Seb Derm Flashcards

1
Q

seb derm

A

chronic relapsing skin disorder, scalp, face, trunk, mild dandruff to exfolliative erythroderma, worsens in stress and during cold and dry months

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2
Q

epidemiology

A

males > females, infants affected resolve by 1 year, peak in adults between 30-40, increase in HIV and parkinsons

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3
Q

patho

A

malassezia yeast releases inflammatory free fatty acids

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4
Q

clinical features - mild

A

mild; white, dry, scaling flakes minimal pruritus. no erythema

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5
Q

features - moderate

A

excessive oil with erythema, visible scale with pruritus impacting daily activities

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6
Q

features - severe

A

inflammation with fierce erythema, coarse scale and pruritus interferes with sleep

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7
Q

in infants

A

scalp is cradle cap with thick, greasy scale on the vertex of the scalp

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8
Q

face seb derm

A

forehead, below hairline, eyebrows, glabella, NL folds, can resemble a butterfly on the cheeks, mustache and beard in men, eyes can get crusted

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9
Q

dx

A

clinically

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10
Q

ddx

A

psoriasis, tinea, PR, AD, rosacea

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11
Q

infants

A

cradle cap is self limiting, wash frequently with mild shampoo to remove scale with a soft brush, small amount of emollient, low potent steroids, keto shampoo

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12
Q

adults

A

chronic, long term tx may be needed, goal to dx malassezia, topical antifungals, anti-inflamm, oral antifungals

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13
Q

antifungals

A

ketoconazole 2% bid to clear then daily for maintenance, leave on scalp for 5 min, can also do ciclopirox, otc selenium sulfide otc zinc pyrithione

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14
Q

oral antifungal

A

for severe - Itraconazole 200mg once daily x 1 week,

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15
Q

antiinflammatory

A

high potent steroids for no more than 2 weeks, topical cacineurin inhibitors - pimecromilus and tacrolimus – not for children < 2

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16
Q

keratolytics

A

promote swelling of the epithelium and allow it to soften. coal tar, sulfar, salicytic acid. rx fluocinolone scalp oil for scales on scalp

17
Q

face tx

A

low potency steroid, ketoconazole 2%, ciclopirox 1% or a combo, 1-2x daily until resolved

18
Q

men mustaches and beards

A

ketoconazole 2% shampoo daily until resolved then once a week to maintain, or low potent topical steroid

19
Q

trunk treatment

A

mid potent steroids, topical antifungals