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derm 15% Flashcards

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1
Q

MC cutaneous drug rxn and 2nd MC

A 
MC = IV (morbilliform)
2nd = I (urticaria/angioedema)
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2
Q

how long after exposure does type I rxn occur? type IV?

A

I- mins-hrs

IV- 2-14days

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3
Q

what disease is lichen planus associated with

A

HCV

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4
Q

what is the patho of lichen planus

A

cell-mediated immune response

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5
Q

describe lesions of lichen planus

A

5 p’s (polygonal, pruritic, planar, purple papules)
with irregular borders + fine scales
on FLEXOR surfaces

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6
Q

what 2 phenomenons are seen in lichen planus

A

koebners phenomenon

wickhams striae

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7
Q

what is koebners phenomenon

A

new lesions at sites of trauma

seen in psoriasis + lichen planus

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8
Q

what is wickham striae

A

fine white lines on skin lesions or oral mucosa in lichen planus

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9
Q

how long does lichen planus last

A

8-12mo

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10
Q

tx of lichen planus (1st + 2nd line)

A

1: topical corticosteroid
2: PO steroids, UVB, retinoids

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11
Q

what viral infection is associated w pityriasis rosea

A

HHV-7

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12
Q

what are the KEY words for pityriasis rose presentation

A

collarette scaling
cleavage lines
X-mas tree
face is spared

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13
Q

what tests should you get if you suspect pityriasis rosea

A

RPR- mimics syphilis

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14
Q

how long does pityriasis rosea last

A

6-12wks

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15
Q

difference btw SJS + TEN

A 
SJS = <10% BSA
TENS = >30% BSA
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16
Q

what is the presentation of SJS/TEN

A

fever + URI sx –> blisters on trunk/face
involves 1+ mucous membrane
+ Nikolsky

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17
Q

what is the patho of erythema multiforme

A

type IV cutaneous reaction

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18
Q

what is the MC cause of erythema multiforme + what is more common in kids

A

HSV

mycoplasma more common in kids

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19
Q

how long does erythema multiforme last

A

2wks

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20
Q

what do the lesions of erythema multiforme look like

A

target (iris) lesions
dusty-red/violet
pale edematous ring + peripheral red halo
NEG nikolsky

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21
Q

difference btw Erythema multiforme minor + major

A

minor- no mucous membranes

major- 1+ mucous membranes

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22
Q

when do you use isotretinoins for acne

A

if nodular or cystic

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23
Q

when do you use topical abx for acne and which can you use

A 
if mild (comedones +/- some papules/pustules)
clindamycin - use w benzoyl peroxide
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24
Q

when do you use PO abx for acne and which can you use

A

moderate (papules + pustules)

doxy, minocycline, emicin, clinda

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25
tx of lice (head/body/pubic) + 2nd line
permethrin- topical head- shampoo x10min body/pubic- lotion x8-10hr 2nd line = lindane
26
what is the cause of erythema toxicum and what age does it present at
neonates (3-5 days old) | immune system activation
27
what does erythema toxicum look like
pustules on erythematous bases 3-5 days after birth, sparing palms + soles
28
how long does erythema toxicum last
1-2wks
29
what is the name for genital warts
condyloma acuminata
30
tx of warts
podophylin
31
how do you dx mucosal HPV
whitens w acetic acid application | histology- koilocytic squamous cells
32
what strains of HPV does gradualism protect against
6, 11, 16, 18 | gardasil 9 = + 31, 33, 45, 52, 58
33
how does urticaria present
``` blanchable edematous pink papules/wheals/plaques may coalesce dermatographism drier's sign angioedema (painless) ```
34
what is dermatographism
new hives caused by local pressure to skin
35
what is dariers sign
localized urticaria where skin is rubbed
36
what can you use to tx contact dermatitis
avoid irritants | burrows
37
what are the ADRs of lindane
shower --> seizure
38
when is scabies worst
night
39
what part of the body does scabies affect
everywhere but face + neck
40
tx of scabies (1st + 2nd line)
permethrin x8-14hr + repeat in 1wk | 2nd line- lindane
41
cause of androgenic alopecia vs alopecia areata
andro- dihydrotestosterone (DHT) excess | areata- immune-mediated (assoc w other autoimmune)
42
location of androgenic alopecia vs alopecia areata
andro- temporal, mid-front or vertex areas of scalp | areata- smooth, discrete patches
43
what type of alopecia has exclamation point hairs
areata
44
is alopecia scarring
no
45
tx of androgenic alopecia
minoxidil if recent + limited | finasteride (PO)
46
tx of alopecia areata
local- intralesional injections of corticosteroids | extensive- topical corticosteroids
47
what causes atopic dermatitis
T cell + IgE mediated
48
where is atopic dermatitis MC
flexor surfaces
49
what is nummular eczema
sharply defined coin/discoid shaped | dorm of hands + feet + extensor surfaces
50
presentation of atopic dermatitis
ill-defined blisters/papules/plaques that dry/crust/scale | dermatographism
51
tx of atopic dermatitis
topical steroids | topical calcineurin inhibitors (tacrolimus, pimecrolimus)
52
difference btw topical steroids vs calcineurin inhibitors for atopic dermatitis
calcineurin inhibitors- no skin atrophy but can cause irritation, lymphoma/skin CA
53
presentation of perioral dermatitis
papulopustules on erythematous base --> confluent into plaques w scales spares vermillion border
54
tx of perioral dermatitis
flagyl or e-micin | NO CORTICOSTEROIDS
55
pathogen involved in seborrheic dermatitis
m.furur
56
tx of seborrheic dermatitis
selenium sulfide, oral antifungles | cradle cap- baby shampeoo, ketoconazole, topical corticosteroids
57
what does dyshidrosis look like
tapioca-like vesicles on soles, palms + fingers
58
tx of dyshidrosis
topical steroids
59
what kind of virus is molluscum
poxviridae
60
what does molluscum look like
dome-shaped, flesh-colored pearly/waxy papules central umbilication curd material in center
61
how long does molluscum last
3-6mo
62
what organism causes tinea versicolor
m.furfur
63
what does tinea versicolor look like
hyper/hypopigmented well-demarcated may coalesce fine scaling
64
what diagnostic tools can diagnose tinea versicolor
KOH prep- hyphae + spores (spaghetti + meatballs) | woods lamp- yellow-green fluorescence
65
tx of tinea versicolor
topical antifungals
66
MC cause of ringworm
trichophyton
67
what is tinea capitus
fungal infection of scalp
68
presentation of tinea capitus
annular, scaling lesions | scarring + alopecia
69
what skin layer is affected by tinea capitus
stratum corneum
70
tx of tinea capitus
``` PO griseofulvin (1st) PO terbinafine, itraconazole or fluconazole ```
71
tx of tinea pedis/cruris/corporis
topical antifungal | PO griseofulvin if failed
72
what toe is MC affected by onychomycosis
big toe
73
tx of onychomycosis
itraconazole + terbinafine
74
what is vitiligo
autoimmune destruction of melanocytes
75
where is vitiligo MC
``` dorsum of hands axilla face fingers folds genitals ```
76
tx of vitiligo
localized- topical steroids, calcineurin inhibitors | disseminated- phototx
77
what is the MC type of impetigo
nonbullous
78
what causes nonbullous impetigo
s.aureus (MC) | GABHS (2nd MC)
79
what is the keyword for nonbullous impetigo
honey-colored crust
80
what causes bullous impetigo
S.aureus MC
81
who usually gets bullous impetigo
newborns
82
what does bullous impetigo look like
vesicles --> large bullae --> rupture --> thin varnish-like crust fever + diarrhea
83
what causes ecthyma
GABHS MC
84
what does ecthyma look like
ulcers heal w scarring
85
what is the tx for nonbullous impetigo, bullous impetigo and ecthyma
mupirocin (bactroban) 1st | keflex if systemic (fever) or extensive
86
what causes miliaria
blocked sweat glands
87
what are the 3 types of miliaria (superficial to deep) and their differences
crystallina- tiny, friable, clear vesicles rubra- severely pruritic papules profunda- flesh-colored
88
what causes milia
keratin retention in dermis
89
what does milia look like
pearly white-yellow papillose on cheeks, forehead, chin + nose
90
how long does milia last
1-3mo of age
91
what is another name for staph scalded skin
ritter disease
92
what causes staph scalded skin
exfoliative exotoxins from s.aureus
93
who MC gets staph scalded skin
<5yo
94
presentation of staph scalded skin
malaise/fever/skin tenderness --> blanching erythema starting around mouth --> diffuse worst in flexor areas + around orifces --> sterile flaccid blisters in mechanical stress areas positive nikolskys --> desquamative phase
95
tx of staph scalded skin
nafcillin or oxacillin +/- clinda (1st line)

Pediatrics (9 decks)

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