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Pance Re-Up > Dermatology > Flashcards

Dermatology Flashcards

1
Q

MCC Cellulitis in adults

A

Group A Strep

Other Causes: Staph A,

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2
Q

MCC Cellulitis in Neonates

A

Group B Strep

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3
Q

Etiology of cellulitis & Symptoms

A

Breaks in skin, bites, etc.

Erythema, warmth, induration, pain, LAD, fever, edema

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4
Q

Although cellulitis is a clinical diagnosis mainly, what can be seen on US?

A

Cobblestoning appearance

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5
Q

If an abscess is present, what is the MCC?

A

Staph A

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6
Q

Explain erysipelas (form of cellulitis)

A

Superficial skin infection involving local lymphatics

Sharp, demarcated border on LE or face, indurated, pruritic, painful

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7
Q

MCC of erysipelas

A

Strep Pyogenes

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8
Q

Treatment for erysipelas

A

Oral: PCN, Amoxicillin, Cephalexin
IV: Cefazolin, Ceftriaxone

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9
Q

The MC form of impetigo is _____ and the MCC of impetigo is _____

A

Non-bullous

Staph A

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10
Q

Explain the rash of impetigo

A

Honey-colored crusts

Face and extremities MC

Erythematous macule –> pustule

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11
Q

Treatment for Impetigo (non-medical and medical)

A

-Remove crusts with warm cloth
-Mupirocin topical
-Avoid scratching
-oral ABX if severe (Doxy, Clinda, Bactrim if MRSA)

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12
Q

Acne vulgaris is overproduction of _______ and has four parts to the pathophysiology. Name them.

A

Sebaceous glands

1) follicular hyperkeratinization, 2) increased sebum production, 3) propioniobacterium overgrowth, 4) inflammatory response

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13
Q

Open comedones (_____) and closed comedones (_____) are symptoms of which type of acne?

A

Open: blackheads
Closed: whiteheads

Mild

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14
Q

Treatment for acne vulgaris

A

Mild: Topical (Azelaic acid, salicylic acid, benzoyl peroxide, Clindamycin ointment

Moderate: Topical + Oral (Mino, Doxy, Spironolactone)

Severe: Oral Isotretinoin

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15
Q

What are some adverse effects to isotretinoin?

A

Dry skin/lips, teratogenic, increased cholesterol and triglycerides

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16
Q

What are some triggers for rosacea?

A

Alcohol, cold/heat, spicy foods, hot drinks, sun exposure

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17
Q

Symptoms of rosacea

A

-Intermittent facial flushing
-No comedones
-telangiectasias
-Rhinophyma

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18
Q

First-line medical treatment for rosacea

A

Topical metronidazole

Others: Tetracyclines, laser therapy

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19
Q

However, for facial erythema, you can use

A

Topical Brimonidne

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20
Q

Bullous pemphigoid is a Type ______ hypersensitivity reaction that occurs in what population?

A

Type IV

Elderly

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21
Q

Explain the rash of bullous pemphigoid

A

-Negative Nikolsky
-Low mortality
-Tense bullae that do not rupture easily
-Rarely oral lesions
-Pruritic lesions with urticarial plaques

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22
Q

The gold standard diagnostic for bullous pemphigoid is

A

Skin biopsy with direct immunofluorescence

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23
Q

Treatment for bullous pemphigoid

A

Topical corticosteroids, but systemic if severe

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24
Q

Pemphigus vulgaris, on the other hand, occurs in what population? What are the symptoms of this condition?

A

Younger people, life threatening

-Positive Nikolsky
-Painful erosion
-Oral lesions (MC)
-Flaccid skin bullae that rupture easily

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25
Q

What are two medications that likely can cause pemphigus vulgaris?

A

Captopril & Penacillamine

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26
Q

Treatment for pemphigus vulgaris?

A

Systemic high dose corticosteroids and local wound care

27
Q

Erythema Multiforme, a Type IV hypersensitivity reaction, has etiologies in

A

HSV (MC)

Mycoplasma (in kids)

Meds: Sulfa, Allopurinol, Phenytoin

28
Q

Symptoms of erythema multiforme

A

Target lesions: dusky with pale ring and halo in periphery

Negative Nikolsky

Palms and soles affected!!!!

29
Q

Explain the difference between Erythema Multiforme minor and major

A

Minor: No mucous membrane involvement

Major: mucous membrane involvement (oral, genital, ocular)

30
Q

Treatment for erythema multiforme

A

-D/C offending drug

-If HSV related: Acyclovir

-Diphenhydramine mouthwash (oral lesions)

31
Q

Steven-Johnson Syndrome and TEN are associated with detachment of the epidermis and necrosis. What occurs in this condition?

A

Sloughing (dermal-epidermal cleavage)

32
Q

Explain the difference in SJS and TEN

A

SJS: < 10%
TEN: > 30% sloughing

33
Q

Risk factors for SJS and TEN

A

MC: Meds (Sulfa (PCN), Lamotrigine, anticonvulsants, NSAIDs, and Allopurinol)

Infections: HSV, HIV

34
Q

Symptoms of SJS and TEN

A

-Rarely soles and palms
-Widespread flaccid bullae (trunk/face)
-Target lesions with mucous membrane involvement
-Positive Nikolsky sign
-Ocular involvement (uveitis, corneal ulcer)

35
Q

Treatment for SJS/TEN

A

D/c causative agent
Burn unit/ICU admission
IVIG

36
Q

Eczema (atopic dermatitis) is part of the atopic triad. Name the triad.

A

Eczema + asthma + allergic rhinitis

37
Q

Most eczema manifests by what age? What is the gene mutation?

A

Infancy or age 5

Filaggrin gene mutation

38
Q

Triggers for eczema

A

Heat, allergens, perspiration, contact

39
Q

Symptoms of eczema

A

-Excoriation
-Pruritis (hallmark)
-MC in flexor creases (behind knee, elbow, etc.)
-Nummular: coin shaped lesions on dorsum of hands, feet, knees, and elbows

40
Q

Treatment for acute eczema

A

-Topical corticosteroids (first line)
-Antihistamines for itching
-Wet dressings
-Calcineurin inhibitors: Tacrolimus, Pimecrolis

41
Q

Treatment for chronic eczema

A

Systemic phototherapy
Methotrexate
Oral antihistamines
Trigger avoidance

42
Q

Contact dermatitis has two types. Name them and which is more common?

A

Irritant (MC) and allergen

43
Q

What are some causes of allergen contact dermatitis?

A

Nickel (MC), poison ivy, poison oak, poison sumac

44
Q

Contact dermatitis is a Type IV hypersensitivity reaction. What is the difference in symptoms showing up in allergen related vs irritant?

A

Allergic: delayed by days

Irritant: immediate

45
Q

Treatment for contact dermatitis

A

Topical corticosteroids

-Burrow’s solution, cool compresses, etc.

46
Q

What is toxicodendron dermatitis? What is the cause?

A

Contact dermatitis due to plants (oak, ivy, sumac)

The urushiol in plants causes this

47
Q

What is diaper rash?

A

Type of irritant contact dermatitis

48
Q

Dyshidrosis, also known as pomphlyx, is a recurrent rash affecting which area of the body? Describe it.

A

The palms and soles

Tapioca-like, pruritic vesicles on soles, palms, and fingers

49
Q

Treatment for dyshidrosis

A

Topical corticosteroid ointments
Cold compresses, Burrow solution
Dry hands, use cotton gloves, etc.

50
Q

What is Lichen Simplex Chronicus?

A

Skin thickening in patients with atopic dermatitis due to rubbing and scratching

51
Q

Symptoms of lichen simplex chronicus

A

scaly, well-demarcated plaques, exaggerated skin lines

52
Q

Treatment for lichen simplex chronicus

A

Avoid scratching
Topical corticosteroids
Occlussive dressings

53
Q

What is the pathophysiology of psoriasis?

A

Keratin hyperplasia and proliferating cells in the stratum basalt and stratum spinosum due to T cell activation and cytokine release

-Accelerated epidermis turnover

54
Q

Symptoms of psoriasis

A

-Plaques: raised well-demarcated, pink plaque with thick silvery white scales MC on EXTENSOR surfaces (elbows, knees, scalp, and neck)

Nail involvement: pitting, oil spot (yellow discoloration under the nail)

55
Q

What is the Auspitz sign associated with psoriasis?

A

Bleed with removal of plaque

56
Q

What is Koebner’s Phenomenon associated with psoriasis?

A

new lesion at the site of trauma

57
Q

Guttate psoriasis is associated with ______ and has symptoms such as _______

A

Occurs after strep pharyngitis

Tear drop plaques that spare palms and soles

58
Q

Treatment for mild-moderate psoriasis?

A

Topical corticosteroids (Betamethasone, Clobetasol)

Vitamin D analogs (Calcipotriene)

Calcineurin inhibitors (Tacrolimus, Pimecrolus)

59
Q

For moderate to severe psoriasis, use

A

Phototherapy, UVB, PUVA

60
Q

If systemic psoriasis, what is the treatment?

A

Systemic treatment
-Retinoids (Acitretin)
-TNF Inhibitors (Etancercept, -mabs)
-Methotrexate (last resort)

61
Q

Psoriatic arthritis, a systemic disease, is associated with what?

A

HLA-B27 positivity

62
Q

Where does psoriatic arthritis usually affect?

A

Distal IP arthritis

63
Q

Treatment for psoriatic arthritis

A

Methotexate, Cyclosporin

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