acute dermatitis itching is ___ ___ dermatitic poison ivy 2 types: ___ and ___

intense contact allergic and irritant

atopic dermatitis allergic rhinitis asthma

Topical Calcineurin Inhibitors MOA: blocks ___ cytokine genes ___ and ___ considered ___ line treatment can be used on ___ area equivalent to ___ corts no risk of ___ ___ use only $$$

pro-inflammatory pimecrolimus and tacrolimus 2nd any atrophy intermittent

DERM Flashcards by Reagan Smith

What is xerosis

dry skin

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Xerosis treatment

Emollients
* first line for ___
* restores barrier and skin ___

itching
function

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Agents to reduce itching

menthol and camphor
* ___ sensation
pramoxine
* local ___
aluminum acetate
* alter C-fiber ___ transmission hydrocortisone
* anti- ___

cooling
anesthetic
nerve
inflammatory

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Dermatitis - Inflammatory process of the upper
___ layers of skin

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acute dermatitis

itching is ___
___ dermatitic
poison ivy
2 types: ___ and ___

intense
contact
allergic and irritant

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sub-acute dermatitis

itching is common but less ___
___ dermatitis

intense
atopic

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chronic dermatitis

lichenification
___ dermatitis

stasis

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Acute Contact Dermatitis

Irritant - non ___ reaction to frequent contact with everyday substances
* more common than allergic
* reaction within a few ___

immunologic
hours

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Contact Dermatitis - Poison Ivy

T or F: poison ivy does not spread from lesions

True

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Contact Dermatitis - Poison Ivy
* ___ is key
* Ivy-Block - reapply every ___ hours
* topical therapy OK if less than ___ % BSA involved
* Treat with: ___ lotion, topical or oral antihistamines, topical or oral corticosteroids

prevention
4
10%
calamine

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T or F: corticosteroid dose packs are first line therapy for acute dermatitis

False; do not provide treatment for long enough

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Treatment of acute dermatitis

prednisone ___ mg per day; taper every ___ days
* minimum of ___ days of treatment

40-60 mg
3 days
10-14 days

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Atopic Triad

atopic dermatitis
allergic rhinitis
asthma

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atopic dermatitis

Pruritis

symmetrical red papules or plaques

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Topical Corticosteroids

Classified according to potency which corresponds to ___ activity and ___ potency
* only ___ % absored when applied to normal intact skin
* vehicle impacts delivery and ___ of corticosteroids

anti-inflammatory
vasoconstrictive
2%
potency

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Side effects of topical corticosteroids
* ___ of skin
* ___ blood vessels
* ___ bruising
* skin ___ changes
* development of ___ (tachyphylaxis)
* risk of ___ suppression with long term use of high potency agents

thinning
dialated
increased
color
tolerance
HPA

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Topical Corticosteroids

very high potency class 1
* betamethasone dipropionate ___
* halobetasol proprionate
* clobetasone proprionate
* do not use on ___
* do not use longer than ___ weeks
* no more than ___ grams per week

ointment
face
2 weeks
50 grams

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Topical Corticosteroids

high potency class 2
* betamethasone dipropionate ___
* fluocinolide
* same comments as very high potency class 1

cream

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Topical Corticosteroids

mid potency classes 3-5
* triancinolone acentonide
* mometasone furoate
* betamethasone dipropionate ___
* used on mores skin surfaced for exacerbations
* moderate ___ effect
* safer for ___ term useage
* dont use long term on ___

lotion
anti-inflammatory
long
face

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Topical Corticosteroids

low potency calsses 6-7
* ___
* desonide
* can use on ___ , groin, ___ , axilla
* mild ___ effect
* safest for ___ term use

hydrocortisone
face, genitals
anti-inflammatory
long

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Topical Calcineurin Inhibitors

MOA: blocks ___ cytokine genes
___ and ___
considered ___ line treatment
can be used on ___ area
equivalent to ___ corts
no risk of ___
___ use only
$$$

pro-inflammatory
pimecrolimus and tacrolimus
2nd
any
atrophy
intermittent

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Crisaborole 2% Ointment

mild-mode AD
non-steroidal - ___ - 4 inhibitor
good for patients who are scared of steroids
BID for ___ days
$$$

phosphodiesterase
28 days

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Dupilumab

Dupixent
* MOA: Human monoclonal antibody against ___ receptor alpha. Inhibits ___ and ___ signalling
* administered ___ every ___ weeks
* first biologic indicated for mod-severe AD for ages ___ +

IL-4, IL-4, IL-13
SC, 2 weeks
12+

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Upadacitinib

Rinvoq
* moderate to severe AD
* MOA: ___ inhibitor
* Mediates signaling of cytokines and ___
* higher rates of major __ events and ___

Janus kinase (JAK)
growth factors
CV, thrombosis

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# Ruxolitinib Opzelura® 1.5% Cream * mild to moderate AD * MOA: ___ inhibitor * medicates signalling of ___ * ___ term use * MAX: ___ g per week * avoid in ___ patients

* JAK * cytokines * short * 60 g * immunocompromised

comedone

hair follicale plugged with sebum, keratine, and dead skin

___ naturallly colonize the skin and sebaceous glands * bacteria converts TG to ___ which irritates local cell resulting in ___

* Propionibacterium acnes * FFA * inflammation

non-inflammatory acne (2)

1. whiteheads 2. blackheads

inflammatory acne (3)

1. papules 2. pustules 3. ruptured contents

secondary lesions are ___

scars

first choice for comedonal, noninflammatory acne (mild)

topical retinoids

first choice for Mild-moderate papulopustular inflammatory acne

adapalene + BP or clindamycin + BP

first choice for Severe papulopustular or moderate nodular acne

oral isotretinoin

first choice for Nodular or conglobate acne

oral isotretinoin

first choice for Maintenance therapy

adapalene

adapalene brand name

Differin | retinoid

tazorotene brand name

Tazorac | retinoid

tretinoin brand name

Retin-A | retinoid

Azelaic acid brand name

Azelex | antibacterial and keratolytic

benzoyl peroxide brand name

Oxy-10 | antibacteria;, comedolytic/keratolytic, anti-inflammatory

topical antibiotcs

* clindamycin (Cleocin-T) * erythromycin * clindamycin + BP (BenzaClin, DUAC)

# ora; antibiotics * minocylcine and ___ * erythromycin and ___ * TMP/SMX * most effective when ___ present

* doxycline * azithromycin * inflammatio

# Oral Anti-androgen Therapy * low dose oral ___ * ___ 100-150 mg per day * ideal for females who have acne flares during ___

* contraceptives * spironolactone * menstrual

# Topical Hormone Treatment Clascoterone 1% Cream * ___ receptor inhibtor * may be used in both ___ and ___ * $$$

* androgen * males and females

# treatment for severe acne Isotretinoin * vitamin ___ derivative * reduces ___ production and shrinks ___ glands * acne will get worse before it gets better

* A * sebum * sebaceous

# Rosacea - General Information * chronic ___ instability * facial ___ * more common in __

* vascular * blushing * women

* main trigger factor of rosacea * main drug that triggers rosacea

* temperature * vasodilators

# rosacea. treatment topical antibiotic * ___ 1% applied ___ topical retinoid * ___ acid 15% (Finacea)

* metronidazole * azelaic

# new rosacea treatment * ___ 0.33% (Miravasco) * ___ -2 adrenergic agonist * treatment for persistent facial ___ * available in drops of ___ rosacea | originally for glaucoma to cause vessles in eye to shrink

* Brimonidine * alpha * erythema * ocular

# Psoriasis * chronic ___ inflammatory skin disorder * ___ mediated * ___ proliferation (7x faster than normal) * thickened red patches covered by ___ white scales

* autoimmune * T-lymphocyte * keratinocyte * silvery

severe psoriasis is > ___ % BSA

10 %

psoriasis triggers

* STRESS * cold * smoking * drugs (NSAIDs, ACE, Li+)

T or F: some sun exposure is good for psorias

True | getting burnt will cayse more lesions so need to be careful

general treatment for psoriasis

* sun * baths * emollients * keratolytics (salicylic acid 2%)

# topical therapy for psoriasis * most effective when less than ___ % BSA is effected

* 20%

# Topical therapy for psoriasis (first line) * emollients * corticosteroids - preferred for ___ lesions * calipotriene/calcitriol - Vit ___ analogs, inhibit ___ of lesions * corticosteroids + tazarotene * calcineurin inhibitor - for areas not suitable for corts like the ___

* scaly * D, proliferation * face

T or F: topical corticosteroids have the possibility of tacyphylaxis

True

# phototherapy for psoriasis * targeted phototherapy for ___ and ___ plaques * for mild-moderate patients who do not respond to __ agents * used in combination with systemic/biologic treatment in patients with ___ disease * ___ has greater risk of skin aging and ___ cell cancer

* limited and resistant * topical * severe * UVA, squamous

# phototherapy for psoriasis * ___ penetrates thicker lesions better * ___ for thinner lesions * 20-25 treatments given ___ per week

* UVA * UVB * 2-3x

# psoriasis treatmet ___ taken PO before UVA * photosensitizer

Methoxsalen

# Severe Psoriasis treatment First line: Biologics * tumor ___ factor inhibitors * ___ cell activation inhibitors Second Line: systemic therapy * oral ___ * cyclosporine * methotrexate | methotrexate has long term effects of ___ dysfunctiion

* necrosis * T * retinoids | liver

# Key aspects of psoriasis treatment with biologic agents * PA usually required * many patiets will require supplemental ___ therapies * avoids ___ vaccines

* topical * live