Dermatology 4

Question 1

TRX of Actinic Keratosis for

Small/localized?

Larger areas involved?

Answer 1

Small/Localized –> Cryotherapy or Surgical Excision

Large are –> Field therapy with

• 5-FU *****
• Topical Diclofenac
• Imiquimod

Question 2

Seborrheic Keratosis presents as greasy brown “stuck on lesions…

A sudden explosive onset is known as “Lesser Trelet Sign” and is associated with what?

TRX?

Answer 2

GI and lung Malignancy

TRX = none, unless symptomatic or for cosmetic reasons

Question 3

TRX of Tinea PEDIS?

TRX for onychomycosis?

Answer 3

TOPICAL antifungal

Onychomycosis –> First line = Oral Terbenafine

Question 4

What is Intertrigo?

RFs?

DX?

TRX=

Answer 4

Fungal infection of creases (inguinal, genital, perianal, under breasts ext)

RFs: Obesity, immunocompromised, increased moisture

Dx= clinical but can do KOH prep

TRX = topical antifungal

Question 5

Skin tags have an associated with what 5 things?

Answer 5

Pregnancy
Crohns (perianal) 
DM/Insulin resistance 
Obesity 
Colonic polyps

Question 6

candidial diaper dermatitis presents as beefy red plaques and papule, often with “satellite” lesions in the groin area.

What is the pathophysiology?

Children who are recently exposed to what are at an increase risk?

TRX?

Answer 6

Pathophysiology = moisture breaking down skin, with subsequent candidial infection.

Recent Abx use is a RF, bc disrupts normal flora, allowing yeast to overgrow.

TRX = Topical Antifungal (Nystatin, Clotrimazole)

Question 7

What are the two most common forms of tattoo removal?

What is the most common SE of the removal?

Answer 7

dermabrasion or laser..

Hyper or hypo pigmentation of area (LASER)

Question 8

What causes contact diaper dermatitis?

What is the classic finding that helps differentiate it from candida diaper dermatitis?

TRX?

Answer 8

Exposure to feces, friction, overhydration. Classically after diarrhea.

Spares folds (unlike Candida)

TRX: Zinc oxide pase or Petrolium jelly.

Question 9

What skin disorder presents as large freckles, of sun exposed areas, usually on face?

Women experience increased incidence during what time in their lives?

Associated with use of what two class of medications?

TRX?

Answer 9

Malasma

Increased in pregnancy (due to increased E and P stimulating melanocytes)

OCP and AEDs.

TRX:

• Avoid sun, sunscreen
• Skin lightening agents (Azeliec acid, hydroquinone)
• Topical Retinoids (C/I in pregnancy)

Question 10

Describe Stage 1-4 pressure ulcers.

Answer 10

Stage 1:
- Skin intact, non-blanchable redness

Stage 2:
- Shallow upon ulcer

Stage 3:

• Full thickness skin loss +/- subcutaneous fat exposure
• NO bone, tendon or muscle.

Stage 4:
- Bone, tendon and muscle exposed

Question 11

How do you manage Stage I and II vs Stage III and IV?

Answer 11

• All stages do wound care + nutritional suport + frequent repositioning.

Stage I/II:
- keep wound moist with semipermeable dressing

Stage III/IV:
- Debridement needed

Question 12

What is the tx of cherry hemangioma?

Answer 12

None, benign. Will increase with age.

Question 13

Tinea capitus is a fungal infection of the scalp that presents as scaly, erythematous plaques, with HAIR LOSS. (Not dandruff)

What is TRX?

Answer 13

Oral Griseofulvin or Oral Terbenafine.

Question 14

How does treatment of Acne change in pregnancy?

What are the preferred agents to use?

Answer 14

Category b/prefered agents:
COMDEDONAL –> Azelaic acid
Inflammatory –> Topical Erythromycin or Clindamycin

Avoid topical tertian and Benzoyl Peroxide.

ABSOLUTE C/I is oral tretinoin

Question 15

What is chronic paronychia? What is the cause?

TRX?

Answer 15

inflammed proximal and lateral nail folds lastin g> 6 weeks. Caused by environmental irritants and is a form of contact dermatitis.

TRX:

• Avoid irritant
• Gloves
• topical glucocorticoids.