Dermatology Flashcards Preview

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Flashcards in Dermatology Deck (53):
1

skin cancer
risk factors

RF: fair complexion, h/o blistering sunburn as a child, increased sun exposure, fhx.

2

actinic keratosis

-small , light pigmented scaly spots
- sun exposed areas
-

tx: cryotherapy for isolated lesions( SE: hypo pigmentation)

-5-fu- Efudex- applied bid and make skin red and angry and apply until lesions crust over

3

squamous cell carcinoma

- presentation varied
-ulceration or sore that bleeds and does not heal
- rare for mets
- Bowens dz--> SCC in situ

dx: biopsy


tx: excision, treat thoroughly with Mohls' surgery to check margins

4

basal cell carcinoma

slowly enlarging nodule with central depression or ulceration with surface telangiectasis

mets rare

tx: same as squamous cell

5

Melanoma

- ABCs of mole evaluation

-Asymmetry
-border irregular
-colore mottled
-diameter > 6 mm
-elevation common, irregular


-leading cause of death
- appear flat or raised
- h/ o dysplasia nevi --> incr risk
- px r/t thickness of melanoma

6

seborrheic keratoses

benign, age-related plaques
-beige to brown to black
no tx needed
-waxy appearance

tx: curettage and freezing

-sudden eruption --> underlying malignancy

7

atopic dermatitis

pruritic, leads to scratch/itch cycle
-- seen with fix with asthma or allergy

-tends to grow out
- seen in arm and flexural folds

s/s: denny's lines -inftraorbital darkness

tx: avoid triggers, topical steroids, protonic, elderly
systemic steroids only for extensive dz,
oral histamines.

8

contact dermatitis

irritant- chemical exposure
- erythema, scaling
- industrial and detergents

allergic: poison ivy and nickle
-confined to area of contact and later can spread beyond

tx: avoid irritants
-topical steroids
-burrow solution for wheeling solution
- tacrolimus
severe > 20% - use oral steroids

9

diaper dermatitis

d/t prolonged exposure to urine/ feces
- get with yeast

- tx: topical antifungals
-nystatin
-clotrimazole
-miconazole

10

nummular eczema

coin-like lesions on LE
seen in older or younger adults
-older male/ETOH abuse

- mild to sever pruritus

tx: hydration and systemic anti-histamines
-topical steroids
-phototherapy

11

perioral dermatitis

-seen in women of child bearing age
- h/o topical steroid use

- tx: topical metronidazole, erythromycin,
avoid steroids,

severe: oral tetracycline, doxycycline, minoclycline
taper meds

12

seborrheic dermatitis

-seen in Males with oily skin
- seen in nasal folds, eyebrows, eyelids
-tends to recur
-scales with background erythema

tx:cleaning the area
- shampoos with selenium sulfide, ketoconazole,
-mild topical steroids
- maintenance tx required

13

stasis dermatitis

inflam reaction to leaky serum from varicose veins

brownish-purplish skin with weepiness
tx: improve blood flow to area

avoid neomycin ( neosporin)
wear compression stocking and wrap
-burrows solution
-abx for infection

14

dyshidrosis

-bubbling of tapioca-like vesicle--> scale and leas to fissures

- seen in hands and fingers

- outgrow it

dx: clinical

tx:topical steroids
burrows solution
only systemic steroids for systemic cases

15

lichen simplex chronicus

- intense itching caused by self-perpetuating scratch-itch
-lichenified lesions
-Neck and extremities common

-tx: cessation of itch-scratch cycle
-topical steroids
-occlusion to prevent further trauma
-pt educ.

16

lichen planus

-purple violaceous, polygonal, papular or planar
-Wickhams striae on surface - fine lacy white lesions
- oral and nail manifestations

-tx: often resistant
-topical steroids w/ occlusion
-oral steroids in severe cases
- UVA therapy

can be caused by drugs

- koebner's phenomna- lesions seen in previous area of trauma

17

pityriasis rosea

benign, seen in young adults

-spring and Fall

-oval erythematous to fawn colored discrete lesion with collarette scale

- Herald patch 2 weeks prior to the rash
- christmas tree pattern

- self- limiting, resolved in 6 weeks

- topical steroids

- consider STI testing

18

drug eruptions

- varied presentations
- occurs day to week from tx
- PCN and sulfa are common

- self-limited


tx: d/c drug
-supportive care

fixed drug eruption- reintroduce drug and manifest in the same exact way and place

19

erythema multiforme

target lesions

20

Steven Johns and TEN ( toxic epidural necrolysis)

fever, HA, arthralgia,
-confluent, asymmetric area of dusky erythema
- shedding full sheets of skin
-mm affected
- taken to burn unit
-causes: abx, anticonvulsant, NSAIDS
- life-threatening
Nikolksy sign- sloughing of skin and shear epidermis

tx:

21

bulls pemphigoid

pruritic tense blisters
-abrupt onset
- oral leions

tx: months--> years
topical potent steroids
-oral steroids
dapsone
negative Nikolsky

immune suppression

22

psoriasis

chronic, papulosquamous dz, genetic

silvery scales on bright red

Ausptiz sign, Koebner's phenom a

worse in winter

- gutate - associated with strep throat, class tear drop salmon plaques

tx; depend on extent of sz
localized- topical steroids
dovonex
duodenum
tazorac
tar based products
avoid stress and ETOH

generalized dx: phototherapy
methotrexate
oral retinoids

23

tine corporis

- round, oval, semicircular
- central clearing

mild contagious

tx; topical anti fungal( azoles)
systemic: itraconazole

24

tine pedis

seen in young adult males

- mocassin type

hype on KOH exam

management: prevention- use show shoes
dry, scaly- anti fungal txt
macerate: burrow wet dressing

25

tinea veriscolor

- fair skin- hyppigmented
- overgrowth of year

tx; topical selenium sulfide lotion / shampoo
- topical or systemic ketoconazole

26

folliculitis

inflame of hair
- pustules in hair follicles

pseudo folliculti: beard area from ingrown hairs

tx; depend on etiology

27

cellulitis

GAS and S. aureus

tx: oral abx
severe: admit for IV abx

28

erysipelas

superficial
- fatal

- prodrome sx: rash
- LE more common
-shiny bright red rash

dx: clinical

tx; IV abx first 48 hours and support therapy

29

impetigo

kids
- staph auteurs
- site of bug bite

- vesicle, homy-colored crust

tx; bactroban
oral abx for larger area

30

viral warts

HPV- 100 serotypes

tx; OTC salicylic acid
cryotherapy
co2 laser therapy
surgical excision

31

viral condylomata acumiat

genital area
HPF 6, 11
highly infectious
cauliflower, fleshy growth

tx: podofilox, imiquimod
cryotherapy

32

herpes simplex

hsv 1- labials
hsv 2- genital

prodrome at site

giant cell on Tzanck

tx: valtrex, famvir,
pt education

33

shingles

pain ful rash from parcel

-thoracic/ lumbar root
trigeminal nerve- blindness

tx: anti-viral s, oral steroids in immunocompromised
help reduce pain

34

molluscum contagiosum

- central umblication
- self limited
-benign
seen on trunk and extremities
viral in origin

35

acne vulgaris

- common adolescent and young adults

- comedones, papules, pustules, cysts
- improves in summer

midl: topical- retinoids, benzoyl peroxide

moderate inflame: add oral abx ( mine or doxy)

severe inflame: isotretinon, intralesional, injeciton

36

rosacea

- seen in women middle age
- no comedones
- worse w/ heat, exercise
- papulres and telangecasia

tx; avoid of flushing with sunscreen
topical flail,
oral mino, doxy
severe: isotretinoin

37

vitiligo

autoimmune disorder?
no pigment

tx; depend on extent and disfiguration

- topical steroids, UVB/ PUVA
cosmetic are, protective sunscreen

38

acanthuses nigrican

adenoma ca of GI tract
-bening type- seen with overweight, insulin resistant

mangement:
loose weight
- control BS
- cosmetic care

39

Burns

ABCs
rule of 9's , dictate who goes to burn center
1st degree: redness w/o change in texture

2nd degree; blister

3d degrees: area is white, leathery
myoglobinuria ( electrial )
look or exit wound from lighting strike
no ice, check for harness

40

hidradenitis suppurative

obesity,acne
- tender inflame nodule in axilla
males- groin, button
tx: weight reduction, loose garments,
clean area,
drysol,
tetra/ erythromycin

check for access

41

urticaria

self -limited

chronic: > 6 weeks in duration

angiogema

tx: anti-histamin maintain
short course of steroids
avoidance of identified triggers

42

melasma

hyperpigmenation of un exposed area
seen in young women
OTC cause

difficult to treat:
hydroquino
tretioin
azelaic acid
slow to resolve

43

lipomas

bening tumors of fat cell

- just monitor
- check for lip sarcoma( more fixed)
FNA

44

epidermoid cyst

firm, mobile, young

no tx
triamcinola if inflamed
I and D , oral abx if infected

45

Kaposi sarcoma

AIDs indicative
purple nodules anywhere

-tx: antiviral therapy

46

decubitus ulcers

bed sores
press over bone prominence

Stage 1-intact skin, warmth
Stage 2: patial thickness
stage 3- full thickness
stage 4: full thickness and extension into mm bone and mm

move often
wound dressing
sharp debridement

47

pediculosis ( lice)

overcrowding dwelling
-schools
tx: all intimate contacts
seen in hair and body
topical premetharin ( NiX shampoo)
clean/ dispose of infections clothing, linen

48

scabies

arachnid mite
spares head and neck
pruritic vesicle in web spaces of hand
groin

- confirm under microscopy

tx: tx all contact
clean clothing and bedding
permethrin 5% cream- resistance
rare, use 2X one week apart

49

spider bites

black widow- bite if disturbed
mm pain, mm spasm
tx: parental opioids, mm relaxers

brown recluse: more active in spring and fall
progressive local necrosis, possible, fever, chills, n/v
excision of bite see
oral steroids, dapsone, colchicine

50

alopecia area

patchy loss of hair
- small hairs that are broken off ( exclamation point hairs)

tx: intralesional triamcinolone
topical and systemic steroid
PUVa phot therapy
minoxidil

51

androgenic alopecia

hair will not grow back
M> F
males- receding hairline at temples and vertex
females: loss of hair over central scalp
tx: finasteride and minoxiidil

52

oncyomycosis

fungus of toenail and fingernails
- older age, low immune system

tx; topical generally ineffective
newer oral anti fungal
regrowth slow

53

paronychia

soft tissue infection around the nail

- acute: I and d and abx
chronic: occupational
- candida
keep dry, topical, anti fungals