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American Board of Internal Medicine COPY > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the most serious side effect of Isotretinoin?

A

Pseudotumor Cerebri

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2
Q

Treatment of Acne (4)

A
  1. COMEDONAL: Tretinoin (Retin-A) gel
  2. MODERATE PAPULOPUSTULAR: Tretinoin (Retin-A) gel + TOPICAL abx or Benzoyl peroxide 2.5%*
  3. SEVERE PAPULOPUSTULAR: Benzoyl peroxide 2.5% + ORAL abx**
  4. NODULOCYSTIC: Isotretinoin (Accutane)
  • Not Tretinoin and Benzoyl at same time
  • *Tetracycline, Minocycline, Erythromycin
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3
Q

Lichen Simplex Chronicus

  1. History
  2. Treatment
A
  1. Chronic scratching leads to lichenification and hyperpigmentation
  2. Steroids to stop itching
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4
Q

Contact Allergy Offenders (4)

A
  1. Nickel
  2. Latex
  3. Plants
  4. Lotions (benadryl cream)
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5
Q

Dyshidrotic Eczema

  1. Exam
  2. Treatment
A
  1. Pruritic veiscles leading to desquamation of hands, palms and sides of fingers
  2. Medium to high potency corticosteroids
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6
Q

Stasis Eczema

  1. Exam
  2. Treatment (2)
A
  1. BILATERAL lower extremities above ankles (vs. unilateral with cellulitis)
  2. Treat venous stasis and medium potency steroids
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7
Q

Etiology of Malar Rashes (4)

A
  1. Erysipelas - sharp demarcation, fever, WBC, peau-d’orange
  2. SLE - photosensitivity sparing nasolabial fold
  3. Acne Rosacea - flushing, telangiectasias and papules and pustules
  4. Seborrheic dermatitis - accentuation of nasolabial fold
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8
Q

Etiology of Acanthosis Nigricans (2)

A
  1. Obesity and insulin resistance

2. Gastric Carcinoma

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9
Q

Cutaneous manifestations of HCV (3)

A
  1. Porphyria Cutanea Tarda
  2. Leukocytoclastic Vasculitis / Cryoglobulinemia
  3. Lichen Planus - (five Ps = purple, puritic, planar, polygonal, papules)
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10
Q

Porphyria Cutanea Tarda

  1. Correlation to which disease?
  2. Trigger factors (3)?
  3. Treatment?
A
  1. HCV
  2. Alcohol, Estrogens, Iron Overload
  3. Phlebotomy and NOT treating HCV
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11
Q

Erythema Multiforme

  1. Exam findings
  2. Etiology if recurrent
  3. Etiology if drugs (3)
A
  1. TARGETOID Lesions
  2. HSV if recurrent
  3. PCN, dilantin, sulfa
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12
Q

Lofgren’s Syndrome:

  1. Features (3)
  2. Treatment (3)
A
  1. a. Erythema Nodosum
    b. Arthalgias/arthritis (ankles)
    c. Bilateral hilar adenopathy
  2. a. NSAIDS
    b. Prednisone
    c. Potassium iodide (for EN, SE with GI upset)
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13
Q

Etiology of Erythema Nodosum (5)

A
  1. Post-strep
  2. Drugs (OCP, sulfa)
  3. Inflammatory Bowel Disease
  4. Deep fungal infections (cocci, histo, TB)
  5. Sarcoid (Lofgren Syndrome)

Mnemonic = P DIDS

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14
Q

Perioral Dermatitis

  1. Etiology (2)
  2. Exam
  3. Treatment (topical 2, oral 3)
A
  1. Topical or inhaled steroids
  2. Perioral erythematous micropapules on patchy erythematous background with scaling
  3. Topical metronidazole or erythromycin, OR oral minocycline, tetracycline or doxycycline
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15
Q

Pityriasis Rosea

  1. History
  2. Exam
  3. Treatment
  4. Differential diagnosis (3)
A
  1. Viral prodrome with URI and “herald patch”
  2. Salmon colored oval lesions with fine scales in “Christmas tree distribution”
  3. Antihistamines or topical steroids because it will spontaneously resolve
  4. a. Secondary syphilis
    b. Drug eruption
    c. Tinea
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16
Q

What can patients with Psoriasis develop after being treated with corticosteroids?

A

Pustular Psoriasis

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17
Q
  1. Define Erythroderma

2. Name etiologies (4)

A
  1. Eruption > 90% of body surface
  2. a. Drug eruptions
    b. Psoriasis
    c. Atopic dermatitis
    d. Cutaneous T-cell lymphoma (Sézary)
18
Q

What is a common contaminant in cocaine and what dermatologic pathology can develop?

A
  1. Levamisole (antihelmintic agent)

2. Reticular purpura on ears and nose

19
Q
  1. What organism causes cellulitis from saltwater?

2. What are treatment options for severe and mild disease?

A
  1. Vibrio vulnificus
  2. a. Severe = Tetracycline + 3rd-gen Ceph
    b. Mild = Tetracycline OR Fluorquinolone
20
Q

What organism causes skin ulcers in neutropenic patients, and what is the ulcer called?

A

Pseudomonas causing Ecthyma Gangrenosum

21
Q

If you see pyoderma gangrenosum, consider (3)…

A
  1. Inflammatory Bowel Disease
  2. Inflammatory Arthritis
  3. Leukemia (lymphoproliferative disorders)
22
Q

If you see “moccasin” apearing foot with silvery scales, consider…

A

Tinea Pedis

23
Q

Name two scenarios that require URGENT consultation for Herpes Zoster

A
  1. Trigeminal V1 distribution = Ophtho

2. Ears, tongue or facial paralysis = ENT

24
Q

If you see palpable purpura, consider…

A

HCV

25
Q

If you see porphyria cutanea tarda, consider…

A

HCV

26
Q

If you see severe seborrheic dermatitis, consider…

A

HIV

27
Q

If you see sudden onset psoriasis, consider…

A

HIV

28
Q

If you see dermatitis herpetiformins, consider… and treat with …

A
  1. Celiac Disease

2. Dapsone (after checking G6PD) and gluten-free diet

29
Q

If you see livedo reticularis, consider (3)…

A
  1. Atheroemboli
  2. Vasculitis
  3. Phospholipid Antibodies
30
Q

If you see acanthosis nigricans, consider (2)…

A
  1. DM

2. GI cancers

31
Q

Another name for Melanoma In Situ is…

A

Lentigo Maligna

32
Q

What is treatment for Pyoderma Gangrenosum?

A

Corticosteroids

33
Q

What is the serologic work-up for Neurogenic Pruritis (6)?

A
  1. CBC - iron deficiency anemia or malignancy (hematologic, lymphoma)
  2. BMR - ESRD
  3. LFTs - Cholestasis
  4. TSH - hypo- or hyperthyroidism
  5. ESR
  6. HIV infection
34
Q

What chronic disease is associated with Vitiligo?

A

Autoimmune thyroid disease

35
Q

What nail disease is associated with HIV?

A

PWSO (proximal white subungual onychomycosis)

36
Q

What is the difference between Stevens-Johnson and Toxic Epidermal Necrolysis?

A

Degree of epidermal detachment:

SJS < 10%
TEN > 30%

37
Q

What is Sézary Disease?

A

Cutaneous T-Cell Lymphoma causing erythroderma

38
Q

What are side effects (2) of Minocycline?

A
  1. Vertigo

2. Bluish skin discoloration

39
Q
  1. Differential for groin rashes (3)

2. Which one is treated with antibiotics?

A
  1. Candida - satellite lesions
  2. Tinea Cruris - serpiginous borders
  3. Erythrasma - brown scaley, well-demarcated, positive Wood’s lamp***

***Treated with topical Erythromicin or Clindamycin -OR- topical fusidic acid -OR- oral Erythromycin, Tetracycline or Clarithromycin

40
Q

What is appropriate ointment for impetigo?

A

Mupiricin

41
Q

What is the “itch without the rash”?

A

Brachioradial Pruritis

42
Q
  1. What is seen on scrapings of Tinea Versicolor?

2. What is treatment for Tinea Versicolor?

A
  1. Malassezia globosa (or less often furur) with appear like spaghetti and meatballs
  2. a. Topical ketoconazole
    b. Zinc pyrithione shampoo

American Board of Internal Medicine COPY (15 decks)

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