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Clinical Medicine 1 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Etiology for Tinea Capitis

A

-Trichophyton tonsurans -Microsporum canis

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2
Q

Epidemiology for Tinea Capitis

A

Age: Childhood infection Ethinicity: African American Other: personal hygiene, over crowding, asymptomatic carriers

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3
Q

How is Tinea capitis acquired

A

-Direct contact -Fomites

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4
Q

How does Tinea Capitis present

A

-Scaly patches w/ Alopecia -Patches of alopecia w/ black dots -Wide spread scaling w/ subtle hair loss -Kerion -Flavus

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5
Q

DDx for Tinea Capitis (6)

A

-Seborrheic dermatis -Contact dermatitis -Pustular/plaque psoriasis -Atopic dermatitis -Alopecia areata -Trochotillomania

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6
Q

How is Tinea Capitis evaluated (5)

A

-Physical exam -KOH prep -Woods light -Culture -Dermosocopy

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7
Q

How is Tinea Capitis treated (3)

A

Griseofulvin x6-12wks (mirosporum) Terbinafine x2-4wks (trichphyton) Itraconazole x4-6wks or Fluconazole x8-12wks

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8
Q

Etiology for Tinea Corporis

A

-T. rubrum -Epidermophyton floccosum, T. interdigitale, M. canis, T. tonsurans

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9
Q

Epidemiology for Tinea corporis (4)

A

-Caregivers w/ children -Athletes (Tinea gladiatorum) -Immunocompromised -Pets

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10
Q

How does Tinea Corporis present

A

Pruritic annular erythematous plaque with central clearing and advancing border

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11
Q

DDx for Tinea corporis (5)

A

-Erythema annulare centrifugum -Granuloma annulare -Nummular eczema -Psoriasis -Tinea versicolor

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12
Q

How is Tinea corporis evaluated (3)

A

-Hx and physical exam -KOH prep -Culture

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13
Q

How is Tinea corporis treated

A

-Topical antifungals (-azoles) x2 *Avoid Nystatin -Systemic: Terbinafine, Fluconazole, Itraconazole PO

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14
Q

Why shouldn’t you give steroids to treat Tinea corporis (5)

A

-Doesnt work -Changes appearance of lesions -Majocchi’s granuloma -Skin atrophy -Expensive

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15
Q

Etiology for Tinea Cruris (Jock itch)

A

-T rubrum and E floccosum -T interdigitale -T verrucosum

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16
Q

Epidemiology for Tinea cruris

A

-Autoinnoculation from tinea pedis -Men>women -Skin folds

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17
Q

How does Tinea cruris present (5)

A

-Well marginated annular plaque w/ scaly raised border. -Extends from inguinal fold -Pruritis and pain -Scrotum spared -Chronic and progressive

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18
Q

DDx for Tinea cruris (8)

A

-Erythrasma -Cutaneous candidiasis -Candida intertrigo -Contact dermatitis -Psoriasis -Sehorrheic dermatitis -Lichen simplex chronicus -Folliculitis

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19
Q

How is Tinea cruris evaluated (3)

A

-Hx and physical exam -KOH prep -Culture

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20
Q

How is Tinea cruris treated

A

-Topical antifungals -Resitant: oral Griseofulvin -Treat Tinea pedis -Lifestyle (no tight clothing or hot baths)

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21
Q

Etiology for Tinea pedis

A

-T rubrum, T interdigitale, E floccosum

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22
Q

Epidemiology of Tinea pedis

A

-Most common dermatophytosis -Occlusive footwear, communal showers/pools

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23
Q

How does acute Tinea pedis present

A

-self-limited, intermittent, recurrent -Itchy/painful vesicles after sweating -Secondary staph infection -Cn cause dermatophytid reactions

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24
Q

How does chronic Tinea pedis present

A

-Slowly progressive -Erosion/scales between toes -Interdigital fissures -Moccasin ringworm -Sharp demarcation with scales in creases

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25
Q

DDx for Tinea pedis

A

-Eczema -Psoriasis -Bacterial co-infection -Interdigital erythrasma -Dyshidrosis -Contact dermatitis

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26
Q

How is Tinea pedis evaluated

A

-Hx and exam -KOH prep

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27
Q

How is Tinea pedis treated

A

-Topical antifungal x4wks -Terbanifine, itraconazole, Fluconazole for chronic disease -Burrows wet dessing, 20min BID/TID -Lifestyle (foot powder, proper footwear)

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28
Q

Etiology for Onychomycosis

A

-T. rubrum -T. mentagrophytes -Candida albincans -Nondermatophyte mold

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29
Q

Epidemiology for Onychomycosis

A

-Dermatophyte (toenails) -Yeast (fingernails) -Non-dermatophyte molds -Risk factors; age, tines pedis genetics, immunodeficiency, household infection

30
Q

How does distal subungual Onychomycosis present

A

-Starts with great toe. Discoloration at distal corner toward cuticle Distal end of nail breaks to expose nail bed

31
Q

How does proximal subungual Onychomycosis present

A

-Starts near the cuticle Seen in severely immunocompromised (AIDS)

32
Q

How does white superficial Onychomycosis present

A

-Dull white spots on the surface of nail plate and spread centrifugally

33
Q

How does yeast Onychomycosis present

A

-Thickening of fingernail with brown/yellow discoloration. May cause paronychia

34
Q

DDx for Onychomycosis

A

-Psoriasis -Eczematous conditions -Onychogryphosis -Lichen planus -Iron deficiency

35
Q

How is Onychomychosis evaluated

A

-KOH prep of nail scrapings -Culture -Biopsy

36
Q

How is Onychomycosis treated

A

-Oral Terbinafine (6wks fingernails, 12wks toenails) or Fluconazole/Itraconazole (for both dermatophyte and nondermatophyte)

37
Q

Another name for Atopic dermatitis is?

A

Atopic eczema

38
Q

What are the characteristics of dematitis/eczema

A

-Pruritis -The itch that rashes -Begins early in life -Chronic

39
Q

What is the Atopic triad

A

-Atopic dermatitis -Allergic rhinitis (hay fever) -Asthma

40
Q

How does Eczema present

A

-Ill-defined erythematous scaling patches to edematous papules and vesicles -Children; cheeks, scalp and extensor surfaces -Adults; flexor surfaces, hands/feet

41
Q

How is dermatitis diagnosed

A

Based on clinical presentation (pruritus, eczema, Hx, early age of onset, Xerosis-dryskin)

42
Q

What is DDx for Eczema

A

-Nummular dermatitis -Seborrheic dermatitis -Scabies -Contact dermatitis -Tinea infections -Cutaneous T cell lymphoma

43
Q

How is eczema treated

A

-Topical steroids (briefly) -Oral antihistamines prn for pruritis -Abx for secondary infection -Topical calcinerin inhibitors (Tacrolimus,P Pimercrolimus) -Avoid exposure to triggers -Use emollients

44
Q

How does Lichen simplex chronicus present

A

-Dry leather appearance, hyper pigmented, exaggerated skin markings -On back of neck, wrists, forearms, lower legs, genitals

45
Q

How is Lichen simplex chronicus treated

A

-Stop itch-scratch cycle

46
Q

Etiology for Dyshidrotic Eczema

A

-Dyshidrosis -Pompholyx

47
Q

how does Dyshidrotic eczema present

A

-pruritic deep vesicles with tapioca like appearance -on hands, sides of fingers, palms, soles

48
Q

How is Dishydrotic eczema treated

A

-Wet dressings -Topical steroids

49
Q

What happens in Keratosis pilaris

A

disorder of keratinization that forms horny plugs in hair follicles

50
Q

How does Keratosis pilaris present

A

Rough raised flesh colored/red/brownish papules -On upper arms, thighs, cheeks, upper back

51
Q

How is Keratosis pillars treated

A

-Creams -Exfoliating scrubs -Topical retinoids -Salicylic acid/alpha-hydroxy acid

52
Q

How does allergic contact dermatitis present

A

??

53
Q

How is contact dermatitis treated

A

-Bacitracin ointment (avoid neomycin) -Avoid allergenic agents(Ni, Latex, Poison oak/ivy, preservatives) -Emollient -Topical steroids

54
Q

What is the cause of irritant contact dermatitis

A

-Occupational -repeated friction -Chemicals

55
Q

Etiology for seborrheic dermatitis present

A

Malessezia furfur

56
Q

Epidemiology of seborrheic dermatitis

A

-Infants, teens, adults

57
Q

How does seborrheic dermatitis present

A

Infants: yellow greasy adherent scales on vertex of scalp, diaper area, axillary skin Adults; greasy scales and yellow macules, patches, papules on scalp, face,ears

58
Q

DDx for seborrheic dermatitis

A

-Rosacea -Psoriasis -Perioral dermatitis -Rash of SLE

59
Q

How is seborrheic dermatitis treated

A

-Selenium sulfide/anti-dandruff shampoo -ketoconazole shampoo/cream -Mild topical steroids

60
Q

Etiology of Pityriasis rosea

A

unknown - viral

61
Q

How does Pityriasis rosea present

A

-Exanthem; herald patch on trunk w/ secondary patch in 2wks, may or may not be pruritic -Oval papules/plaques with christmas tree pattern -Trunk and proximal extremities

62
Q

DDx for Pityriasis rosea

A

-Tinea corporis -Tinea versicolor -Guttate psoriasis -Nummular eczema -Drug eruptions -Secondary syphilis

63
Q

How is Pityriasis rosea treated

A

-Self limiting -Loratidine (Claritin) 10mg PO x1 daily, Cetirizine (zyrtec) 10mg PO x1 daily, DIphehydramine (benadryl) 25-50mg PO q6hrs PRN -Med strength topical corticosteroids

64
Q

Epidemiology of Lichen planus

A

-Middle aged adults

65
Q

How does lichen planus present

A

-4Ps(purple, pruritic, polygonal, papules) -Wickham’s striae visible (white lines) -Affects wrists, back, shins, scalp, penis, mouth

66
Q

How is lichen planus treated

A

-Topical/oral intralesional steroids -Cyclosporin

67
Q

Etiology of Psoriasis

A

-2% of western popn -Peaks at 15-30 and 50- -Hereditary component -Infections (strep) -Drugs -Stress/injury

68
Q

How does Psoriasis present

A

-Thickened red plaques with silvery scale -Pitted nails (onycholysis), arthritis -On extensor surfaces -Koebner phenomenon-plaques in areas of skin injury(rubbing, scratching)

69
Q

How do you evaluate Psoriasis vulgaris evaluated

A

-Auspitz sign (remove scale=punctate bleeding)

70
Q

What are the morphological variants of Psoriasis

A

-Vulgaris(chronic plaque) -Guttate (small drop like plaques) -Inverse/flexural -Palmar-plantar -Generalized pustular -Nail

71
Q

DDx for Psoriasis

A

-Seborrheic dermatitis -Nummular eczema -Candidiasis -Tinea corporis/capitis -Mycosis fungoides -Psoriasiform drug eruptions

72
Q

How is Psoriasis treated

A

-Depends on pattern and severity -General measures (sunshine, baths, emollients, occlusive dressing, rest) **Do not use oral steroids** -Topical (Anthralin, Ultra high potency steroids, calcipotriol, tazarotene, coal tar, calcineurin inhibitors) -Phototherapy (UVB/UVA) -Systemic (Methotrexate, Biologics)

Clinical Medicine 1 (5 decks)

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