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Flashcards in Dermatology 2 Deck (23)
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0
Q

Pemphigus vulgaris – clinical features? Clinical sign?

A
#Easily ruptured bullae
#Mouth involvement
#Fluid loss infection widespread (like a burn)

Nikolsky sign

1
Q

Pemphigus vulgaris – causes?

A
#drug induced (ACE inhibitors, penicillamine, phebobarbitol, penicillin)
#autoimmune
2
Q

Pemphigus vulgaris - diagnosis and management?

A

Biopsy showing antibodies on a immunofluroescent studies

#Systemic steroids
#Azathioprine or mycophenolate to wean patient off steroids
#Rituximab 
#IVIg in refractory cases
3
Q

Bullous Pemphgoid vs Pemphigus vulgaris - bullae? Mouth involvement? Infection rates?

A

Intact versus rupture easily

Uncommon versus common

Less lots of fluid and infection vs more

4
Q

Patient presents with intact bullae and negative Nikolaky sign – suspected diagnosis? Most accurate test? Best initial therapy? (Subsequent therapy?)

If mild, can treat with?

A

Bulbous pemphigoid

Biopsy with immunofluorescence stains

Prednisone (later steroid alternatives)

#Dapsone
#Nicotinamide
5
Q

Patient presents with blistering skin disease on the backs of hands and face – suspected diagnosis? Specific history to get?

A

Porphyria cutanea tarda (rash on sun exposed areas)

#Hepatitis C, or liver disease from alcohol
#Estrogen use
#Hemachromatosis
6
Q

Patient presents with blisters on sun exposed areas – diagnosis? Deficiency? most accurate diagnostic test? Treatment?

A

Porphyria cutanea tarda

Uroporphyrin decarboxylase

24-urine for uroporphyrins

#stop EtOH and estrogens
#phlebotomy
7
Q

Oral vs IV medications for cellulitis, folliculitis, furuncles, carbuncles?

If penicillin allergic?

If MRSA?

A
Mild disease (oral meds)
#dicloxacillin, cephalexin, cefadroxyl
#Penicillin allergic – erythromycin, clarithromycin, clindamycin
#MRSA – doxycycline, clindamycin, Bactrim
Severe disease (IV)
#Oxacillin, nafcillin, cefazolin
#Penicillin allergy – clindamycin, vancomycin
#MRSA – vancomycin, daptomycin, tigecycline, ceftaroline
8
Q

Anti-staph penicillins?

A

OX-CLOX-DICLOX-NAF

9
Q

Staph infection - Switch to these if patient develops penicillin induced rash? Anaphylactic reaction?

A

Switch to cephalosporins

If mild infection: macrolides, clindamycin, doxycycline, Bactrim

If severe infection: vancomycin, linezolid, daptomycin, tigecycline, ceftaroline

10
Q

Location of body:

  1. Tinea corporis
  2. Tinea manus
  3. Tinea pedis
  4. Tinea cruris
  5. Tinea unguium
A
  1. Body
  2. Hand
  3. Foot
  4. Groin
  5. Nail
11
Q

Fungal skin infection – best initial test? Most accurate test? Best initial therapy if hair/nails not involved?

Best initial therapy if hair and nails involved?

A

KOH prep

Fungal culture

Topical Antifungal

Terbinafine Or itraconazole

12
Q

Topical antifungals?

A
#Clotrimazole
#Ketoconazole
#Econazole
#Miconazole
#Nystatin
#Ciclopirox
13
Q

Side effect of oral ketoconazole?

A

Gynecomastia (anti-androgenic)

14
Q

Patient with oral/vaginal candidiasis best initial test? Most accurate test? Best initial treatment?

A

KOH prep

Fungal culture

Topical antifungal

15
Q

Drugs that cause hypersensitivity skin reactions?

A
#Penicillins
#Sulfa drugs (including thiazides, furosemide, sulfonylureas)
#Allopurinol
#Phenytoin
#Lamotrigene
#NSAIDs
16
Q

Drugs that cause hypersensitivity skin reactions also cause?

A
#Hemolysis 
#Interstitial nephritis
#Drug induced thrombocytopenia
17
Q

Hypersensitivity skin reactions in order of the severity? Therapies?

A

Morbilliform rash (skin intact without mucous membrane involvement – no therapy)

18
Q

In addition to drug reactions, erythema multiforme also seen with?

A

Herpes or Mycoplasma

19
Q

Staphylococcal scalded skin syndrome findings vs Toxic shock syndrome?

A

Like TEN, including Nikolsky sign

Versus
#Same skin findings AND:
#Hypotension
#Renal dysfunction (elevated BUN and creatinine)
#Liver dysfunction
#Delirium (CNS involvement)
20
Q

Treatment of staphylococcal scalded skin syndrome him and toxic shock syndrome?

A

Oxacillin or Nafcillin or cefazolin

21
Q

Side effect of isotretinoin?

A

Hyperlipidemia

22
Q

Before placing person on vitamin A derivative, must?

A

If female, pregnancy test and place on hormonal and barrier birth control

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