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Flashcards in Derm Deck (55)
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1

open comodones

blackheads

2

closed comodones

whitehead

3

Impetigo etiology

S. aureus or strep

4

Impetigo tx

Topical mupirocin for small number of non-bullous lesions

Oral therapy for anything else: dicloxacillin, cephalexin, or clindamycin

Suspect MRSA→ clindamycin or linezolid

5

Lice tx

Permethrin 1% ​(shampoo & lotion), Ivermectin (Lindane restricted d/t neurotoxicity)

2nd tx in 7-10 days to kill any surviving nits

Can return to school after 1st tx

Mechanical wet combing is an alternative therapy for kids too young for medical therapy ( < 2 months)

Examine household & close contacts

Wash bedding & clothing in hot water w/ detergent, dry in hot drier x20min

Toys that can’t be washed should be placed in air-tight plastic bag x14days

6

Lichen Planus presentation

Develop on flexor surfaces of extremities, mucous
membranes of skin, mouth, scalp, genitals, nails

Purple popular pruritic polygonal planar

Oral white lacy patches = ​Wickam striae

Koebner phenomenon, fine scales

7

Lichen Planus tx

Typically resolves in 8-12mo

1st line = antihistamines, steroid ointment

2nd line = systemic steroids, UVB therapy

8

Scarlet Fever presentation

Pharyngitis

Strawberry tongue

Sandpapery rash that is worse in the groin and axilla with desquamation of palms and soles

9

Scarlet Fever tx

Penicillin VK or amoxicillin administered to prevent sequelae of rheumatic fever

10

Scarlet Fever etiology

GAS

11

Androgenetic alopecia

Male pattern baldness

Variable and unpredictable

12

Androgenetic alopecia tx

Minoxidil solutions = most effective in recent onset and smaller areas of hair loss

Finasteride may also be effective

SE = loss of libido and ED

13

Atopic derm presentation

Papules and plaques, with or without scales, are noted and may be associated with edema, erosion, and
crusts

MC on the flexural surfaces, neck, eyelids, forehead, face, and dorsum of the
hands and feet

pruritus and dry, scaly skin. Scratching leads to lichenification, fissures, and
worsening rash

Secondary infections caused by Staph aureus

14

Atopic derm etiology

Type I IgE mediated hypersensitivity rxn

15

Atopic derm tx

Antihistamines → ↓ itching

Topical corticosteroids = mainstay of the treatment; systemic corticosteroids should be
avoided

Tacrolimus and pimecrolimus are topical calcineurin inhibitors (immunomodulators) approved for moderate to severe atopic dermatitis
(less atrophy w/ prolonged use when compared to topical corticosteroids but may carry a potential to cause malignancy)


Hydration and topical emollients are key to management

Soaps, vigorous rubbing, frequent bathing, and irritant clothing such as wool should be avoided

UVB phototherapy is effective

Severe systemic cases may necessitate cyclosporine

16

Contact derm etiology

Type IV T-cell mediated rxn

17

Posion ivy tx

Tecnu, calamine lotion, oatmeal baths, astringents (witch hazel)

18

Allergic vs contact derm etiology

Type IV T-cell mediated rxn

Allrgic → metallic salts, plants (poison ivy), fragrances, nickel, preservatives, formaldehyde, propylene glycol, oxybenzone, bacitracin, neomycin, bleached rubber, chrome, sorbic acid

Irritant → water, soaps, detergents, wet work, solvents, greases, acids, alkalis, fiberglass, dusts, humidity, chrome, lip licking or other trauma

19

Allergic vs contact derm presentation

Eczematous (irritant), vesicular (allergic)

Allergic → Acute with macules, papules, vesicles, and bullae, chronic with lichenification, scaling, fissures, uncommon on scalp, palms, soles, or other thick-skinned areas that allergens can’t get through

Contact → Acute with bullae, erythema, and sharp borders, chronic with poorly-demarcated erythema, scales, and pruritus, fissured, thickened, dry skin, usually palmar

20

Diaper Dermatitis etiology

Candida

21

Diaper Dermatitis presentation

Red, well defined margins, pustules, vesicles, papules or scales

Satellite lesions

Common in dark, moist areas (axillae, under breast)

22

Diaper Dermatitis treatment

Topical antifungals such as nystatin

23

Perioral Dermatitis presentation

Papulopustules form on erythematous bases and may become confluent with plaques and scales

Vermilion border is spared, and satellite lesions are common

24

Perioral Dermatitis treatment

Avoid topical steroids bc will aggravate the lesions

Topical metronidazole or erythromycin or oral minocycline, doxycycline, or tetracycline

Untreated lesions will fluctuate over time, similar to rosacea

25

Type I drug rxn

IgE mediated​, immediate

urticaria, angioedema

26

Type II drug rxn

Ab-mediated​, cytotoxic (drugs in combo with cytotoxic antibodies)

27

Type III drug rxn

immune​ ab-antigen complex​

drug mediated vasculitis and serum sickness

28

Type IV drug rxn

delayed ​cell-mediated​

erythema multiforme

29

Exanthematous Drug Eruption presentation

>2 d after drug

Limited to skin

Lesions initially appear on trunk and spread to extremities in symmetric fashion

Erythematous macules and infiltrated papules, pruritus and mild fever may be present

30

Exanthematous Drug Eruption tx

Resolves a few days - week after med stopped

Can continue med if not too severe and med cannot be subsuituted

Topical steroids, oral antihistamines and reassurance

Cold to help with itch