PANCE PREP PEARLS Flashcards

1
Q

ALOPECIA AREATA

A

ETIOLOGY IMMUNE-MEDIATED HAIR LOSS (ASSOCIATED WITH THRYOID, ADDISONS DISEASE)
PRESENTATIONS “SMOOTH CIRCULATE PATCHES OF COMPLETE HAIR LOSS
EXCLAMATION POINT HAIRS”

TREATMENT TOPICAL AND INTRALESIONAL CORTICOSTEROIDS.

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2
Q

ANDROGENETIC ALOPECIA

A

ETIOLOGY PROGRESSIVE HAIR LOSS- DIHYDROTESOSTERONE IS KEY ANDROGEN LOSS.
PRESENTATIONS MC AFFECTING TEMPORAL SCALP

TREATMENT “MINOXIDIL
ORAL FINASTERIDE: 5-a REDUCTASE INHIBITOR”

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3
Q
ATOPIC DERMATITIS (ECZEMA)
ATOPIC TRIAD
A

“ECZEMA
ALLERGIC RHINITIS
ASTHMA”

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4
Q

ATOPIC DERMATITIS (ECZEMA)

A

ETIOLOGY ^ IgE PRODUCTION
PRESENTATIONS “ACUTE LESIONS = MC IN FLEXOR CREASES
NUMMULAR ECZEMA= COIN SHAPED”

TREATMENT	"TOPICAL CORICOSTEROIDS
ANTIHISTAMINES FOR ITCHING
WET DRESSING
ANTIBIOTICS FOR SECONSARY INFECTIONS. 
PREVENTIONS: 
  AVOID IRRITANTS. "
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5
Q

CONTACT DERMATITIS

A

ETIOLOGY IRRITANT CAUSED
PRESENTATIONS “DIAPER RASH
BURNING, ITCHING, ERYTHEMA”

TREATMENT FREQUENT DIAPER CHANGES, TOPICAL PETROLEUM OR ZINC OXOIDE

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6
Q

DYSHIDROSIS (DYSHIDROTIC ECZEMA)

A

ETIOLOGY “TRIGGERED BY SWEATING/WARM HUMID WEATHER.
^ WITH TIMES OF STRESS”
PRESENTATIONS TAPIOCA-LIKE TENSE VESICLES ON THE SOLES, PALMS AND FINGERS-LATERAL DIGITS.

TREATMENT TOPICAL STEROIDS

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7
Q

LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS)

A

ETIOLOGY SKIN THICKENING IN PATIENTS WITH ECZEMA- REPETATIVE RUBBING/SCRATCHING
PRESENTATIONS SCALY, ROUGH SKIN WITH EXAGGERATED SKIN LINES

TREATMENT “AVOID SCRATCHING LESIONS
TOPICAL STEROIDS”

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8
Q

PERIORAL DERMATITIS

A

ETIOLOGY “MC YOUNG WOMEN
HISTORY OF TOPICAL CORTICOSTEROID USE”
PRESENTATIONS

TREATMENT “TOPICAL: METRONIDAZOLE OR ERYTHROMYCIN
ORAL: TETRACYCLINES
AVOID TOPICAL STEROIDS”

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9
Q

LICHEN PLANUS

A
ETIOLOGY	^ WITH HEPATITIS C
PRESENTATIONS	"5 P's:
PURPLE
POLYGONAL
PLANAR (Flat-topped)
PRURITIC PAPULES w/ FINE SCALES

SKIN, MOUTH, SCALP, GENITALS AND NAILS
KEOBNER’S PNENOMENON: NEW LESIONS AT SITE OF TRAUMA
WICKHAM STRIAE: FINE WHITE LINES ON THE SKIN LESIONS OR ON THE ORAL MUCOSA”

TREATMENT “TOPICAL CORTICOSTEROIDS #1
PO STEROIDS UVB THERAPY #2”

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10
Q

LICHEN PLANUS

5 PS

A
5 P's:
PURPLE
POLYGONAL
PLANAR (Flat-topped)
PRURITIC PAPULES w/ FINE SCALES
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11
Q

PITYRIASIS ROSEA

A

ETIOLOGY “IDIOPATHIC
CHILDREN/YOUNG ADULTS”
PRESENTATIONS “HERALD PATCH: SOLITARY SALMON-COLORED MACULE —–>
CHRISTMAS TREE PATTERN”

TREATMENT NONE NEEDED

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12
Q

PSORIASIS

A

ETIOLOGY STRATUM BASALE + STRATUM SPINOSUM —-> T CELL ACTIVATION
PRESENTATIONS “PLAQUE : MC TYPE—RAISED, DARK RED PLAQUES/PAPULES WITH THICK SILVER/WHITE SCALES
PUSTULAR: YELLOW NON-INFECTED PUSTULES
GUTTATE: SMALL, ERYTHEMATOUS PAPULES WITH FINE SCALES
PSORIATIC ARTHRITIS”

TREATMENT “MILD-MODERATE: TOPICAL STEROIDS
MODERATE/SEVERE: POTOTHERAPY, UVB
SYSTEMIC: METHOTREXATE”

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13
Q

PIRYRIASIS (TINEA) VERSICOLOR

A

ETIOLOGY MALASSIZEA FURFUR - OVERGROWTH OF THIS YEAST
PRESENTATIONS HYPER/HYPOpigmentation w/ WELL DEMARCATED MACULES WITH FINE SCALING
DIAGNOSIS “KOH PREP: HYPHAE AND SPORES (SPEGHETTI AND MEATBALLS)

TREATMENT TOPICAL ANTIFUNGALS: SELENIUM SULFIDE, SODIUM SULFACETAMIDE, ZINC PYRITHIONE, “ AZOLES”

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14
Q

SEBORRHEIC DERMATITIS

A
ETIOLOGY	HYPERSENSITIVITY TO MALASSEZIA FURFUR YEAST
PRESENTATIONS	"CRADLE CAP: INFANTS
ADULTS: DANDRUFF"
DIAGNOSIS	
TREATMENT	"TOPICAL: 
SELENIUM SULFIDE- SELSON BLUE
SODIUM SOLFACETAMIDE 
KETOCONAZOLE
SYSTEMIC: 
ORAL ANTIFUNGALS"
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15
Q

CUTANEOUS DRUG REACTIONS

A

ETIOLOGY “TYPE 1- IgE Mediated- Urticaria/angioedema- Immediate
TYPE 2 - Cytotoxic
TYPE 3- Immune antibody-antigen complex
TYPE 4- Delayed (Cell mediated)”
PRESENTATIONS “Exanthematous/Morbiliform Rash
- Bright Red macules & papules that form plaques
Uticarial
- 2nd MC”

TREATMENT Antihistamens and Systemic Coricosteroids

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16
Q

UTICARIA (HIVES) & ANGIOEDEMA

A

ETIOLOGY “Type 1 HSN IgE
MAST CELLS RELEASE HISTAMINE”
PRESENTATIONS UTICARIA- BLANCHABLE, EDEMATOUS PAPULES, WHEALS AND PLAQUES

TREATMENT ORAL ANTIHISTAMINES

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17
Q

ERYTHEMA MULTIFORME

A

ETIOLOGY “ACUTE SELF-LIMITED TYPE IV HYPERSENTISIVITY REACTION
HERPES SIMPLEC VIRUS MC”
PRESENTATIONS TARGET (IRIS) LESIONS

TREATMENT SYMTOMATIC- STEROIDS/BENADRYL

18
Q

STEVENS-JOHNSON SYNDROME (SJS) & TOXIC EPIDERMAL NECROLYSIS (TEN)

A

ETIOLOGY DRUG ERUPTIONS —-> SULFA/ANTICONVULSANT MEDS
PRESENTATIONS “WIDESPREAD BLISTERS
>1 MUCOUS MEMBRANE w/ EPIDERMAL DETACHMENT”
DIAGNOSIS “>1 MUCOUS MEMBRANE w/ EPIDERMAL DETACHMENT
NIKOLSKY SIGN- Able to make a new blister with pencil eraser. “
TREATMENT TREAT LIKE SEVERE BURNS

19
Q

ACENE VULGARIS

A

ETIOLOGY “4 MAIN PAHTO FACTORS:

INCREASED SEBUM PRODUCTIONS: 
    - ^ ANDROGENS
CLOGGED SEBACEOUS GLANDS 
PROPIONIBACTERIUM ACNE OVERGROWTH
INFLAMMATORY REPSONSE"
PRESENTATIONS	"COMEDONES: 
  - OPEN ==== BLACKHEADS
  - CLOSED ==== WHITEHEADS
INFLAMATORY
NODULAR OR CYSTIC ACNE"
DIAGNOSIS	"MILD: Comedones w/ small papules
MODERATE:Comedones w/ large papules
SEVERE: Nodular >5mm or cystic "
TREATMENT	"MILD: TOPICAL RETINOIDS  + BENZOYL PEROXIDE
MODERATE: TOPICAL/SYSTEMIC ANTIBIOTICS (DOXY) +/- KERATOLYTIC +/- TOPICAL RETINOID
SEVERE: ISOTRETINOINS 
    - HIGHLY TERATOGENIC"
20
Q

ACENE VULGARIS

TREATMENT

A

“MILD: TOPICAL RETINOIDS + BENZOYL PEROXIDE
MODERATE: TOPICAL/SYSTEMIC ANTIBIOTICS (DOXY) +/- KERATOLYTIC +/- TOPICAL RETINOID
SEVERE: ISOTRETINOINS
- HIGHLY TERATOGENIC”

21
Q

ROSACEA

A

ETIOLOGY “IDIOPATHIC
TRIGGERS: ETOH, ^ TEMPERATURE

PRESENTATIONS ACNE-LIKE RASH + ERYTHEMA, FACIAL FLUSHING, TELANGIECTASIA, SKIN COARSEING, PAPULOPUSTULES

TREATMENT METRONIDAZOLE

22
Q

ACTINIC KERATOSIS

A
ETIOLOGY	"MC- fiar skinned Parmers
PREMALIGNANT CONDITION TO SQUAMOUS CELL CARCINOMA
MC- PREMALIGNANT SKIN CONDITION"
PRESENTATIONS	"DRY, ROUGH, SCALY -SANDPAPER- SKIN LESIONS 
HYPERKERATOTOC-HYPERPIGMENTED"
DIAGNOSIS	BIOPSY
TREATMENT	"DERM-REFERAL
CRYOSURGERY"
23
Q

SEBORRHEIC KERATOSIS

A

ETIOLOGY MC BENIGN SKIN TUMOR
PRESENTATIONS SMALL PAPULE/PLAQUE VELVETY WARTY LESIONS—— GREASY/STUCK ON APPEARANCE

TREATMENT NO TREATMENT NEEDED

24
Q

VITILIGO

A

ETIOLOGY AUTOIMMUNE DESTRUCITON OF MALANOCYTES —-> DEPIGMENTATION
PRESENTATIONS

TREATMENT “LOCALIZED ====> TOPICAL STEROIDS
DISSEMINATED: SYSTEMIC PHOTOTHERAPY”

25
Q

BASAL CELL CARCINOMA

A

ETIOLOGY “MC TYPE OF SKIN CANCER IN US
SLOW GROWING w/ LOW INCIDENTS OF METASTISIS”
PRESENTATIONS TRANSLUCENT/PEARLY/WAXY PAPULE AND CENTRAL ULCERATION
DIAGNOSIS PUNCH OR SHAVE BIOPSY
TREATMENT “ELECTRODESICCATION/CURETTAGE
MOHS MICROGRAPHIC SURGERY FOR FACIAL INVOVLMENT”

26
Q

MALIGNANT MELANOMA

A

ETIOLOGY “UV RADIATION
AGGRESIVE HIGH METS POTENTIAL——> MC SKIN CANCER RELATED TO DEATH

4 MAJOR SUBTYPES

  1. SUPERFICIAL SPREADING- MC TYPE
  2. NODULAR
  3. LENTIGO MALIGNA
  4. ACRAL LENTIGINOUS”
    PRESENTATIONS “ABCDE’S

ASYMMETRY
BORDERS: IRREGULAR
COLOR: DARK/BLACK
DIAMETER: >6MM
EVOLUTION: RAPID CHANGE”
DIAGNOSIS FULL-THICKNESS WIDE EXCISIONAL BIOPSY + LYMPH NODE BIOPSY
TREATMENT COMPLETE WIDE SURGICAL EXCISION

27
Q

MALIGNANT MELANOMA

ETIOLOGY

A

“UV RADIATION
AGGRESIVE HIGH METS POTENTIAL——> MC SKIN CANCER RELATED TO DEATH

4 MAJOR SUBTYPES

  1. SUPERFICIAL SPREADING- MC TYPE
  2. NODULAR
  3. LENTIGO MALIGNA
  4. ACRAL LENTIGINOUS”
28
Q

MALIGNANT MELANOMA

ABCDES

A

“ABCDE’S

ASYMMETRY
BORDERS: IRREGULAR
COLOR: DARK/BLACK
DIAMETER: >6MM
EVOLUTION: RAPID CHANGE"
29
Q

SQUAMOUS CELL CARCINOMA OF THE SKIN

A

ETIOLOGY “OFTEN PRECEDED BY ACTINIC KERATOSIS
HPV INFECTION
BOWMENS DISEASE = SQUAMOUS CELL CARCINOMA IN SITU

PRESENTATIONS RED- ELEVATED, THICKEND NODULE W/ WHITE SCALY OR CRUSTED BLOODY MARGINS
DIAGNOSIS BIOPSY
TREATMENT WIDE LOCAL SURGICAL EXCISION TREATMENT OF CHOICE

30
Q

IMPETIGO: NON- BULLOUS

A

ETIOLOGY “STAPH AUREUA
VERY CONTAGIOUS”
PRESENTATIONS “SMAL MACULE BECOMES PAPULE, THEN VESICLE THAT RUPTURES AND DEVELOPS HONEY-COLORED CRUST
-All Ages”

TREATMENT MUPIROCIN

31
Q

IMPETIGO: BOLLOUS

A

ETIOLOGY STAPH AUREUA toxin causes flaccid bullae that rupture, minimal redness
PRESENTATIONS Less contagiousInfants- Preschool

TREATMENT MUPIROCIN

32
Q

CELLULITIS

A

ETIOLOGY “STAPH AUREUS & GROUP A BETA HEMOLYTIC STREPTOCOCUS

PRESENTATIONS “LOCAL: MACULAR ERYTHMEA —-> NOT SHARPLY DEMARCATED

SYSTEMIC: NOT COMMON”
DIAGNOSIS
TREATMENT “CEPHALEXIN, DICLOXACILLIN
MRSA: IV VANCOMYCIN”

33
Q

SCABIES

A

ETIOLOGY “SARCOPTES SCABIEI
BURROW INTO THE SKIN AN LAY EGGS/FEED/DEFECATE”
PRESENTATIONS “INTENSELY PRURITIC LESIONS- LINEAR BURROWS
WEB SPACES BETWEEN FINGERS/TOES SCALP
RED ITCHY PRURUITC PAPULES OR NODULES ON THE SCROTUM/GLANS/PENIL SHAFT/BODY FOLDS”
DIAGNOSIS
TREATMENT “PERMETHRIN TOPICAL
LINDANE- DO NOT USE AFTER BATH/SHOWER——-> SEIZURES
CI: TERATOGENIC- NO BREASTFEEDING”

34
Q

PEDICULOSIS (LICE)

A
ETIOLOGY	"PEDICULUS HUMANUS CAPITUS
PERSON TO PERSON"
PRESENTATIONS	"INTENSE ITCHING, PAPULAR URTICARIA NEAR THE LICE BITES
NITS- WHITE OVAL EGGS CAPSULES
LYMPHADENOPATHY"
DIAGNOSIS	
TREATMENT	"PERMETHRIN TOPICAL
LINDANE- DO NOT USE AFTER BATH/SHOWER-------> SEIZURES
    CI: TERATOGENIC- NO BREASTFEEDING"
35
Q

PEMPHIGUS VULGARIS

A

ETIOLOGY Autoimmune —-> desmosome distruption
PRESENTATIONS Painful flaccid skin bullae- rupture easily
DIAGNOSIS IgE throughout the epidermis
TREATMENT HIGH DOSE CORTICOSTEROIDS

36
Q

BROWN RECLUSE SPIDER BITES

A

ETIOLOGY MC IN SOUTHWEST & MIDWEST
PRESENTATIONS “LOCAL EFFECTS: BURNING/ERYTHMEA
RED HALO
HEMORRHAGIC BULLAE THAT UNDERGOES ESCHAR FORMATION”
DIAGNOSIS
TREATMENT “LOCAL WOUND CARE- CLEAN WITH SOAP AND WATER- COLD PACK
PAIN CONTROL - NSAIDS”

37
Q

BLACK WIDOW SPIDER BITES

A

ETIOLOGY CLINICAL PROBLEM- NOT A SURGICAL PROBLEM (HOBO-SURGICAL PROBLEM)
PRESENTATIONS “< 8 HOURS AFTER BITE
LOCAL SYMPTOMS: ASYMPTOMATIC OR PAINFUL
SYSTEMIC: MUSCLE PAIN, SPASMS AND RIGITIDY- ABD CRAMPS”
DIAGNOSIS
TREATMENT “MILD: WOUND CARE/ PAIN CONTROL
MODERATE/SEVERE: OPOIODS AND MUSCLE RELAXANTS”

38
Q

MILIARIA

A
ETIOLOGY	"PRURITIC RASH CAUSED BY TRAPPED SWEAT
OCCURS IN WARM MOIST AREAS OF BODY"
PRESENTATIONS	
DIAGNOSIS	
TREATMENT	"CONTROL HEAT
REDUCED SWEAT
ANTIHISTAMIES
STEROIDS"
39
Q

DERMATITIS HERPETIFORMIS aka “DUHRING”

A
ETIOLOGY	"NOT RELATED TO HERPES VIRUS
AUTO IMMUNE
LINKED WITH CELIAC DZ"
PRESENTATIONS	PRURIGO PAPULES AND VESICLES WHICH ARISE ON NORMAL OR REDDNED SKIN. 
DIAGNOSIS	BX
TREATMENT	"TOPICAL STEROIDS
ANTIBIOTICS TO PREVENT SECONDARY BACTERIAL INFECTION. 
GLUTEN FREE DIET"
40
Q

EPIDERMOLYSIS BULLOSA

A
ETIOLOGY	RARE GENETIC
PRESENTATIONS	NORMAL DAILY ABBRASION CAUSES BLISTER FORMATION
DIAGNOSIS	
TREATMENT	"NO CURE
BEST TREATMENT IS PREVENTION"