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Dermatitis, etc Flashcards

(47 cards)

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1
Q

Atopic dermatitis

A

eczema
filaggrin deficiency
lichenification, dry, scaly

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2
Q

Atopic dermatitis nonpharm treatment

A

bath
maintain hydration – NO LOTION
oral antihistamine for pruritus

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3
Q

Mild-moderate atopic

A

low dose GC desonide BID 2-4 weeks
if face, 5-7 days
high GC triamcinolone 0.5 1-2 week tapered
Topical CNI, PDE4i

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4
Q

Mod-severe atopic

A

Soak and smear high potency steroid
jak stat if refractory = itinib
– monitor liver function
SQ IL- antagonist
Immunosupressants (CNI/MTX/AZA)

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5
Q

Allergic contact

A

urushiol or latex

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6
Q

mild-mod ACD

A

med-high potency GC x 2 weeks max
if chronic or face due: topical CNI (not for urushiol)

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7
Q

Severe ACD

A

systemic GC 3-4 weeks
taper 2-3 weeks
(DO NOT GIVE MEDROL DOSEPACK)

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8
Q

Do not use in ACD urushiol

A

antihistamines
topical CNI

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9
Q

Latex ACD

A

Steroids
Epi pen
Immunotherapy
anti-IgE therapy omalizumab

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10
Q

Seborrheic

A

due to malassezia yeast
infants - cradle cap
HIV, AIDs, Parkinsons patients

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11
Q

Cradle cap

A

often resolves
Baby shampoo, remove scales
emollient cream
AVOID steroids in baby

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12
Q

Seborrheic mild - mod tx

A

use twice a week
if <2 y/o ask ped
Ketoconazole - leave in 3 min
Selenium sulfide - discoloration
Zinc pyrithione -
Ciclopirox - V tach, contact derm

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13
Q

Severe seborrheic tx

A

systemic antifungals
Itraconazole
Ketoconazole
Fluconazole
Terbinafine

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14
Q

Seborrheic symptom relief

A

topical GC
not for baby or facial

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15
Q

Plaque Psoriasis

A

chronic inflammatory immune disorder
silvery white scale
auspitz sign = removal cause bleeding

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16
Q

risk factors for plaque psoriasis

A

FHx
infection
obesity
smoking
EtOH abuse

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17
Q

Comorbidities of plaque psoriasis

A

psoriatic arthritis
cardiometabolic disease
IBD
nonalcoholic fatty liver
mood disorder
cancer
osteoporosis

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18
Q

Triggers for psoriasis

A

Koebner phenomenom (injury)
- sunburn, infection, tattoo, vax
Infection, stress
Steroid withdrawal
Medications
- NSAID, lithium, BB, Quinidine, antimalarial

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19
Q

Psoriasis classification

Study These Flashcards
A

based on BSA
mild <3-5
moderate 3-10
severe >10 or affects emotions/folds

20
Q

Target response for psoriasis tx

Study These Flashcards
A

BSA <1% plaque infolvement

21
Q

Mild psoriasis

Study These Flashcards
A
  1. topical GC +/- vitamin D analog
  2. Retinol (tazorac)
    alternate
    - topical CNI
    - keratinolytics
22
Q

Mod-severe psoriasis

Study These Flashcards
A
  1. MTX (monitor liver)
  2. Cyclosporine
    Alternate
    - PDEI Apremilast
    - Vitamin A (Soritane)
    - IL inhibitors (risankizu, guselki, Brodalu, Ixekizu)
    - TNFa inhibitors
    - Psoralen +UV-A
23
Q

FTU

24
Q

bacterial conjunctiva

Study These Flashcards
A

crusting, purulent
S. aureus, S.pneumo, H.inf, M.cat
- gonorrhea eye rare, prophy
- chlamyida eye, no prophy

25
bacterial conjunctiva prophylaxis
Gonorrhea - erythromycin IM or IV ceftriaxone for sx
26
bacterial conjunctiva treatment
QID 5-7 days (if improve BID) 1. Erythromycin ointment 2. PolymyxinB/TMP 1-2 drops if Chlamydia - PO Erythromyycin QID 5-7 days -- Azithromycin x 3days
27
Contacts w/ bacterial conjunctivitis
Give Fluoroquinolone (pseudomonas risk)
28
bacterial conjunctiva avoid
aminoglycosides sulfacetamine azithromycin (expensive, resistant)
29
Viral conjunctivitis
pink eye, congagious self limiting sandy gritty morning crust adenovirus prodrome - fever, pharyngitis, URI jumps from one eye to the other
30
Viral conjuncitivs tx
1. Lubricating ointments + cold compress Symptom relief - naphazoline/phenriamine - azelastine - ketotifen - olopatadine
31
Allergic conjunctivitis
IgE hypersensitivity
32
Allergic conjunctivitis tx
avoid rub eye, avoid allergen, avoid contacts 1. antihistamine/vasoconstrictor (naphazoline/phenriamine) 2. antihistamine/mast cell stabilizer aka - azelastine - ketotifen - olopatadine Refractory - GC PO antihstiamine for prophylaxis
33
Toxic conjunctivitis
Redness, edema, mucus discharge, swollen eyelids, thickened eyelids TAKES YEARS TO DEVELOP
34
Cause of toxic conjunctivitis
aminoglycoside abx eyedrop antiviral agents glaucoma meds topical anesthetics contact lens solution artificial tears
35
Toxic conjunctiva tx
use preservative free short course LOTEPREDNOL QID
36
NONALLERGIC conjunctivitis
Transient chemica/mechanical causes Resolves in 24 hrs usually Similar sx to dry eye Diagnosis of exclusion No keratitis, iritiis, angle closure glaucoma, style, ulceration, or blepharitis
37
nonallergic conjuctivitis tx
Eye lubricants
38
Fleas
oral antihistamines topical GC
39
Bed bugs
wash, dry, freeze, professional exterminator, silica low potency GC systemic antihistamine
40
Head lice
wet comb Permethrin NIX - wet hair Pyrethrin/pip Rid - dry hair + retreat 7-10 days Lindane - BBW seizure/death/carcinogen TMP/SMX + NIX == resistant cases (kill symbiotic bacteria in lice gut that prod vitaminB)
41
Body lice
hot water, dry clean, evaluate STD Topical permetrin Pyrethrins/pip Cillaris
42
Scabies
Treat all fam/close contact wash, store bag 3 days SX: antihistamines max 2 weeks + MEDIUM potency topical GC Mites: 1. permetrin 2. Ivermectin 3. Crotamiton Crusted scabies PERMETRIN + POIVERMECTIN
43
Chiggers
soap/water, mitigate with belt REPEL with DEET topical anti-itch (methol) Topical GC Oral sedating AH (benadryl)
44
Mosquitos
nonsedating AH Topical GC 5-10 days Oral GC 5-7 days
45
Ticks
DEET ≥20%
46
Things to avoid in bug bites
Dibucaine Topical benadryl Hydrocortisone
47
DEET use
2 months + conc >30% children 10-35% for most Ticks 20% or higher

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