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Paige: Derm > Random Tidbits > Flashcards

Random Tidbits Flashcards

1
Q

How do you diagnose allergic contact dermatitis?

A

Patch test

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2
Q

How do you treat allergic contact dermatitis?

A

Wash with water or Burow’s soln

Topical steroids

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3
Q

Where do infants get atopic dermatitis?

A

on cheeks, diaper area, extensors

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4
Q

Where do adults get atopic dermatitis?

A

flexor surfaces, hands, face, neck

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5
Q

How do you treat seborrheic dermatitis?

A

selenium sulfide/zinc/ketoconazole/cold tar shampoos

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6
Q

How do you remove crusts in seborrheic dermatitis?

A

warm oil and sulfur shampoos

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7
Q

What does stasis dermatitis look like?

A

edema, scaling, brown pigment, petechiae, ache in legs while standing

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8
Q

What is the mainstay of tx with stasis dermatitis?

A

compression socks

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9
Q

What does nummular eczema look like?

A

coin shaped plaques w/ papules on erythematous base c crusting

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10
Q

Where do people get dishydrotic eczema?

A

palms and soles

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11
Q

What does dishydrotic eczema classically look like?

A

tapioca pudding

deep clustered vesicles, papules, scaling, lichenification

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12
Q

How do you treat dishydrotic eczema?

A

wet dressings with burow’s, antihistamines

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13
Q

Does lichen simplex chronicus have:

a) papules?
b) plaques?
c) scaling?

A

a) no
b) yes
c) no!

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14
Q

What is the mainstay of tx for lichen simplex chronicus?

A

occlusive dressings to stop scratching

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15
Q

When do people get asteatotic dermatitis?

A

after hot baths, especially in the winter!

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16
Q

What is the pathophys of psoriasis?

A

keratin hyperplasia

inflamed cells

dilated blood vessels

Type 4 hypersensitivity

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17
Q

Where do people get plaque psoriasis?

A

trunk, scalp, extensors

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18
Q

What is pathognomonic of plaque psoriasis?

A

yellow-brown “oil spot” discoloration of nail beds

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19
Q

What sign will be + for plaque psoriasis and what is it?

A

Auspitz’s Sign

When you peel off a scale and it shows pinpoint bleeding

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20
Q

“50 y.o. man with no history of psoriasis has sudden bright red, scaling papules covering his entire torso and upper extremities. He reports having a cold a while ago that he just can’t seem to get over. What does this most sound like?”

A

this hx matches with guttate psoriasis

(buzz word = raindrop or splatterpaint)

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21
Q

Where do people get palmoplantar pustular psoriasis?

A

palms and soles

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22
Q

What is the mainstay of treatment for psoriasis?

A

Topical steroids

(Plaque = also Vitamin A/D)

(Guttate = also oral abx)

(PPP = also cover in plastic wrap)

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23
Q

Christmas tree pattern on torso

Herald Patch

Disease?

A

Pityriasis rosea

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24
Q

What is the tx for pityriasis rosea?

A

It’s self-limiting! 3-8weeks

Lotions, antipruritics

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25
Q

What infection is associated with lichen planus?

A

HCV

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26
Q

What are the 5 P’s of lichen planus?

A

purple

polygonal

planar

pruritic

papules

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27
Q

How do you dx fungal infections?

A

KOH prep will be +

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28
Q

beefy red with satellite lesions. what is it?

A

some sort of yeast infection

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29
Q

What is the tx for almost all mucocutaneous fungal inf? (thrush, vaginal, balanitis, candidal intertrigo)

A

topical nystatin

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30
Q

“Young pt returns from tropic area after tanning a lot and using lots of tanning oils with hypopigmented lesions”

A

tinea versicolor

(caused by malassezia furfur)

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31
Q

What does tinea versicolor look like on KOH prep?

A

spaghetti and meatballs

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32
Q

how do you tx tinea versicolor?

A

rx strength shampoo

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33
Q

What is the most common type of dermatophytes?

A

Trichophyton rubrum

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34
Q

How are dermatophytes transmitted?

A

fomites, animals, soil

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35
Q

Where is tinea pedis and what is the common term for it?

A

feet - Athlete’s foot

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36
Q

Where is tinea corporis and what is the common term for it?

A

trunk, arms, legs, neck

ringworm

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37
Q

How long should you continue topical antifungal tx for ringworm?

A

1-2 weeks after it has cleared

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38
Q

Where is tinea cruris and what is the common term for it?

A

upper thigh and groin

jock itch

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39
Q

How long do you continue tx for tinea cruris?

A

months to years

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40
Q

What disease is alopecia areata associated with?

A

alzheimer’s disease

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41
Q

What is pathognomonic for alopecia areata?

A

exclamation point hair

(the disease consists of round patches of hair loss)

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42
Q

How do you treat alopecia areata?

A

intralesional triamcinolone

systemic steroids but only a temporary fix

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43
Q

What is tinea unguium?

A

onychomycosis

fungus (trichophyton rubrum) of fingernails or toenails

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44
Q

Which type of onychomycosis is associated with immunocompromised?

A

Proximal Subungual Onychomycosis

Begins proximally on nail fold

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45
Q

What is the diagnostic testing for onychomycosis?

A

ALWAYS do lab testing to confirm!

*Histology of nail clipping

KOH, wet mount, or fungal culture

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46
Q

How do you tx onychomycosis?

A

only treat those with discomfort or immunocomp

oral terbinafine daily for 12 weeks

remission common

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47
Q

What is paronychia?

A

infection/abcess of lateral nail fold

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48
Q

How do you treat paronychia?

A

I+D with nerve block

local wound care, topical abx (bacitracin)

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49
Q

How do you tx lice?

A

topical insecticides (permethrin 1% cream rinse) once, then a week later

50
Q

do head lice transmit ID?

do body lice?

A

no

yes

51
Q

what do pubic lice look like?

A

brown grey specks

52
Q

What do bedbug (cimex lectularius) bites look like?

A

papular utricaria

53
Q

What will you see if you suspect scabies?

A

widespread skin-colored lesions

*burrows found at places without hair follicles (webs of hands, belt line, edge of socks)

*red papules/nodules on scrotum and shaft

54
Q

How do you tx scabies?

A

permethrin 5% cream to all skin sites

also, oral ivermectin

treat partner

55
Q

What causes generalized muscle pain, spasms, rigidity, and a target lesions?

A

black widow bites

56
Q

How do you treat black widow bites?

A

pain: IV opioids or muscle relaxants
rigidity: IV calcium gluconate 10%

57
Q

What causes progressive local necrosis, as well as fever, HA, malaise, arthralgias, nausea, and vomiting?

A

brown recluse bite

58
Q

How do you treat a brown recluse bite?

A

local wound care, abx, oral steroids, excision

59
Q

what is the patho of acne vulgaris?

A

plugged follicles lead to keratinization and retained sebum

leads to bacterial growth and release of fatty acid

60
Q

What are the 4 grades of acne?

A

1: comedones
2: papulopustular
3: pustularnodular
4: nodulocystic

61
Q

How do you tx acne?

A

benzoyl peroxide topical

topical abx

azeleic acid, glycolic acid, salycylic acid

topical retinoids (trenitoin)

etc

62
Q

What are the 3 stages of rosacea?

A
  1. persistent red c telangectasia
  2. that + papules and pustules
  3. that + nodules, edema, and more severe sx
63
Q

How do you tx rosacea?

A

topical metronidazole***

64
Q

What is a brown to black plaque that is velvety and appears stuck on?

A

seborrheic keratosis

65
Q

is SK benign or malignant?

A

benign

66
Q

What appears as dry skin with a rough, erythematous border, caused by repeated exposure to the sun?

A

actinic (solar) keratosis

67
Q

Is AK benign or malignant?

A

pre-malignant

68
Q

How do you tx AK?

A

topical 5-fluorouracil 2x daily for 2-4 weeks

cryo or laser surg

69
Q

What is an epidermal inclusion cyst?

A

cyst filled with cream-cheese like keratin

70
Q

Looks like a nodule with a pearly border, telangectasia, and a central ulceration?

A

basal cell carcinoma

71
Q

Where are you most likely to get BCC?

A

ear, face, neck

72
Q

How do you dx BCC?

A

punch or shave bx

73
Q

What is the tx of choice for BCC?

A

electric curettage

74
Q

Does BCC spread fast or slow?

Does it metastasize?

A

slow

no

75
Q

Appears as red, firm nodules, scaly with crusting.

Looks like unhealing sore, sometimes bleeds

A

squamous cell carcinoma

76
Q

Does SCC spread fast or slow?

Does it metastasize?

A

slow

yes

77
Q

How do you dx SCC? What will you see?

A

bx

large, pleomorphic, hyperchromic nuclei

78
Q

What is a variant of SCC that is a dome-shaped nodule with a crater at the center?

A

keratocantoma

79
Q

Does melanoma spread fast or slow?

Does it metastasize?

A

fast

yes

80
Q

What is the most common type of skin CA?

A

BCC

81
Q

How do you dx a melamona?

A

Full thickness bx

NOT a shave or punch bx!

82
Q

Who gets Kaposi sarcoma?

A

HIV/immunocomp

83
Q

What does erythema multiforme look like?

A

macules that become papules, with vesicles and bullae at center

target lesions

84
Q

What manifestation of erythema multiforme is practically diagnostic?

A

mucosal lesions with pain, erosion

85
Q

Pt. presents with sx of a URI, with cutaneous lesions on the trunk that are painful, sting, and burn. It started about 4 days ago as a rash, and now he has loose skin and blisters. There are also lesions on his mucosal surfaces. What sign will be +?

A

This is SJS or TEN

Nikolsky sign is +

86
Q

Pt has had a rapid progression of local erythema and severe tenderness, and there appears to be ruptured bullae at the site that have turned black. Pt has a fever, tachycardia, hypotension, and an altered mental status. What will the labs look like?

A

This is necrotizing fasciitis

Triad: inc WBC, inc BUN, dec Na

Also get histopathologic, radiologic, and gram stain

87
Q

what causes necrotizing fasciitis?

A

group A strep

88
Q

How do you treat necrotizing fasciitis?

A

aggressive debridement

abx

89
Q

Who gets necrotizing fasciitis?

A

It’s rare.

Immunocomp, DM, malignancy, C4 deficiency, some meds

90
Q

Pt has systemic sx with a local warm, red and tender spot that has swelled up. It’s hard to distinguish where the lesion ends. Pt remembers having a cut in that spot last week. How will you treat?

A

This is cellulitis

Tx with abx (dicloxacilin, cephalosporin, macrolide)

91
Q

Where do people get erysipelas?

A

face and lower extremities

92
Q

What causes erysipelas?

A

group a strep

93
Q

How do you treat erysipelas?

A

penicillin, macrolides

94
Q

“honey colored crust” on child’s face

A

impetigo

95
Q

How do you treat impetigo?

A

topical mupirocin [bactroban]

96
Q

“gray to white tan, flat papules with rough, pebble-like surfaces”

A

verrucae

97
Q

How will you dx verrucae?

A

Microscope: hyperplasia, hyperkeratosis, koilocytic squamous cells

immunofluorescence: HPV cells

98
Q

How do you treat common verrucae?

A

salycylic acid, cryo, electrodecussation, imiquimod

or you could excise surgically

99
Q

What strains of HPV cause

a) cervical ca?
b) common warts?

A

a) 16/18
b) 6/11

100
Q

Pt. has a fever and sore throat. on PE, you notice vesicles on the posterior pharynx that have ruptured, leaving a gray exudate. Rapid strep test is negative. What do you suspect?

A

HSV1

101
Q

How will the initial infection of HSV2 present?

A

pt has been very sick for a week

developed vesicles on genitalia with crusted, ruptured ulcers

102
Q

What will you see on Tzank smear for HSV?

A

multinucleated giant cells

103
Q

Pt has skin colored papules on his genitals, with a dome shape and a central umbilication that has white underneath the depression. He is sexually active. How will you treat this?

A

This is molluscum contagiosum.

It’s self-limiting, so you don’t need to treat.

If requiring tx, use imiquimod, cryo, curettage, retin-a

104
Q

rash over 1 dermatome

A

varicella zoster

105
Q

Pt. with DM has velvety hyperpigmentation. Where would you most likely find this hyperpigmentation?

A

Acanthosis nigricans

in the body folds

106
Q

What is the #1 risk for melasma?

A

OCP! and pregnancy

107
Q

how do you tx melasma?

A

skin-lightening creams like hydroquinone, azelaic acid

108
Q

Pt. reports pain at the base of their spine, and on PE you notice swelling, redness, and draining pus at the PSIS. What causes this?

A

This is pilonidal disease

Cause by multiple ingrown hairs (probably)

109
Q

Pt has pruritic wheals after eating shellfish that are worsened when scratching. What will diascopy show?

A

Utricaria

Diascopy shows it’s blanchable

110
Q

How do you treat utricaria?

What type of hypersensitivity is it?

A

antihistamines, prednisone

type 1

111
Q

How do you dx vitiligo?

A

Wood’s lamp

112
Q

Pt has a tender abcess at the site of an apocrine gland (e.g. in her armpit). She is wondering what you can do for her.

A

It’s usually self-limited, so probably watchful waiting.

Look for S aureus and consider abx

113
Q

How do you tx a stage 2-4 decubitus ulcer?

A

moise sterile gauze (Gelfoam)

hydrocolloid

debridement

114
Q

Which degrees of burns have capillary refill?

A

1 and 2 (superficial)

115
Q

Which degrees of burns have blistering?

A

2 (deep) and 3

116
Q

Which degrees of burns have no pain

A

2 deep (no pain unless pressure)

3 and 4

117
Q

Which degree of burn extends down through the dermis?

A

2nd (deep) and on

118
Q

Which type of burn is moist?

A

2nd superficial

119
Q

How do you care for burns?

A

clean with soap and water

debride

remove blisters only if they’ve ruptured

pain: acet, NSAIDs, +/- opioids

Abx (superficial = topical; silver sulfadiazine = 2nd/3rd)

press if not superficial

IVF

(ABCD PP fluids - abx, blisters, clean, debride, pain and press, IV fluids)

120
Q

What looks like utricaria, but has large, tense bullae, and appears mostly in the elderly?

A

bullous pemphigoid

Paige: Derm (2 decks)

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