Rotation Gouge Flashcards
1
Q
Sebulex
A
An OTC medicated shampoo for dandruff
2
Q
Carmol HC
A
A topical combination moisturizer that uses urea and hydrocortisone
3
Q
Lamasil
A
Terbenafine
4
Q
What is the MOA of terbenafine
A
Inhibits squalene epoxidase and therefore reduces fungal cell membrane ergosterol synthesis
5
Q
What is the indication for terbenafine
A
Antifungal for onychomychosis
6
Q
What is the mechanism of Naftin
A
Topical antibiotic that inhibits the fungal squalene epoxidase reducing fungal cell membrane ergosterol synthesis
7
Q
Dovinex
A
Calcipotriene
8
Q
What is the MOA of calcipotriene
A
Used for the treatment of psoriasis
Exact mechanism is unknown; binds to vitamin D receptors inducing cell differentiation and inhibiting cell proliferation
9
Q
Clobex
A
Clobetasol topical
10
Q
What are the indications for clobex
A
Psoriasis and dermatoses that are steroid responsive
11
Q
Olux
A
Clobetasol topical
12
Q
Nizoral
A
Ketoconazole
13
Q
What are the indications for ketoconazole
A
Tinea versicolor
Seborheric dermatitis
tinea capitis adjunct
14
Q
What are Dennie Morgan folds
A
A fold or line in the skin below the lower eyelid caused by edema in atopic dermatitis
A diagnostic marker for allergy
15
Q
What birth control pills can be used for a means of treating acne
A
Yaz and Yasmin
Drosperinone component is potassium sparing antiadrenergic (suppresses FSH & LH)
16
Q
What additional labs need to be ordered for patients starting yaz or Yasmin?
A
Electrolytes for potassium at drug initiation and again at 30 days
17
Q
Duac
A
Clinicamycin and benzoyl peroxide
Indicated for acne
18
Q
Retin- A micro
A
Tretinoin topical
Indicated for acne vulgaris
19
Q
What is the mechanism for topical retinoids
A
Binds to retinoic acid receptors, stimulating epethelial cell turnover
20
Q
What is the shorthand “UD” stand for?
A
As directed
21
Q
What is the most common etiology for acne In A jawline distribution
A
Hormonal
22
Q
Discuss demadex folicularum and d. Brevis
A
A species of the face mite
Usually found in greater numbers around the cheeks, nose, eye brows, eye lashes and forehead
D. Brevis is shorter and has a pointier tale when compared to folicularum.
23
Q
Pityriasis alba
A
Common in pediatrics and is a loss of melanocyte density
24
Q
Tinea versicolor
A
Discoloration of the skin due to (malassezia furfur) pityrosporum ovaleand p. biculare
25
Vitiligo
Autoimmune response that causes hypo pigmentation
Two types a and b
A- symmetrical
B- asymmetrical
26
Desonate
Desonide topical (class VI steroid)
27
Nevus hypo pigmentation
Nevus with inadequate or dysfunctional melanocytes
28
Ephilides
Freckle
29
Lentigo
Liver spots (sun spots)
Increases in number and prevalence with age
30
Skin tag
Acrochordon
31
Stucco keratosis
Referred to as barnacles
Common, nearly inconspicuous papular warty lesions occurring in the lower legs especially around the Achilles' tendon.
32
Prurigo nodularis
Uncommon disease
Nodular form of lichen simplex
Intractable pruritis
Nodules are typically 1-2 cm
33
Generalize the Fitzpatrick skin scale
Type I blue eyed celts with high susceptibility for skin cancer
Type VI African American with low susceptibility for skin cancer
34
Mucosis fungiodes
Most common type of cutaneous T cell lymphoma
Typical affects skin but May progress internally
35
Onychodystrophy
Nail pitting and onycholysis
36
Nail pitting associated with psoriasis is most commonly associated with what additional characteristic
Psoriatic arthritis: 90% of patients with psoriatic arthritis have nail changes
37
Trachyonychia
Psoriatic nails that appear as if they have been scraped with sand paper
38
What nail features are associated with psoriasis
Nail pitting
Trachyonchia
Onycholysis
Subungal hyperkeratosis
39
What are the treatment options for systemic psoriasis
1. Phototherapy: nbUVB or PUVA
2. Oral meds: Methotrexate, acetretin, cyclosporine
3. Biologics: alefacept, TNF-a inhibitors
40
Alefacept
Immune modulator that works by inhibiting T cells
41
What are the types of psoriasis?
Based on their morphology
1. Plaque
2. Gutate
3. Inverse
4. Pustular
5. Erythrodermic
42
What are the types of rosacea
1. Erythematotelangectetic
2. Papulopustule (no comedones)
3. Phymatous
43
Why should you not use strong steroids on the face
Induce steroid rosacea: eruption of papular around the mouth.
If a pt has a perioral dermatitis that looks like rosacea, ask about topical steroid use.
44
What are the diagnostic criteria for lupus
Mnemonic DOPAMINE RASH
```
D: discoid lupus
O: oral ulcers
P: photosensitivity
A: arthritis
M: malar rash
I: immunologic criteria (ANA)
N: neurological changes
E: increased ESR
```
R: renal disease
A: ANA +
S: serositis
H: hematologic disease
45
What is the primary symptom of atopic dermatitis
Itch
It's the itch that rashes
46
What are the side effects of oral isoretinoin
```
Birth defects
Dry eyes
Dry lips
Nose bleeds
Hypertriglyceridemia
Myalgias and elevated CK
```
47
What are the types of melanoma
```
Superficial spreading
Nodular
Lentigo maligna
Acral lentiginous
Amelanotic
```
48
Actinic purpura
Senile bruising
49
Actinic cheilitis
AK's on the lips
50
What will the histopathology show for muluscum contagiosum
Henderson Patterson bodies
51
What medications are fungistatic
Imidazoles
52
What medications are fungicidal
Allylamines, benzylamines
Terbenafine
Butenafine
Cyclopirox
53
What is the topical treatment for candida infections
Nystatin ointment
54
What is the most common dermatological complaint of school aged children?
Tinea capitis
Caused by trichophyton tonsurans
55
What are the two types of contact dermatitis
Irritant contact dermatitis (ICD)
| Allergic contact dermatitis (ACD)
56
What is erysipelas
Superficial cellulitis with marked dermal lymphatic involvement
57
What is the hallmark lesion of leukocytoclastic vasculitis (small vessel vasculitis)
Palpable purpura
58
What is asteototic dermatitis
Xerotic eczema
More common in the elderly during the winter with multiple hot showers.
Pruritis is resolved with prolonged baths, but returns shortly after
59
What is lipodermatosclerosis
Subcutaneous fat is replaced by fibrosis that eventually impedes venous and lymphatic flow leading to edema above the fibrosis
60
What topical therapies can be used to inhibit keratinocytes proliferation
Tar
Vitamin D analog
Tazarotene
61
What is a furuncle
Boil
An acute, round, tender, circumscribed, perifollicular abscess that generally ends in central suppurations
62
What is a carbuncle
A coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles
63
What is echthyma
An ulcerative form of impetigo in which the lesions extend through the epidermis and deep into the dermis
Consist of punched out ulcers
64
What is necrotizing fasciitis
Life treating infection of the fascia just above the muscle layer. Rapidly expanding dusky, edematous red plaque with blue discoloration.
Anesthesia of the skin is the characteristic finding
65
What is cellulitis
Bacterial infection of the dermis
66
Cimex lectularius
Bed bugs
67
What leads to tissue destruction with a brown recluse spider bite
Sphingomyelenase D
68
Compound W
An over the counter wart removing agent that has an active ingredient of salicylic acid
69
What medications are associated with SJS/TEN
SATAN
```
Sulfa antibiotics
Allopurinol
Tetracyclines
Anticonvulsants
NSAIDs
```
70
What is a sclerosing agent that can be used for spider angiomas
glycerine
71
What is the treatment for keloids
- inject smaller keloids on the face with 2.5 mg/ml kenolog
- inject keoloids on the scalp with 10 mg/ml kenolog.
- inject large keloids with 20-40 mg/ml kenolog
72
Elidel
pimecrolimus
73
What is the indication for elidel
atopic dermatitis
74
What is the mechanism for elidel
inhibits T lymphocyte activation
75
What is paronychia
a nail disease that is often a tender fungal or bacterial infection of the hand or foot where the nail and the skin meet at the side or base of a finger or toe nail
76
What are the classification levels of retinoids
From Strongest to Weakest
- isotretinoin
- tazorotene
- tretinioin
- adapalene
- retinaldehyde
- retinol
- retinyl palmitate
77
What are the classification levels of topical steroids
```
I - Clobetasol 0.05%
II - Fluocinonide 0.05%
III- Triamcinolone ointment 0.1%
IV - Triamcinolone cream 0.1%
V - Triamcinolone lotion 0.1%
VI - Fluocinolone acetonide 0.01%
VII - desonide 0.05%
VII - Hydrocortisone 1 %
```
78
Retin-A
tretinoin
79
Retin-A Micro
tretinoin
80
Renova
tretinoin
81
tazorac
tazorotene
82
accutaine
isotretinoin
83
What is sebhorreic dermatitis
a common chronic inflammatory papulosquamous disease. Proposed that pityrosporum yeast is the cause
84
What is soriatane
acetretin (retinoid)
85
What is the treatment options for lichen planus
acetretin
cyclosporin
griseofulfin
86
Sarna
camphor/menthol topical
87
When is sarna indicated
generalized itching
88
What complication may arise if you use a topical retinoid with a benzyl peroxide?
benzoyl peroxide will oxidize the retinoid and will cause skin irritation
89
What are the common side effects of oral retinoids
```
xerosis
cheilitis
elevated liver enzymes
hypertirglyceridemia
mood changes
depression
Head ache associated with pseudotumor
```
90
What is the general approach for treating acne
based on the severity of disease
91
What is the treatment for mild comedones
topical retinoid
| +/- topical benzoyl peroxide
92
What is the treatment for mild papular pustular acne
topical retinoid
topical antibiotic
topical benzyl peroxide
93
what is the treatment for moderate papular pustular acne
oral antibiotics
topical retinoids
topical benzoyl peroxide
94
What is the treatment for moderate nodular without scarring acne
oral antibiotics
topical retinoid
topical benzoyl peroxide
95
What is the treatment for sever acne or the presence of scaring from acne
oral retinoids (acutaine)
96
What distribution of acne is consider hormonal cause for women
jaw line distribution
97
What can be used for the treatment of hormonal induced acne in women
OCP
- Yaz
- Yasmin
- Orthotricyclen
Spiranolactone
98
What is poikiloderma
- A skin condition that consists of areas of hyper pigmentation, hypo pigmentation, teleangectasisas and atrophy.
- Commonly associated with sun damaged areas
- most frequently seen on the chest and neck
99
What is tine incognito
a fungal infection of the skin that is caused or hidden by the use of a topical immunosuppresant
100
What is is seborrhoeic dermatitis
- inflammatory skin disorder of the face, scalp and torso (T-area)
- typically presents with flaky, itching and red skin
- true mechanism is unknown
101
What is the treatment for seborhoeic dermatitis
- ketoconazole shampoo
| - topical steroids
102
What is keratosis pilaris
common, autosomal dominant genetic skin condition manifested by the appearance of rough slightly red bumps on the skin of the arms and shoulders primarily.
103
actinic keratosis is a precursor to what skin lesion
squamous cell carcinoma
104
hyperhydrosis
excessive sweating
105
Protopic ointment
tacrolimus topical
106
What is the mechanism of protopic
inhibits T-lymphocyte activation and acts as an anti inflammatory
107
What are the indications for protopic ointment
atopic dermatitis
| can be used for psoriasis
108
lidex
fluocinonide
109
What are the lines of blahsko
- follow a "V" shape over the back and an "S" shape over the chest, stomach and sides with wavy shapes on the head.
- believed to trace migration of embryonic cells
110
What is dermatosis papulosa nigra (DPN)
a condition of many small, benign skin lesions on the face generally presenting on dark skinned individuals.
- DPN may resemble SK
111
What is the leser-trelat sign
A sudden explosion of lesions similar to DPN (Dermatosis papulosa nigra) that is due to a growing tumor
112
What is the dimple sign
Associated with dermatofibroma
113
What is sebaceous hyperplasia
disorder of sebaceous glands in which they become enlarged producing yellow shiny bumps on the face
- not always associated with hair follicles
114
differin
adapalene topical
| - topical retinoid
115
What is the indication for differin?
acne vulgaris
116
What diseases should be included in your differential that has a skin rash that is unique or does not respond to therapy
1. SLE
| 2. Sarcoidosis
117
Can tagament be used for wart removal?
Can be used as an off label use for wart removal in peds
118
What is reeds syndrome
multiple cutaneous leiomyomas and is associated with renal cell carcinoma
119
What is madelungs disease
- benign symmetric lipomatosis
| - substantial fat deposits on the head, neck, and girdle
120
What is dercums disease
painful lipomatosis
more common in females
very rare
associated with thyroid malfunction
121
What is the only way to definitively treat comedones
retinoids, primarily oral
122
What oral antibiotics can be used to treat acne
doxycycline
minocycline
septra
123
What is idiopathic gutate hypomelanosis
- very common
- increases with age, 80% over 80
- typical lesion is a circumscribed well demarcated symptomatic porcelain white macule
- associated with flattening of the dermal-epidermal junction
124
What can be done for patients that have developed scars from acne
1. Cosmetic laser resurfacing
| 2. chemical peels with agents similar to glycolic acid
125
What is lachydrin
ammonium lactate topical
126
What is the mechanism of lachydrin
increases skin moisture and decreases epidermal keratinization
127
What is erosive lichen planus
(ELP)
- can occur with in the paloplantar lesion of LP particularly on the sole
- chronic lesions are at risk of developing squamous cell carcinoma
- more common in the 3rd - 5th decade
128
Beaus lines
typically caused by trauma
| - makes a full transverse path across the nail
129
What medication can be incorporated to help minimize the side effects of steroids
protopics can be added to give a steroid break
130
What are good indications to use a woods lamp
Lentiginous melanoma
melasma
vitiligo
Erythrasma
131
What is erythrasma
a skin disease that causes brown, scaly skin patches. It is caused by the Gram-positive bacterium Corynebacterium minutissimum. It is prevalent among diabetics and the obese, and in warm climates; it is worsened by wearing occlusive clothing.
132
What are the 6 P's of lichen planus
```
planar (flat)
purple
polygonal
pruritic
papule
plaque
```
133
What is lichen striatus
- form of LP that presents in a linear, lichenoid dermatosis
- primarily effects children
- lesions follow the lines of blasko
- spontaneously resolves
134
What is chondrodermatitis nodular is halicus
common, benign, painful condition of the helix or antihelix
135
Laser therapy for scars
- the brighter the red hue of the scar, the more likely the therapy would be successful
- the laser freezes the epidermis and focus the laser at the appropriate depth at which point the hemoglobin will absorb the energy and damage the adjacent area
136
Myrmecia warts
- palmar plantar warts
- round horny deep painful nodule most often on weight bearing sights
- mosaic warts are typically asymptomatic and are also a group of warts
137
What is a good treatment of plantar warts that have failed home therapy
1. Cryotherapy
| 2. Triple Acid
138
What is the technique for triple acid therapy for wart removal
1. Carbolic acid
2. Dichloracetic acid
3. pyruvic acid
139
What is a digital mucous cyst
- benign ganglion cyst of the digits typically located at the DIP or in the proximal nail fold.
- This condition is often worsened by osteoarthritis
140
How much epi can be safely used in the digits
limit the use of epi with lidocaine in the digits to 4 cc's. The pressure from volume is often the limiting factor.
141
What is finacea
azelaic acid topical
142
What is the indication for finacea
mild to moderate inflamatory lesions of acne rosacea
143
What is the mechanism of finacea
inhibits protein synthesis, exerting antibiotic effects
144
What is a nevus comedonicus
- rare hamartoma of the pilo-sebaceous unit
145
What is the treatment for nevus comedonicus
topical retinoids
146
What are the types of basal cell carcinoma
Non-Aggressive:
Nodular
Superficial
Aggressive:
Morpheoform
Sclerosing
Cystic
Micronodular
Basosquamous
Fibroepethilioma of Pinkus
147
What are a few details that help to separate a basal cell carcinoma from an actinic keratosis
AK's typical are never alone
| AK's are most often associated with scales
148
Aside from cryotherapy and chemotherapy agents, what can be used for tx of AK's covering a large area
Photo dynamic therapy (PDT)
149
What is the difference between hypertrophic scars and keloids
Keloids typically extend beyond the margins of the lesion
Keloids are often painful
Hypertrophic scars are typically a localized over growth.
150
What is the treatment for perioral dermatitis
antibiotics (topical)
151
What is the etiology of perioroal dermatitis
Common with age (50's)
associated with steroid withdrawal
associated with topical facial steroid use
152
What is lichen nitiditis
- Uncommon chronic eruptions consisting of multiple tiny discrete skin colored papules often arranged in large clusters.
- considered a variant of LP
- Most cases resolves spontaneous
153
What is the treatment for lichen nitiditis
topical steroids and oral antihistamines
154
What is a nevus sebaceous
- a hamartoma that exhibits follicular sebaceous and apocrine malformations to varying degrees
- classically a nevus or congenital malformation
- most commonly on the scalp or face
155
What is fraxel
non surgical tx for facial rejuvenation
156
When is a bleach bath indicated
atopic dermatitis
157
What is the assumed mechanism of a bleach bath
anti-inflammatory effects by inhibiting NfKb
| bleach is diluted to 0.005%
158
Pityriasis lichenoides chronica
- papular, clonal T cell disorders that may rarely be associated with mycosis fungi odes
- erythematous to red-brown scaly papules with an indolent course; regressing over weeks to months. - Lesions often leave a hypopigmented macule.
- treatment resolves once triggering factor or medication has been removed. Topical steroids can be used
159
What is longitudinal melanonychia
- longitudinal brown to black band
- commonly seen in dark pigmented individuals
- Single nail may be a sign of melanoma.
160
What may be the initial finding in a patient with Sjogrens disease
painful tears and atopic dermatitis
161
What oral medication may be used as an adjunct to hyperhydrosis
robinol
162
What oral medication can be used for the treatment of acne that is not OCP or a retinoid
Spiranolactone
- start at 25-50mg qd then increase to 100 mg qd (therapeutic dose)
163
Creams or Ointments: which is more pure
Ointments; therefore are less commonly associated with allergic reaction
- ointments tend to be more greasy
164
What is ichthyosis vulgaris
- skin may appear normal at birth but most symptoms appear by 5yo
- can affect all parts of the body including face and scalp while the bends of the arms and legs are typically spared
- Pals are typically excessively lined
- associated with atopic dermatitis
165
What is angular cheilitis
Common inflammatory condition affecting the corners of the mouth or oral commisures
- treatment with lip balm or thick emollient +/- topical steroids
166
What are the causes of angular cheilitis
most commonly an irritant contact dermatitis from drool or spit often seen in down syndrome and associated with atopic dermatitis
Rare causes include:
- anemia
- nutritional deficiency (zinc)
167
What is onychomadresis
nail shedding may arise in severe or bullous lichen plans or acute and severe systemic illness
168
What foods are associated with acne flares
Milk
| Foods with a high glycemic index
169
What is the concern for SLE patients that may be elgible for light box therapy
May exacerbate the SLE
170
What is the treatment for granuloma anulare
Steroid injection
potassium iodide
light therapy
cyclosporin
often may be self limiting
171
What are campbell de morgan spots
Cherry angiomas
172
what are naevus araneous
spider angiomas
173
What is telogen effluvium
temporary hair loss due to the shedding of resting or telogen hair after some shock to the system. New hair continues to grow
174
What is anogen effluvium
hair shedding is due to the interruption of active or anagen hair growth (drugs, toxins, inflammation) such as alopecia areata
Anogen hair has a pointed or tapered tip
175
What labs should e drawn for patients with alopecia areata
thyroid
vitamin D
Vitamin B-12
Folic acid
176
Leprosy can mimic a fixed drug eruption, what additional stain should be done
stain for AFB
177
Psoriasis is associated with an increased risk for what other pathologies
HTN
| Stroke
178
What is EAC
Erythema Annulare Centrificum:
| -the lesion will be annular with central clearing but will often have a trailing scale.
179
What is acquired keratoderma
Presents with thickening of the skin of the palms and soles
180
What is a known trigger for gutate psoriasis
strep throat; be sure to get an ASO titer.
ASO > 200 is diagnostic
181
What nail finding is associated with alopecia areata
nail pitting
more uniform than the nail pitting that is associated with psoriasis
182
Grovers disease
Transient akantholytic dermatosis:
skin condition that affects the chest and back
- most often in men over 50
- presents with small red papules that may blister, crust or erode
183
What is a fibrous papule
- firm bump that most often appears on the nose
- often resembles a flesh colored dermal nevus
- it is a benign lesion, but needs to be separated from a BCC
184
What is an angiokeratoma
- small dark red raised papules often presenting with scale
| - composed of dilated capillaries
185
What is the treatment for bed bugs
Lesions will appear with the typical "breakfast, lunch and dinner" lesions
only treat symptomatically with topical steroids
- replace linens and check for cracks and crevices around the bed.
186
What is the set up for PDT
Photodynamic therapy (Blue light)
1. Pre clean with acetone
2. cover face with ALA kerastick
3. Sit in light box for 16:40
4. Avoid sun for 48 hours
187
What is a short term treatment for rosacea
Afrin sprayed in a cotton ball then applied to the affected areas
188
What is a newer treatment for rosacea
Mirvaso (bromonidine)
- an alpha adrenergic agonist
189
What is lichen sclerosus
a chronic skin disorder that most often affects the genital and perianal areas. It usually persists for years, and can cause permanent scarring.
no known cure, although most people are substantially improved and quite comfortable with treatment. The condition was previously known as lichen sclerosus et atrophic us.
More common with redundant skin over the penis of an uncircumcised man
190
What does the term lichenoid signify for histopath evaluation
lymphocyte bands at the DEJ
191
Aldera
Imiquimod
192
Laser treatment for warts
pulse dye and vascular laser can be used for the treatment of warts
193
EPS
Elastosis perforans serpiginosa (EPS) is a rare skin disorder in which abnormal elastic tissue fibre passes from the papillary dermis (inner layer of skin) to the epidermis (outer layer of skin). This is described as transepithelial elimination and results in a group of small reddish bumps
194
What ingredient in eucerin and aquaphor may cause an adverse reaction
lanolin
195
Where is lanolin derived from
A wax secreted by wool bearing animals
