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Clin Med IV Derm > Week 5 > Flashcards

Week 5 Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the two classifications of contact dermatitis?

A

Allergic

Irritant

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2
Q

Allergic contact dermatitis is a ______ type hypersensitivity reaction

A

Delayed (cell-mediated)

Examples: poison ivy, nickel

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3
Q

80% of all contact dermatitis is what type?

A

Irritant

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4
Q

What can predispose you to irritant contact derm?

A

Household duties or occupational exposures (hair dressers, bar tenders, janitors)

Ie - hands in water, detergents, solvents

Most common occupational skin disease

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5
Q

What is the dominant symptom for allergic contact derm?

A

Itchiness, localized to skin areas that came in contact with the allergen

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6
Q

What does allergic contact derm look like?

A

Erythematous, popular dermatitis with indistinct margins

Often blisters and edema

Can take 1-2 days to appear

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7
Q

What is the dominant symptom of irritant contact derm?

A

Burning, stinging pain

Hands most common

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8
Q

What does irritant contact derm look like?

A

Erythema, chapped skin, dryness, and fissuring

More immediate onset

Hands most common

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9
Q

Common allergens that can cause allergic contact derm

A

Poison ivy, oak, and sumac (urushiol oil)

Nickel

Rubber/latex

Preservatives/cosmetics

Neomycin

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10
Q

Lip licker’s dermatitis is a type of …

A

Irritant contact derm

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11
Q

Treatment options for contact derm

A

D/c exposure to allergen/irritant

Decrease frequency of hand-washing (if that’s the cause)

Wear gloves/protective clothing

Apply bland emollient (Vaseline)

Topical steroids 1-2x daily for 7-14 days

Consider oral corticosteroid for ACD involving face or >20% BSA

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12
Q

When should you consider oral corticosteroids for allergic contact derm?

A

If it involves face or >20% BSA

Prednisone 0.5-1mg/kg/day (max 60 mg/day) x 7 days

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13
Q

Infection of the nail by fungus, yeast, or non-dermatophyte mold

A

Onychomycosis

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14
Q

Risk factors for onychomycosis

A

Advanced age

Tinea pedis

Genetics

Immunodeficiency

Household infection

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15
Q

Most common subtype of onychomycosis

A

Distal subungual

Typically starts with great toe

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16
Q

Proximal subungual onychomycosis is usually seen in…

A

Severally immunocompromised patients (ie AIDS)

Starts near the cuticle and progresses distally

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17
Q

Yeast onychomycosis is usually due to…

A

Candida Albicans

Can also cause chronic paronychia

18
Q

How do you diagnosis onychomycosis and differentiate from other nail dystrophies?

A

KOH prep of nail scrapings

Culture

Histopathology

19
Q

When should you consider treatment of onychomycosis?

A

Hx of cellulitis

DM

Patient desires cosmetic improvement

Patient complains of discomfort/pain

20
Q

What are the treatment options for onychomycosis?

A

Dermatophyte onychomycosis:
• Oral terbinafine x 6 weeks for fingernails or 12 weeks for toenails
• Fluconazole
• Itraconazole

Non-dermatophyte onychomycosis:
• Oral itraconazole x 6 weeks for fingernails or 12 weeks for toenails

21
Q

Risk factors for candidal intertrigo

A

Moisture

Skin friction (obesity, sumo wrestlers)

Immunocompromised

22
Q

Candidal intertrigo typically affects…

A

Groin

Mammary/abd folds

Web spaces

Axilla

23
Q

How do you diagnose candidal intertrigo

A

Primarily a clinical dx

PE

KOH prep

Culture

24
Q

Treatment of candidal intertrigo

A

Preventative measures (drying agents, weight loss, address underlying conditions)

Topical Nystatin or azole

Systemic meds in resistant/severe cases (Itraconazole)

25
Q

Tinea versicolor is a fungal infection caused by…

A

Malassezia furfur or M. globosa

26
Q

What populations are most at risk for tinea versicolor?

A

Tropical climate

Adolescents/young adults

Hyperhidrosis

Genetics

Immunosuppression

IT’S NOT CONTAGIOUS

27
Q

How is tinea versicolor diagnosed?

A

Like other tinea infections

PE
KOH prep

Wood’s lamp —> yellow to yellow-green fluorescence

28
Q

How do you treat tinea versicolor?

A

Topical tx:
• Azole antifungals (clotrimazole) x 2 weeks
• Selenium sulfide x 1 week
• Zinc Pyrithione shampoo x 2 weeks

Systemic tx:
• Oral azole (itraconazole)

Recurrence common

29
Q

Where does stasis dermatitis most commonly occur?

A

Medial ankle (can also be circumferential)

30
Q

What skin changes do you see with stasis dermatitis?

A

Erythema, inflammation, pruritis, scaling, and vesicle formation

31
Q

How do you treat stasis dermatitis?

A

Emollients

Barrier creams

Topical corticosteroids (triamcinolone, betamethasone)

32
Q

Arterial or venous ulcer:

Location = toe joints, malleoli, anterior shin, base of heel, other pressure points

A

Arterial

33
Q

Arterial or venous ulcer:

Location = malleoli above bony prominence, posterior calf, may be large/circumferential

A

Venous

34
Q

Arterial or venous ulcer:

Dry, often pale/necrotic (brown/black fibrous tissue)

A

Arterial

35
Q

Arterial or venous ulcer:

Pink/red with yellow fibrinous tissue, exudate common

A

Venous

36
Q

Arterial or venous ulcer:

Absent pulses

A

Arterial

37
Q

Arterial or venous ulcer:

Pulses present

A

Venous

38
Q

Arterial or venous ulcer:

Skin atrophy, shiny, taut, loss of hair

A

Arterial

39
Q

Arterial or venous ulcer:

Skin erythematous, hyperpigmented, edema, dry skin, varicosities

A

Venous

40
Q

Arterial or venous ulcer:

Foot becomes pale with leg elevation

A

Arterial

Clin Med IV Derm (1 decks)

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