Vascular Abnormalities & Acneiform Eruptions

Question 1

common inflammatory condition caused by chronic venous insufficiency, where the skin capillaries begin to leak d/t congestion

Answer 1

stasis dermatitis

Question 2

where does stasis dermatitis occur? why?

Answer 2

lower extremities
blood is backed up

Question 3

a patient presents with lower extremity edema that is non-tender and non-painful, and rusty/erythematous/hyperpigmented skin. what are they experiencing?

Answer 3

stasis dermatitis

Question 4

a patient presents with this skin lesion. what is the diagnosis and management?

Answer 4

stasis dermatitis

skin care (gentle cleanse, moisturizer)
leg elevation/walking

Question 5

a patient presents with this skin lesion, what medication can be used to treat it? give the mnemonic

Answer 5

“the pent up blood in the legs is fixed with pentoxifylline”

Question 6

a patient presents with lower extremity edema + pruritis, erythema, and oozing. what are they experiencing? treatment (2)?

Answer 6

acute stasis dermatitis

topical steroids
unna boot

Question 7

proliferation of capillaries commonly found on the trunk

Answer 7

cherry angiomas

Question 8

visible, small, linear blood vessels also called spider angiomas

Answer 8

telangiectasia

Question 9

how can this be treated for cosmetic reasons?

Answer 9

laser therapy

Question 10

most common benign tumor of infancy

Answer 10

hemangiomas

Question 11

bright red, dome-shaped, vascular papules, plaques, or nodules

Answer 11

superficial hemangiomas

Question 12

firm-rubbery, compressible, bluish, vascular plaques or nodules with overlying venous network or telangiectasia; noticed at 3-6 months of age

Answer 12

deep hemangiomas

Question 13

what is the most common skin condition?

Answer 13

acne vulgaris

Question 14

tender, painful, itchy lesions that are erythematous or hyperpigmented skin changes that occur with interspersed comedones

Answer 14

acne vulgaris

Question 15

what is an open comedone also known as?

Answer 15

black head pimple

Question 16

what is an closed comedone also known as?

Answer 16

white head pimple

Question 17

what is the treatment for comedonal acne? (2)

Answer 17

tretinoin topical
benzoyl peroxide +/- antibiotic combo

Question 18

what is the treatment for mild papular or cystic inflammatory acne? (2)

Answer 18

topical benzoyl peroxide + clindamycin
OR
topical benzoyl peroxide + adapalene

Question 19

what is the treatment for moderate papular or cystic inflammatory acne? (4)

Answer 19

oral doxycycline, minocycline, erythromycin
+
topical benzoyl peroxide

Question 20

in which areas are oral antibiotics useful to treat acne?

Answer 20

chest or back

Question 21

what is the treatment for severe papular or cystic inflammatory acne? (3)

Answer 21

oral isotretinoin (vit A analog)
intralesional steroid injection
topical clascoterone

Question 22

which patient population should not use tretinoin topical or isotretinoin to treat acne?

Answer 22

pregnant patients

Question 23

since isotretinoin is a teratogenic, what is required before starting a female patient on it? (2)

Answer 23

2 forms of contraception

pregnancy test before and q 1 month

Question 24

what is some patient education for the treatment of acne vulgaris?

Answer 24

lesions take 4-6 weeks to resolve

skin can develop post-inflammatory pigmentation changes

Question 25

how does diet affect acne vulgaris?

Answer 25

low glycemic diet associated with improved acne if patient is insulin resistant

Question 26

common disorder characterized by erythema of the central face that persists for months; flares are often initiated by triggers

Answer 26

rosacea

Question 27

at what age does rosacea typically occur?

Answer 27

over 30 yo

Question 28

in which patients is rosacea more common in, in regards to fitzpatrick scale?

Answer 28

lower fitzpatrick scales

Question 29

how does rosacea differ from acne vulgaris?

Answer 29

rosacea does not have comedones

Question 30

what are some flare triggers of rosacea? (6)

Answer 30

sunlight exposure exercise exposure to hot/cold weather emotional stress topical steroids alcohol (wine)

Question 31

a patient presents with a gradual onset of facial redness, flushing, or "pimples" on the central face. Their central face stings/burns. They also report that their skin has become sensitive to their usual skin care products. what is the diagnosis?

Answer 31

rosacea

Question 32

what is patient education for rosacea?

Answer 32

wear sunscreen and avoid triggers

Question 33

what is the treatment for facial erythema in rosacea? (2) give mnemonic

Answer 33

"the red face hit its brim(onidine) and need to be treated with oxymetazoline (afrin)" brimonidine oxymetazoline

Question 34

what is the treatment for papules and pustules in rosacea? give the mnemonic

Answer 34

"meta-zapping papules with Aztec acid for Iver in the Minor's (minocycline)" topical metronidazole azelaic acid ivermectin minocycline

Question 35

what is the systemic treatment in rosacea? (2) give the mnemonic

Answer 35

"if rosacae is(otreninoin) exaggerating, she can talk to doxy(cycline)" isotreninoin doxycycline

Question 36

what is important to know about rosacea?

Answer 36

long-term disorder but sx can be controlled with meds and avoiding triggers

Question 37

very common disorder of the hair follicle that can be seen at any age in hair bearing sites

Answer 37

folliculitis

Question 38

what are 3 common etiologies of folliculitis?

Answer 38

infection mechanical irritation mite overpopulation

Question 39

a patient presents with pruritic, red "pimples" that spread (infection) via autoinoculation, and are often grouped and localized. what is the diagnosis and first line treatment?

Answer 39

folliculitis topical mupirocin (bactroban)

Question 40

small 1-3 mm tender pustules or papules in hair bearing areas

Answer 40

folliculitis

Question 41

what can develop from folliculitis?

Answer 41

staph folliculitis = larger abscesses

Question 42

what treatment may limit the spread of infection in a patient with folliculitis?

Answer 42

topical disinfectant

Question 43

what 3 oral antibiotics can be used to treat the organism in folliculitis?

Answer 43

cephalexin amoxicillin trime-sulfa

Question 44

a patient presents with 1-2 mm clustered, erythematous or hyperpigmented papules, papulovesicles, or papulopustules with possible scale in the perioral region (sparing the vermillion border). what is the diagnosis and treatment?

Answer 44

perioral dermatitis (POD) zero therapy + gentle skin cleansing

Question 45

what can we do once a patient is in remission from perioral dermatitis?

Answer 45

readd skin products; one per week to identify offender

Question 46

what should we do for a patient with perioral dermatitis whose condition does not resolve?

Answer 46

refer to dermatologist