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Dermatology Flashcards

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1
Q

what is Cholasma?

A

also known as melasma

“Mask of pregnancy”
sun spots of the face

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2
Q

what is straie gravidarum?

A

stretch marks

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3
Q

normal age related skin changes

A

loss of elastin, collagen & subcutaneous fat

**sweat glands & sebaceous glands decrease _> decrease thermoregulatory _> increases risk for heat stroke

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4
Q

what is NOT a normal age related skin change?

A

Dermatophytes - fungus infection on skin when in sun, skin turns darker pigment (expected) except for area with fungi infection which turns lighter

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5
Q

what is an example of a macule vs patch?

A

Macule is small (<1cm) = flat nevi (freckle)

Patch = bigger macule >1cm = mongolian spot, vitiligo, chloasma

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6
Q

location of tinea curis vs corporis vs capitis

A 
cruris = peri area 
corporis = body (ringworm) 
capitis = head (cradle cap in babies)
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7
Q

what is the tx for tinea capitis?

A

grisefulvin 500mg daily 4-6 weeks.

Take with high fat meals to improve absorption.
avoid sun exposure
may reduce efficacy of oral contraceptives
monitor for clay stool

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8
Q

when can children return to school after diagnosed with tinea capitis?

A

after treatment initiated

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9
Q

what could the diagnosis of a skin lesion that appears hypo or hyperpigmented with slightly scale macules on the trunk, neck, and upper arems?

A

Tinea Vesicolor (superficial fungal infection)

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10
Q

Treatment for Tinea fungal infection?

A

Topical : “-azole” creams (Clotrimazole 1%, miconazole 2%, ketoconazole 2%, econazole 1%)

Oral: Griseofulvin 125mg/250mg.
Derived from PCN, possible cross sensitivity
Take with high fat meal to improve absorption
Contraindicated in pts with hepatic dysfunction

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11
Q

after 3 weeks of antifungal therapy pt still has infection what should the provider do?

A

NOTHING. fungal infections take 4-8 weeks of antifungal therapy to resolve.

DO NOT change tx before this time frame

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12
Q

Most common causative agent of cellulitis?

A

Group A streptococcus

***If purulence is present think Staph/MRSA

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13
Q

Treatment for Group A streptococcus cellulitis?

A
  1. PCN
  2. if allergic to PCN –>
    1st gen cephalosporin (cephalexin) or macrolide (azithromycin)
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14
Q

Assessment of psoriasis

A

silvery scales on erythematous base
-often on extensor surfaces (outer surfaces) elbows, knees, scalp, gluteal cleft, fingernails, palms & soles of feet

-Nails may be pitted

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15
Q

what is an Auspitz sign?

what does it indicate?

A

Auspitz sign = pinpoint bleeding when plaque removed

Indicates PSORIASIS
differentiates psoriasis vs eczema

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16
Q

Treatment for Psoriasis

A

Keep skin hydrated with emollient
Topical steroids - low dose first
scalp: strong- potency steroid in alcohol base
Face: low potency

Tar solutions
Salicylic acid gel

*** no more then 50G/week for steroids

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17
Q

pt with psoriasis has salicylic acid sensitivity and should be instructed to avoid?

A

ALMONDS

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18
Q

what type of skin cancer arises from epithelial tumors from keratinocytes of the epidermis. Often are red, tan, brown and pearly gray

A

Squamous cell carcinoma (SCC)

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19
Q

What type of skin cancer develops in the basal cell layer of skin in middle aged men and appear pearly domed nodule?

A

Basil cell carcinoma (BCC)

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20
Q

Malignant melanoma

A

arising from melanocytes (pigment producing cells)

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21
Q

what is the most deadly form of skin cancer?

A

Malignant melanoma

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22
Q

ABCDE mnemonic

A 
Asymmetry 
Border irregular 
color variation 
diameter >6mm (size of pencil eraser) 
Evolving (elevation, hypo/hyper pigmentation, bleeding, scaling, texture)
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23
Q

HARMM risk tool evaluates what?

what does it stand for?

A

Melanoma risk model

Hx of previous 
Age >50
Regular derma visits missing 
Mole changing 
male gender
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24
Q

Pagets disease (breast cancer)

A

uncommon form of breast CA

Scaley, exzema like lesion that may weep, erode, crust

indicative of ductal breast cancer in situ

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25
Peau d'orange
"orange peel breast" breast dimpling or edema, thickened with enlarged pores
26
what is Herpes Zoster (HSV-3)
Shingles reactivation of varicella-zoster virus (chickenpox) that lays dormant in nerve cells, typically along a single dermatome
27
Can you transmit shingles to others?
Pts who have shingles are NOT able to transmit shingles to susceptible pts on transmit chickenpox virus to susceptible pts -Older, immunocompromised, or pregnant pts should avoid contact with anyone with shingles
28
Phases of herpes zoster virus
prodrome - occurs along 1/more dermatome from 1-10 days. fatigue, itching, burning, ect. Acute phase - rash erupts over 3-4 days. maculopapular rash progresses to groupd vesicles. fever, malaise, headache, pain Convalescent phase - w/in 2-3 weeks rash resolves. pain can last for more than 30 days
29
what is post herpatic neuralgia and what is the tx?
pain for more than 30 days after HSV 3 rash resolved. tx 1. gabapentin 2. lyrica
30
Prevention of herpes zoster
VACCCINATION- shingrix, 2 doses 2-6 months apart
31
can you give antiviral medications to pts with HSV 3?
yes, may shorten length and severity of illness if given within 48-72 hours of symptom presentation
32
Symptom management for shingles
OTC analgesics Capsaicin top cream - can lead to irritation of eyes and mucous membranes antipuritic - calamine lotion, colloidal oatmeal bath topical lidocaine (xylocaine) & nerve blocks steroids
33
What is eczema?
chronic pruritic skin eruption - common in pts with other atopic illness (asthma, allergic rhinitis)
34
Assessment findings for eczema
pruritus, erythema, dry skin patchy plaque on flexural surfaces (bends of the body - inside elbows, back of knees, ankles)
35
Non pharm tx for atopic dermatitis/eczema
bathing, moisturizer applied 1-3 mins after patting skin dry superfatted soaps best, low or neutral pH prevent skin trauma /burns soak in warm water for 20 mins prior to applying emollient cool wet compress (burrows solution) if lesions are weeping or oozing bleach baths 3x week (1/4c bleed in full bath, 2-3 mins)
36
can you use ointments for oozing atopic dermatitis?
no. wait for lesions to dry
37
pt has eczema would you give steroids?
Only low dose topical steroids - Alclometasone dipropionate/Aclovate 0.05% - Flucinolone acetonide 0.01% - Hydrocortisone buyrate 0.1%
38
High dose topical steroids
Betamethasone dipropionate 0.05%/0.25% Amcinoide 0.1% Desoximetasone 0.05%, 0.25%
39
Pharm management for eczema (general)
low dose topical steroids antihistamine (oral/topical) emollients (eucerin, lubriderm, cetaphil) intralesional steroid injection topical calcinerun inhibitors - pimecrolium cream 1% or tacrolimus ointment 0.03%
40
Pt presents with inflammation and excoriated skin of the skin of the perineum, buttocks, lower abdomen and inner thighs. what is the probable diagnosis and treatment?
Diaper dermatitis Tx: Zinc oxide (skin barrier)
41
what is a chronic superficial disorder affecting hairy area of the body where many sebaceous glands are present?
seborrheic dermatitis
42
What is dermatyphytosis / dermatophytes
Fungal infection of the skin that causes pathologic changes - when in sun, skin turns darker pigment except for area with fungal infection which turns lighter tx: griseofulvin or other antifungal
43
superficial dermatophytosis that attacks hair shafts on the scalp, eyebrows, and elelashes is known as...
tinea capitis
44
can dermatophytes associated with tinea pedis survive for months in bathrooms, changing rooms and around swimming pools?
YESS = athletes foot
45
what is the most common cause of onychomycosis ?
Trichophyton rubrum
46
When sebaceous glands produce excessive sebum leading to comedones, pustules, papules, systic nodules, and scarring... what is this?
Acne Vulgaris
47
what is the treatment of Acne Vulgaris?
Topical ABX + Benzoyl peroxide = combo prevents microbial resistance erythromycin or clindamycin Store in refigerator
48
what is pediculus?
LICE pruritis d/t allergic reaction
49
Probable diagnosis for intensely pruitic skin infection with mite that burrows into the upper layer of the skin ?
Scabies. (Sarcoptes scabiei) HIGHLY contagious
50
Assessment findings for scaibes
Itching - more noticeable at night, small itching blisters in a thin line, scaling, erythema Mites burrow between finger webbing, feet, wrists, axilla, scrotum, penis, waist, buttocks Vesicles/papules may appear as a black dot or scab at end of a burrow
51
Treatment for scabies
non pharm - wash all clothing, bedding, towels used w/in 4 days. vacuum/mop floors as usual. Pharm- MUST tx all members of house at same time! topical scabicides - inhibit nerve function in the mites producing paralysis and death. 3 days of treatment -Permethrin 5% - ok in immunocompromised kids wash off after 8-14 hours. -Sulfur 6% -Ivermectin (antiparasitic) Retreat in 14 days if warranted
52
what is paronychia?
inflammation of the perionchium = skin bordering the nails tx: vinegar/water soaks --> fix green colored nail mupirocin ointment ** if exposed to oral flora (nail biting/thumb sucking) then Amoxicillin/Clavulanate or Clindamycin
53
antigen induced development of pruitic edematous circular plaques is known as....
Urticaria
54
Fluorouracil (Carac) classification and use for treatment
Antineoplastic Tx actinic keratosis Contraindicated : Pregnancy
55
what is Nystatin (Mycostatin) used for
topical antifungal agent
56
what is pimecrolimus (Elidel) indicated for the treatment of...
Atopic dermatitis
57
potential systemic reaction to imiquimod (Aldara) used to treat superficial BCC is....
flu like symptoms
58
Minocycline (Dynacin) classification of abx and use for derm
Tetracycline | tx of acne / some skin infections
59
Which of the following is NOT a topical pediculicide? a. Benzyl alcohol b. Ivermectin c. Permethrin d. Selenium sulfide
Selenium sulfide - used for dandruff not pediculidcide
60
potential adverse reaction r/t use of sulfacetamide (klaron) topical, indicated for the tx of seborrheic dermatitis is....
SLE Sulfa medications reactions : SLE, agranulocystosis, acute hemolytic anemia, aplastic anemia, purpura hemorrhagic, steven-johnson syndrome, toxic epidermal necrolysis ect
61
Half life of Trimethoprim - sulfamethoxazole (bactrim)
10 hours.
62
What is a Fingertip Unit (FTU)?
measured from the very tip of the finger to the first crease (DIP joint) in the finger. -Each FTU is approx = to 0.5g (Men) and 0.4 grams (women) of ointment. Estimate of number of FTUs required to cover various areas of the body as: Head/neck = 4.5, Trunk (front/back) = 7, arm = 3, hand = 1, leg = 6, foot = 2.
63
Diclofenac (Solaraze), an antiflammatory, is used in the tx of...
Actinic keratosis applied to lesion BID
64
Tetracycline in children younger then 9 may cause...
bone growth retardation tissue hyperpigmentation enamel hypoplaisa PERMANENT tooth discoloration

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