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Flashcards in Derm Deck (33):
1

Tinea versicolor is caused by this organism

Malassezia species

2

pityriasis rosea treatment

oral erythromycin

3

deeply seated mass in the trunk that is associated w/ vague abdominal discomfort; previously had similar things in the area that were surically excised

desmoid tumor - locally aggressive benign arising from fibroplastic elements within the muscle or fascial planes

low potential for mets or differentiation

can cause intestinal obstruction and bowel ischemia

high rate of recurrence, even after surgery

4

What is the Leser-Trelat Sign?

What is it associated with?

acute onset of numerous seborrheic keratoses

associated w/ many internal malignancies, most commonly adenocarcinoma of the GI tract

5

what is characteristic of chronic urticaria's presentation?

prognosis?

episodes of well-circumscribed and raised erythematous plaques w/ central pallor - lesions appear and enlarge over minutes to hours before disappearing within 24 hours

intense pruritus

resolves spontaneously within 2-5 yeras

6

treatment for infantile hemangiomas

propranolol

7

tinea capitis treatment

PO griseofulvin or PO terbinafine

caused by Trichophyton tonsurans or microsporum species

topical antifungals are ineffective of the infection in patients w/ involvement of the hair folliciles, but some people recommend it to reduce transmission to household contacts during treatment.

8

treatment of actinic keratosis

treat early w/ destructive or pharmacologic measures to prevent degeneration into invasive SCC 

5-FU

imiquimod

liquid nitrogen

photodynamic therapy

9

treatment of psoriasis (plaques only)? 

treatment of psoriasis (w/ joint involvement)?

plaque psoriasis = TOPICAL high-potency steroids or Vit D derivatives (i.e. calcipotriene) 

topical steroids may trigger pustular psoriasis

psoriatic arthritis = methotrexate. phototherapy

10

shingles treatment

when is the vaccine indicated?

treatment of post-herpectic neuralgia

acycolvir or valacycolvir started within 72 hours of onset of rash

(steroids have not been proven beneficial, but have actually been associated with secondary bacterial infections)

vaccines recommended for adults ≥60, shown to reduce risk of zoster and post-herpetic neuralgia

PHN: TCA, topical capsaicin, gabapentin, long-acting oxycodone

11

scabies rash is due to what type of hypersensitivity reaction?

delayed type IV reaction to the mite, its feces and ova

12

scabies treatment

5% permethrin cream

or

PO ivermectin if it is an outbreak in a nursing home or a facility where it may be difficult to use topical therapy 

13

"tomato-red plaques and satellite papules" are characteristic of ...

candidal intertrigo and perineal infection

14

treatment for photoaging

all-trans-retinoic acid (ATRA) aka tretinoin

15

rosacea treatment

metronidazole

16

painLESS blisters, fragile skin, facial hair overgrowth and pigmentation triggered by ingestion of substances (e.g. ethanol, estrogens)

what is it often associated wtih?

how to cinch the diagnosis?

treatment?

porphyria cutanea tarda - ∆uroporphyrinogen decarboxylase (enzyme in heme synthesis)

often associated w/ HepC

urine test for urinary uroporphyrins

tx: phlebotomy, hydroxychloroquine, IFNa (for those who are also infected w/ HepC)

17

Alopecia areata is commonly associated with what other physical finding

what other autoimmune conditions are they at increased risk for?

nail pitting

thyroid disease, vitiligo, pernicious anemia

18

DIfference between telogen and anagen effluvium

both have diffuse thinning of hair, but anagen effluvium affects the growing phase of the hair growth cycle (hair formation) and telogen effluvium affects hte resting stage of the hair cycle

19

Treatment regimen for patients w/ hidradenitis suppurativa (HS)

weight loss, smoking cessation, daily skin cleansing

if + nodules, sinus tracts, scarring -> PO tetracyclines

if +diffuse involvement/extensive sinus tract -> infliximab, PO retinoids, surgical excision

20

rosacea treatment

erythema + telangiectasias - topical brimonidine (peripheral a2 agonist->vasoconstriction of blood vessels)

(clonidine is also a central a2 agonist -> decreases sympathetic tone)

 

21

complication most frequently associated w/ rosacea 

ocular manifestations (burning, foreign body sensation, blepharitis, keratitis, conjunctiviitis, corneal ulcers, recurrent chalazion)

22

venous sinus thrombosis is a complication of which type of infection?

mucormycosis 

23

when is PO antibiotics indicated for acne?

for patients w/ severe or nodular (cystic) acne 

moderate acne that is unresponsive to topical antibiotics

widespread acne (back, arms)

24

what is melasma

acquired hypER-pigmentation on sun-exposed areas of the face

more common in women, esp during pregnancy

25

patient on acne treatment develops sunburn, which medications is he on?

of the acne medications, which has the lowest risk of photosensitivity?

oral tetracycline, doxycycline, benzoyl peroxide

minocycline - lower risk of photosensitivity

26

what medication has been shown to reduce pain and erythema,a and minimize damage to the epidermis if administered immediately after sun exposure?

NSAID

27

8 main ADRs of isotretinoin

  1. teratogen
  2. hyperglycemia
  3. hypertriglyceridemia (avoid etoh due to risk of pancreatitis)
  4. hepatotoxicity
  5. mucocutaneous reaction
  6. blood dyscrasias
  7. ocular toxicity
  8. severe depression, suicidal ideation

28

this whitish, lacy streak on a background of erythema on the buccal mucosa is a common finding in which disorder?

what is it commonly associated with?

Q image thumb

lichen planus (5P's)

pruritic

purple

polygonal

planar papules and plaques

mucosal involvement = Wickham striae (reticular white lines)

commonly associated w/ HepC

29

patient presents w/ new onset of severe seborrheic dermatitis. what should you consider?

HIV

30

treatment of potentially disfiguring or complicatied infantile hemangiomas (those that involve viscera, airways, necks, periorbital areas)

propranolol

31

prodrome of urticaria followed by an erythematous rash w/ tense bullae

diagnosis? confirmatory test?

bullous pemphigoid

test: skin biopsy, serum assay for basement membrane antibodies

32

explosive onset of pruritic seborrheic keratosis - consider this:

lung/GI malignancies

33

patient on BP medication develops sun burn, what medication is likely to have caused it?

patient on BP medication develops SJS, what medication is likely to have caused it?

patient on BP medication develops angioedema, what medication is likely to have caused it?

photosensitivity: HCTZ 

SJS: furosemide

angioedema: ACEi