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604 > Dermatitis, etc > Flashcards

Dermatitis, etc Flashcards

1
Q

Atopic dermatitis

A

eczema
filaggrin deficiency
lichenification, dry, scaly

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2
Q

Atopic dermatitis nonpharm treatment

A

bath
maintain hydration – NO LOTION
oral antihistamine for pruritus

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3
Q

Mild-moderate atopic

A

low dose GC desonide BID 2-4 weeks
if face, 5-7 days
high GC triamcinolone 0.5 1-2 week tapered
Topical CNI, PDE4i

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4
Q

Mod-severe atopic

A

Soak and smear high potency steroid
jak stat if refractory = itinib
– monitor liver function
SQ IL- antagonist
Immunosupressants (CNI/MTX/AZA)

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5
Q

Allergic contact

A

urushiol or latex

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6
Q

mild-mod ACD

A

med-high potency GC x 2 weeks max
if chronic or face due: topical CNI (not for urushiol)

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7
Q

Severe ACD

A

systemic GC 3-4 weeks
taper 2-3 weeks
(DO NOT GIVE MEDROL DOSEPACK)

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8
Q

Do not use in ACD urushiol

A

antihistamines
topical CNI

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9
Q

Latex ACD

A

Steroids
Epi pen
Immunotherapy
anti-IgE therapy omalizumab

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10
Q

Seborrheic

A

due to malassezia yeast
infants - cradle cap
HIV, AIDs, Parkinsons patients

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11
Q

Cradle cap

A

often resolves
Baby shampoo, remove scales
emollient cream
AVOID steroids in baby

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12
Q

Seborrheic mild - mod tx

A

use twice a week
if <2 y/o ask ped
Ketoconazole - leave in 3 min
Selenium sulfide - discoloration
Zinc pyrithione -
Ciclopirox - V tach, contact derm

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13
Q

Severe seborrheic tx

A

systemic antifungals
Itraconazole
Ketoconazole
Fluconazole
Terbinafine

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14
Q

Seborrheic symptom relief

A

topical GC
not for baby or facial

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15
Q

Plaque Psoriasis

A

chronic inflammatory immune disorder
silvery white scale
auspitz sign = removal cause bleeding

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16
Q

risk factors for plaque psoriasis

A

FHx
infection
obesity
smoking
EtOH abuse

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17
Q

Comorbidities of plaque psoriasis

A

psoriatic arthritis
cardiometabolic disease
IBD
nonalcoholic fatty liver
mood disorder
cancer
osteoporosis

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18
Q

Triggers for psoriasis

A

Koebner phenomenom (injury)
- sunburn, infection, tattoo, vax
Infection, stress
Steroid withdrawal
Medications
- NSAID, lithium, BB, Quinidine, antimalarial

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19
Q

Psoriasis classification

A

based on BSA
mild <3-5
moderate 3-10
severe >10 or affects emotions/folds

20
Q

Target response for psoriasis tx

A

BSA <1% plaque infolvement

21
Q

Mild psoriasis

A
  1. topical GC +/- vitamin D analog
  2. Retinol (tazorac)
    alternate
    - topical CNI
    - keratinolytics
22
Q

Mod-severe psoriasis

A
  1. MTX (monitor liver)
  2. Cyclosporine
    Alternate
    - PDEI Apremilast
    - Vitamin A (Soritane)
    - IL inhibitors (risankizu, guselki, Brodalu, Ixekizu)
    - TNFa inhibitors
    - Psoralen +UV-A
23
Q

FTU

A

0.5g

24
Q

bacterial conjunctiva

A

crusting, purulent
S. aureus, S.pneumo, H.inf, M.cat
- gonorrhea eye rare, prophy
- chlamyida eye, no prophy

25
Q

bacterial conjunctiva prophylaxis

A

Gonorrhea
- erythromycin
IM or IV ceftriaxone for sx

26
Q

bacterial conjunctiva treatment

A

QID 5-7 days (if improve BID)
1. Erythromycin ointment
2. PolymyxinB/TMP 1-2 drops

if Chlamydia
- PO Erythromyycin QID 5-7 days
– Azithromycin x 3days

27
Q

Contacts w/ bacterial conjunctivitis

A

Give Fluoroquinolone (pseudomonas risk)

28
Q

bacterial conjunctiva avoid

A

aminoglycosides
sulfacetamine
azithromycin (expensive, resistant)

29
Q

Viral conjunctivitis

A

pink eye, congagious
self limiting
sandy gritty morning crust
adenovirus
prodrome - fever, pharyngitis, URI
jumps from one eye to the other

30
Q

Viral conjuncitivs tx

A
  1. Lubricating ointments
    + cold compress

Symptom relief
- naphazoline/phenriamine
- azelastine
- ketotifen
- olopatadine

31
Q

Allergic conjunctivitis

A

IgE hypersensitivity

32
Q

Allergic conjunctivitis tx

A

avoid rub eye, avoid allergen, avoid contacts
1. antihistamine/vasoconstrictor (naphazoline/phenriamine)
2. antihistamine/mast cell stabilizer
aka
- azelastine
- ketotifen
- olopatadine

Refractory - GC
PO antihstiamine for prophylaxis

33
Q

Toxic conjunctivitis

A

Redness, edema, mucus discharge, swollen eyelids, thickened eyelids
TAKES YEARS TO DEVELOP

34
Q

Cause of toxic conjunctivitis

A

aminoglycoside abx eyedrop
antiviral agents
glaucoma meds
topical anesthetics
contact lens solution
artificial tears

35
Q

Toxic conjunctiva tx

A

use preservative free
short course LOTEPREDNOL QID

36
Q

NONALLERGIC conjunctivitis

A

Transient chemica/mechanical causes
Resolves in 24 hrs usually
Similar sx to dry eye
Diagnosis of exclusion
No keratitis, iritiis, angle closure glaucoma, style, ulceration, or blepharitis

37
Q

nonallergic conjuctivitis tx

A

Eye lubricants

38
Q

Fleas

A

oral antihistamines
topical GC

39
Q

Bed bugs

A

wash, dry, freeze, professional exterminator, silica
low potency GC
systemic antihistamine

40
Q

Head lice

A

wet comb
Permethrin NIX - wet hair
Pyrethrin/pip Rid - dry hair + retreat 7-10 days
Lindane - BBW seizure/death/carcinogen
TMP/SMX + NIX == resistant cases (kill symbiotic bacteria in lice gut that prod vitaminB)

41
Q

Body lice

A

hot water, dry clean, evaluate STD
Topical permetrin
Pyrethrins/pip
Cillaris

42
Q

Scabies

A

Treat all fam/close contact
wash, store bag 3 days
SX: antihistamines max 2 weeks + MEDIUM potency topical GC
Mites:
1. permetrin
2. Ivermectin
3. Crotamiton

Crusted scabies
PERMETRIN + POIVERMECTIN

43
Q

Chiggers

A

soap/water, mitigate with belt
REPEL with DEET
topical anti-itch (methol)
Topical GC
Oral sedating AH (benadryl)

44
Q

Mosquitos

A

nonsedating AH
Topical GC 5-10 days
Oral GC 5-7 days

45
Q

Ticks

A

DEET ≥20%

46
Q

Things to avoid in bug bites

A

Dibucaine
Topical benadryl
Hydrocortisone

47
Q

DEET use

A

2 months +
conc >30% children
10-35% for most
Ticks 20% or higher

604 (18 decks)

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