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Flashcards in Dermatology Deck (33):
1

Common things that can trigger SJS-TEN?

Mycoplasma, vaccination and GVHD

Allopurinol, sulfonamides, anticonvulsants, sulfasalazine, NSAIDs

2

Delineation between SJS and TEN?

SJS = 30% BSA involvement

3

Steroid acne vs. adolescent acne

Steroid = monomorphous pink papules and absent comedones

Adolescent = pleomorphic inflammatory nodules with open and closed comedones

4

Treatment for seborrheic dermatitis

Since the fungus malassezia is often involved, topical antifungal creams are effective

5

Pathophysiology of scabies rash

Type IV hypersensitivity against the mite, feces and egg

6

Scabies treatment

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.

7

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.

8

Medications that can trigger bullous pemphigoid

Furosemide, NSAIDs, captopril, penicillamine and various antibiotics

9

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.

10

Why are the blisters seen in pemphigus vulgaris more flaccid?

Anti-desmoglein IgG antibodies result in intradermal antibody and complement deposition.

11

Most common malignancy in women 25-29 years old

Melanoma

12

Treatment of tinea corporis

Topical antifungals like terbinafine or systemic griseofulvin

13

Treatment for pemphigus vulgaris

Steroids +/- azathioprine or MTX

14

What is an acrochordon?

Skin tag

15

Treatment of tinea versicolor

The condition is often due to malassezia globosa and can be treated with selenium sulfide or ketoconazole

16

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".

Ichthyosis vulgaris

17

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+

18

Small, vascular, bright-red papular lesions that arise more commonly in the elderly

Cherry hemangioma

19

Condition that has cavernous hemangiomas in the brain and viscera?

VHL

20

Treatment of rosacea

Topical metronidazole

21

Preferred method of evaluation for melanoma

Excisional biopsy to be able to quantify Breslow depth

22

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.

23

Define:
Acanthosis

Parakeratosis

Dyskeratosis

Hyperkeratosis

Acanthosis: epidermal thickening

Parakeratosis: nuclei retained in stratum corneum

Dyskeratosis: abnormal keratinization

Hyperkeratosis: thickening of stratum corneum

24

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

25

Frostbite treatment

Rapid rewarming with warm water

Wait a few weeks for debridement

26

Treatment for dermatitis herpetiformis

Gluten-free diet + dapsone (relieves pruritis)

27

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

28

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

29

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

30

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

31

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?

Eczema Herpeticum

Admission to hospital for IV acyclovir and urgent ophthalmologic evaluation

32

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?

Bacterial culture

33

Treatment of impetigo outbreak

PO abx + antibacterial soap