Quick Questions PANCE Flashcards
Pathogenesis of Acne Vulgaris
- propionibacterium infection
- follicular hyperproliferation
- increased sebum production
- inflammation
Folliculitis: MCC, RF, Tx
MCC: s. aureus (pseudomonas for hot tun)
RF: steroids, ABX, male, shaving
Tx: Topical mupirocin
Rosacea Tx options for different types
For papulopustules: Topical metronidazole
For erythema: Topical brimonidine
For phymatous: PO isotretinoin/surgery
Erythema multiforme: MCC, Types, Sx
MCC: Herpes Simplex Virus
Types: Minor and Major
Sx:
Minor- targeted lesions with dusky center, pale ring, erythematous halo on palms/soles and spreads to trunk; no mucosal involvement
Major: 2+ mucosal involvement (commonly oral w hemorrhagic crusting on vermillion zones)
*NEGATIVE NIKOLSKY SIGN
Alopecia Areata: Patho, Assoc, Sx, Definitive Dx
Patho: autoimmune, follicle prematurely go from anlagen to telogen phase
Assoc: SLE, Addison’s Thyroid
Sx: sudden, circular hair loss, EXCLAMATION point hairs
Dx: punch bx (peribulbar lymphocytic inflammation infiltrates
Androgenic alopecia: Patho, Tx options & ADRs
Patho: increased levels of DHT which causes shorter anlagen phase and longer telogen phase
Tx:
Topical Minoxidil (best for new onset, 4-6 mo of tx before effect) – vasodilator;
ADR: itching/flushing
PO Finasteride (5-alpha reductase inhibitor) stops conversion of testosterone to DHT
ADR: ED, increase risk of prostate CA
Onychomycosis: MCC, Dx, Tx/ADR
MCC: Trichophyton rubrum (dermophytes)
Dx: Periodic acid-Schiff stain (PAS) = most sensitive
Tx: PO Terbinafine x 12 wks
ADR: HEPATOTOXICITY
Paronychia: MCC of acute vs chronic
MCC acute: s. aureus
MCC chronic (>6 wks): candida
Brown Recluse Spider Bite: Spider, Patho, Tx
Spider: brown violin on abdomen
Patho: cytotoxic venom –> local necrosis, bullae
Tx: local wound care, NSAIDS
Black Widow Spider Bite: Spider, Patho, Tx
Spider: red hourglass on belly (lactrodectus Hesperus)
Patho: neurotoxin –> muscle pain, spasms, rigidity, convulsions
Tx: opioids, BZDs
Erythema infectiousum: Cause, Patho, Sx, Complications
Cause: Parvovirus B19
Patho: virus destroys retics leading to decreased RBCs
Sx: viral sx –> “slapped cheek” w circumoral pallor –> lacy, reticular rash SPARES palms/soles
Complications: *Aplastic crisis in Sickle Cell/G6PD deficiency
Hand-Foot-And-Mouth Disease: Cause, Sx, Complications
Cause: Coxsackie Type A virus (enterovirus)
Sx: grayish-yellow lesions on palms/soles (non-tender, non-pruritic), small, painful red vesicles on buccal mucosa
Complications: Myocarditis, Aseptic meningitis
Measles: AKA, Sx, Complications, Tx option
AKA: Rubeola
Sx:
Prodrome of 3 Cs + Fever
Koplik spots
Rash: morbilliform, red, blanching rash, that begins on face (cephalocaudal spread)
Complications: Diarrhea (MC), PNA (MCC of measles-related deaths), AOM, encephalitis
Seborrheic Keratosis: RF, Sx, Malignancy Risk, Tx
RF: elderly, fair-skinned, sun exposure
sx: warty, velvety lesions w/greasy “stuck on” appearance
Malignancy Risk: NOT pre-malignant, MC benign epidural skin tumor
no tx needed
Actinic keratosis: Sx, Dx, Malignancy Risk, Tx (local & multiple)
Sx: rough/dry “sandpaper” feeling lesion on sun-exposed areas, pink/yellowish, slowly enlarging
dx: punch or shave biopsy
Malignancy Risk: precursor to squamous cell carcinoma
Tx:
Local: cryotherapy
Multiple: Topical Imiquimod or 5-FU cream
Basal Cell Carcinoma: RF, Sx, Tx, Recurrence rate
RF: Xeroderma pigmentosum, fair skin, UV exposure
Sx: pearly, raised, rolled border w central erosion
nose and hands
telangietasias
Tx: Excision (Mohs for difficult) – locally invasive but rarely mets
Recurrence: 50% will have recurrence within 5 years
Malignant melanoma: RF, MC type, Sx, Dx, Tx, Tumor marker, Prognostic factor
RF: >50 yo, Hx, no dermatologist, male, >3 burns by 20 yo, large # of nevi, tanning beds
MC type: Superficial Spreading (70%)
Sx: ABCDEs anywhere in body, nail discoloration
Dx: wide-excisional/full-thickness biopsy
tx: excision w LN bx
Tumor marker: S-100
Prognostic factor: more depth = worse prognosis
Squamous cell carcinoma: Sx, Dx, Tx, Prognosis
Sx: enlarged nodule w SCALING, crusting, bleeding,
chronic scab/non-healing ulcer
Dx: Bx
Tx: excision
Prognosis: excellent (95% cure rate and rarely metastasize)
Marjolin’s ulcer
squamous cell carcinoma arising from chronic inflammation
Kaposi sarcoma: Patho, Assoc, Sx, Dx, Tx
Patho: endothelial tumor of skin/LN/GIT/Lungs
Assoc: HHV-8 and HIV **AIDS-defining illness (CD4 <100)
Sx: pink/red/vilet macule, papule, and nodules on cutaneous/mucosal surfaces
LAD
Dx: Bx (spindle cells mixed with vascular tissue)
Tx: Highly Active Antiviral Therapy (HAART)
Perioral dermatitis: RF, Sx, Tx
RF: young women, topical steroid use
Sx: papulopustules around the mouth that spare the vermillion border
Tx: Discontinue topical steroids (alt. Topical flagyl/erythromycin)
Seborrheic dermatitis: Patho, Sx, Tx
