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USMLE Step 3 MTB > Dermatology > Flashcards

Flashcards in Dermatology Deck (134)
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1

- 30-40 yoa
- AI disease of unclear etiology
- Abs produced against Ags in intercellular spaces of epidermal cells
- possible causes are idiopathic, ACEI, penicillamine
- bullae are relatively thin and fragile
- POSITIVE Nikolsky's sign
- PAINFUL
- not pruritic
- fluid loss and risk of infection d/t loss of skin integrity
- life-threatening
- mouth involvement

pemphigus vulgaris

2

MOST ACCURATE test for pemphigus vulgaris

skin biopsy

3

treatment for pemphigus vulgaris

steroids

4

treatment for pemphigus vulgaris if steroids are ineffective

- azathioprine
- mycophenolate
- cyclophosphamide

5

- 70-80 yoa
- can be sulfa drug-induced
- deep blisters
- thicker bullae much less likely to rupture
- oral lesions are RARE

bullous pemphigoid

6

test for bullous pemphigoid

skin biopsy w/ immunofluorescent Abs

7

treatment for bullous pemphigoid

steroids

8

alternative treatment to steroids for bullous pemphigoid

- tetracycline
- erythromycin w/ nicotinamide

9

- associated w/ other AI diseases
- can be drug-induced by ACEIs or NSAIDs
- very superficial
- NO oral lesions

pemphigus foliaceus

10

diagnosis for pemphigus foliaceus

skin biopsy

11

treatment for pemphigus foliaceus

steroids

12

- d/o of porphyrin metabolism
- photosensitivity reaction to abnormally high accumulation of porphyrins
- NONHEALING blisters on sun-exposed parts of body
- hyperpigmentation of skin
- hypertrichosis of face

porphyria cutanea tarda

13

are associated w/ porphyria cutanea tarda

- alcoholism
- liver disease
- chronic hepatitis C
- OCPs
- hemochromatosis
- DM

14

test for porphyria cutanea tarda

urinary uroporphyrins

15

treatment for porphyria cutanea tarda

- stop drinking alcohol
- stop all estrogen use
- barrier sun protection
- phlebotomy/deferoxamine
- chloroquine (increases porphyrin excretion)

16

- hypersensitivity reaction, most often mediated by IgE and mast cell activation
- evanescent wheals and hives (onset w/i 30 minutes, and lasts

urticaria

17

MCC of urticaria

- medications
- insect bites
- foods
- emotions
- latex

18

chronic urticaria is associated w/

- pressure on skin
- cold
- vibration

19

treatment for severe, acute urticaria

- H1 antihistamines
- steroids if life-threatening

20

treatment for chronic urticaria

H2 antihistamines

21

treatment for urticaria when trigger cannot be avoided

desensitization

22

- milder version of hypersensitivity reaction than urticaria
- "typical" drug reaction
- rash resembles MEASLES (hence the name)
- can appear days after exposure, and even after medication has been stopped
- lymphocyte mediated

morbilliform rash

23

treatment for morbilliform rash

antihistamines

24

erythema multiforme causes

- penicillins
- phenytoin
- NSAIDs
- sulfa drugs
- HSV, or mycoplasma infection

25

- target-like lesions especially on PALMS and SOLES
- can be described as "iris-like"

erythema multiforme

26

treatment for erythema multiforme

antihistamines and treat underlying infection

27

- hypersensitivity response to medications (penicillins, sulfa drugs, NSAIDs, phenytoin, phenobarbital)
- involves

Stevens-Johnson syndrome (SJS)

28

treatment for Stevens-Johnson syndrome (SJS)

- should be managed in burn unit
- IVIG, cyclophosphamide, cyclosporine, or thalidomide

29

- most serious version of cutaneous hypersensitivity reaction
- 30-100% BSA involvement
- positive Nikolsky's sign
- drug-induced

toxic epidermal necrolysis

30

MCC of death in toxic epidermal necrolysis

sepsis