Flashcards in Master the Boards: Dermatology Deck (32):
What type of biopsy may be done in suspected basal cell carcinoma?
A shave biopsy is ok
What is the pathogenic origin of Kaposi sarcoma?
Human herpes virus 8
Kaposi sarcoma is red-purple because it is more vascular. Besides the skin what other two areas may it be found in?
How is Kaposi sarcoma treated?
Generally no surgery. Treat AIDS or HIV with antiretrovirals and generally regresses.
Occasionally can use intralesional vincristine or interferon injections
Should actinic keratosis be removed?
Yes, they should be removed with curettage, cryotherapy, laser, or topical 5-FU
Overactivity of mast cells leads to what common skin disorder?
Levels of what Ig are elevated in atopic dermatitis (eczema)?
What are general skin care measures for tx?
Avoid irritants (bathing, soap, washcloths)
Cotton is less irritating than other clothing
What are topical treatments of atopic dermatitis?
Tacrolimus and pimecrolimus
*Antihistamines can also be used (including doxepine in severe disease)
What are topical treatments for local psoriasis?
Vitamin A and vitamin D ointment
Coal tar preparation
Tacorlimus and pimecrolimus on more delicate areas
What is treatment for extensive psoriasis?
Anti-TNF drugs (e.g. etanercept, adalimumab, and inflliximab)
Patient presents with a single lesion which disseminates but spares the palms and soles. What is the likely dx?
The single lesion was the Herald patch which can spread to form a "Christmas tree" like rash distribution
What is tx of Pityriasis roasea?
Usually remits on own but UV light and steroids can be used
What agents are helpful for seborrheic dermatitis (aka dandruff)?
Topical steroids and topical antifungals (e.g. ketocanzole)
These are helpful bc it is a hypersensitivity reaction to dermal infection with noninvasive dermatophytes
What common drug is associated with pemphigus vulgaris?
(Also penicillin, phenobarbital, and penicillamine)
What disease presents with blisters which easily rupture, oral involvement, and fluid loss and infection?
What is Nikolsky sign (positive in this condition)?
Nikolsky sign: removal of superficial layer os skin with slight pressure
What is treatment of pemphigus vulgaris?
Systemic steroids (prednisone)
Azathioprine or mycophenolate to wean patients off steroids
Rituximab or IVIG in refractory cases
What disease presents with tense bullae?
What is the best initial therapy?
Mild disease responds to what other meds?
Mild: Erythromycin, dapsone, and nicotinamide
Porphyrea cutanea tarda leads to blistering of the hands and feet. What two conditions is it associated with?
Hemochromatosis (iron overload)
Porphyrea cutanea tarda is a deficiency of what enzymes activity and what builds up?
What are underlying causes (environmental; 2)?
What procedural treatment helps?
Uroporphyrin decarboxylase defect leading to increased uroporphyrins (detected in urine)
Estrogen and alcohol
Phlebotomy to remove iron
Impetigo due to community-acquired MRSA can be treated with what agents (3)?
Skin infections with group A Strep (i.e. Strep pyogenes) can have what harmful sequela?
(NOT rheumatic fever)
What is a more severe disease, impetigo or erysipelas?
Which more commonly has a leukocytosis?
Erysipelas is more severe since deeper involvement and more likely to have fever and leukocytosis
(More commonly due to Strep)
Place the following in order of size (from small to large)
Generally what is the best initial test for detecting fungal infection?
What is the most accurate test?
Accurate: Fungal culture
What is a major side effect of ketoconazole?
What is the best initial therapy for tinea capitis (hair) and tinea unguium (nail)?
(Itraconazole close in efficacy)
What are drugs which commonly cause hypersensitivity reactions? (6)
Erythema multiforme can be a precursor to more severe infections like Stevens-Johnson syndrome. However, what are other pathogenic causes?
Herpes or Mycoplasma
Sloughing off of epithelium and mucous membrane involvement is due to ______. What is tx?
(Steroids are NOT helpful)
Toxic shock syndrome (TSS) and Staph scalded skin syndrome (SSSS) are both caused by _____.
What is tx?
Oxacillin or nafcillin if sensitive
What is the order of drug treatment for acne based on severity?
Topical benzoyl peroxide
topical vitamin A derivatives (e.g. tretinoin)
oral vitamin A/isotretinoin.