Dermatology Flashcards Preview

American Board of Internal Medicine > Dermatology > Flashcards

Flashcards in Dermatology Deck (42):
1

What is the most serious side effect of Isotretinoin?

Pseudotumor Cerebri

2

Treatment of Acne (4)

1. COMEDONAL: Tretinoin (Retin-A) gel

2. MODERATE PAPULOPUSTULAR: Tretinoin (Retin-A) gel + TOPICAL abx or Benzoyl peroxide 2.5%*

3. SEVERE PAPULOPUSTULAR: Benzoyl peroxide 2.5% + ORAL abx**

4. NODULOCYSTIC: Isotretinoin (Accutane)

*Not Tretinoin and Benzoyl at same time
**Tetracycline, Minocycline, Erythromycin

3

Lichen Simplex Chronicus
1. History
2. Treatment

1. Chronic scratching leads to lichenification and hyperpigmentation
2. Steroids to stop itching

4

Contact Allergy Offenders (4)

1. Nickel
2. Latex
3. Plants
4. Lotions (benadryl cream)

5

Dyshidrotic Eczema
1. Exam
2. Treatment

1. Pruritic veiscles leading to desquamation of hands, palms and sides of fingers
2. Medium to high potency corticosteroids

6

Stasis Eczema
1. Exam
2. Treatment (2)

1. BILATERAL lower extremities above ankles (vs. unilateral with cellulitis)
2. Treat venous stasis and medium potency steroids

7

Etiology of Malar Rashes (4)

1. Erysipelas - sharp demarcation, fever, WBC, peau-d'orange
2. SLE - photosensitivity sparing nasolabial fold
3. Acne Rosacea - flushing, telangiectasias and papules and pustules
4. Seborrheic dermatitis - accentuation of nasolabial fold

8

Etiology of Acanthosis Nigricans (2)

1. Obesity and insulin resistance
2. Gastric Carcinoma

9

Cutaneous manifestations of HCV (3)

1. Porphyria Cutanea Tarda
2. Leukocytoclastic Vasculitis / Cryoglobulinemia
3. Lichen Planus - (five Ps = purple, puritic, planar, polygonal, papules)

10

Porphyria Cutanea Tarda
1. Correlation to which disease?
2. Trigger factors (3)?
3. Treatment?

1. HCV
2. Alcohol, Estrogens, Iron Overload
3. Phlebotomy and NOT treating HCV

11

Erythema Multiforme
1. Exam findings
2. Etiology if recurrent
3. Etiology if drugs (3)

1. TARGETOID Lesions
2. HSV if recurrent
3. PCN, dilantin, sulfa

12

Lofgren's Syndrome:
1. Features (3)
2. Treatment (3)

1. a. Erythema Nodosum
b. Arthalgias/arthritis (ankles)
c. Bilateral hilar adenopathy

2. a. NSAIDS
b. Prednisone
c. Potassium iodide (for EN, SE with GI upset)

13

Etiology of Erythema Nodosum (5)

1. Post-strep
2. Drugs (OCP, sulfa)
3. Inflammatory Bowel Disease
4. Deep fungal infections (cocci, histo, TB)
5. Sarcoid (Lofgren Syndrome)

Mnemonic = P DIDS

14

Perioral Dermatitis
1. Etiology (2)
2. Exam
3. Treatment (topical 2, oral 3)

1. Topical or inhaled steroids
2. Perioral erythematous micropapules on patchy erythematous background with scaling
3. Topical metronidazole or erythromycin, OR oral minocycline, tetracycline or doxycycline

15

Pityriasis Rosea
1. History
2. Exam
3. Treatment
4. Differential diagnosis (3)

1. Viral prodrome with URI and "herald patch"

2. Salmon colored oval lesions with fine scales in "Christmas tree distribution"

3. Antihistamines or topical steroids because it will spontaneously resolve

4. a. Secondary syphilis
b. Drug eruption
c. Tinea

16

What can patients with Psoriasis develop after being treated with corticosteroids?

Pustular Psoriasis

17

1. Define Erythroderma
2. Name etiologies (4)

1. Eruption > 90% of body surface

2. a. Drug eruptions
b. Psoriasis
c. Atopic dermatitis
d. Cutaneous T-cell lymphoma (Sézary)

18

What is a common contaminant in cocaine and what dermatologic pathology can develop?

1. Levamisole (antihelmintic agent)
2. Reticular purpura on ears and nose

19

1. What organism causes cellulitis from saltwater?
2. What are treatment options for severe and mild disease?

1. Vibrio vulnificus
2. a. Severe = Tetracycline + 3rd-gen Ceph
b. Mild = Tetracycline OR Fluorquinolone

20

What organism causes skin ulcers in neutropenic patients, and what is the ulcer called?

Pseudomonas causing Ecthyma Gangrenosum

21

If you see pyoderma gangrenosum, consider (3)...

1. Inflammatory Bowel Disease
2. Inflammatory Arthritis
3. Leukemia (lymphoproliferative disorders)

22

If you see "moccasin" apearing foot with silvery scales, consider...

Tinea Pedis

23

Name two scenarios that require URGENT consultation for Herpes Zoster

1. Trigeminal V1 distribution = Ophtho
2. Ears, tongue or facial paralysis = ENT

24

If you see palpable purpura, consider...

HCV

25

If you see porphyria cutanea tarda, consider...

HCV

26

If you see severe seborrheic dermatitis, consider...

HIV

27

If you see sudden onset psoriasis, consider...

HIV

28

If you see dermatitis herpetiformins, consider... and treat with ...

1. Celiac Disease
2. Dapsone (after checking G6PD) and gluten-free diet

29

If you see livedo reticularis, consider (3)...

1. Atheroemboli
2. Vasculitis
3. Phospholipid Antibodies

30

If you see acanthosis nigricans, consider (2)...

1. DM
2. GI cancers

31

Another name for Melanoma In Situ is...

Lentigo Maligna

32

What is treatment for Pyoderma Gangrenosum?

Corticosteroids

33

What is the serologic work-up for Neurogenic Pruritis (6)?

1. CBC - iron deficiency anemia or malignancy (hematologic, lymphoma)
2. BMR - ESRD
3. LFTs - Cholestasis
4. TSH - hypo- or hyperthyroidism
5. ESR
6. HIV infection

34

What chronic disease is associated with Vitiligo?

Autoimmune thyroid disease

35

What nail disease is associated with HIV?

PWSO (proximal white subungual onychomycosis)

36

What is the difference between Stevens-Johnson and Toxic Epidermal Necrolysis?

Degree of epidermal detachment:

SJS < 10%
TEN > 30%

37

What is Sézary Disease?

Cutaneous T-Cell Lymphoma causing erythroderma

38

What are side effects (2) of Minocycline?

1. Vertigo
2. Bluish skin discoloration

39

1. Differential for groin rashes (3)
2. Which one is treated with antibiotics?

1. Candida - satellite lesions
2. Tinea Cruris - serpiginous borders
3. Erythrasma - brown scaley, well-demarcated, positive Wood's lamp***

***Treated with topical Erythromicin or Clindamycin -OR- topical fusidic acid -OR- oral Erythromycin, Tetracycline or Clarithromycin

40

What is appropriate ointment for impetigo?

Mupiricin

41

What is the "itch without the rash"?

Brachioradial Pruritis

42

1. What is seen on scrapings of Tinea Versicolor?
2. What is treatment for Tinea Versicolor?

1. Malassezia globosa (or less often furur) with appear like spaghetti and meatballs
2. a. Topical ketoconazole
b. Zinc pyrithione shampoo