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d3 Flashcards

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1
Q

Clinical feature of TEN/SJS?

A

4-28 days after the first and 2 days after the second exposure
Acute influenza-like prodrome
Rapid onset erythematous bullae, macule, and vesicle
Necrosis and sloughing of the epidermis
Mucosal involvement
S.Sign–Sepsis sign including AMS and Seizure

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2
Q

SJS and TEN nomniclature?

A

<10 % SJS
>30% TEN
10-30 % 0verlap

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3
Q

Common triggers?

A 
Drug
Another factor(M.Pnumonia.GVH disease and vaccination)
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4
Q

Drug?

A 
Allopurinol
Ab(TMP-SMX)
Anticonvelsant(Carbamazepine,Lamotrigen and Phenitoin)
NSAID
SULFASALAZINE
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5
Q

Risk factor for onychomycosis?

A 
T.Runrum
Old age
T.Pedis
DM
PAD
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6
Q

Exam finding?

A

Thick, Brittle nail and discolored mail

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7
Q

Diagnosis?

A

KOH, PAS, and culture

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8
Q

Managment?

A

1st line:Terbinafine and intraconazole

2nd line: Grisofulvin,fluconazol

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9
Q

Do condylomata accumulate etiology?

A

HPV

MC STI in the USA

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10
Q

Lesion?

A

Verrucous
Papiliform
Pink/skin-colored
may have Iching and burning

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11
Q

Managment?

A

Usually self-limited
Trichloroacetic acid/podophyllin
Immunotherapy(imiquimod)
Surgery(cryosurgery,excision or lesser tx)

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12
Q

Pudofolliculitis barbe pathophysiology?

A

Enterance of hair to parafolicular line
Occur in area of barbe
Shaving by the blade is risky(leave hair below skin)

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13
Q

lesion?

A

area of barbe
Papular
Painful
Sign of complication

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14
Q

Sign of complication?

A

Hyperpigmentation
Bacterial infection
Keloid

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15
Q

Managment?

A

Leave hair cutting
Use a single blade or non-blade cutter(clamper)
Hot Water compression before shaving

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16
Q

Managment of psoriasis?

A

Topical if area <5%

Systemic if area > 5 and presence of P.artheritis

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17
Q

Topical Tx?

A

Topical GC

Topical vit D(calcipotriene), calcineurin inhibitor or retinoid if GC induced skin thinking feared

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18
Q

Systemic?

A

UV phototherapy
Methotrexate
Apremilast
TNF alpha inhibitor(apremilast)

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19
Q

Dermatofibroma?

A 
Usually, affect LE
Hyperpigmented
Painless
Discrete and firm
dimple when periphery compressed(buthole sign)
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20
Q

When did treatment require?

A

If symptomatic

Cosmetic reason

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21
Q

Rosacea CM?

A

chronic
erythematous
affect convex of face
symptom(flushing, skin sensitivity…..)

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22
Q

Pathophysiology?

A

A chronic inflammatory reaction to microorganism, UV light, or vasomotor dysfunction

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23
Q

Symptoms are precipitated by?

A

Hot/spicy food
Alcohol
Sun exposure
High ambient Tempratue

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24
Q

managment?

A

General measure

Specific Tx based on the type

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25
General measure?
Maybe enough for mild and moderate case A gentle cleanser and emollient Avoid precipitating factor Use for all type
26
Erythematotelengectatic rosacea?
erythema, flushing, and telangiectasia Topical brimonidine Laser/Intense pulsed light therapy
27
Papulopustular rosacea?
superimposed infection papule and pustule 1st line: Topical metronidazole/azelik acide/ivermectine 2nd line: Oral tetracycline
28
Phymatous rosacea?
Irregularly thickened skin Oral isotritinoin Laser therapy/surgery
29
Ocular rosacea?
Burning, foreign sensation, blepharitis, conjunctivitis and keratitis, and corneal ulcer Lid scrubs and ocular lubricant Topical/systemic antibiotic
30
Irritant contact dermatitis cause?
Physical/chemical irritation | Soap/deteregent,chemical/acide/alkali
31
CM?
commonly in hard erythema fissure
32
Allergic contact dermatitis triggers?
``` Poison oak/ivy/sumac Nicker Ruber/latex Leather dye medication ```
33
CM?
``` Well demarcated area of skin in contact papule/vesicle chronic lichenification weeping crusting ```
34
Disease-associated with seborrheic dermatitis?
Parkinson | HIV
35
Urushiol?
MCC of Allergic CT Produced by Toxicodendron (poison IV/oak/sumac) Founded in a wooded area and unclean building Form linear eczematous lesion at the area of contact The lesion may have a secondary infection
36
Drug-induced acne triggers?
``` Glucocorticoid,androgen Immunomodulator(azathioprine, EDGF inhibitor......) Anticonvulsant (phenitoin) Antipsychotic Antituberculosis drug(Isoniazide) ```
37
Presentation?
Monomorphic papule/pustule Lack of comedones, cyst, and nodule Location and age may be atypical for acne
38
Managment?
Stope the causative drug | Anti Acne Tx is not effective
39
Chery hemangioma caracter?
``` MC benign VT Common in 3rd and 4th decade Papular Small Bright red Sharpley demarcated always cutaneous(not involve mucosa or deep tishue) ```
40
pathology?
congested capillary and post-capillary venule in the papillary dermis
41
prognosis?
Not regress | Tx only for the cosmic reason
42
Clinical presentation of urticaria?
``` Well-Circumscribed Raised Erythematous Itchy It May have a different shape Develop within minute and hour and resolve within 24 hr Central pallor ```
43
Etiology?
``` Infection IgE mediated Direct mast cell activation NSAID 50% Idiopathic ```
44
Do factors cause direct mast cell activation?
Narcotics Muscle relaxant Contrast medication
45
mast cell activation in the superficial dermis?
Urticaria
46
Mast cell activation in the deep dermis and sc tissue?
angioedema
47
Tuberous sclerosis manifestation?
Dermatologic Nurologic CVS Renal
48
Dermatologic?
Ash-leaf spot Shagreen patches Malar angiofibroma
49
Ash-leaf spot?
Hypopigmented lesion
50
angiofibroma?
Red/flesh-colored papule | Mistaken as acne
51
Shagreen patches?
A shagreen patch (arrows) is an irregularly shaped, irregularly thickened, slightly elevated soft skin-colored patch, usually on the lower back, made up of excess fibrous tissue.
52
Neurologic?
``` CNS tumor (subependymal tumor..) Epilepsy(infantile spasm..) Intellectual disability Autism Behavioral disorder(hyperactivity) ```
53
CVS?
Rhabdomyoma
54
Renal?
Angiomyolipoma
55
HPV wart common in?
Plantar Palmar genital
56
Plantar common in?
Young HIV Organ transplant
57
Moccasin-type tinea pedis?
scales/fissure Hyperkeratosis Flaking extension to sole, side, or dorsum of the foot
58
Vesiculobullous type?
painful bullae | erythema(lateral foot)
59
Female & male pattern hair loss?
Chronic, progressive thinning of hair F: Vertex, the center of the hair, No hairline M: Vertex, Temporal area, frontal hairline
60
Genetics?
``` Polygenic inheritance Hormonal factor (DHT) ```
61
Managment?
M:minoxidine,fenastride F:Minoxidine
62
Androgen level in FPHL?
mostly normal | elevated in case of PCOS
63
Acute palmoplantar eczema also called?
dyshidrotic eczema
64
CM?
Recurrent acute episode Deep-seated, pruritic vesicle on hand and feet Palm and sole with typical palm side involvement
65
Complication?
Desquametization Chronic dermatitis Secondary infection
66
Biopsy?
Intraepidrmal spongiosis | lymphocyte infiltration
67
management?
emollient | potent topical medication
68
Epidermolysis bullosa?
``` Inherit disorder Epithelial fragility(bullae, erosion, and ulcer) Triggered by minor trauma Lesion heal w/o scaring Thickening of the skin of the sole ```
69
Benefit of antiviral in herps zoster?
Should begin in 72 hr Decrease symptom duration Decrease PHN risk
70
the d/c between drug-induced and idiopathic lichens planus?
DILP: more diffuse
71
What is a drug that can cause DILP?
ACE inhibitor Tiazide Betablocker Hydroxychloroquine
72
Pemphigus vulgaris AB taarget?
Desmosome
73
CM?
Flaccid bulla and ulcer Mucosal erosion Nikolisky sign
74
Histopathology?
Intraepidermal cleavage acantholysis tombstone cells along the basal layer
75
Managment?
Systemic CS CS sparing agents Aggressive wound care
76
CM of erythema nodusum?
Tender Erythematous Nodule MC in the anterior leg
77
Etiology?
``` Infection IBD Sarcoidosis Medication(Ab or OCP) Malignancy ```
78
Pathology?
Septal paniculitis | No vasulitis
79
Natural history?
Spontaneous resolution | Hyperpigmentation
80
Sebhoric keratosis?
``` Any part of the body except palm and sole Flat macule Wart-like lesion Pink/white Brown/dark Velvety/greasy surface Stuck-on lesion ```
81
Biopsy?
Basal cell Variable pigmentation Hyperkeratosis Keratine containing cyst
82
Lether trelat sign?
Multiple seborrheic keratosi | Indicate occult internal malignancy
83
managment?
Observation | removal if cosmetic
84
Ichthyosis Vulgaris?
Inherited disorder | Due to filaggrin gene mu
85
CM?
``` Diffuse dermal scaling Dry Rough horny Plates resemble reptile ```
86
Prognosis?
Mild in early life and sever latter | life long disease
87
Managment?
Emollient only is not effective Keratinolytics(coal tar/salicylic acid) Topical retinoid for controlling the symptom

dermatology (4 decks)

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