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derm > Lecture 12: Misc Derm Disorders > Flashcards

Lecture 12: Misc Derm Disorders Flashcards

1
Q

What ethnicity is Acanthosis Nigricans MC in?

A

African Americans

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2
Q

If you see Acanthosis nigricans is a patient who is not obese or diabetic, it should raise your suspicion for…

A

Malignancy

Gastric carcinoma

Esp if not on the classic neck or axilla

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3
Q

The MC drug that can induce acanthosis nigricans is

A

Niacin

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4
Q

Acanthosis can be inherited via a (genetic pattern)

A

Autosomal dominant

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5
Q

The two classic locations for Acanthosis nigricans are…

A
  • Neck folds
  • Axillae
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6
Q

What is diagnostic for acanthosis nigricans?

Not required

A

Skin biopsy

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7
Q

Two chronic conditions commonly associated with acanthosis nigricans are…

A
  • DM
  • PCOS

I feel like he might ask you what labs to order if you see this

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8
Q

If a non-obese, non-diabetic, non-PCOS patient presents with acanthosis nigricans on their knuckles, you should consider sending them to…

A

GI for endoscopy

Gastric carcinoma

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9
Q

The MCC of pressure injuries overall is…

A

Impaired mobility

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10
Q

The MC 2 locations for pressure injuries are…

A
  • Sacrum
  • Hip
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11
Q

Pressure injuries place patients with same risk factors at () times greater risk of death

A

4.5x

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12
Q

The top two

A
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13
Q

T/F: A pressure injury is generally wider at the base.

A

True

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14
Q

NPUAP staging for pressure injuries is specially for….

A

Initial evaluation + documentation

NOT TO EVALUATE WOUND PROGRESS

Also can’t reverse stage by healing.

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15
Q

Stage 1 pressure injury buzzwords

A
  • Skin is intact
  • Non-blanchable hyperemia

Skin intact is automatically stage 1

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16
Q

Stage 2 pressure injury buzzwords

A
  • No visible SC tissue
  • No granulation or eschar
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17
Q

Stage 3 pressure injury buzzwords

A
  • Full thickness skin loss
  • Exposed SC tissue
  • Eschar or granulation
  • Epibole: rolled wound edge
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18
Q

Stage 4 pressure injury buzzwords

A
  • Full thickness skin loss + tissue loss
  • Visible muscle/bone/cartilage
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19
Q

Unstageable pressure injuries are characterized by…

A

Covered in slough or eschar

Will be at least a stage 3.

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20
Q

T/F: You should remove a stable eschar in order to properly stage a pressure injury

A

False

Do not remove for staging purposes

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21
Q

A foul odor associated with a pressure injury indicates…

A

Anaerobic infection

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22
Q

The 3 mainstays of reducing risk factors for pressure injuries include…

A
  1. Nutrition (more protein/calories)
  2. Redistribute pressure (Q2h turns, head 30deg, massage)
  3. Clean skin (mild cleansing) and keep dry
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23
Q

Local wound care of a stage 1 pressure injury is…

A

Cover with transparent film for protection.

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24
Q

Local wound care for a stage 2 pressure injury uses…

A

Transparent or hydrocolloid dressings.

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25
Q

Hydrocolloid wound dressings cannot be used in…

A

Active infection

26
Q
A
27
Q

Local wound care for stage 3/4 pressure injuries is…

A

Debridement

28
Q

A pressure ulcer scale score will (inc/dec) with healing

A

Decrease

29
Q

Your patient with a stage 1-2 pressure injury wants to know how long it will take for their wound to heal.

A

1-2 weeks

30
Q

Your patient with a stage 3/4 pressure injury wants to know how long it will take them to heal.

A

6-12 weeks

31
Q

The MC complications associated with pressure injuries is…

A

Infection

32
Q

Hidradenitis suppuritiva is a chronic suppurative disease of the () gland bearing skin areas

A

Apocrine

33
Q

Hidradenitis suppurative MC is found in (sex) and begins at …

A

Females at onset of puberty

34
Q

The Characteristic finding on physical exam for hidradenitis suppurativa is…

A

Open comedones

35
Q

Immeidate treat of acute lesions in hidradenitis suppurative use 3 options:

A
  • Intralesions steroid followed by I&Ds of abscesses
  • Oral abx: B-lactamasePCN, cephalos, augmentin, clinda
  • Oral steroids
36
Q

Recurrent hidradenitis suppurativa lesions can be treated pharmacologically with…

A
  • Clinda + isotreinoin
  • Systemic biologics (tx-resistant, mod-severe): adalimumba/humira or infliximab/remicade
37
Q

Surgical treatment in hidradenitis suppurativa is only for… and requires () margins

A

Chronic recurrent, fibrotic nodules, or sinus tracts with WIDE MARGINS

38
Q

T/F: You should advise patients to use cold compresses with Burow solution for Hidradenitis suppurativa.

A

False, should be warm

39
Q

What are the 3 types of acute photosensitivity?

A
  • Sunburn
  • Rash
  • Urticarial
40
Q

The terms used to describe chronic photosensitivity changes to skin are…

A
  • Dermatoheliosis
  • Photoaging
41
Q

Which UV band causes acute sunburn?

A

UVR

42
Q

In a patient with severe sunburn, they may appear like they have ()

A

FLS

Fever, chills, fatigue, weakness, tachycardia

43
Q

Timing wide, sunburns will develop after () hours and peak after () hours

A

6-24 hours

44
Q

The topical tx for acute sunburns are… (3)

A
  • Cool, wet dressings
  • Topical glucocorticoids
  • Aloe vera
45
Q

SPT I/II should avoid sun exposure between the hours of…

A

10AM-2PM

46
Q

There are two types of drug/chemical reactions related to photosensitivity, which are…

A
  • Phototoxic: similar to irritant contact dermaitis or sunburn.
  • Photoallergic: Type IV HSR like allergic eczematous contact dermatitis
47
Q

Xerosis is characterized by dry skin with a () texture and is often (symptom)

A
  • Scaly
  • Pruiritic
48
Q

What is the underlying pathophysiology of xerosis?

A
  • Low lipid levels in stratum corneum
  • Deficiency in water-binding capacity
49
Q

By the age of (), you would expect most patients to have some degree of xerosis

A

60

50
Q

The 3 MC locations for xerosis are…

A
  • Lower extremities
  • Trunk
  • Dorsal hands
51
Q

The 3 possible organs you should consider for underlying cause in xerosis are…

A
  • Thyroid
  • Renal
  • Liver
52
Q

A patient pearl for improving xerosis is after showering…

A
  1. Pat skin to keep it moist
  2. Place lotion onto DAMP SKIN

ty mak best derm PA i know

53
Q

Ichthyosis vulgaris is inherited via an ()

A

Autosomal dominant pattern

54
Q

Ichthyosis is characterized by () skin texture and is seen often with conditions like (2)

A
  • Fish-skin-like scale
  • Atopic Dermatitis
  • Keratosis pilaris

Abnormal Cornification

55
Q

Generally, ichthyosis vulgaris presents as a () and resolves in ()

A

3-12 months, but alleviates in adulthood.

Its like childhood xerosis

56
Q

Adulthood onset ichthyosis vulgaris is associated with…

A

Systemic disease + malignancy

57
Q

Besides fish skin, you should look for (2) on the palm in ichthyosis vulgaris

A
  • Accentuated palmar creases
  • Scaly palms
58
Q

The diagnosis of ichthyosis vulgaris is made…

A

Clinically, but biopsy is characteristic

59
Q

The mainstay of therapy for ichthyosis vulgaris is…

A

Emollients

Esp after bathing.

Use non-drying soaps like Dove or non-soap cleansers like cetaphil.

60
Q

You can use mid-potentcy topical steroids for ichthyosis vulgaris if there is associated (2)

A

Itching or dermatitis

derm (16 decks)

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