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Pance Re-Up > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

MCC Cellulitis in adults

A

Group A Strep

Other Causes: Staph A,

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2
Q

MCC Cellulitis in Neonates

A

Group B Strep

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3
Q

Etiology of cellulitis & Symptoms

A

Breaks in skin, bites, etc.

Erythema, warmth, induration, pain, LAD, fever, edema

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4
Q

Although cellulitis is a clinical diagnosis mainly, what can be seen on US?

A

Cobblestoning appearance

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5
Q

If an abscess is present, what is the MCC?

A

Staph A

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6
Q

Explain erysipelas (form of cellulitis)

A

Superficial skin infection involving local lymphatics

Sharp, demarcated border on LE or face, indurated, pruritic, painful

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7
Q

MCC of erysipelas

A

Strep Pyogenes

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8
Q

Treatment for erysipelas

A

Oral: PCN, Amoxicillin, Cephalexin
IV: Cefazolin, Ceftriaxone

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9
Q

The MC form of impetigo is _____ and the MCC of impetigo is _____

A

Non-bullous

Staph A

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10
Q

Explain the rash of impetigo

A

Honey-colored crusts

Face and extremities MC

Erythematous macule –> pustule

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11
Q

Treatment for Impetigo (non-medical and medical)

A

-Remove crusts with warm cloth
-Mupirocin topical
-Avoid scratching
-oral ABX if severe (Doxy, Clinda, Bactrim if MRSA)

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12
Q

Acne vulgaris is overproduction of _______ and has four parts to the pathophysiology. Name them.

A

Sebaceous glands

1) follicular hyperkeratinization, 2) increased sebum production, 3) propioniobacterium overgrowth, 4) inflammatory response

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13
Q

Open comedones (_____) and closed comedones (_____) are symptoms of which type of acne?

A

Open: blackheads
Closed: whiteheads

Mild

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14
Q

Treatment for acne vulgaris

A

Mild: Topical (Azelaic acid, salicylic acid, benzoyl peroxide, Clindamycin ointment

Moderate: Topical + Oral (Mino, Doxy, Spironolactone)

Severe: Oral Isotretinoin

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15
Q

What are some adverse effects to isotretinoin?

A

Dry skin/lips, teratogenic, increased cholesterol and triglycerides

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16
Q

What are some triggers for rosacea?

A

Alcohol, cold/heat, spicy foods, hot drinks, sun exposure

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17
Q

Symptoms of rosacea

A

-Intermittent facial flushing
-No comedones
-telangiectasias
-Rhinophyma

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18
Q

First-line medical treatment for rosacea

A

Topical metronidazole

Others: Tetracyclines, laser therapy

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19
Q

However, for facial erythema, you can use

A

Topical Brimonidne

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20
Q

Bullous pemphigoid is a Type ______ hypersensitivity reaction that occurs in what population?

A

Type IV

Elderly

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21
Q

Explain the rash of bullous pemphigoid

A

-Negative Nikolsky
-Low mortality
-Tense bullae that do not rupture easily
-Rarely oral lesions
-Pruritic lesions with urticarial plaques

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22
Q

The gold standard diagnostic for bullous pemphigoid is

A

Skin biopsy with direct immunofluorescence

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23
Q

Treatment for bullous pemphigoid

A

Topical corticosteroids, but systemic if severe

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24
Q

Pemphigus vulgaris, on the other hand, occurs in what population? What are the symptoms of this condition?

A

Younger people, life threatening

-Positive Nikolsky
-Painful erosion
-Oral lesions (MC)
-Flaccid skin bullae that rupture easily

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25
What are two medications that likely can cause pemphigus vulgaris?
Captopril & Penacillamine
26
Treatment for pemphigus vulgaris?
Systemic high dose corticosteroids and local wound care
27
Erythema Multiforme, a Type IV hypersensitivity reaction, has etiologies in
HSV (MC) Mycoplasma (in kids) Meds: Sulfa, Allopurinol, Phenytoin
28
Symptoms of erythema multiforme
Target lesions: dusky with pale ring and halo in periphery Negative Nikolsky Palms and soles affected!!!!
29
Explain the difference between Erythema Multiforme minor and major
Minor: No mucous membrane involvement Major: mucous membrane involvement (oral, genital, ocular)
30
Treatment for erythema multiforme
-D/C offending drug -If HSV related: Acyclovir -Diphenhydramine mouthwash (oral lesions)
31
Steven-Johnson Syndrome and TEN are associated with detachment of the epidermis and necrosis. What occurs in this condition?
Sloughing (dermal-epidermal cleavage)
32
Explain the difference in SJS and TEN
SJS: < 10% TEN: > 30% sloughing
33
Risk factors for SJS and TEN
MC: Meds (Sulfa (PCN), Lamotrigine, anticonvulsants, NSAIDs, and Allopurinol) Infections: HSV, HIV
34
Symptoms of SJS and TEN
-Rarely soles and palms -Widespread flaccid bullae (trunk/face) -Target lesions with mucous membrane involvement -Positive Nikolsky sign -Ocular involvement (uveitis, corneal ulcer)
35
Treatment for SJS/TEN
D/c causative agent Burn unit/ICU admission IVIG
36
Eczema (atopic dermatitis) is part of the atopic triad. Name the triad.
Eczema + asthma + allergic rhinitis
37
Most eczema manifests by what age? What is the gene mutation?
Infancy or age 5 Filaggrin gene mutation
38
Triggers for eczema
Heat, allergens, perspiration, contact
39
Symptoms of eczema
-Excoriation -Pruritis (hallmark) -MC in flexor creases (behind knee, elbow, etc.) -Nummular: coin shaped lesions on dorsum of hands, feet, knees, and elbows
40
Treatment for acute eczema
-Topical corticosteroids (first line) -Antihistamines for itching -Wet dressings -Calcineurin inhibitors: Tacrolimus, Pimecrolis
41
Treatment for chronic eczema
Systemic phototherapy Methotrexate Oral antihistamines Trigger avoidance
42
Contact dermatitis has two types. Name them and which is more common?
Irritant (MC) and allergen
43
What are some causes of allergen contact dermatitis?
Nickel (MC), poison ivy, poison oak, poison sumac
44
Contact dermatitis is a Type IV hypersensitivity reaction. What is the difference in symptoms showing up in allergen related vs irritant?
Allergic: delayed by days Irritant: immediate
45
Treatment for contact dermatitis
Topical corticosteroids -Burrow's solution, cool compresses, etc.
46
What is toxicodendron dermatitis? What is the cause?
Contact dermatitis due to plants (oak, ivy, sumac) The urushiol in plants causes this
47
What is diaper rash?
Type of irritant contact dermatitis
48
Dyshidrosis, also known as pomphlyx, is a recurrent rash affecting which area of the body? Describe it.
The palms and soles Tapioca-like, pruritic vesicles on soles, palms, and fingers
49
Treatment for dyshidrosis
Topical corticosteroid ointments Cold compresses, Burrow solution Dry hands, use cotton gloves, etc.
50
What is Lichen Simplex Chronicus?
Skin thickening in patients with atopic dermatitis due to rubbing and scratching
51
Symptoms of lichen simplex chronicus
scaly, well-demarcated plaques, exaggerated skin lines
52
Treatment for lichen simplex chronicus
Avoid scratching Topical corticosteroids Occlussive dressings
53
What is the pathophysiology of psoriasis?
Keratin hyperplasia and proliferating cells in the stratum basalt and stratum spinosum due to T cell activation and cytokine release -Accelerated epidermis turnover
54
Symptoms of psoriasis
-Plaques: raised well-demarcated, pink plaque with thick silvery white scales MC on EXTENSOR surfaces (elbows, knees, scalp, and neck) Nail involvement: pitting, oil spot (yellow discoloration under the nail)
55
What is the Auspitz sign associated with psoriasis?
Bleed with removal of plaque
56
What is Koebner's Phenomenon associated with psoriasis?
new lesion at the site of trauma
57
Guttate psoriasis is associated with ______ and has symptoms such as _______
Occurs after strep pharyngitis Tear drop plaques that spare palms and soles
58
Treatment for mild-moderate psoriasis?
Topical corticosteroids (Betamethasone, Clobetasol) Vitamin D analogs (Calcipotriene) Calcineurin inhibitors (Tacrolimus, Pimecrolus)
59
For moderate to severe psoriasis, use
Phototherapy, UVB, PUVA
60
If systemic psoriasis, what is the treatment?
Systemic treatment -Retinoids (Acitretin) -TNF Inhibitors (Etancercept, -mabs) -Methotrexate (last resort)
61
Psoriatic arthritis, a systemic disease, is associated with what?
HLA-B27 positivity
62
Where does psoriatic arthritis usually affect?
Distal IP arthritis
63
Treatment for psoriatic arthritis
Methotexate, Cyclosporin

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