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CMT-uno > vesicular dermatoses/pustular disorders > Flashcards

vesicular dermatoses/pustular disorders Flashcards

1
Q

HSV1

Clin Man

primary & recurrent

A

Primary infection: most commonly asymptomatic, but may cause tonsil pharyngitis or gingivostomatitis

Recurrent infection: prodromal symptoms within 24 hours of reactivation of virus followed by the development of
grouped vesicles on an erythematous base that crossed over prior to healing

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2
Q

HSV1

Dx and Tx

A

▸ Diagnosis : PCR (most sensitive and specific)
▸ Treatment: Valacyclovir 2g bid x 1 day

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3
Q

HSV2

Clin Med

A

▸ Painful genital ulcers often preceded by prodromal symptoms
▸ Multiple, shallow, tender grouped 2–4 mm vesicles on an erythematous base that progressed to vesicle pustules, erosions, and
alterations +/- inguinal lymphadenopathy

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4
Q

HSV2

Dx and Tx

A

Diagnosis : PCR (most sensitive and specific)
Tzanck smear: multinucleated giant cells - classic but not specific

▸ Treatment: Valacyclovir, acyclovir, famciclovir

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5
Q

Herpes Zoster

Clin Man

A

▸ Prodrome: fever, malaise, sensory changes followed by rash
▸ Rash: unilateral, the secular dermatomal eruption of painful, grouped vesicles or bola on an
erythematous base that does not cross midline
▸ Boards: thoracic and lumbar roots are most commonly affected

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6
Q
A

HSV1

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7
Q
A

HSV2

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8
Q
A

herpes zoster

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9
Q

zoster

Tx, prevention

A

Treatment: Valacyclovir, acyclovir, famciclovir within 72 hours of onset
▸ Topical analgesics
▸ Education: no longer infectious once lesions crust over
▸ Immunocompromised: VZV immune globulin to exposed individuals

Prevention : Shingrix vaccine - reduces the risk of postherpetic neuralgia

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10
Q
A

Atopic dermatitis

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11
Q

atopic dermatitis

general
Triad

A

Rash due to defective skin barrier susceptible to drying, leading to pruritus and inflammation
▸ Atopic triad: Eczema + Allergic Rhinitis + Asthma

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12
Q

atopic dermatitis

triggers

A

heat, perspiration, allergens, contact irritants

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13
Q

atopic dermatitis

Dx

A

clinical

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14
Q

atopic dermatitis

clin man
Hallmark

A

▸ Hallmark: pruritus, xerosis
▸ Erythematous, scaly, ill-defined papules or plaques. Most common flexor creases in older children
and adults.
▸ Nummular: sharply-defined discoid or circular coin-shaped lesions especially on hands, feet,
extensor surfaces

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15
Q

atopic dermatitis

Tx 3- and severe

A

First-line: topical corticosteroids with emollient use. Antihistamines for itching

Moderate-Severe: dupilumab

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16
Q

contact dermatitis

general

A

Inflammation of the epidermis and dermis from Direct contact between a substance in the surface
of the skin – either irritant or allergic

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17
Q

contact dermatitis

irritant

A

most common type – caused by chemical, alcohol, or cream exposure
▸ Pathophysiology: Nonimmunologic reaction – immediate

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18
Q

contact dermatitis

Allergen

A

nickel most common, poison ivy, metal, chemicals, detergent, cleaners, prolonged water
exposure

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19
Q

contact dermatitis

Dx

A

clinical. Patch testing may identify potential allergens to prevent future exposures

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20
Q
A

contact dermatitis

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21
Q
A

contact dermatitis

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22
Q

contact dermatitis

clin man

A

Erythematous papules or vesicles with linear or geometric distribution. often associated
with localized intense pruritus, stinging, or burning

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23
Q

contact dermatitis

Tx
If extensive?

A

Identification and avoidance of irritants is the most important aspect
▸ First line: topical corticosteroids + General measures
▸ General measures: Cool compresses, oatmeal baths, skin emollients
▸ Severe/extensive: oral corticosteroids – 10 day prednisone taper recommended

24
Q

DYSHIDROTIC ECZEMA / POMPHOLYX

general

A

Recurrent, pruritic, vesicular rash affecting the palms and our soles most commonly affecting young adults

25
Q

DYSHIDROTIC ECZEMA / POMPHOLYX

triggers

A

sweating, emotional stress, warm and humid weather, metals

26
Q

DYSHIDROTIC ECZEMA / POMPHOLYX

Clin Man

A

Sudden onset of the development of pruritic “tapioca like “small tense vesicles on the soles, palms,
and/or fingers

Followed by desiccation, desquamation, papules, scaling, lichenification, and erosions may occur

27
Q

DYSHIDROTIC ECZEMA / POMPHOLYX

Dx and Tx
Mild\mod and severe

A

Treatment:
▸ Mild-moderate: topical corticosteroid ointment preferred
▸ Severe: oral corticosteroids, potent topical corticosteroid
▸ General measures: use of lukewarm water, fragrance free & sensitive skin
products, frequent use of emollients, wearing gloves during household
chores

28
Q
A

DYSHIDROTIC ECZEMA / POMPHOLYX

29
Q

IMPETIGO

general

A

Highly contagious superficial vesicopustular skin infection most commonly found in children

30
Q
A

Impetigo

31
Q

impetigo

risk factors

A

Poor personal hygiene, poverty, crowding, warm and humid weather, skin trauma

32
Q

impetigo

classification

A

Nonbullous - most common type, typically caused by staphylococcus aureus, group a streptococcus. Presents as papules,
vesicles, and pustules with weeping and later development of honey color, golden crust, primarily on exposed surfaces of
the face and arms
▸ Bullous - most commonly caused by staphylococcus aureus. Vesicles form large bulla rapidly that rupture and develop a
thin, varnish-like crust
▸ Ecthyma - ulcerative pyoderma caused by group a strep – rare

33
Q

impetigo

Dx and Tx
Mild and extensive

A

Diagnosis: clinical
▸ Treatment:
▸ Mild: mupirocin TID x 10days + good skin hygiene
▸ Treat household members, make sure to treat nasal cavities
▸ Extensive disease: cephalexin, dicloxacillin

34
Q

impetigo

complications

A

Complications
▸ Common cause of cellulitis – 10%
▸ Acute glomerulonephritis – 1-5%

35
Q

Acne Vulgaris

general

A

Inflammatory skin condition associated with papules, pustules involving the pilosebaceous
unit

36
Q

acne vulgaris

4 main factors

A

four main factors – follicular hyperkeratinization, increased sebum production,
Cutibacterium acnes overgrowth, inflammatory response

37
Q
A

acne vulgaris

38
Q
A

Rosacea

39
Q

Rosacea

General

A

Chronic acneiform skin condition most commonly affecting adults, typically lighter skin phototypes
▸ Etiology is unclear – persistent vasomotor instability, capillary vasodilation, and abnormal pilosebaceous activity

40
Q

rosacea

triggers

A

alcohol, changes in weather, spicy foods, sun exposure (chocolate, and citrus)

41
Q

rosacea

clin man

A

Macular erythema, telangiectasia, possible papules and or pustules – there are no comedones

Some patients develop rhinophyma – overgrowth of the dermis and sebaceous glands on the nose

Ocular – ocular erythema, tearing, foreign body sensation, burning, itching

42
Q

rosacea

Dx and Tx
SIM + severe

A

Diagnosis: clinical
Treatment:
▸ Mild-Moderate: topical metronidazole, topical ivermectin cream, topical
sulfacetamide
▸ Moderate-Severe: oral antibiotics (doxycycline) + topical agent
▸ Facial erythema : topical brimonidine
▸ Telangiectasia: laser therapy

43
Q

Milia

general

A

Skin eruption due to keratin retention and sebaceous material in the pilosebaceous follicles
within the dermis

44
Q

Milia

Clin man

A

▸ 1–3 mm pearly, white – yellow papules especially seen on cheeks, forehead, chin and nose

45
Q

Milia

Tx

A

▸ Treatment: Observation
▸ Can be manually extracted or treated with liquid nitrogen if desired for cosmetic reasons

46
Q
A

milia

47
Q
A

milia

48
Q

folliculitis

general

A

▸ Superficial hair follicle infection or inflammation
▸ Staphylococcus aureus most common, other gram positive organisms
▸ Recent hot tub use? Think Psuedomonas aeruginosa

49
Q
A

folliculitis

50
Q

folliculitis

risk factors

A

More common in men, prolonged use of antibiotics, topical steroids

51
Q

folliculitis

clin man

A

Solitary or clusters of perifollicular papules/pustules with surrounding erythema on hair bearing skin

52
Q

folliculitis

Tx
First line and severe

A

▸ First Line: topical mupirocin, clindamycin +benzoyl peroxide, erythromycin
▸ Severe: oral cephalexin or dicloxacillin

53
Q

perioral dermatitis

age group affected

A

20-45 females

54
Q

perioral dermatitis

risk factors

A

History of topical corticosteroid use or fluoridated toothpaste

55
Q

perioral dermatitis

clin man

A

▸ Erythematous group papules or pustules which may become confluence into plaques with scales
▸ Spares the vermilion border
▸ May affect the periorbital or paranasal skin

56
Q

perioral dermatitis

Tx
PEM

If extensive?

A

▸ First line: Topical pimecrolimus, metronidazole, or erythromycin + elimination of topical corticosteroids, irritants
▸ Oral: tetracyclines if extensive or refractory

CMT-uno (54 decks)

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