Flashcards in Dermatology 2 Deck (23):
Pemphigus vulgaris – causes?
#drug induced (ACE inhibitors, penicillamine, phebobarbitol, penicillin)
Pemphigus vulgaris – clinical features? Clinical sign?
#Easily ruptured bullae
#Fluid loss infection widespread (like a burn)
Pemphigus vulgaris - diagnosis and management?
Biopsy showing antibodies on a immunofluroescent studies
#Azathioprine or mycophenolate to wean patient off steroids
#IVIg in refractory cases
Bullous Pemphgoid vs Pemphigus vulgaris - bullae? Mouth involvement? Infection rates?
Intact versus rupture easily
Uncommon versus common
Less lots of fluid and infection vs more
Patient presents with intact bullae and negative Nikolaky sign – suspected diagnosis? Most accurate test? Best initial therapy? (Subsequent therapy?)
If mild, can treat with?
Biopsy with immunofluorescence stains
Prednisone (later steroid alternatives)
Patient presents with blistering skin disease on the backs of hands and face – suspected diagnosis? Specific history to get?
Porphyria cutanea tarda (rash on sun exposed areas)
#Hepatitis C, or liver disease from alcohol
Patient presents with blisters on sun exposed areas – diagnosis? Deficiency? most accurate diagnostic test? Treatment?
Porphyria cutanea tarda
24-urine for uroporphyrins
#stop EtOH and estrogens
Oral vs IV medications for cellulitis, folliculitis, furuncles, carbuncles?
If penicillin allergic?
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
Staph infection - Switch to these if patient develops penicillin induced rash? Anaphylactic reaction?
Switch to cephalosporins
If mild infection: macrolides, clindamycin, doxycycline, Bactrim
If severe infection: vancomycin, linezolid, daptomycin, tigecycline, ceftaroline
Location of body:
1. Tinea corporis
2. Tinea manus
3. Tinea pedis
4. Tinea cruris
5. Tinea unguium
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?
Terbinafine Or itraconazole
Side effect of oral ketoconazole?
Patient with oral/vaginal candidiasis best initial test? Most accurate test? Best initial treatment?
Drugs that cause hypersensitivity skin reactions?
#Sulfa drugs (including thiazides, furosemide, sulfonylureas)
Drugs that cause hypersensitivity skin reactions also cause?
#Drug induced thrombocytopenia
Hypersensitivity skin reactions in order of the severity? Therapies?
#Morbilliform rash (skin intact without mucous membrane involvement – no therapy)
#Erythema multiforme (small target lesions without mucous membrane involvement – prednisone)
#Stevens-Johnson syndrome (rash involves mucous membranes and sloughing off of respiratory epithelium leading to respiratory failure – IVIg)
#Toxic epidermal necrolysis (rash with mucous membrane involvement and Nikolsky sign – IVIg)
In addition to drug reactions, erythema multiforme also seen with?
Herpes or Mycoplasma
Staphylococcal scalded skin syndrome findings vs Toxic shock syndrome?
#Like TEN, including Nikolsky sign
#Same skin findings AND:
#Renal dysfunction (elevated BUN and creatinine)
#Delirium (CNS involvement)
Treatment of staphylococcal scalded skin syndrome him and toxic shock syndrome?
Oxacillin or Nafcillin or cefazolin
Side effect of isotretinoin?