DERM Flashcards
(155 cards)
1
Q
Irritant vs Allergic Contact dermatitis
A
Irritant = diaper damage to kerotincytes and agent ; Vessicles FAST
Allergic = delayed hypersensitivity Type 4 [metals; nickel // fragrances ] ; slower
2
Q
Mild severe CD management
A
Mild = topical high potency
PO predinisone = SEVERE
3
Q
Eczema most common treatment for flares
A
High potency steroid
4
Q
Eczema patho
A
Chronic skin barrier dysfunction
IgE mediated hypersensitive reaction
The ITCH that RASHES
Cyclic ; spares diaper ; extensor surface = kids ;; flexor surface kids
5
Q
Pityriasis Rosea
A
Recent URI
Rash is sudden ; pruritic!@ “Christmas Tree Pattern”
1 Herald patch rash
HHV 6 // 7
6
Q
PR treatment
A
Supportive self limited 6-8 weeks
7
Q
Psoriasis nail findings
A
Nail pitting
Onycholysis
8
Q
Psoriasis patho
A
T cell mediated ‘’keratin hyperproliferation”
+Koebner phenomenon
+Auspitz sign = scratch and bleed
9
Q
What vitamin can be helpful in psoriasis
A
Vit D
10
Q
Mild to moderate psoriases is how much of the body surface
A
10-30%
11
Q
Organism of tinea vesicolor
A
M. Furfur
12
Q
Woods lamp findings for tinea versicolor
A
Yellow green
Copper orange
Fluorescence
13
Q
1st line tinea vesicolor
A
Azole anti fungals creams
Topical selenium sulfide
Topical zinc pyrithione
14
Q
Superficial =
A
Epidermis only + blanching
15
Q
Second degree burn
A
Deep partial thinkness in the dermis = not into the fat
[ sluggish blanching // pain is only to pressure]
Superficial partial thinkness
Partial thickness = + blanching
+ blisters
16
Q
3rd degree burns =
A
= full thinking into the fat
Central white clearing
17
Q
4th degree burn =
A
Full thickness into the muscle
“Painless”
18
Q
Deep partial burn to 4th degree re fluid number
A
4 mL x TTBSA of burn (%) x body wt (kg)
First half over first 8 hours
Rest over 24 hours
19
Q
Best topical antibiotics for burn conditions
A
Silver sulfadizine
Triple antibiotic ointment
TETANUS
20
Q
Stage 1 vs stage 2 pressure ulcer
A
1 = in tact non blanching erythema ; intact skin
+/- pain
2= shallow open ulcer
Red pink wound bed
21
Q
Stage 3 pressure ulcer
A
Into the fat slough + Eschar
22
Q
Stage 4 pressure ulcer is concerning for what
A
Undermining tunneling // bugs —> osteomyelitis
23
Q
Mc types of lesion in Steven Johnson sydnrome and what type of medication
A
Sulfa based
Mucosal lesions
24
Q
MC cause of Erythema Multiforme
A
HSV
25
EM can effects what part of the body
Legs arms —> palms ,, soles
26
SJS and TEN
SJS = less than 10%
TEN = 30%
Epileptics and Bactrim
27
SJS TEN has lesions that are like what
Proximal > Distal ;; think in the faceeee and trunkkkkkk
28
Bx of SJS and TEN will show what
Epidermal necrosis
29
Bullous pemphigoid think what?
NEGATIVE NIKOLSKY no slough
IgG autoantiboides
Attack hemidesmosomes
PRURITIC
+FLEXURAL AREAS
30
Bullous pemigoig Dx
Dx
Histopathology ; linear deposition
31
Pemphigoius vulgaris patho
Connection between skin cells messed up!
Fucked up the desmosomes
Vesicular blistering
IgG deposition
ACANTHOLYSIS
+NIKOLSKY SIGN
[myathesenia gravis// thymoma] - assoc
32
1st line pemphigous vulgaris
IV CC
33
What part of the skin/hair is affected in acne vulgaris
P. Acne’s at the pilosebacuos follicle
34
Describe moderate acne
Comedomal with; inflammatory lesions
= no cysts no scars
35
Evolution of treatment in acne
Topical retinoid
BP
PO ABX
Isotretinoin
36
Rosacea colonization of what ?
Demodex mites
37
What 3 ocular sxs in rosacea
Eye pruritis
Dry eyes
Gritty watery eyes
38
Best topical vs. oral treatment for rosacea
Topical = metronidazole
Oral = Doxy
39
What is the melanoma prognostic
Breslows Thickness
40
Mc type of melanoma
Superficial spreading
41
Eye involvement with pupil changing size think what pathology
Melanoma
42
Precursor to squamous cell carcinoma
AK !
43
#1 reason for squamous cell carcinoma in the skin
SUN
44
What does SCC look like
Pimple like on sun exposed area
+/ - bleeding
Non healing
Asxs
45
Describe AK
Solar keratosis
Atypical keratin cells
Thickness scaly crusted !
Hypopigmentation
46
SCCs management
5 ASA
Imiquimod
Standard excision
Radiation
47
BCC on the nose how do you treat it
MOhs Surgery !!
48
BCC looks like
MC type
Pearly nodule
Telenagiectasias
Mc type : NOdule ulcerated
49
Paronychia
Lateral proximal nail folds swelling infection on ONE finger
Wraps around the nail
Strep pyogenes
Staph A
50
Herpetic whitlow
Probably have HSV somewhere else , might be white
51
Felon is usually where on the nail
Palmar surface
52
Oral ABX for finger [ felon paraynchia ]
Dicloxacillin
Cephalexin
53
Cellulitis onset of sxs
Slow onset of chilled fever malaise
Tender erythematous gredaully increase in size
UNILATERAL
54
Upside down bottle leg
Lipedermatosclerosis
Fat limiting distal
Cellulitis complication
55
MRSA cellulitis
Vancomycin
Doxy
Clinda
Bactrim
56
Erysipeals mc infective agent
Strep pyogenes
57
Borders of erysipeals
WELL DEMARCATED epidermis
Super red
58
Oral ABX for erispeals
PCN
Amoxicillin
Cephalexin
IV = Ceftriaxone // Cefazolin
59
Derantophyte infection how do we diagnose
10% KOH
60
Tinea cap it’s has what characteristic sign
Black dot hyperkaratotic plaque
61
Tinea corporis
= TING WORM
Scaling annular lesion
Multiple stages of development
62
Tinea Pedis
Macerated wet moist interdigital show
KEEP IT DRY
63
Alopecia areata
Non scarring hair loss
Smooth
AUTOIMMUNE
64
Mainstay tinea treatment
Corporis // curries
PO griseofulvin
Corporis .. Curtis = mild topical anitfungal
65
Lice =
Pedicures is cavities
Hatch in 8 days NITS first then NYMPHS
Intense pruritis
66
Head lice treatment
Body
Pubic
Topical permethrin
Body = PO ivermectin
Pubic = PO ivermectin
67
Scabies transmitted
Skin to skin
68
Scabies patho
Mites lays less and drops feces ;; mite continuous to burrow
69
Treatment scabies
Topical // ORal
Permethrin
70
Condyloma acuminatam
HHV 6 and 11 anal warts
71
Treatment HHV 6 and 11
PA administered
Impiquimod
Podophyllotoxin
Sinecatchines
Physician administered : cryo // trichloroacetic acid // surgery
72
Pilonidal disease affects where
Acute vs chronic
Gluteal cleft
Inflammation —> pore —> skin/hair inflammation
Sudden pain odor
Or recurrent = chronic
73
What is the outer most layer of the dermis
Stratum Corneum
74
3 primary lesions
Macule
Patch
Papule
75
secondary lesions 3
Crusts
Erosions
Ulcers
76
Small lightly pigmented
Rough
Sandpaper
Pre malignant
AK —> SCC
Field txm =
5ASA
Imiquimod
Diclofenac sodium
77
HPV 12 18 31 plaque like psoriasis or AK and can progress to invasive SCC
Bowens
78
MC least aggressive skin cancer
Basal cell carcinoma
79
Most important prognostic factor for melanoma
Tumor thickness = breslow depth
80
Diameter greater than what is concern in for melanoma
6cm
81
If lesion is greater than what consider a sentinel lymph node test
1 cm
82
Kaposi sarcoma [4]
HHV 8 // HIV AIDS
GI tract / lung / skin mucocutaneous plaques
Purplish brown [firm]
Antiviral therapy cryotherapy
83
Expresses foul smelling cheese like material
From o plantations of epidermal elements
Erythematous
TXM?
Epidermal inclusion cyst
TXM = only if sxs = CC injection; ABX and Drainage = 2nd line
84
Sign of lesser trellat
Sudden explosion of seb kerrotosis on the back of
85
Proximal nail fold telangiectasias are found in what diseases
Scelroderma ; RA ; SLE
86
The itch that rashes
Where MC?
Eczema = atopic dermatitis
Antecubital / flexural area
87
Ointments
Creams
Gels
Lotions
Foams
O= most hydrating ; use in chronic
C = more drying ; better for acute subacute
G = best for acute ; weeping lesions
L = drying ; good for moist INTERTRIGINOUS areas or SCALP
F = quick absorption
88
HOW LONG SHOULD ONE USE CORTISONE AND THEN STOP
LESS THAN 2 WEEKS
89
Contact dermatitis does not what
Spread
90
Poison ivy has what
Linear vesicles
91
Pompholyx =
Dyshidrosis
TXM = CC
92
Coin shaped plaques
Mild to Severe PRuritis
LE on Men
Nummular Eczema = winter months!
93
MC location of lichen simplex chronicus
Itch scratch cycle
Neck and Extremities
Topical steriods w/ occlusion = TXM
94
Pruritic / purple
Polygonal / popular
Planar
W/ what else ?
-Lichen Planus-
Wickhams striae
+koebners phenomenon
TXM = top cc,
95
R/o what in pityriasis rosea
Syphillis
96
Perioral dermatitis txm
Topical metronidazole
2nd = doxy
*SPARES THE VERMILLION BOARDER!*
97
Seb dermatitis MC site
Scalp
TXM = selenium sulfide, ketoconazole foam
-worse in cold weather-
98
Increased risk of what with stasis dermatitis
Contact dermatitis due to progressive loss of the derm boarder
99
Photosensitivity reaction mgmt
UV protective clothing
Sync screen
100
MC photodermatosis
Polymorphous light eruption
101
2 MC drugs in drug eruptions
PCN and Sulfa drugs = MC
Tetracyclines, OCPs, NSAIDS
102
Bilateral target lesion occur where
Dull red Mcauleys that enlarge
-Hands and genitals-
Erythema Multiforme
103
MC drugs implicated in SJS and TEN
Allopurinol
Sulfonamides
Anticonvulsants
NSAIDs
104
TEN is correlated with lower prognosis if what is present
Neutropenia
105
Strep can set off what kind of psoriasis
Guttate psoriasis
106
What does psoriasis do the nails
Pitting
107
AUSPITZ sing in psoriasis
Pin point bleeding when you scrape the surface
108
Can you use tazarotene in pregnancy
NO
109
General mgmt psoriasis [4]
UVB light exposure
PUVA
Methotrexate
Oral retinoids
110
Bullous pemphigus
Over 60 yrs old
Pruritis TENSE blisters
Bx and DIF [IgG and C3]
Negative nikolsky sign
111
Pemphigus vulgaris begins where
The mouth ; mucous membranes
112
Flaccid Bullae
Skin and mucous membranes
+nikolsky sign
Staph A septicemia = cause of death
Pemphigus vulgaris
113
Tinea corporis
T. Rubrum
Round oval or semicircular border
Central clearing
TXM = azole ; PO if recalcitrant
114
Tinea pedis
Dry scaly patches
Bottom of foot —> whole foot
Hyphae on JOH and dermatophyte on Cx
TXM buries wet dressings ; aluminum
115
Tinea verisicolor [3]
Does not tan evenly
M. Furfur
Selenium lost ion shampoo; ketoconazole
116
Beefy red satellite lesions
Itching burning
Body folds // umbilicus
Candidiasis
Keep trying
Nysastin // oral FLUCONAZOLE = TXM
117
Cellulitis infection where
Dermis and subcutaneous tissues
Red hot tender fever + LAD
118
Erysipelas is from what
B hemolytic strep
119
Erysipelas TXM
IV PCN first 48 hours if severe
120
Fifth disease
Slapped cheek
Parvovirus
Droplet spread
Lacey rash
Adults = joint pain
121
Viruses of HFM : 2
Coxsackie and enterovirus
122
Enterovirus 71 ; HFM think what
CNS involvement
123
Measles [4]
Unvaccinated kids - respiratory
2-3 days after fever —> koplik spots —> rash at the hair line then spreads to trunk
Resolves 4 to 6 days
Multi-nucleated giants cells in secretions
124
Treatment verrucae
OTC salicylic acid
Imiqomoud
Cryotherapy
Self limited in 3 years
125
Genital warts
Condyloma acuminata
HPV 6 and 11
126
Herpes has what on tzanck
Multinucleated giant cells
127
Chicken pox vs. Shingles
Chickenpox = varicella
Shingles = herpes zoster
128
How long does it take shingles to resolve on its on
2-3 weeks
129
Post herpetic neuralgia can be treated with
Gabapentin
130
Molluscus is what virus
POX virus
131
Lice treatement
Malathion [flammable]
Topical ivermectin lotion
Clean and dispose of linen and clothing
Treat anyone in contact
132
Scabies is due to what
Mites and ovaries
That burrow : hands ; genitals ; but ; axillae
133
What is the stain for scabies
Lactophenol cotton blue
134
Who do you treat for scabies
Patient and all members of family
135
Why does acne improve in the summer
UV rays are anti-inflammatory
136
Isotretinoin used with tetracycline can cause :
Pseudotumor ceribri
137
Are there commodones in rosacea
No ;
Topical metronidazole = best treatment
PO = minocycline ; doxy ; oral tretinoin
138
Hidradenitis affects where
Apocrine gland follicles
*sinus tracts, double comedomes*
139
Folliculitis treatment
Bacterial;cephalosporin
Hot tub = self resolve
Gram negative on acne treatment = isotretinoi n
Esoinophillic = top cc + AH
140
Vitiligo genetic component
More than 30% have family history
141
Depigmented areas of vitiligo need what education
Sunscreen because highly prone to burning
142
Acanthosis nigricans think what two things
Insulin resistance
Adenocarcinoma of the GI tract
143
Electrical burn 2 high risk
Compartment syndrome
And
Necrosis
144
Less than what on the hands does not need sutures
Less than 2 cm
145
Highest rate of dehiscence
Adhesive tape
146
Pressure over bony prominences think what
Pressure ulcer
147
Wheals of varying sizes
Allergic or non allergic
Lesions can fade in 24 hours and then reappear ; differently
Urticaria
TXM = AH mainstay
CC
148
Fleas present as
Popular urticaria
149
Black widow bite
Red hour glas
Abdominal pain muscle cramping HTN
TXM = Antivenin of Lactrodectus
150
Brown recluse
Violin marking
Later Local necrosis possible
Fever chills N//V
TXM = bite excision // PO CC / Dapsone /Colchicine
151
Alopecia areata
Excalmmation point hairs
Non scarring hair loss
TXM = ILK
152
Androgenic Alopecia
Men = receding hairline at temples and hair loss at the vertex
Women = loss of hair over central scalpe wide part
TXM = Male = minoxidil / Finasteride
153
Onychomycosis
Fungal infection
T. Rubrum T. Ment.
R/O Diabetes
TXM = PO terbinafine /itraconazole = best
154
Periodic what for oral antifungal therapy
CBC and LFTs
155
Acute vs Chronic paronychia
Acute = S Aureus ; trauma hx
TXM = I & D if abscess ; PO ABX ; warm soaks
Chronic = Candida ; water workers
TXM = keep dry ; topical anti fungals
