Dermatology

Question 1

cellulitis tx

Answer 1

• cephalexin (PO) OR cefazolin (IV)
• ADD TMP/SMX or clindamycin if MRSA risk present

(hot, tender leg…PAD is cool to the touch, DVT is warm, and tender)

Question 2

2 MCC of cellulitis (microbes)

Answer 2

1. staph aureus
2. strep pyogenes (group A strep)

Question 3

how can you differentiate cellulitis from necrotizing fasciitis on exam?

(remember: nec fasc is a toxin-producing disease)

Answer 3

• Necrotizing fasciitis has crepitus, dusky, purple and bullous (hemorhagic), extreme pain
• cellulitis: hot, tender, swollen, unilateral, ill-defined borders

Question 4

abx for necrotizing fasciitis?

(remember: nec fasc is a toxin-producing disease)

Answer 4

Vancomycin (MRSA coverage) + Piperacillin-tazobactam (Zosyn) or carbapenem (broad gram-neg + anaerobes) + Clindamycin (to suppress toxin production from Strep pyogenes and Clostridium)

Question 5

major difference between squamous cell carcinoma and basal cell carcinoma on gross examination?

Answer 5

SSC: red & ulcerated throughout, ugly
BCC: red & ulcerated at center, pearly & pretty

top: BCC; bottom: SCC