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X Clin Med Exam 1 > L7 Cellulitis and Other Derm Disorders > Flashcards

L7 Cellulitis and Other Derm Disorders Flashcards

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1
Q

Lymphangitis

A

Seen as red streak in areas of cellulitis, mark borders to notice this

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2
Q

Folliculitis

A

Inflammation of hair follicle leading to pustules and papules, itching and painful

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3
Q

Cause of folliculitis

A

S. aureus

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4
Q

Cause of hot tub folliculitis

A

Pseudomonas

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5
Q

Progression of folliculitis

A

Furuncle (well-circumscribed, painful, inflammatory nodule) and can become carbuncle/abscess

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6
Q

Treatment of staph. folliculitis

A

Usually self-limited, for moderate/ severe use topical abx (mupirocin) or oral abx (cephalexin), if MRSA then sulfa, clindamycin or doxycycline

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7
Q

Impetigo

A

Contagious superficial bacterial infection seen more in kids due to autoinoculation causing satellite lesions

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8
Q

3 variants of impetigo

A

Nonbullous, bullous or ecthyma

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9
Q

Nonbullous impetigo

A

Most common, see papules, vesicles, pustules and “honey colored crusting”- s aureus

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10
Q

Bullous impetigo

A

Vesicles enlarge and form a flaccid bulla- s aureus

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11
Q

Ecthyma

A

“Punched out” ulcers with overlying crust (like a cigarette burn)- strep bacteria

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12
Q

Treatment of variants of impetigo

A

Non-bullous and bullous is topical abx like mupirocin with oral abx for more severe, ecythma is always treated orally

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13
Q

Cellulitis

A

Inflammation of skin with a diffuse, spreading superficial infection

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14
Q

Pathogen of cellulitis

A

Beta-hemolytic strep, can be staph

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15
Q

2 types of cellulitis

A

Nonpurulent (cellulitis or erysipelas)-strep and purulent (abscess and purulent cellulitis)-staph aureus

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16
Q

Symptoms of cellulitis and erysipelas

A

Erythema, edema, warmth and can be fever

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17
Q

Symptoms of an abscess

A

Painful, fluctuant (squishy), erythematous nodule

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18
Q

Erysipelas

A

Superficial skin infection from b-hemolytic strep., seen mostly on cheeks and LE, sharply demarcated border with tender, warm and erythematous

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19
Q

Treatment of abscess

A

Most important is incision and drain, sometimes abx (because purulent)

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20
Q

Treatment for cellulitis

A

Empiric coverage for beta-hemolytic strep and staph (cephalexin or cefazolin)

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21
Q

Treatment of erysipelas

A

Empirical treatment for beta-hemolytic strep

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22
Q

Reasons to do I&D and abx for abscess

A

Abscess greater than 2 cm (or multiple), toxicity, extensive cellulitis, immunosuppression, indwelling medical device, high risk for transmission

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23
Q

Decolonization of MRSA

A

Chlorohexidine wash, mupirocin ointment intranasally

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24
Q

When IV abx necessary for MRSA

A

Extensive involvement, toxicity, rapid progression, failure PO tx, immunocompromised pt, infection near indwelling device

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25
Cutaneous manifestations of SLE
Discoid lupus or malar/butterfly rash
26
Discoid lupus
Annular, erythematous, scaly plaques on sun-exposed areas (15-30% of SLE pts)
27
Malar/butterfly rash
Erythema on cheeks and bridge of nose, nasolabial folds spared
28
Tx for SLE
Topical or intralesional steroids (not face), hydroxychloroquine or other systemic med, must confirm it is not drug induced cutaenous lupus (1-5 mos after new med)
29
Erythema multiforme
Acute, immune mediated condition causing distinct target-like lesions
30
Erythema multiforma major
Will also affect the mucosa
31
Cause of erythema multiforme
Herpes simplex is most common, but be some drugs (NSAIDs or abx)
32
Tx for erythema multiforme
Usually self-limited within 2 wks, can use topical steroids or oral antihistamines, mouthwash for symptoms, no anti-virals for acute EM
33
Dermatitis herpetiformis
Uncommon autoimmune skin condition associated with gluten sensitivity (Celiac)
34
Sxs dermatitis herpetiformis
Intensely pruritic papules and vesicles seen on forearms, knees, scalp and buttocks
35
Tx for dermatitis herpetiformis
Dapsone and gluten elimination
36
Pemphigus
Group of rare, autoimmune, life-threatening, blistering disorders
37
Forms of pemphigus
Vulgaris, foliaceus, IgA and paraneoplastic
38
Acantholysis
Separation of epidermal cells from each other (caused by antibodies in pemphigus), lead to blister
39
Presentation of pemphigus
Mucosal involvement in oral cavity where see flaccid bullae that may spread to skin (scalp, face, axilla, groin), Nikolsky sign, S=superficial
40
Nikolsky sign
Gentle application of lateral pressure in an uninvolved area that causes superficial layer of skin to slough off
41
How to diagnosis pemphigus/pemphigoid
Lesional (routine histological exam) or perilesional (direct immunofluorescence) skin biopsies, DIF is gold standard
42
Tx of pemphigus
Refer to derm, main choice is systemic corticosteroids or immunosuppressive agents, can then treat oral lesions with lidocaine or acetonide or abx for secondary infection, death possible if not treated
43
Pemphigoid
Chronic autoimmune subepithelial blistering disorder, D=deep
44
Types of pemphigoid
Bullous and mucuous membrane (MMP)
45
Presentation of pemphigoid
Urticarial, erythematous plaques and tense bullae that do not slough off on the trunk and extremities (can see mucosal involvement)
46
Tx for pemphigoid
Skin care and topical or systemic corticosteroids, refer to derm, some immunosuppressive agents
47
Melasma/chloasma
Acquired hyperpigmentation of the skin, hormonal effect, "mask of pregnancy"
48
Acanthosis nigricans
Hormonal effect, common disorder associated with insulin-resistance (DM, obesity), presents with hyperpigmented velvety plaques
49
Hirsutism
Male pattern hair growth in women
50
Causes of hirsutism
Polycystic ovarian syndrome, idiopathic, cushing's disease, insulin resistance, drugs etc
51
Cushing Syndrome
Excess androgens/steroid hormone, this affects pilosebeaceous unit so increased sebum/acne/ atrophy, striae
52
Addison's disease
Adrenal insufficiency, hyperpigmentation of gums, buccal mucosa, elbows, knees, palms and genitalia
53
Pretibial myxedema
Thyroid dermopathy seen in hyperthyroidism, nonpitting, scaly thickened skin, orange peel appearance, warm, moist skin
54
Presentation of hypothyroidism
Dry, cool skin
55
Porphyrias
Metabolic disorders due to altered activity of enzymes in heme synthesis
56
Cause of porphyria cutanea tarda
Deficiency of uroporphyrinogen decarboxylase (UROD) in liver, leads to excess porphyrins
57
Sxs of porphyria cutaneous tarda
Painless sub-epidermal blistering of skin on sun exposed areas, photosensitivity, seen on dorsum of hands, forearm, face, neck and feet
58
Tx of porphyria cutanea tarda
Phlebotomy in order to deplete iron and prevent formation of UROB inhibitor and then low dose hydroxychloroquine
59
Ulcer
Pressure induced injury over bony prominences, usually related to immobility- prevention!
60
Stage 1 of ulcer
Intact skin with localized erythema
61
Stage 2 of ulcer
Partial thickness skin loss with exposed dermis, adipose not visible, no eschar (thick, dark, black scab)
62
Stage 3 of ulcer
Full thickness skin loss, see adipose, rolled wound edges, may see eschar
63
Stage 4 of ulcer
Full thickness skin and tissue loss with exposed muscle, tendon, bone or fascia, common eschar and rolled edges, fistulas
64
Tx of stage 1 ulcer
Transparent film for protection
65
Tx of stage 2 ulcer
Dressing that maintains moist wound environment (if no infection)
66
Tx of stage 3/4 ulcer
Debridement of necrotic tissue, appropriate dressing, maybe abx
67
Findings associated with tick borne illness
Erythema migrans or rocky mountain spotted fever
68
Why remove tick within 2-3 days
Prevent lyme disease (if so single 200mg dose of doxycycline)
69
Erythema migrans
Seen in early stage of lyme disease, bull's eye appearance of rash (slightly raised, warm red with central clearing), 7-14 days after tick bite
70
Pathogenesis of erythema migrans
Borrelia Burgdorferi
71
Late stages of erythema migrans
Cardiac, arthritis and neurologic sxs, bell's palsy
72
Tx of erythema migrans
Abx like doxycycline or amoxicillin
73
Pathogenesis of rocky mountain spotted fever
Rickettsia rickettsia
74
Sxs of rocky mountain spotted fever
Nonspecific sxs (fever, HA, malaise) within 2 wks, rash within 3-5 days that is macular with petechial lesions seen on ankles, wrists and trunk
75
Why must treat rocky mountain spotted fever early
It is lethal within 5 days!
76
Tx of rocky mountain spotted fever
Empiric tx based on suspicion (doxycycline)

X Clin Med Exam 1 (7 decks)

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