicles (capitis/barbae)
in nail plate
if infection doesn’t respond

Question 9

t or f: other tineas may need periodic tx to prevent recurrence esp if theres reservoir

Answer 9

true

Question 10

why don’t many providers treat tinea in nails

Answer 10

risk of liver toxicity with the oral meds and high recurrence rate

Question 11

what condition do we call ringworm

Answer 11

tinea corporis

Question 12

what tinea involves black dots, scale, itching and cervical lymphadenopathy

Answer 12

tinea capitis

Question 13

what is tinea cruris and where is it?

Answer 13

its the groin/jock itch
does NOT involve the scrotum

Question 14

name for tinea in nails/onychomycosis

Answer 14

tinea unguium

Question 15

what kind of tinea has moccasin distribution +/- maceration btwn toes

Answer 15

tinea pedis

Question 16

what causes pityriasis rosea

Answer 16

virus + immune response (maybe HHV6,7)

Question 17

duration of pityriasis rosea

Answer 17

fade after 3-6 wks but can last 4 months; self-limited

Question 18

herald patch is hallmark sign of what

Answer 18

pityriasis rosea

Question 19

what does pityriasis rosea look like

Answer 19

herald patch then diffuse oval patches on trunk, neck, proximal arms & legs 5-15 days later

Question 20

location of pityriasis rosea

Answer 20

trunk, neck & proximal arms and legs

Question 21

with which condition is reassurance very important

Answer 21

pityriasis rosea

Question 22

which 3 conditions in this lecture can you treat w/ topical steroids

Answer 22

pityriasis rosea
psoriasis
lichen planus (can also do systemic steroids)

Question 23

topical meds to treat pityriasis rosea (2)

Answer 23

topical corticosteroids
anti-itch lotion (sarna- camphor/menthol)

Question 24

what causes psoriasis

Answer 24

TH1 hypersensitivity/inflammatory condition characterized by epidermis overgrowth

Question 25

which two conditions in this lecture do you see the koebner phenomenon

Answer 25

psoriasis lichen planus

Question 26

what is the koebner phenomenon

Answer 26

trauma leads to more inflammation so you might notice the skin issues in places with a lot of trauma

Question 27

describe psoriasis lesions

Answer 27

well demarcated, erythematous plaques w/ silvery micaceous scale usually limited chronic stable plaques

Question 28

what is the complication where they get sausage digits with flares

Answer 28

psoriatic arthritis

Question 29

2 ways to manage psoriaris

Answer 29

prevent trauma-- moisturize and dont scratch mid to high potency topical corticosteroid w/ vit D analagoue &/or Tar

Question 30

which two mid to high potency topical corticosteroids can be used with psoriasis

Answer 30

triamcinolone or clobetasol

Question 31

when do you refer someone w/ psoriasis to rheumatology? (3)

Answer 31

if they have joint sx for phototherapy for immunosuppressants

Question 32

when do you refer someone w/ psoriaris to derm?

Answer 32

for phototherapy or immunosuppressants

Question 33

why must you never give prednisone/systemic steroids to someone with psoriasis

Answer 33

risk of pustular psoriasis with withdrawal

Question 34

chronic inflammatory dz of skin + mucous membrane

Answer 34

lichen planus

Question 35

what are the 5Ps and what condition do you see it?

Answer 35

Pruritic, Polygonal, Purple, Papules, Phlat-topped seen with lichen planus

Question 36

the two conditions in this lecture associated with itching

Answer 36

psoriasis & lichen planus

Question 37

location- lichen planus

Answer 37

inner wrists, ankles, oral/genital, nails koebner locations

Question 38

fine (reticulated in oral/genital) white reticulated scale ('Wickham straie') is seen with which condition

Answer 38

lichen planus

Question 39

lichen planus tx (localized vs diffuse/severe)

Answer 39

localized: ultra potent corticosteroids (Clobetasol) diffuse: systemic retinoids (acitretin)

Question 40

what is acitretin & can it be used in child-bearing women

Answer 40

it is a systemic RETINOID for diffuse/severe lichen planus no

Question 41

what happens if you misdiagnose a dermatohyte/tinea condition & tx with steroid

Answer 41

tinea incognito! inflammation reduces while infection spreads and hides in follicles (resistant to topical tx)

Question 42

why should you avoid lotrisone (combo steroid & antifungal)

Answer 42

its very potent in steroid & suboptimal in antifungal; know what youre treating

Question 43

lichen planus vs sclerosus

Answer 43

planus: "flat-topped" sclerosus: "scar-like", chronic genital eruption w/ whitening and scarring