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Flashcards in Derm Deck (118):
1

Syndromes associated with acanthosis nigrican?

Hashimto's
Phenylketonuria
Dermatomyositis
SLE
Scleroderma
Wilson syndrome
Hodgkin + nonhodgkin
Pheochromocytoma
Ovarian / endometrial Ca
Genitourinary ca
GI ca

2

What thyroid conditions associated with acanthosis nigrican?

Hashimto's
Thyroid Ca

3

Rx of ganuloma annulare?

Self limiting (None)
Or
IL steroids
Topical / oral steroids

4

Is granuloma annulare contagious?

No.

5

Morphology of erysipelas?

Well demarcated warm tender erythema with raises borders.

6

Causative organism of erysipelas?

GAS (S. pyogenes)

7

Erysipelas in DM?

Associated with tinea pedis (portal of entry)

8

Why does s. aureus infection spreads to dermis & SQ?

Coagulase enzyme.

9

Characteristic features of actinomyces Israelii?

Infection of cervicofacial

Sinuses discharging sulphur granules

10

Hall mark of C. Perfringens?

Gas gangrene

11

Organism of molluscum?

Pox virus

12

Mode of infection of molluscum?

Direct contact

13

Classic molluscum?

Small nodule or papule with umbilicated center (1-5 mm)

Filled with caseous material.

14

Rx of erysipelas?

1st line: penicillin, dicloxacillin, cefazoline

2nd: cefaloxine, erythromycin

15

Most common cause of chronic urticaria?

Unknown

16

Infection associated with urticaria?

H. Pylori.

17

Classic BCC?

Slowly growing shiny papule with pearly borders and telangiectasia

With central dell or ulcer.

18

Rx of BCC?

Curettage
Excision
Radiation

19

Classic pyogenic granuloma?

Dumb-bell shapes bright red mass without white areas of surface ulcerations (<2.5 cm)

Found on mucosal surfaces after trauma or infection (oral)

20

Leukoplakia?

Persistent adherent white patch / plaque can't be rubbed off.

Associated with smoking.

21

Rx of leukoplakia,

Stop smoking.
Disappears within year after smoking cessation.

22

Pityriasis Rosea Classic?

Red thin oval plaques / patches with central scaling

Starts as one herald patch the progresses.

Following Langer's lines.

Christmas tree on back.

23

Varicella Rash?

2-3 successive corps of pruritic vesicles + papule over days

Evolve into pustules + crusts with various stages of development present.

24

Steroid induced acne?

Mono-morphic acne form eruption with explosive onset.

Upper trunk.

25

Skin tags association?

Obesity
DM

26

Skin tags + risk of cancer?

Not significant

27

Skin tags + risk of HIV?

Not associated.

28

Leishmaniasis classic?

Papule > ulcerates > shallow annular with raised margins


None healing after months.

29

Causes of scaring alopecia?

1. Infection:
Syphilis
TB
AIDS
HZV

2. Autoimmune:
DLE

3. Sarcoidosis

4. Trauma

30

Scalp in trichotillomania?

Decrease hair density
Broken hair of varying length

31

Rx of rosacea?

Topical metro gel
Azelaic acid

32

Dupuytren's contracture?

Shortened thickened fibrous fascia of palmar surface
With nodules on distal palms

33

Dupuytrens Contracture age?

> 40 YO
Men

34

Dupuytren's contracture association?

DM
Smoking
Alcohol
Epilepsy

35

Rx of dupuytren's contracture?

Observation
IL steroid injection
Surgery

36

Tinea pedis classic?

Painful, pruritic, vesicles/bullae with clear or purulent flui.
On anterior foot


Rupture => Scaling with erythema.

37

Complications of inflammatory tinea pedis?

Cellulitis, lymphangitis, adenopathy.

38

Tinea pedis association?

Dermatophytid reaction
On Palms and side of fingers symmetrically

Hyper sensitivity to infection on foot
(DDx dyshidrosis)

39

Rx of uncomplicated herpes zoster ophthalmicus?

Oral anti vitals
Acyclovir
Famcyclovir
Valicyclovir

Steroids for pain (no effect on post herpetic neuralgia)

40

Rx of post herpetic neurologia?

Capsaicin cream

41

Risk of paronychia?

Handling water
Exposure to irritant

42

Rx of paronychia?

Avoidance of water / chemicals

Potent topical steroids for 3-4 wk

43

Acute vs chronic paronychia?

Acute: swelling redness around nail + lateral pus

Chronic: swelling tenderness redness + thick discolored nail.

44

Pityriasis Rosea classic?

Herald patch:
3-5 cm erythematous patch with scaly border and central clearing

Followed by similar lesions on cleavage lines of skin.

Rash persist 2-3 mo

45

Rx of pityriasis Rosea?

1. Reassurance
2. Topical Steroids for itch
3. Sever = phototherapy
(?) erythromycin for 2 weeks.

46

Keratoacanthoma classic?

Skin colored - red Dome shaped nodule with central keratin plug smooth shiny surface heals within 6-12 mo

47

Most common cause of EM?

HSV

48

Rheumatological Dz with risk of Ca?

Dermatomyositis

49

Cancer associated with dermatomyositis?

Ovarian
Lung
Pancreas
Gastric
CRC
Non-Hodgkin

50

Sjogren syndrome associated with what Ca?

Non-Hodgkin lymphoma

51

Dupuytren's contracture affected finger?

4th > 5th

52

Trigger finger classic?

Locking of finger in flexed position when extended snaps back

Due to narrowing of space within sheath that surrounds tendon (inflammation)

53

Sx of trigger finger?

Pain
Stiffness
Clicking with movement
Nodule on base of finger

54

Most common affected finger in tigger finger?

Thumb

55

Camptodactylyl classic?

Painless flexion contracture of the proximal inter-phalangeal joint (progressive slowly)

56

Most affected finger in camptodactylyl?

5th

57

Sx of camptodactylyl?

No swelling (IMP)
Involves MP + distal IP

58

What mediate an allergic reaction?

IgE

59

Rx of cellulitis?

Oral:
Cephalexin
Dicloxacillin
Clindamycin


IV:
Cefazolin
Oxacillin
Nafcillin

60

Rx of seborrheic dermatitis?

1. Hygiene, shampoo, topical steroids

2. Resistant => oral ketoconazole or fluconazole

61

Causative organism in seborrheic dermatitis?

Pityroaporum

62

Rx of dental infection w/ cellulitis?

Penicillin
Clindamycin if allergic

63

Risk of leukoplakia malignant transformation?

2-6%

64

Onychomycosis classic?

Nail plate separation from nail bed.

Thickened nail

Dystrophic nail

Discolored nail (white, yellow)

65

Rx of onychomycosis?

1st line:
Terbinafine 250mg OD 6wk for fingernails + 12wk for toe nail.

2nd line:
Itraconazole 200mg for 6 + 12 wks.

66

Monitor labs in terbinafine?

CBC, AST, ALT at 0, 4, 6

67

Cause of acute paronychia?

Trauma to nail fold or cuticle

68

Rx of acute paronychia?

Topical Abx +/- steroids.
Oral Abx
Warm compressors
I+D

69

Rx of psoriasis?

Topical Steroid
Phototherapy
MTX
Etretinate stopped = risk of birth defects now used for T-Cell lymphomas.

70

Erythema multiforme classic?

Target / iris like lesions

71

Is nutritional supplement helpful in pressure ulcer healing?

No

72

Head elevation is helpful in pressure ulcer to minimize sheer pressure?

No

73

Degree of bed elevation in pressure ulcer to help minimize sheer pressure?

< 30 degrees

74

When to use oral antibiotics in pressure ulcer?

Complicated by:
Cellulitis
Osteomyelitis
Bacteremia

75

Period to use topical Abx in pressure ulcer?

> 2 wk

76

Cause of stasis dermatitis?

Chronic venous insufficiency

77

Lichen simplex chronicus classic?

Habitual scratching > isolated hyper-pigmented edematous nodules/papules.

78

Cause of chronic paronychia?

Candida

79

Canadiasis classic?

Poorly marginated
Bright red plaques
With satellite papules / pustules

Pruritic

80

Location of candidiasis in M+F?

Men: inguinal-scrotal fold > thighs , gluteal cleft , scrotum

Female: labia majora + minora +

81

Dx of candidiasis?

KOH
Culture

82

Rx of candidiasis?

Topical imidazoles BID (clotriazole, ketoconazole, miconazole)

Drying agents: anti-fungal powders (miconazole, nystatin, tolnaftate, 12% benzoic acid, undecylenic acid)
Or aluminum sulfate calcium acetate solution.

If sever itchiness > add steroids (hydrocortisone)

83

Topical or oral anti-fungal for tinea capitulation? Why?

Oral

To penetrate hair shaft.

84

Rx of contact dermatitis?

Anti-pruritic
Avoidance of irritants
Cool compressors (burow's solution)
Topical steroid: (triamcinolone 0.1% or betamethasone valerate cream 0.1%)

Oral prednisolone 60mg OD for 7-14 days for sever blistering disease.

85

Mechanism of action of minoxidil?

Prolongs anagen phase
Increase blood flow to follicle

86

Minoxidil helps what areas of scalp the most?

Vertex alopecia

87

Mechanism of action of finasteride?

5a reductase
Blocks conversion of testosterone to dihydrotesteron

88

Dose of proscar?

1 mg PO OD

89

Rx of andogentic alopecia?

Minoxidil
Finastride
Hair transplant
OCP
Spirnolactone

90

Natural course of actinic keratosis?

Most regress spontaneously

Some => SCC

91

Felon classic?

Sever pain
Fluctuance
Redness
Tenderness
On top of medial / dorsal finger.

92

What's felon / whitlow?

Infection of digital pulp of terminal phalanx

93

Eponychia classic?

Painful
Pus around nail.

94

When do symptoms of contact dermatitis appear and why?

12-48 hr after contact

Delayed hypersensitivity reaction

95

Patch test results in contact dermatitis?

+1 = erythema + edema
+2 = papules
+3 = vesicles / bullae

96

Leishmaniasis transmission?

Sandflies bite

97

Rx of leishmaniasis?

Sodium stibogluconate

98

What nutritional intervention help pressure ulcer?

Protein intake at 1.2-1.5 g/kg/day
+ increased calorie intake.

99

Cause of erythrasm?

Corynebacterium infection

100

Erythrasm under woods light?

Coral red

101

Rx of erythrasm?

Topical Abx:
Fusidic acid
Clindamycin (1st line)
Erythromycin

102

Sx of sarcoidosis?

- Eye = uveitis
- Neuro = 7th CN
- skin = lupus pernio + erythema nodosum
-Cardio = restrictive cardiomyopathy
- renal
- hepatic
- hyper calcemia

103

What's pernio lupus?

Indurated red-purple shiny nodules and papules on face

104

Cause of hypercalcemia in sarcoidosis?

Secondary to Vit D production by granulomas

105

Labs for HSV?

Culture
PCR
DIF
Serology

106

Sx of sarcoidosis?

- Eye = uveitis
- Neuro = 7th CN
- skin = lupus pernio + erythema nodosum
-Cardio = restrictive cardiomyopathy
- renal
- hepatic
- hyper calcemia

107

What's pernio lupus?

Indurated red-purple shiny nodules and papules on face

108

Cause of hypercalcemia in sarcoidosis?

Secondary to Vit D production by granulomas

109

Labs for HSV?

Culture
PCR
DIF
Serology

110

Derm causes of pruritus?

Scabies
Pediculosis
Insect bite
Urticaria
Atopic dermatitis
Contact dermatitis
Lichen planus
Dermatitis herpetiformis

111

Anti-pruritic Rx?

Topical:
Camphor/menthol lotions

Systemic:
Hydroxyzine

112

Rx of scabies?

Permethrin
Lindane

113

Rx of dermatitis herpitiformis?

Dapson
Sulfonamides

114

Prodorm of lichen planus?

Low grade fever for 2 days.

115

Lichen planus classic?

6 p
Purple
Planar = flat topped
papule
Plaques
Polygonal
Pruritic
Penis

116

Maximal period of LP rash to spread!

2-16 wks

117

Rash of 2ry syphilis?

Proceeded by chancre
Maculopapular eruption
Widespread (+palms / soles)

118

Tinea corporis classic?

Pink scaly patches with the raised borders and occasional Papules and pustule