Test # 1 Flashcards
1
Q
Layers of the epidermis
A
*corneum *lucidum *granulosum *spinosum *basal
2
Q
keratinocytes lose nuclei, continue to flatten
A
Granulosum
3
Q
dead cells, primary fxn is barrier
A
corneum
4
Q
keratinocytes connected by desmosomes, langerhan’s cells located here
A
spinosum
5
Q
appear lucent, very thin, only in thick skin
A
Lucidum
6
Q
dividing keratinocytes and melanocytes
A
Basal
7
Q
Description of lesions
A
- Number
- Size
- Color
- Primary/Secondary Lesions
- Distribution
8
Q
a circumscribed, flat, discoloration
A
Macule
9
Q
Referred to a macule that is greater than 1 cm as a ___
A
Patch
10
Q
An elevated solid lesion up to 0.5 cm in diameter
A
Papule
11
Q
A circumscribed, elevated, superficial, solid lesion more than 0.5 cm in diameter. ( Confluence of papules)
A
Plaque
12
Q
a circumscribed, elevated, solid lesion more than 0.5 cm in diameter
A
Nodule
13
Q
A large nodule is referred to as a _______
A
Tumor
14
Q
A circumscribed collection of leukocytes and free fluid that varies in size.
A
Pustule
15
Q
a circumscribed collection of free fluid up to 0.5 cm in diameter
A
Vesicle
16
Q
A circumscribed collection of free fluid more than 0.5 cm in diameter
A
Bulla
17
Q
A firm edematous plaque resulting from infiltration of the dermis with fluid.
Transient and last a few hours
A
Wheal Hive (Dermatographism)
18
Q
develop during evolutionary process of skin Dz or are created by scratching or infection- infers primary dz
A
Secondary lesions
*Scale * crust *Erosion *Ulcer *Fissure *Atrophy * Scar
19
Q
Excess dead epidermal cells that are produced by abnormal keratinization and shedding
A
scale
20
Q
A focal loss of epidermis heal w/o scaring. Do not penetrate dermoepidermal junction
A
Erosion
21
Q
A collection of dried serum and cellular debris (scab)
A
Crust
22
Q
A focal loss of epidermis and dermis
A
Ulcer
23
Q
a depression in the skin resulting from thinning of the epidermis or dermis
A
Atrophy
24
Q
A linear loss of epidermis and dermis w sharply defines nearly vertival walls
A
Fissure
25
An abnormal formation of connective tissue implying dermal damage
Scar
26
Special Lesions
* Excoriation *Milia *Cyst *Burrow * Petechiae
* Comedone * Lichenification * Talangiectasia
* Purpura
27
A small superficial keratin cyst w no visible opening
Milia
28
A plug of sebaceous and keratinous material lodged in the opening of a hair follicle (dilate or narrow)
Comedone
29
An erosion caused by scratching
Excoriation
30
A circumscribed lesion with a wall and a lumen (Fluid or solid matter)
Cyst
31
An elevated tortuous channel produced by a parasite
Burrow
32
Dilated superficial blood vessel
Talangiectasia
33
An area of thickened epidermis induced by scratching
| Accentuated like a washboard
Lichenification
34
A circumscribed deposit of blood less than 0.5 cm in diameter
Petechiae
35
A circumscribed deposit of blood greater than 0.5 cm in diameter
Purpura
36
used to dx pigmented lesions for Malignant Melanoma (MM)
Dermoscopy
37
Cytology prep dx for herpes test
Tzanck prep
38
Worse in dry winter months. "Winter itch" MC hands and lower legs. skin is rough covered w white scales
progresses to thicker tan or brown scales (crisscrossed and fissured.) severe itching or burning
Xerosis (severe dry skin)
39
Xerosis (severe dry skin) Tx
Emollients 12 % lactate lotion (Lac Hydrin )
40
valuable aid in treatment of exudative skin dzs
Wet dressings (Topical Therapy)
41
Creams are thicker and more lubricating than lotions.
Most effective when applied to damps skin.
Pat dry and apply immediately apply to skin. menthol or phenol added to reduce pruritus (added urea/lactic acid which have special lubricating properties
Emollient Creams and lotions
42
Wet to dry dressing technique.
use 4-8 layers of clean soft material folded (wring out until sopping wet (Leave in place 30-60 min. 2-4x/day
DC if signs of dryness
43
PA's use what groups of topical steroids strongest to weakest Group____ to Group ____
PA's Group V - VII
Strongest Group I - Weakest group VII
44
If no response in ______ reevaluate
1-4 weeks
45
mix of organic chemicals/oils, water and preservative
slightly greasy. use almost anywhere.
--> Drying effect w long use. best= acute exudative inflammation. and Intertriginous areas.
Cream
46
Limited number of organic compounds. primary grease w little / no water. translucent
Great penetration--> increased potency. Too occlusive for intertriginous or acute eczematous inflammation
Ointments
47
Mix of propylene glycol and water sometimes alcohol.
Greaseless, and clear. useful for = poison ivy and scalp
Not tangle hair: poison ivy= exudative inflammation
Gels
48
Mix of water, ETOH, and other chemicals. clear or milk.
Least Lypophilic can be very drying
most useful in scalp--> penetrate easily through hair stinging and drying may result in intertriginous areas
Solutions and Lotions
49
useful for scalp dermatoses. Acute eczematous inflammation poison ivy and plaque psoriasis
not for use > 2 weeks or < 12 YOA. Suppresses hypothalamus.
Foams (mousse)
50
skin Dz that Increases barrier and decreases absorption
Thick scale
Lichenification
Thick skin areas (Soles and palms)
51
Side effects of steroids
- Burning or itching
- Hypopigmentation
- Atrophy
- easy bruising
- Striae Inection IM = short needle= Atrophy
- Rosacea
- Elevate sugar in Diabetics
- Pregnancy (avoid in trimester)
52
Number 1 steroid MC mistakes
Steroid too weak for process and area
53
Steroid dosing in general
Fingertip units= 0.5 gm /5mm diameter (One hand area)
Group I- QD BID, pulse therapy 2 wks on 1 week off
Group II- VI BID x 2-6 weeks
54
Tinea cruris treated w topical steroid --> what?
Tinea incognito
55
water cover enhances absorption increases potency by 100Xs
Occlusion
56
Worse in winter. develop lesion related to trauma "Koebnerize" phenomenon. Increases risk
thick adherent silvery-white scale. Begins as red then Discrete oval plaques auspitz sign. Extensor surfaces
pitting or Oil spots on nail
Chronic Plaque Psoriasis
57
Psoriasis management
Mod-Severe : Methotrexate
Mild-Moderate: Clobetasol or Fluocinonide/ Triamcinolone (Salicylic Acid removes plaque)
Topical Vitamin D (Calcitriol) Calcipotriene Vitamin D3
UVB, Tazarotene retinoid
58
Strep pharyngitis/Viral URI precedes eruption. 1-2 wks
sudden appearance of scaling papules trunk/extrem.
Teardrop scattered red papule w thick scale. May have classic plaques on elbows and knees.
Guttate Psoriasis
59
Guttate Psoriasis management
Throat Cx to r/o Strep and UVB 6-8 weeks (1st Line)
Empirical Tx w PCN or erythromycin 10days
60
Serious and sometimes fatal. Pt toxic, febrile and leukocytosis. Pts is smoker w plaques
Tiny sterile pustules that coalesce on middle of pal, or sole of foot. Pustules dry up and fall off not burst
Pustular Psoriasis
61
Pustular Psoriasis Management
Clobetasol- wean off (Consider plastic occlusion)
NO PO Steroids- Abx for 2ndary infx
Retinoid and Cyclosporine/Methotrexate
62
Common, chronic inflammatory dz. peaks In infancy, maternity, teens (High hormones).
Winter, stress, hygiene changes. MC in aids: Greasy flakes,eye braws/lashes, ext ear canals
Seborrheic Dermatitis
63
Seborrheic Dermatitis
Shampoos
- Head N shoulder, T/Gel, Selsun -Tar based
- Sulfur/zinc -Selenium sulfide -Ketoconazole 2%
- Hydrocortisone 1% -Triamcinolone -Fluocinolone
- Itraconazole 200mg /day
64
Chronic pruritic dz. Always begins in childhood. Recurring improves w age. Bilat Flexor creases
Cold/Dry weather, hot humid weather, pollens, stress, illness. Flaking, xerosis, cracking, fissures patchy
(Itch rashes- Itchiness that is eruptive)
Atopic Dermatitis
65
Atopic Dermatitis Management
Tepid baths, wash less often, moisturize w/I 3 min post shower (Thick Emollient). Hydroxyzine or Benadryl
Inflammation: Triamcinolone or GRP V Fluticasone
Tracrolimus (If all failed)
Infx: Abx Dicloxacillin, Cephalexin, Erythromycin
66
Eczema w Thickened skin- excoriations, fissuring, accent skin line Top steroids, AH1, Abx, Emollients
Eczema Chronic
67
Eczema w Erythema, scaling, fissuring. parched app. scaled app. moderate itch/pain/burning.
Steroids (Occlusion), emollients after, AH1 abx
Eczema Subacute
68
Eczema w Vesicles, bullae, intense erythema and itch
Contact allergy "Rhus" Contact derm.
Cold wet compress, PO or topical steroids AH1, abx
Eczema Acute
69
Eczema w symmetric vesicular hand and foot dermatitis. Mod-Severe itching before vesicles.
MC in teens: Unknown etiology. Tapioca lesions. hands and lateral aspects of fingers and hands. Pts have hyperhidrosis
Dyshidrotic Eczema (Pompholyx)
70
Dyshidrotic Eczema (Pompholyx) management
Avoid water, irritants, trauma. emollients
Potent steroid then wean- Hydroxizine Diclox, Erythro, Cpehalexin
Methotrexate- If all fails
71
Eczema that occurs after excess drying in winter/ and the elderly. Long hot showers
Lower legs become dry and scaly. Xerosis red plaques w horizontal fissures. "Cracked porcelain"
Asteatotic Eczema (Craquele)
72
Eczema occurs on same spot q winter. round coin-shape red plaque. Back of hand MC.
Often dx as ring worm. Tx Potent steroids 4-6 weeks, correct dryness
Nummular Eczema
73
Created by habitual scratching. Great pleasure in relief from frantically scratching. Nerve entraps= Super itch
Occurs in convenient areas to scratch. Prurigo nodularis. Tx break itch Intra lesion steroids, Clobetasol, Betamethasone 1st Gen AH1
Lichen Simplex Chronicus
