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HARRISSONS > DERMA > Flashcards

DERMA Flashcards

1
Q

Which treatment is appropriate in order to avoid overuse of topical corticosteroids and minimize likelihood of flares in atopic dermatitis?

A

EMOLLIENTS

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2
Q

A 31/M, known to have asthma and allergic rhinitis, complains of difficulty sleeping due to pruritus of eczema. Which drug can benefit the patient?

A

Diphenhydramine

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3
Q

May be used as prophylactic treatment for AD

A

Tacrolimus Ointment

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4
Q

Systemic therapies used for wide spread and nonresponsive AD are

A 
1. Cyclosporine 3-5 mg/kg/day 
(first line for refractory AD)
2. Mycophenolate mofetil 2 g/day
3. Methotrexate 10-22.5 mg/week
4. Azathioprine 1.5-2.5 mg/kg/day
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5
Q

What are the most common causes of irritant contact dermatitis?

A

either “wet,” such as detergents, organic solvents, soaps, weak acids and alkalis,
or
“dry,” such as low humidity air, heat, powders and dusts

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6
Q

Mainstay of diagnosis in allergic contact dermatitis. It has a sensitivity and specificity of 70-80%. Reproduces allergic contact dermatitis in an individual sensitized to a particular allergen.

A

Patch testing

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7
Q

The optimum timing of readings is day ___. An additional reading at day 6 or 7 will pick up a ~10% more positives that were negative at days 2 and 4.

A

2 and 4

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8
Q

A patient with chronic spontaneous urticaria reports persistent symptoms despite treatment with Cetirizine 10 mg tablet OD for the last 2 weeks. What should you do next?

A

Continue Cetirizine 10 mg tablet OD for another 2 weeks

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9
Q
  1. Which antihistamine is a standard treatment of acute spontaneous urticaria?
A

Loratidine

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10
Q

Cutaneous expression of the atopic state (family hx of asthma, allergic rhinitis or eczema)

A

Dermatitis

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11
Q

Characteristic defect in atopic dermatitis

A

Impaired epidermal barrier

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12
Q

Mutation of this protein in the stratum corneum is responsible for Impaired epidermal barrier in atopic dermatitis

A

FILAGGRIN

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13
Q

Clinical criteria for the diagnosis of atopic dermatitis

A
  1. Pruritus and scratching
  2. Course marked by exacerbations and remissions
  3. Lesions typical of eczamatous dermatitis
  4. Personal or family history of atopy (Asthma, AR, FOOD ALLEGIES, OR ECZEMA)
  5. Clinical course lasting longer than 6 weeks
  6. Lichenification of skin
  7. Presence of dry skin
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14
Q

Cutaneous stigma of AD

A

Perioral pallor
Extra fold of skin beneath lower eyelid ( DENNIE MORGAN FOLDS)
Increased palmar skin markings
Increased of cutaneous infections (esp STATUS AUREUS)

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15
Q

Macrolide immunosuppressants derived from soil fungi for AD

A

Tacrolimus ointment

Pimecrolimus cream

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16
Q

Preferred systemic antibiotics for secondary infections that exacerbates AD

A

DICLOXACILLIN (penicillinase resistance penicillines)

Cephalosporins (CEPHALEXIN)

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17
Q

Preferred systemic antibiotics for secondary infections that exacerbates AD if Dealing MRSA 7-10days

A

TMP SMX
Minocycline
Doxycycline
Clindamycin

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18
Q

May represent the end stage of a variety of pruritus and eczematous disorders.
Well circumscribed plaques with lichenified skin due to chronic scratching.

A

Lichen simplex chronicus

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19
Q

Common areas involved in Lichen simplex chronicus

A

Posterior nuchal region

Dorsum of the feet or ankles

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20
Q

Treatment of Lichen simplex chronicus

A

Break cycle of chronic itching by HIGH potency GC

IF RECALCITRANT: GC under occlusion or intralesion injection of GC

21
Q

Contact dermatitis caused by an inherent characteristic of a compound
And prior exposure is NOT NECESSARY

A

Irritant contact dermatitis

22
Q

Delayed type hypersensitivity mediated by memory T lymphocytes in the skin, occurring 12- 72H upon exposure, prior exposure is NECESSARY

A

Allergic contact dermatitis

23
Q

Most common type of ICD

A

Chronic low grade irritant dermatitis

MC in hands

24
Q

Control of pruritus Is essential for treatment of AD with

A

Antihistamine:
Diphenhydramine
Hydroxyzine
Doxepin

25
Q

A variant of hand eczema that appears as multiple , intensely pruritic, small pa pulse and vesicles occurring on thenar and hypothenar eminences and sides of fingers

A

Dyshidrotic eczema

26
Q

For hand eczema, examine for Dermatophyte infection by

A

KOH Preparation and Culture

27
Q

Circular or OVAL “COINLIKE” lesion, frequently in Middle aged men, usually located at the TRUNK, Extensor surfaces of extremities (pretibial areas of dorsum of the hands)

A

NUMMULAR ECZEMA

28
Q

Also known as WINTER ITCH , mc develops on Lower legs of elderly during dry times of the year. Mild inflammatory variant of dermatitis

A

XEROTIC ECZEMA
OR
ASTEOTIC ECZEMA

29
Q

Caused by venous incompetence of the LOWER EXTREMITIES + chronic edema, most commonly affecting MEDIAL ASPECT of the ankle over a distended vein and may proceed to chronic dermal fibrosis recognized as BRAWNY edema of the skin

A

Statis dermatitis

30
Q

Treatment for Statis dermatitis

A
  1. Elevation of legs
  2. Use of compression stocking with gradient >30-40mmhg
  3. Emollients
  4. Mid potency Topical GC
  5. Avoid irritants
31
Q

(+)blister and mucosal or epidermal detachment resulting form FULL THICKNESS epidermal necrosis in the absence of substantial dermal inflammation

A

SJS/TEN

32
Q

Blister developing on TARGET LESIONS, dusky orpurpuric macular in which MUCOSAL involvement is significant, and total body surface area blistering and eventual detachment is <10%
Rare confluence

A

SJS

33
Q

total body surface area blistering and eventual detachment is 10-30%

A

SJS/TEN OVERLAP

34
Q

total body surface area blistering and eventual detachment is >30%

+confluence erythema

A

TOXIC EPIDERMAL NECROLYSIS

35
Q

Most common drugs associated with SJS AND TEN

A 
Allopurinol
Sulfonamide
NSAID - OXICAM
AROMATIC ANTICONVULSANT (phenytoin, carbamazepine, phenobarbitone)
Lamotrigine (anticonvulsant)
NEVIRAPINE
36
Q

Pustular eruptions + high spiking fever + leukocytosis - innumerable pinpoint pustules overlying a diffuse edematous erythema
20% oral lesions

A

AGEP

Acute generalized exanthematous pustulosis

37
Q

Adverse drug reaction for type I

A

IgE mediated

Urticaria
Anaphylaxis
Angioedema

38
Q

Adverse drug reaction for type II

A

IgG mediated

DRUG INDUCED Hemolysis
THROMBOCYTOPENIA

39
Q

Adverse drug reaction for type III

A

Immune complex

Vasculitis
Serum sickness
Drug induced lupus

40
Q

Adverse drug reaction for type IVA

A

T cell mediated MACROPHAGE inflammation:

Tuberculin skin test
Contact dermatitis

41
Q

Adverse drug reaction for type IVB

A

T cell mediated EOSINOPHILS inflammation:

MORBILLIFORM ERUPTIONS
DRUG INDUCED HYPERSENSITIVITY REACTION (DIHS)

42
Q

Adverse drug reaction for type IVC

A

T cell mediated CYTOTOXIC inflammation:

MORBILLIFORM ERUPTIONS
SJS/TEN

43
Q

Adverse drug reaction for type IVD

A

T cell mediated NEUTROPHIL inflammation:

AGEP acute generalized exanthematous pustulosis

44
Q

(+)mucositis in 30%,
Diffuse, red morbilliform eruption with facial involvement, facial and acral swelling. (Fever, LAD, hepatitis, nephritis, carditis, eosinophilia, atypical lymphocytosis)

A

Dress or DIHS

45
Q

Urticarial serpiginous or polycystic dash, purpuric eruption along the sides of the feet and hands is characteristic

A

Serum sickness or serum sickness reactions

46
Q

Seen with urticaria or swelling of the face with respiratory distress and cardiovascular collapse

A

ANGIOEDEMA

47
Q

Associated with red man syndrome, a histamine related AnaPhylactoid reaction characterized by FLUSHING, DIFFUSE MACULOPAPULAR ERUPTION AND HYPOTENSION

A

Vancomycin

48
Q

Commonly implicated in vasculitis

A

B lactams

HARRISSONS (62 decks)

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