Flashcards in Dermatology Deck (33):
Common things that can trigger SJS-TEN?
Mycoplasma, vaccination and GVHD
Allopurinol, sulfonamides, anticonvulsants, sulfasalazine, NSAIDs
Delineation between SJS and TEN?
SJS = 30% BSA involvement
Steroid acne vs. adolescent acne
Steroid = monomorphous pink papules and absent comedones
Adolescent = pleomorphic inflammatory nodules with open and closed comedones
Treatment for seborrheic dermatitis
Since the fungus malassezia is often involved, topical antifungal creams are effective
Pathophysiology of scabies rash
Type IV hypersensitivity against the mite, feces and egg
5% permethrin cream or oral ivermectin. Antihistamines can help with itching. Put bedding in bags for 2-3 days because the mite can only live away from human skin for a maximum of 3 days.
What is responsible for GVHD?
Donor T-cells recognize host HLA-antigens as foreign and mount an immune response against host antigens in the skin, intestine and liver.
Medications that can trigger bullous pemphigoid
Furosemide, NSAIDs, captopril, penicillamine and various antibiotics
Why are the blisters seen in bullous pemphigoid tense? What pediatric condition can present with tense blistering?
Anti-hemidesmosome IgG antibodies result in sub-epidermal complement deposition and blistering. Linear IgA bullous dermatosis can present similarly in children.
Why are the blisters seen in pemphigus vulgaris more flaccid?
Anti-desmoglein IgG antibodies result in intradermal antibody and complement deposition.
Most common malignancy in women 25-29 years old
Treatment of tinea corporis
Topical antifungals like terbinafine or systemic griseofulvin
Treatment for pemphigus vulgaris
Steroids +/- azathioprine or MTX
What is an acrochordon?
Treatment of tinea versicolor
The condition is often due to malassezia globosa and can be treated with selenium sulfide or ketoconazole
A patient presents with dry, rough skin with horny plates over the extensor surfaces that worsens in the winter. This condition is sometimes referred to as "lizard skin".
Pathophysiology behind porphyria cutanea tarda? Diagnosis? Treatment?
Uroporphyrinogen decarboxylase deficiency. Confirmed with elevated urinary porphyrin level elevation. Treat with phlebotomy or hydroxychloroquine. Add IFN-alpha if HCV+
Small, vascular, bright-red papular lesions that arise more commonly in the elderly
Condition that has cavernous hemangiomas in the brain and viscera?
Treatment of rosacea
Preferred method of evaluation for melanoma
Excisional biopsy to be able to quantify Breslow depth
What is often in the vesicles that form on the skin secondary to contact dermatitis?
Typically they are sterile. They can also be colonized by coag-negative staph, which is a non-pathologic finding.
Acanthosis: epidermal thickening
Parakeratosis: nuclei retained in stratum corneum
Dyskeratosis: abnormal keratinization
Hyperkeratosis: thickening of stratum corneum
Treatment of molluscum contagiosum
They typically resolve. However, if the patient has HIV and the lesions are not resolving, you can give topical podophyllotoxin, cryotherapy or curretage
Rapid rewarming with warm water
Wait a few weeks for debridement
Treatment for dermatitis herpetiformis
Gluten-free diet + dapsone (relieves pruritis)
A 52-year-old male presents with erythematous papules and pustules on his cheeks and nose for several years. He also is embarrassed by the erythema on his nose and worries that his friends think he’s an alcoholic. The most appropriate next step is:
Metronidazole cream twice daily
A 16-year-old male presents to your office for his health maintenance visit. He has not used any treatment for his acne and has severe nodular cystic acne. The MOST appropriate initial treatment plan is:
Oral doxy, topical tretinoin and benzoyl peroxide with follow-up in 3 months
A 28 year-old mother of two developed a minimally pruritic rash on her wrist over the past 2 months. She used clotrimazole cream daily for 2 weeks without resolution. She was prescribed topical triamcinolone which decreased the redness and itching but did not resolve the rash after using it for 3 weeks. KOH exam was floridly positive. What is the next appropriate treatment?
Naftifine cream or gel twice daily for 4 weeks
For a patient with seborrheic dermatitis of the scalp, what advice would you give with regard to using anti-dandruff shampoos?
Leave them in for at least 10 minutes before rinsing out
This patient has a 2 day history of this painful, rapidly evolving, vesiculobullous eruption on the face, including the periorbital area. He feels unwell, but does not report a viral prodrome. No other areas of the body are affected. What is your diagnosis?
What is the most appropriate management course for this patient?
Admission to hospital for IV acyclovir and urgent ophthalmologic evaluation
A 6-year-old gymnast presents with the following skin rash that developed on her leg over the past few days. She has had no cold symptoms or fever and overall feels well. What would you do to confirm the diagnosis?