skin Flashcards
rocky mountain spotted fever
small red spots on hands/feet that progress toward the trunk
fever, n/v
rash day #3
south central common
actinic keratosis
dry, red round lesions with rough texture
sun exposed areas
meningococcemia
meningitis rash
“sudden” stiff neck, fever, changes in LOC
hemorrhagic rash in the axillae, flanks, wrist, and ankles
rifampin prophylaxis
erythema migraines
early lyme disease bulls eye rash 7-14 days after deer tick bite flu like s/s most common northeast region use DEET
herpes zoster opthalmicus
herpes soter on the trigemnal ( V) nerve. sudden vesicular lesions on the ONE side of the scalp, forehead, and tip of the nose. blurry vision. ED
melanoma
> 6mm, irregular borders. can appear in the nail pads or retina
basal cell carcinoma
pearly or waxy lesion with ulcerated center.
acral lentiginous melanoma
most common type of melanoma in AA and asians. located on the nailbes, palmar, and plantar surface. longitudinal brown to black bands on the nail beds
subungual hematoma
draining
use heated paperclip or 18 g neede press down to create 3-4mm hold. blood may drain for 24-36 hrs
steven johnson syndrome (erythema multiform major)
bulls eye lesions
bulla
painful
involves eyes nose, mouth, esophagus
fever before rashes appear
hypersensitivity caused by medicines, infections,a nd malignancies
PNS, sulfas, barbiturates, and phenytoid ( dilantin)
HIV have 40 fold risk of SJS dt to trimethoprim/sulfa
lyme disease s/s
erythema migraines ( rash that can span 12 inches bulls eye), facial palsy, swollen knee
what skin lesions show bulla (superficial blister >1cm)
impetigo, 2nd degree burn, SJS lesion
vesicle
herpatic lesions
seborrheic keratoses
soft wart like growths, esp on the back
xanthelasma
yellow colored plaques under the brow or upper.lower lids of the eyes. hyperlipidemia if
lipoma
soft fatty cystic tumors, painless, located on trunk, legs/arms, neck
xerosis
extremely dry skin and may involve mucosal or eyes (xerostomia, xeropthalmia)
acanthosis nigrans
thickening of the skin behind the neck/axilla. DM, metabolic syndrome, obesity, cancer of the GI tract
psoriasis
skin cells undergo rapid mitotic division=plaques
koebner phenomenon= new plaques over area of skin trauma
auspitz sign- pinpoint areas of bleeding when plaque is removed
black box warning for topical tacrolimus: skin malignancy. use spf . biologics/anti TNF agents
tx: steroids, retinoids, tar prep (psoralen)
humira, enbrel, ad remicade are associated with malignancy, TB, sepsis. Take baseline PPD
actinic keratosis
precurser to squamous sell.
cryotherapy of 5fu
tinea versicolor
yeast. hypo pigmented maculates that “appear” after skin becomes tan.
labs- koh (potassium hydorxide) slide shoes hphae and spores.
topical selenium sulfide or ketoconazaole
atopic dermatitis (eczema)
pruritic rash on the hands, neck, folds. worse with stress, winter, related to allergies
topical steroids hydrocortisone
traimcinolone
oral thrush
nystatin (mycostatin) oral suspension
severe- lidocaine, diphenhydramine, and maalox mouth wash.
hidradenitis supprativa
bacterial infection of the sebaceous glands of the axilla
augmentin
mupirocin ointment to nares/fingernails
impetigo
skin infection by gram +, s. progenies or s. auras. contagious and pruritic. honey colored
tx: keflex qid x 10 days
if pcn allergy, azithroymycin
meningococcemia
life threatening infection by N. meningitides spread by droplets
The skin rash may advance from a few ill-defined lesions to a widespread petechial eruption within a few hours. Meningococcemia’s potential rapidity of progression cannot be stressed enough.
ie: college students
labs: lumbar CSF, blood culture, throat culture, mdi brain
tx: cefriaxone (rocephin) 2g IV q 12 hours plus vancomycin IV q 8-12 hours
lyme disease tx
erythema migraines by tick B. burgdorferi.
labs: antiboy igM and igG.
tx doxy
rocky mountain tx
dog tick or wood reck infected with rickettsia rickets.
small papules on hands/feet and spread to trunk
fever
doxy or tetracycline x 21 days. refer STAT
biospy lesion 3mm punch
varicella tx
chickenpox- contagious 1-2 days before onset and unit chicken pox crusts over (1-2 wks)
shingles: contagious with onset of rash until crusts over
medications: acyclovir (zovirax) or valtrex
herpatic whitlow
viral infection of the fingers (herpes)
painful red bumps on fingers.
self limited, or tx with acyclovir.
paronychia
vacterial infection of the cuticle . painful smollen area of the nail that becomes abscessed.
soak in warm water for 20 minutes tie, topical antibiotic, incision and drainage prn
pityriasis rosea
christmas tree rash on trunk
self limiting, 4-8 wks
“herald patch”
if high risk std, check PRP to r/o syphilis
scabies
tx: permetherin for 8-14 hrs
rash on webs of hands , breats, buttocks, scrotum. rash appears snakelike (serpinginous) or linear burrows
labs- scarpe burrow or scales with glass slide
treat everyone in the house
tinea capitus
most common in AA children
block dot tines capitis- ring worm
hairs break off and leave block dots on the scalp
medications: antifungal tx Griseofulvin daiy (microsize/ultramicdrosize), 6-12 weeks
avoid hepatotoxic substances (alcohol, statins, acetaminophen)
baseline LFT and repeat 2 weks after initiating
Total body surface area (TBSA) burns
each arm: 9%
head: 9%
each leg 18%, anterior trunk 18%, posterior trunk 18%
anthrax
3 types: cutaneous, GI, and pulmonary
pulmonary- (animals, wool, hides, hair)
post exposure (bioterrorism) cipro
ricin toxin (castor beans)
oral ricin causes vomit, diarrhea, multi organ failure in 6 hours. no antidote
small pox
eliminated in 1977. vaccine 3-4 days post exposure. incubation 2 weeks
pruritic rashes located in the webs of fingers, penis are scabies until proven otherwise. treat entire family.
true
preferred antibiotic for human or animal bites
augmentin
post herpatic neuralgia prophylaxis
TCA (antidepressents), amitriptyline (elavil)
cellulitis clue
walking barefoot
if Beta B infection cellulitis treat for 10 days dt risk of developing postglomerular nephritis
true
