Dermatologic Disorders Flashcards by Onita Bhattasali

side effects of oral isoretinoin

teratogen, hepatotoxicity, hypertriglyceridemia, pancreatitis, suicidal ideation

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adverse effect of combining oral isoretinoin with tetracycline

pseudotumor cerebri

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treatment for necrotizing fascitis caused by streptococcus or clostridia

penicillin G +/- clindamycin

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general empiric treatment of necrotizing fascitis

impinem +/- vancomycin

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treatment for MRSA skin infections

10-14 day course of:
bactrim + rifampin
clindamycin + rifampin
minocyclin + rifampin
linezolid \$\$$

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classic presentation of rosacea

facial erythema with telangiectasias starting at the nose and cheeks
provoked by various stimuli including spicy foods
rhinophyma (sebaceous gland hyperplasia of the nose)

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treatment for rosacea

topical:
sulfacetamide + sulfur
metro-gel, metronidazole
rhinophyma may require laser therapy

systemic treatment:
tetracycline, doxycycline, or accutane

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when antibiotics should be used in the treatment of skin abscesses

if abscess is > 5cm or if patient has comorbidities: diabetes, immunocompromised

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preferred medication in treatment of scabies

permethrin soap

second line: oral ivermectin

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characteristic features of necrotizing fasciitis

necrosis, purple, woody texture, crepitus, pain extends beyond region of cellulitis

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treatment for dry gangrene

auto-amputation

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treatment for wet gangrene

debridement or amputation

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medication options for treatment of acne vulgaris

first line: topical retinoin
second line: oral/topical antibiotic or benzoyl peroxide
other options: OCPs, spironolactone, or oral isoretinoin for cystic acne

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time-frame in treatment of varicella

antivirals if within 72 hours

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side-effects from oral isoretinoin

hepatotoxicitiy, suicidal ideation, teratogenic effects, elevated triglycerides and pancreatitis

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appearance of molluscum contagiosum

painless shiny papules with central umbilication

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treatment for molluscum contagiosum

self-limited, most resolve within 3 years
chemical, laser, or cryotherapy for removal
imiquimod will induce inflammatory reaction against lesion

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treatment for tinea capitis

oral griseofulvin, terbinafine

topical will not work because the tinea is INSIDE the hair follicle

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lichen planus features

pruritis, purple, polygonal, papules, and plaques
shiny and flat on flexor surfaces
associated with HIV and hepatitis C

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treatment of lichen planus

topical or intralesional medium to high-potency steroids

acitretin (oral retinoid)

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stages of decubitous ulcers

stage I: pressure related alteration in intact skin such as change in color, consistency, or temperature
stage II: superficial ulcer, abrasion, or shallow crater
stage III: full thickness skin loss
stage IV: extensive destruction or necrosis, damgage to muscle or bone

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treatment of decubitous ulcers

address nutrition to help body heal
relieve pressure, soft mattress, elevate heels
debride if necessary with hydrocolloid dressing

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stasis dermatitis

caused by vascular insufficiency
increased pigmentation, scaly and crusted erosions, ulcers
treat with compressive stockings, elevation of legs, topical steroids, consider horse chestnut seed extract, aspirin to accelerate healing of ulcers

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medications that cause erythema multiforme

penicillins, sulfonamides, NSAIDs, OCPs, anti-convulsants

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distinctions between erythema multiforme, stevens-johnson, and TEN

erythema multiforme: target lesions, no sloughing of skin | stevens-johnson: 30% body sloughing, decreased WBC, decreased H/H, elevated LFTs

classic presentation of pityriasis rosea

herald patch followed by christmas tree rash 1-2 weeks later

treatment for pityriasis rosea

self-limited, consider UV therapy

clinical features of pityriasis versicolor

salmon/light brown hypopigmented macules that will scale when scraped off wood-lamp shows blue-green scales

treatment for pityriasis versicolor

ketaconozole, selenium sulfide

classic presentation of erythema nodosum

associated with IBD, streptococcus, sarcoidosis | pretibial, tender, painful nodules

classic presentation of lichen planus

pruritic, purple, polygonal, papule, plaque

treatment for seborrheic dermatitis

selenium sulfide, tar, ketoconazole, topical steroids

treatment options for psoriasis

``` topical steroids (NOT ORAL) tar, anthrolin, salicylic acid, UV therapy, anti-TNF agents in refractory cases ```

diagnosis and management: melasma

hyperpigmentation of skin associated with pregnancy minimize sunlight exposure hydroquinone (inhibits tyrosine kinase to block melanin production) mix with flucinolone, tretinoin

diagnosis and management: vitiligo

sharply demarcated patches of complete depigmentation, loss of melanocytes, borders are hyperpigmented associated with thyroid disease in 30% of patients sunscreen, corticosteroids if <10% skin is affected tacrolimus, pimecrolimus (can use around eyes unlike steroids), psoralens, UV light, surgical minigrafting, or depigmentation of normal skin using hydroquinone

diagnosis and management: acanthosis nigricans

hyperpigmentation of skin in creases of body treat diabetes, weight loss, discontinue steroids, survey for visceral malignancy topical retinoin, steroids, fish oil

purple-red hemangioma on face that does not regress with age

port-wine stain | associated with sturge-weber

infant with bright-red lesion that regresses over months-years

strawberry hemangioma most spontaneously resolve, use systemic steroids if periorbital, in airways, or associated with high-output heart failure

benign small red papule that appears on skin with age

cherry hemangioma

bright red papule with radiating blanching vessels

spider angioma | associated with cirrhosis

blue compressible mass that does not regress

cavernous hemangioma

red-pink nodule on a child that is often confused with melanoma

spits nevus

diagnosis and management: alopecia areata

asymptomatic, non-inflamamtory, non-scarring areas of hair loss, often precipitated by stress rule out other causes: CBC, BMP, ESR, TSH, ANA, SLE, syphillis, addison's, trichotilliomania treatment: fluocinolone oil/shampoo, intralesional steroid injections, topical minoxidil, anthralin cream, SADBE, topical steroids ineffective due to poor scalp penetration

diagnosis and treatment: androgenic alopecia

male-pattern hair loss, check serum testosterone, DHEA, prolactin men: finasteride +/- minoxidil women: minoxidil +/- sprionolactone

most important prognostic indicator of melanoma

depth of lesion

skin condition associated with obesity, diabetes, or malignancy

acanthosis nigricans

pigmented plaques that appear to be stuck onto the skin

seborrheic keratosis

black velvety plaques on flexor surfaces and intertriginous areas

acanthosis nigricans

rough lesions on sun exposed skin easier to feel than see

actinic keratosis

circular rash with central clearing on the trunk or arms

tinea corporis

classic appearance of basal cell cancer

pearly lesion with central ulceration and telangiectasias

classic appearance of squamous cell cancer

erythematous papule with scaling or keratinized growths in sun-exposed area, may bleed or ulcerate

classic appearance of porphyria cutanea tarda

blistering on sun-exposed skin, erosions and hyperpigmented skin

how might pemphigus vulgaris be distinguishable from bullous pemphigoid

positive nikolsky test for pemphigus vulgaris

treatment options for actinic keratosis

topical 5-FU or imiquimod, cryotherapy

purple-red hemangioma on face that does not regress with age

port wine stain

infant with bright-red lesion that regresses over months to years

strawberry hemangioma

benign small red papule that appears on skin with age

cherry hemangioma

bright red papule with radiating blanching vessels

spider hemangioma

blue compressible mass that does not regress

cavernous hemangioma

red-pink nodule on a child that is confused with melanoma

spitz nevus

treatment available for androgenic alopecia

men: finasteride +/- minoxidil women: minoxidil +/- spironolactone

underlying causes of alopecia areata

trichotillomania, stress, autoimmune disorders, lupus, addison's disease

round, firm, rapidly growing papule with a central crater

keratoacanthoma

rough surfaced, sharply demarcated, round, firm papule whose color may be gray, yellow, brown, or gray-black

wart

friable, rapidly enlarging, erythematous, vascular-appearing papules with a collarette of scale

pyogenic ganuloma: most commonly develop at sites of previous minor injuries (misnomer, more appropriately known as lobular capillary hemangioma) treatment: surgical excision, curettage, or electrodesiccation

Dermatologic Disorders Flashcards

(66 cards)