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PANRE > Dermatology > Flashcards

Dermatology Flashcards

1
Q

skin cancer

risk factors

A

RF: fair complexion, h/o blistering sunburn as a child, increased sun exposure, fhx.

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2
Q

actinic keratosis

A
  • small , light pigmented scaly spots
  • sun exposed areas

tx: cryotherapy for isolated lesions( SE: hypo pigmentation)
- 5-fu- Efudex- applied bid and make skin red and angry and apply until lesions crust over

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3
Q

squamous cell carcinoma

A
  • presentation varied
  • ulceration or sore that bleeds and does not heal
  • rare for mets
  • Bowens dz–> SCC in situ

dx: biopsy
tx: excision, treat thoroughly with Mohls’ surgery to check margins

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4
Q

basal cell carcinoma

A

slowly enlarging nodule with central depression or ulceration with surface telangiectasis

mets rare

tx: same as squamous cell

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5
Q

Melanoma

A
  • ABCs of mole evaluation
  • Asymmetry
  • border irregular
  • colore mottled
  • diameter > 6 mm
  • elevation common, irregular
  • leading cause of death
  • appear flat or raised
  • h/ o dysplasia nevi –> incr risk
  • px r/t thickness of melanoma
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6
Q

seborrheic keratoses

A

benign, age-related plaques
-beige to brown to black
no tx needed
-waxy appearance

tx: curettage and freezing
- sudden eruption –> underlying malignancy

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7
Q

atopic dermatitis

A

pruritic, leads to scratch/itch cycle
– seen with fix with asthma or allergy

  • tends to grow out
  • seen in arm and flexural folds

s/s: denny’s lines -inftraorbital darkness

tx: avoid triggers, topical steroids, protonic, elderly
systemic steroids only for extensive dz,
oral histamines.

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8
Q

contact dermatitis

A

irritant- chemical exposure

  • erythema, scaling
  • industrial and detergents

allergic: poison ivy and nickle
- confined to area of contact and later can spread beyond

tx: avoid irritants
-topical steroids
-burrow solution for wheeling solution
- tacrolimus
severe > 20% - use oral steroids

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9
Q

diaper dermatitis

A

d/t prolonged exposure to urine/ feces
- get with yeast

  • tx: topical antifungals
  • nystatin
  • clotrimazole
  • miconazole
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10
Q

nummular eczema

A

coin-like lesions on LE
seen in older or younger adults
-older male/ETOH abuse

  • mild to sever pruritus

tx: hydration and systemic anti-histamines
- topical steroids
- phototherapy

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11
Q

perioral dermatitis

A
  • seen in women of child bearing age
  • h/o topical steroid use
  • tx: topical metronidazole, erythromycin,
    avoid steroids,

severe: oral tetracycline, doxycycline, minoclycline
taper meds

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12
Q

seborrheic dermatitis

A
  • seen in Males with oily skin
  • seen in nasal folds, eyebrows, eyelids
  • tends to recur
  • scales with background erythema

tx: cleaning the area
- shampoos with selenium sulfide, ketoconazole,
- mild topical steroids
- maintenance tx required

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13
Q

stasis dermatitis

A

inflam reaction to leaky serum from varicose veins

brownish-purplish skin with weepiness
tx: improve blood flow to area

avoid neomycin ( neosporin)
wear compression stocking and wrap
-burrows solution
-abx for infection

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14
Q

dyshidrosis

A
  • bubbling of tapioca-like vesicle–> scale and leas to fissures
  • seen in hands and fingers
  • outgrow it
    dx: clinical

tx:topical steroids
burrows solution
only systemic steroids for systemic cases

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15
Q

lichen simplex chronicus

A
  • intense itching caused by self-perpetuating scratch-itch
  • lichenified lesions
  • Neck and extremities common
  • tx: cessation of itch-scratch cycle
  • topical steroids
  • occlusion to prevent further trauma
  • pt educ.
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16
Q

lichen planus

A
  • purple violaceous, polygonal, papular or planar
  • Wickhams striae on surface - fine lacy white lesions
  • oral and nail manifestations
  • tx: often resistant
  • topical steroids w/ occlusion
  • oral steroids in severe cases
  • UVA therapy

can be caused by drugs

  • koebner’s phenomna- lesions seen in previous area of trauma
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17
Q

pityriasis rosea

A

benign, seen in young adults

  • spring and Fall
  • oval erythematous to fawn colored discrete lesion with collarette scale
  • Herald patch 2 weeks prior to the rash
  • christmas tree pattern
  • self- limiting, resolved in 6 weeks
  • topical steroids
  • consider STI testing
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18
Q

drug eruptions

A
  • varied presentations
  • occurs day to week from tx
  • PCN and sulfa are common
  • self-limited

tx: d/c drug
- supportive care

fixed drug eruption- reintroduce drug and manifest in the same exact way and place

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19
Q

erythema multiforme

A

target lesions

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20
Q

Steven Johns and TEN ( toxic epidural necrolysis)

A 
fever, HA, arthralgia, 
-confluent, asymmetric area of dusky erythema 
- shedding full sheets of skin
-mm affected
- taken to burn unit 
-causes:  abx, anticonvulsant, NSAIDS
- life-threatening 
Nikolksy sign- sloughing of skin and shear epidermis

tx:

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21
Q

bulls pemphigoid

A

pruritic tense blisters

  • abrupt onset
  • oral leions
tx: months--> years
topical potent steroids 
-oral steroids 
dapsone 
negative Nikolsky

immune suppression

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22
Q

psoriasis

A

chronic, papulosquamous dz, genetic

silvery scales on bright red

Ausptiz sign, Koebner’s phenom a

worse in winter

  • gutate - associated with strep throat, class tear drop salmon plaques
tx; depend on extent of sz
localized- topical steroids
dovonex
duodenum
tazorac
tar based products 
avoid stress and ETOH

generalized dx: phototherapy
methotrexate
oral retinoids

23
Q

tine corporis

A
  • round, oval, semicircular
  • central clearing

mild contagious

tx; topical anti fungal( azoles)
systemic: itraconazole

24
Q

tine pedis

A

seen in young adult males

  • mocassin type

hype on KOH exam

management: prevention- use show shoes
dry, scaly- anti fungal txt
macerate: burrow wet dressing

25
Q

tinea veriscolor

A
  • fair skin- hyppigmented
  • overgrowth of year

tx; topical selenium sulfide lotion / shampoo
- topical or systemic ketoconazole

26
Q

folliculitis

A

inflame of hair
- pustules in hair follicles

pseudo folliculti: beard area from ingrown hairs

tx; depend on etiology

27
Q

cellulitis

A

GAS and S. aureus

tx: oral abx
severe: admit for IV abx

28
Q

erysipelas

A

superficial
- fatal

  • prodrome sx: rash
  • LE more common
  • shiny bright red rash

dx: clinical

tx; IV abx first 48 hours and support therapy

29
Q

impetigo

A

kids

  • staph auteurs
  • site of bug bite
  • vesicle, homy-colored crust

tx; bactroban
oral abx for larger area

30
Q

viral warts

A

HPV- 100 serotypes

tx; OTC salicylic acid
cryotherapy
co2 laser therapy
surgical excision

31
Q

viral condylomata acumiat

A

genital area
HPF 6, 11
highly infectious
cauliflower, fleshy growth

tx: podofilox, imiquimod
cryotherapy

32
Q

herpes simplex

A

hsv 1- labials
hsv 2- genital

prodrome at site

giant cell on Tzanck

tx: valtrex, famvir,
pt education

33
Q

shingles

A

pain ful rash from parcel

-thoracic/ lumbar root
trigeminal nerve- blindness

tx: anti-viral s, oral steroids in immunocompromised
help reduce pain

34
Q

molluscum contagiosum

A
  • central umblication
  • self limited
    -benign
    seen on trunk and extremities
    viral in origin
35
Q

acne vulgaris

A
  • common adolescent and young adults
  • comedones, papules, pustules, cysts
  • improves in summer

midl: topical- retinoids, benzoyl peroxide

moderate inflame: add oral abx ( mine or doxy)

severe inflame: isotretinon, intralesional, injeciton

36
Q

rosacea

A
  • seen in women middle age
  • no comedones
  • worse w/ heat, exercise
  • papulres and telangecasia

tx; avoid of flushing with sunscreen
topical flail,
oral mino, doxy
severe: isotretinoin

37
Q

vitiligo

A

autoimmune disorder?
no pigment

tx; depend on extent and disfiguration

  • topical steroids, UVB/ PUVA
    cosmetic are, protective sunscreen
38
Q

acanthuses nigrican

A

adenoma ca of GI tract
-bening type- seen with overweight, insulin resistant

mangement:
loose weight
- control BS
- cosmetic care

39
Q

Burns

A

ABCs
rule of 9’s , dictate who goes to burn center
1st degree: redness w/o change in texture

2nd degree; blister

3d degrees: area is white, leathery
myoglobinuria ( electrial )
look or exit wound from lighting strike
no ice, check for harness

40
Q

hidradenitis suppurative

A 
obesity,acne
- tender inflame nodule in axilla
males- groin, button
tx: weight reduction, loose garments, 
clean area, 
drysol, 
tetra/ erythromycin

check for access

41
Q

urticaria

A

self -limited

chronic: > 6 weeks in duration

angiogema

tx: anti-histamin maintain
short course of steroids
avoidance of identified triggers

42
Q

melasma

A

hyperpigmenation of un exposed area
seen in young women
OTC cause

difficult to treat:
hydroquino 
tretioin 
azelaic acid
slow to resolve
43
Q

lipomas

A

bening tumors of fat cell

  • just monitor
  • check for lip sarcoma( more fixed)
    FNA
44
Q

epidermoid cyst

A

firm, mobile, young

no tx
triamcinola if inflamed
I and D , oral abx if infected

45
Q

Kaposi sarcoma

A

AIDs indicative
purple nodules anywhere

-tx: antiviral therapy

46
Q

decubitus ulcers

A

bed sores
press over bone prominence

Stage 1-intact skin, warmth
Stage 2: patial thickness
stage 3- full thickness
stage 4: full thickness and extension into mm bone and mm

move often
wound dressing
sharp debridement

47
Q

pediculosis ( lice)

A 
overcrowding dwelling
-schools
tx: all intimate contacts
seen in hair and body 
topical premetharin ( NiX shampoo)
clean/ dispose of infections clothing, linen
48
Q

scabies

A

arachnid mite
spares head and neck
pruritic vesicle in web spaces of hand
groin

  • confirm under microscopy

tx: tx all contact
clean clothing and bedding
permethrin 5% cream- resistance
rare, use 2X one week apart

49
Q

spider bites

A

black widow- bite if disturbed
mm pain, mm spasm
tx: parental opioids, mm relaxers

brown recluse: more active in spring and fall
progressive local necrosis, possible, fever, chills, n/v
excision of bite see
oral steroids, dapsone, colchicine

50
Q

alopecia area

A

patchy loss of hair
- small hairs that are broken off ( exclamation point hairs)

tx: intralesional triamcinolone
topical and systemic steroid
PUVa phot therapy
minoxidil

51
Q

androgenic alopecia

A 
hair will not grow back 
M> F
males- receding hairline at temples and vertex
females: loss of hair over central scalp
tx: finasteride and minoxiidil
52
Q

oncyomycosis

A

fungus of toenail and fingernails
- older age, low immune system

tx; topical generally ineffective
newer oral anti fungal
regrowth slow

53
Q

paronychia

A

soft tissue infection around the nail

  • acute: I and d and abx
    chronic: occupational
  • candida
    keep dry, topical, anti fungals

PANRE (27 decks)

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