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Flashcards in Derm 1 Deck (97):
1

most used form of treatment in dermatology.

Topicals

2

is an ointment good for a hairy person?

Not really, will stick to hair. Best to use a gel or solution.

3

typical location of eczema in an infant

face and cheeks

4

will have the chief complaint of itching. Common on flexor surfaces. Cyclical pattern of relapse and recurrence.

Atopic dermatitis

5

other atopic problems that go hand and hand with eczema

asthma
allergies

6

is there a diagnostic test for eczema?

No (but IgE can be elevated)

7

First line tx for atopic dermatitis

Frequent lubrication with thick emolient creams
Infants- 0.5-1.0% hydrocortisone BID to TID
Adults- higher potency topical steroids (triamcinolone 0.5%) BID to TID

8

Second line tx for atopic dermatitis

systemic steroids
plastic occlusive dressing w/ topicals
immunomodulators

9

Reaction to an external substance
Will have pruritus

Contact dermatitis

10

tx for contact dermatitis

Avoid the irritant
Lotion with zinc oxide, talc, menthol, phenol (i.e. Gold bond)
Topical corticosteroid
Oral antihistamine

11

2 types of contact dermatitis

Irritant dermatitis
allergic contact dermatitis

12

tests for contact dermatitis

Patch test (if severe or persistent)

13

Red maculopapular areas that are aside from the original site

Satellite lesions

14

Occurs under the covered area of a diaper.

Diaper dermatitis

15

causes of diaper dermatitis

Material the diaper is made of
recent diarrhea/ illness

16

are skin folds usually affected by diaper dermatitis?

usually spared, not affected until late

17

Satellite lesions with diaper dermatitis usually indicate what?

Candida

18

Tx for diaper dermatitis

Low potency steroid hydrocortisone

19

tx for diaper dermatitis + candida

antifungal (miconazole cream or powder)

20

Coin-shaped, vesicular, erythematous lesions with some crusting

Nummular eczema dermatitis

21

Tx for nummular eczema dermatitis

Avoid excessive use of soap but use supper-fatted soaps like Dove
lubricate skin immediately after bath or shower

22

Erythematous papules, small pustules with mild scaling at the area of the chin, upper lip, and nasolabial folds

Perioral dermatitis

23

difference between nummular eczema and tinea?

Tine is scaling
eczema is crusting

24

Tx for perioral dermatitis

tetracycline abx (typically doxycycline)
don't use topical steroids (gets worse)

25

causes or perioral dermtiatis

toothpaste, face products

26

Macular, erythematous, greasy lesions on face or near scalp line.

Seborrheic dermatitis

27

tests for seborrheic dermatitis with treatment failure

biopsy

28

tx for seborrheic dermatitis

topical antifungals or corticosteroids
coal tar
selenium sulfide

29

Increased scaling, peripheral edema, erosions, crusts. Erythema, itching, scaling. On the lower extremities. long, insidious process . Typically medial.

Stasis dermatitis

30

Tests for stasis dermatitis

no specific testing
get dx of venous insufficiency (Duplex US)

31

First line Tx for stasis dermatitis

Abx for secondary infection
Burrow's solution (aluminum acetate)
wet dressing and cooling paste is ulcerated
topical corticosteroids
leg elevation

32

Second line tx for stasis dermatitis

Abx based on C&S
lubrication when dermatitis is quiescent

33

Recurring vesicular papules on the palms, soles, or interdigital areas that are typically not erythematous
Possibly associated with excessive sweating

Dyshidrotic eczema

34

Tx for mild dyshidrotic eczema

low potency topical steroids

35

Tx for moderate- severe dyshidortic eczema

Ultrahigh potency steroids with occlusive dressing

36

Tx for recurrent dyshidrotic eczema

Systemic steroids at onset of itching

37

Non pharm tx for dyhidrotic eczema

Don't use hot water
avoid prolonged immersion in water
emollients

38

Chronic dermatitis that results from constant rubbing or scratching of the skin. Pruritus is out of proportion to appearance of the lesion

Lichen simplex chronicus

39

tx for lichen simplex chronicus

topical anti-pruritic agents
high potency topical steroids, transition to lower potency
can also use oral antihistamine for pruritis

40

what are 2 anti-pruritc agents used for lichen simplex chronicus?

doxepin, menthol preparations

41

what is papulosquamous?

Raised and scaly

42

Superficial fungal infections associated with scaling, erythema, or change in skin pigmentation

Dematophyte infections (tinea)

43

typically asymptomatic macules more commonly found in summer with periodic recurrences. Hypopigmented lesions

Tinea versicolor

44

Round to oval patches of alopecia with erythema
Seborrheic dermatitis-like pattern with minimal or no alopecia
Follicular pustules with crusting
Boggy, tender plaque with follicular pustules (kerion)
Diffusely dry scalp

tinea capitis

45

form of tinea capitis with Boggy, tender plaque with follicular pustules

kerion

46

tests for all tineas

Fungal culture
KOH prep

47

tx for tinea corporis/ cruris

topical azole antifungal, use for one week after resolution of symptoms; resort to oral meds if no resolution

48

tx for tinea capitis

oral griseofulvin, terbinafine, or itraconazole

49

tx for tinea pedis

antifungal cream BID until lesions have resolved for three days; resort to oral antifungals if no resolution

50

tx for tinea veriscolor

ketoconazole or selenium sulfide shampoo (Selsun Blue; dandruff shampoo); oral antifungals for non-responders

51

If you press on it and the color goes away then comes back what is it?

Blanchable

52

Adverse skin reaction response to administration of any medication

Drug eruptions

53

Most common type of drug eruptions

Urticarial

54

when can drug eruptions occurs

10-14 days after a patient starts a new medications

55

Small flat top, angular, red to violaceous, shiny, pruritic papules on the skin
"lot of P's"

Lichen planus

56

Common locations of lichen planus

flexor surfaces of UE
extensor surfaces of LE
genitalia
mucous membranes

57

White, lacy pattern on the tongue

Lichen planus

58

if what is on top of the purple, patches of lichen plnaus.

white lacy pattern
Wickham striae

59

new lesions may be noted at sites of minor injuries such as scratches or burns

Koebner phenomenon

60

tx for lichen planus

superpotent topical steroids
soak and smear technique.
systemic steroids if no response

61

What is the soak and smear technique

soak in bath for 20 minutes
then immediately put steroids on
should be done at night
use ointment as solution

62

Self-limiting skin eruption with multiple papulosquamous lesions
initial sign is a herald patch
widespread rash begins 7-14 days later

Pityriasis rosea

63

tx for pityriasis rosea

Topical steroids or oral antihistamines for itching

64

Well-defined red papules coalescing to plaques; sharply demarcated silvery scales on red plaques

Psoriasis

65

Usually presents

Guttate psoriasis

66

True emergency: Severe form characterized by widespread erythema, scaling, pustule formation

Pustular psoraisis

67

First line Tx for psoriasis

emollient
topical corticosteroids
Vit D analgoues
topical retinoids
light therapy

68

Second line tx for psoriasis

topical immunosuppressants
salicylic acid
coal tar

69

what is Underlying pinpoints of bleeding following scraping of psorasis plaques

Auspitz sign

70

Generalized hypersensitivity reaction, usually to a drug, in which skin and mucous membrane lesions are an early manifestation

Stevens-Johnson syndrome

71

what usually causes stevens-johnson syndrome

a drug rxn

72

what do the lesions look like with SJS and TEN

targetoid

73

when is a targetoid rash considered TEN?

>30% of body surface area

74

when targetoid lesions occupy 10–30% of body surface area what is it considered

overlap between SJS and TEN

75

do you managed SJS in clinic?

No, you should admit them

76

Tx for SJS

supportive care in hospital

77

where does a patient with TEN admitted to?

Burn unit

78

Acute and self-limiting hypersensitivity reaction
Previously thought to be on spectrum of SJS and TEN
Mostly triggered by infectious agents, especially HSV

Erythema multiforme

79

3 zones of target lesions with erythema multiforme

raised and cyanotic center, edematous light intermediate ring and bright erythematous border

80

what causes erythema multiforme?

HSV previous infection

81

Tx for erythema multiforme

Medication for any underlying process
Topical corticosteroids or oral antihistamines for symptomatic relief
Possible antivirals with comorbid viral infection

82

Epidermal detachment with light lateral pressure
seen with SJS

Nikolsky’s sign

83

Large, tense subepidermal blisters and urticarial plaques or bullae commonly occur in the flexural areas of the legs and arms, axillae, abdomen, and groin. Due to autoimmune process

Bullous Pemphigoid

84

what signs will be negative with bullous pemphigoid

Nikolsky
Asboe-Hansen

85

what is required for a dx of bullous pemphigoid

biopsy

86

first line tx for bullous pemphigoid

high potency topical corticosteroids
possible oral steroids

87

chronic inflammatory dermatosis notable for open/closed comedones and inflammmatory lesions, including papules, pustules, or nodules

Acne vulgaris

88

what is a Closed comedones

whitehead

89

wat is an open comedones

blackhead

90

when will you do testing with acne

female comes in with signs of androgenation

91

Chronic condition characterized by recurrent episodes of facial flushing, erythema (due to dilatation of small blood vessels in the face), papules, pustules, and telangiectasia (due to increased reactivity of capillaries) in a symmetrical, facial distribution

Rosacea

92

what differentiated rosacea from acne

lack of comedones

93

tx for rosacea

low dose oral tetracyclines
topical metronidazole, or other topical antibiotics
topical sulfur-containing compounds

94

what exacerbates rosacea?

Spicy foods
heat
alcohol
sun

95

Inflammation of the hair follicle caused by infection, irritation, or injury
Will have pustules at the base of hair follicle

Follicuiltis

96

cause of hot tub foliculitis

pseudomonas

97

Tx for folliculitis

systemic abx haven't been found to be helpful
consult sanford guide