32- derm Flashcards Preview

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Flashcards in 32- derm Deck (31):
1

Seborrheic dermatitis presentation

common skin condition in infants scalp

if older- caused by malassezia

erythematous plaques with fine to thick, greasy yellow scale

2

Seborrheic dermatitis treatment

Baby oil and a small brush to remove the scales

Frequent (i.e., daily) shampoong with a gentle baby shampoo, or-for more persistent cases-use of a prescription shampoo containing ketoconazole, an anti-fungal agent, or pyrithione zinc. Care must be taken not to get the shampoo in the infant's eyes.

A low-potency topical steroid cream (e.g., hydrocortisone). In older children and adults, ketoconazole cream may be used.

3

Hidradenitis suppurativa

Pustular lesions caused by occlusion of the apocrine follicular units (instead of the pilosebaceous units).

in women- axilla, groin
in men- perineal, perianal

4

treat roseacea with

topic metronidazole

5

Perioral dermatitis

A variant of rosacea also commonly seen in adolescents, and treated the same way.

erythema, scaling, and papules or pustules, but no comedones.

6

Acne vulgaris causes

Keratinous material and excess sebum (due to androgenic influence) plug the pilosebaceous gland.

Increased sebum provides a growth medium for superinfection with Propioniobacterium acnes.

7

acne triggers

-make up
-overzealous cleanliness
-manipulation (pokin)
-occlusion (sports gear)
-high glycemic diets--insulin res.--> androgens

8

acne treatments

1. benzoyl peroxide
2. Retinoids- tretinoin, adapalene
3. topic erythromycin, clindamycin
4. OCPs, oral antibiotics
5. oral isotretinoin- side effects!

9

oral isotretinoin- side effects!

depression
hypertriglycerides
hepatitis
decreased night vision
photosensitivity
*teratogen

10

retinoids consideration

-apply at night because cause sunburn
-inactivated by benzoyl peroxide
-apply to dry skin only
-will make acne look transiently worse

11

nickel allergy what type of hypersensitivity

Type 4- takes 24-72 hours to manifest after exposure

12

treatment for nickel allergy

resolves within days-weeks

vaseline or lotion (eucerin)
steroid ointment for 2 weeks

avoid- jewlery thats not stainless steel or 24k gold, watches, glasses, metal studs in furniture

13

treating impetigo

mupirocin
watch for abscess if MRSA

14

Toxicodendron Exposure

allergy to urushiol, present in plant

topical steroids and antihistamines

15

lice treatment

-permetherin lotion OTC- 1st line
-benzoyl alcohol for >6 mo
-malathion 0.5% for >2 yo

16

scabies presentation

mites burrows, itchy most at night
Wrists, elbows, fingers, and toes

secondary infections- impetigo, cellulitis

17

scabies dx

scrape lesion laterally and look under light microscope

18

scabies tx

two applications of permethrin 5% cream, one week apart, for all affected household members.

applied at night before bed and washed off in the morning, or after around 8-12 hours.

Adults - from the neck down.
Infants- the entire body should be covered from the hairline down

After bathing, wash all bed linens and clothing worn during treatment.

Itching may persist for a few weeks

19

ringworm appearance

annular, well-circumscribed, scaly plaque with a raised border and a center that is brown or hypopigmented.

20

ringworm dx

clinically, but a KOH wet-mount examination of skin scrapings can confirm

21

treatment of choice for tinea capitis

griseofulvin

22

Pityriasis rosea

scaly papules and plaques in the hallmark "christmas tree" distribution on the back and trunk, following the lines of skin cleavage.
Lesions may also be found on the upper thighs and in the groin area.
The initial lesion, called the "herald patch," is usually the largest scaly plaque with a raised border and can easily be confused with tinea corporis.

23

OTC treatment of warts

Salicyclic acid - apply daily, works slowly

24

causes of diaper rash and their treatments

*irritant dermatitis- keep clean with zinc oxide

-candida- use nystatin

-group A strep- oral antibiotics

uncommon causes:
-zinc def
-langerhans cell histiocytosis

25

potential side effects of topical steroids

Skin atrophy
Telangiectasias
Hypopigmentation
Suppression of the hypothalamic-pituitary axis

26

treatment for irritant dermatitis diaper rash

zinc oxide-containing creams or ointments.
The barrier provided by the zinc oxide helps limit contact of urine and feces with the skin allows the rash underneath to heal.

27

treatment for candida diaper rash

nystatin

28

treatment for bacterial diaper rash

oral abx

29

differential of ringworm

Nummular eczema
Psoriasis
Pityriasis alba
Pityriasis rosea

30

Nummular eczema

Consists of coin-shaped lesions commonly on the legs and buttocks. Has an annular configuration and scaly appearance like tinea.

31

steroid potencies- 4 groups

Mild-hydrocortisone acetate, 1% (OTC)

Intermediate- triamcinolone acetonide, 0.1%

Potent- betamethasonedipropionate, 0.05%

Super Potent-clobetasol propionate, 0.05%