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Flashcards in Rotation Gouge Deck (195):
1

Sebulex

An OTC medicated shampoo for dandruff

2

Carmol HC

A topical combination moisturizer that uses urea and hydrocortisone

3

Lamasil

Terbenafine

4

What is the MOA of terbenafine

Inhibits squalene epoxidase and therefore reduces fungal cell membrane ergosterol synthesis

5

What is the indication for terbenafine

Antifungal for onychomychosis

6

What is the mechanism of Naftin

Topical antibiotic that inhibits the fungal squalene epoxidase reducing fungal cell membrane ergosterol synthesis

7

Dovinex

Calcipotriene

8

What is the MOA of calcipotriene

Used for the treatment of psoriasis

Exact mechanism is unknown; binds to vitamin D receptors inducing cell differentiation and inhibiting cell proliferation

9

Clobex

Clobetasol topical

10

What are the indications for clobex

Psoriasis and dermatoses that are steroid responsive

11

Olux

Clobetasol topical

12

Nizoral

Ketoconazole

13

What are the indications for ketoconazole

Tinea versicolor
Seborheric dermatitis
tinea capitis adjunct

14

What are Dennie Morgan folds

A fold or line in the skin below the lower eyelid caused by edema in atopic dermatitis

A diagnostic marker for allergy

15

What birth control pills can be used for a means of treating acne

Yaz and Yasmin

Drosperinone component is potassium sparing antiadrenergic (suppresses FSH & LH)

16

What additional labs need to be ordered for patients starting yaz or Yasmin?

Electrolytes for potassium at drug initiation and again at 30 days

17

Duac

Clinicamycin and benzoyl peroxide

Indicated for acne

18

Retin- A micro

Tretinoin topical

Indicated for acne vulgaris

19

What is the mechanism for topical retinoids

Binds to retinoic acid receptors, stimulating epethelial cell turnover

20

What is the shorthand "UD" stand for?

As directed

21

What is the most common etiology for acne In A jawline distribution

Hormonal

22

Discuss demadex folicularum and d. Brevis

A species of the face mite

Usually found in greater numbers around the cheeks, nose, eye brows, eye lashes and forehead

D. Brevis is shorter and has a pointier tale when compared to folicularum.

23

Pityriasis alba

Common in pediatrics and is a loss of melanocyte density

24

Tinea versicolor

Discoloration of the skin due to (malassezia furfur) pityrosporum ovaleand p. biculare

25

Vitiligo

Autoimmune response that causes hypo pigmentation

Two types a and b
A- symmetrical
B- asymmetrical

26

Desonate

Desonide topical (class VI steroid)

27

Nevus hypo pigmentation

Nevus with inadequate or dysfunctional melanocytes

28

Ephilides

Freckle

29

Lentigo

Liver spots (sun spots)

Increases in number and prevalence with age

30

Skin tag

Acrochordon

31

Stucco keratosis

Referred to as barnacles

Common, nearly inconspicuous papular warty lesions occurring in the lower legs especially around the Achilles' tendon.

32

Prurigo nodularis

Uncommon disease

Nodular form of lichen simplex

Intractable pruritis

Nodules are typically 1-2 cm

33

Generalize the Fitzpatrick skin scale

Type I blue eyed celts with high susceptibility for skin cancer

Type VI African American with low susceptibility for skin cancer

34

Mucosis fungiodes

Most common type of cutaneous T cell lymphoma

Typical affects skin but May progress internally

35

Onychodystrophy

Nail pitting and onycholysis

36

Nail pitting associated with psoriasis is most commonly associated with what additional characteristic

Psoriatic arthritis: 90% of patients with psoriatic arthritis have nail changes

37

Trachyonychia

Psoriatic nails that appear as if they have been scraped with sand paper

38

What nail features are associated with psoriasis

Nail pitting
Trachyonchia
Onycholysis
Subungal hyperkeratosis

39

What are the treatment options for systemic psoriasis

1. Phototherapy: nbUVB or PUVA
2. Oral meds: Methotrexate, acetretin, cyclosporine
3. Biologics: alefacept, TNF-a inhibitors

40

Alefacept

Immune modulator that works by inhibiting T cells

41

What are the types of psoriasis?

Based on their morphology

1. Plaque
2. Gutate
3. Inverse
4. Pustular
5. Erythrodermic

42

What are the types of rosacea

1. Erythematotelangectetic
2. Papulopustule (no comedones)
3. Phymatous

43

Why should you not use strong steroids on the face

Induce steroid rosacea: eruption of papular around the mouth.

If a pt has a perioral dermatitis that looks like rosacea, ask about topical steroid use.

44

What are the diagnostic criteria for lupus

Mnemonic DOPAMINE RASH

D: discoid lupus
O: oral ulcers
P: photosensitivity
A: arthritis
M: malar rash
I: immunologic criteria (ANA)
N: neurological changes
E: increased ESR

R: renal disease
A: ANA +
S: serositis
H: hematologic disease

45

What is the primary symptom of atopic dermatitis

Itch

It's the itch that rashes

46

What are the side effects of oral isoretinoin

Birth defects
Dry eyes
Dry lips
Nose bleeds
Hypertriglyceridemia
Myalgias and elevated CK

47

What are the types of melanoma

Superficial spreading
Nodular
Lentigo maligna
Acral lentiginous
Amelanotic

48

Actinic purpura

Senile bruising

49

Actinic cheilitis

AK's on the lips

50

What will the histopathology show for muluscum contagiosum

Henderson Patterson bodies

51

What medications are fungistatic

Imidazoles

52

What medications are fungicidal

Allylamines, benzylamines

Terbenafine
Butenafine
Cyclopirox

53

What is the topical treatment for candida infections

Nystatin ointment

54

What is the most common dermatological complaint of school aged children?

Tinea capitis

Caused by trichophyton tonsurans

55

What are the two types of contact dermatitis

Irritant contact dermatitis (ICD)
Allergic contact dermatitis (ACD)

56

What is erysipelas

Superficial cellulitis with marked dermal lymphatic involvement

57

What is the hallmark lesion of leukocytoclastic vasculitis (small vessel vasculitis)

Palpable purpura

58

What is asteototic dermatitis

Xerotic eczema

More common in the elderly during the winter with multiple hot showers.

Pruritis is resolved with prolonged baths, but returns shortly after

59

What is lipodermatosclerosis

Subcutaneous fat is replaced by fibrosis that eventually impedes venous and lymphatic flow leading to edema above the fibrosis

60

What topical therapies can be used to inhibit keratinocytes proliferation

Tar
Vitamin D analog
Tazarotene

61

What is a furuncle

Boil

An acute, round, tender, circumscribed, perifollicular abscess that generally ends in central suppurations

62

What is a carbuncle

A coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles

63

What is echthyma

An ulcerative form of impetigo in which the lesions extend through the epidermis and deep into the dermis

Consist of punched out ulcers

64

What is necrotizing fasciitis

Life treating infection of the fascia just above the muscle layer. Rapidly expanding dusky, edematous red plaque with blue discoloration.

Anesthesia of the skin is the characteristic finding

65

What is cellulitis

Bacterial infection of the dermis

66

Cimex lectularius

Bed bugs

67

What leads to tissue destruction with a brown recluse spider bite

Sphingomyelenase D

68

Compound W

An over the counter wart removing agent that has an active ingredient of salicylic acid

69

What medications are associated with SJS/TEN

SATAN

Sulfa antibiotics
Allopurinol
Tetracyclines
Anticonvulsants
NSAIDs

70

What is a sclerosing agent that can be used for spider angiomas

glycerine

71

What is the treatment for keloids

- inject smaller keloids on the face with 2.5 mg/ml kenolog
- inject keoloids on the scalp with 10 mg/ml kenolog.
- inject large keloids with 20-40 mg/ml kenolog

72

Elidel

pimecrolimus

73

What is the indication for elidel

atopic dermatitis

74

What is the mechanism for elidel

inhibits T lymphocyte activation

75

What is paronychia

a nail disease that is often a tender fungal or bacterial infection of the hand or foot where the nail and the skin meet at the side or base of a finger or toe nail

76

What are the classification levels of retinoids

From Strongest to Weakest
- isotretinoin
- tazorotene
- tretinioin
- adapalene
- retinaldehyde
- retinol
- retinyl palmitate

77

What are the classification levels of topical steroids

I - Clobetasol 0.05%
II - Fluocinonide 0.05%
III- Triamcinolone ointment 0.1%
IV - Triamcinolone cream 0.1%
V - Triamcinolone lotion 0.1%
VI - Fluocinolone acetonide 0.01%
VII - desonide 0.05%
VII - Hydrocortisone 1 %

78

Retin-A

tretinoin

79

Retin-A Micro

tretinoin

80

Renova

tretinoin

81

tazorac

tazorotene

82

accutaine

isotretinoin

83

What is sebhorreic dermatitis

a common chronic inflammatory papulosquamous disease. Proposed that pityrosporum yeast is the cause

84

What is soriatane

acetretin (retinoid)

85

What is the treatment options for lichen planus

acetretin
cyclosporin
griseofulfin

86

Sarna

camphor/menthol topical

87

When is sarna indicated

generalized itching

88

What complication may arise if you use a topical retinoid with a benzyl peroxide?

benzoyl peroxide will oxidize the retinoid and will cause skin irritation

89

What are the common side effects of oral retinoids

xerosis
cheilitis
elevated liver enzymes
hypertirglyceridemia
mood changes
depression
Head ache associated with pseudotumor

90

What is the general approach for treating acne

based on the severity of disease

91

What is the treatment for mild comedones

topical retinoid
+/- topical benzoyl peroxide

92

What is the treatment for mild papular pustular acne

topical retinoid
topical antibiotic
topical benzyl peroxide

93

what is the treatment for moderate papular pustular acne

oral antibiotics
topical retinoids
topical benzoyl peroxide

94

What is the treatment for moderate nodular without scarring acne

oral antibiotics
topical retinoid
topical benzoyl peroxide

95

What is the treatment for sever acne or the presence of scaring from acne

oral retinoids (acutaine)

96

What distribution of acne is consider hormonal cause for women

jaw line distribution

97

What can be used for the treatment of hormonal induced acne in women

OCP
- Yaz
- Yasmin
- Orthotricyclen

Spiranolactone

98

What is poikiloderma

- A skin condition that consists of areas of hyper pigmentation, hypo pigmentation, teleangectasisas and atrophy.
- Commonly associated with sun damaged areas
- most frequently seen on the chest and neck

99

What is tine incognito

a fungal infection of the skin that is caused or hidden by the use of a topical immunosuppresant

100

What is is seborrhoeic dermatitis

- inflammatory skin disorder of the face, scalp and torso (T-area)
- typically presents with flaky, itching and red skin
- true mechanism is unknown

101

What is the treatment for seborhoeic dermatitis

- ketoconazole shampoo
- topical steroids

102

What is keratosis pilaris

common, autosomal dominant genetic skin condition manifested by the appearance of rough slightly red bumps on the skin of the arms and shoulders primarily.

103

actinic keratosis is a precursor to what skin lesion

squamous cell carcinoma

104

hyperhydrosis

excessive sweating

105

Protopic ointment

tacrolimus topical

106

What is the mechanism of protopic

inhibits T-lymphocyte activation and acts as an anti inflammatory

107

What are the indications for protopic ointment

atopic dermatitis
can be used for psoriasis

108

lidex

fluocinonide

109

What are the lines of blahsko

- follow a "V" shape over the back and an "S" shape over the chest, stomach and sides with wavy shapes on the head.
- believed to trace migration of embryonic cells

110

What is dermatosis papulosa nigra (DPN)

a condition of many small, benign skin lesions on the face generally presenting on dark skinned individuals.

- DPN may resemble SK

111

What is the leser-trelat sign

A sudden explosion of lesions similar to DPN (Dermatosis papulosa nigra) that is due to a growing tumor

112

What is the dimple sign

Associated with dermatofibroma

113

What is sebaceous hyperplasia

disorder of sebaceous glands in which they become enlarged producing yellow shiny bumps on the face
- not always associated with hair follicles

114

differin

adapalene topical
- topical retinoid

115

What is the indication for differin?

acne vulgaris

116

What diseases should be included in your differential that has a skin rash that is unique or does not respond to therapy

1. SLE
2. Sarcoidosis

117

Can tagament be used for wart removal?

Can be used as an off label use for wart removal in peds

118

What is reeds syndrome

multiple cutaneous leiomyomas and is associated with renal cell carcinoma

119

What is madelungs disease

-benign symmetric lipomatosis
- substantial fat deposits on the head, neck, and girdle

120

What is dercums disease

painful lipomatosis
more common in females
very rare
associated with thyroid malfunction

121

What is the only way to definitively treat comedones

retinoids, primarily oral

122

What oral antibiotics can be used to treat acne

doxycycline
minocycline
septra

123

What is idiopathic gutate hypomelanosis

- very common
- increases with age, 80% over 80
- typical lesion is a circumscribed well demarcated symptomatic porcelain white macule
- associated with flattening of the dermal-epidermal junction

124

What can be done for patients that have developed scars from acne

1. Cosmetic laser resurfacing
2. chemical peels with agents similar to glycolic acid

125

What is lachydrin

ammonium lactate topical

126

What is the mechanism of lachydrin

increases skin moisture and decreases epidermal keratinization

127

What is erosive lichen planus

(ELP)
- can occur with in the paloplantar lesion of LP particularly on the sole
- chronic lesions are at risk of developing squamous cell carcinoma
- more common in the 3rd - 5th decade

128

Beaus lines

typically caused by trauma
- makes a full transverse path across the nail

129

What medication can be incorporated to help minimize the side effects of steroids

protopics can be added to give a steroid break

130

What are good indications to use a woods lamp

Lentiginous melanoma
melasma
vitiligo
Erythrasma

131

What is erythrasma

a skin disease that causes brown, scaly skin patches. It is caused by the Gram-positive bacterium Corynebacterium minutissimum. It is prevalent among diabetics and the obese, and in warm climates; it is worsened by wearing occlusive clothing.

132

What are the 6 P's of lichen planus

planar (flat)
purple
polygonal
pruritic
papule
plaque

133

What is lichen striatus

- form of LP that presents in a linear, lichenoid dermatosis
- primarily effects children
- lesions follow the lines of blasko
- spontaneously resolves

134

What is chondrodermatitis nodular is halicus

common, benign, painful condition of the helix or antihelix

135

Laser therapy for scars

- the brighter the red hue of the scar, the more likely the therapy would be successful
- the laser freezes the epidermis and focus the laser at the appropriate depth at which point the hemoglobin will absorb the energy and damage the adjacent area

136

Myrmecia warts

- palmar plantar warts
- round horny deep painful nodule most often on weight bearing sights
- mosaic warts are typically asymptomatic and are also a group of warts

137

What is a good treatment of plantar warts that have failed home therapy

1. Cryotherapy
2. Triple Acid

138

What is the technique for triple acid therapy for wart removal

1. Carbolic acid
2. Dichloracetic acid
3. pyruvic acid

139

What is a digital mucous cyst

- benign ganglion cyst of the digits typically located at the DIP or in the proximal nail fold.
- This condition is often worsened by osteoarthritis

140

How much epi can be safely used in the digits

limit the use of epi with lidocaine in the digits to 4 cc's. The pressure from volume is often the limiting factor.

141

What is finacea

azelaic acid topical

142

What is the indication for finacea

mild to moderate inflamatory lesions of acne rosacea

143

What is the mechanism of finacea

inhibits protein synthesis, exerting antibiotic effects

144

What is a nevus comedonicus

- rare hamartoma of the pilo-sebaceous unit

145

What is the treatment for nevus comedonicus

topical retinoids

146

What are the types of basal cell carcinoma

Non-Aggressive:
Nodular
Superficial

Aggressive:
Morpheoform
Sclerosing


Cystic
Micronodular
Basosquamous
Fibroepethilioma of Pinkus

147

What are a few details that help to separate a basal cell carcinoma from an actinic keratosis

AK's typical are never alone
AK's are most often associated with scales

148

Aside from cryotherapy and chemotherapy agents, what can be used for tx of AK's covering a large area

Photo dynamic therapy (PDT)

149

What is the difference between hypertrophic scars and keloids

Keloids typically extend beyond the margins of the lesion
Keloids are often painful
Hypertrophic scars are typically a localized over growth.

150

What is the treatment for perioral dermatitis

antibiotics (topical)

151

What is the etiology of perioroal dermatitis

Common with age (50's)
associated with steroid withdrawal
associated with topical facial steroid use

152

What is lichen nitiditis

- Uncommon chronic eruptions consisting of multiple tiny discrete skin colored papules often arranged in large clusters.
- considered a variant of LP
- Most cases resolves spontaneous

153

What is the treatment for lichen nitiditis

topical steroids and oral antihistamines

154

What is a nevus sebaceous

- a hamartoma that exhibits follicular sebaceous and apocrine malformations to varying degrees
- classically a nevus or congenital malformation
- most commonly on the scalp or face

155

What is fraxel

non surgical tx for facial rejuvenation

156

When is a bleach bath indicated

atopic dermatitis

157

What is the assumed mechanism of a bleach bath

anti-inflammatory effects by inhibiting NfKb
(bleach is diluted to 0.005%)

158

Pityriasis lichenoides chronica

- papular, clonal T cell disorders that may rarely be associated with mycosis fungi odes
- erythematous to red-brown scaly papules with an indolent course; regressing over weeks to months. - Lesions often leave a hypopigmented macule.
- treatment resolves once triggering factor or medication has been removed. Topical steroids can be used

159

What is longitudinal melanonychia

- longitudinal brown to black band
- commonly seen in dark pigmented individuals
- Single nail may be a sign of melanoma.

160

What may be the initial finding in a patient with Sjogrens disease

painful tears and atopic dermatitis

161

What oral medication may be used as an adjunct to hyperhydrosis

robinol

162

What oral medication can be used for the treatment of acne that is not OCP or a retinoid

Spiranolactone

- start at 25-50mg qd then increase to 100 mg qd (therapeutic dose)

163

Creams or Ointments: which is more pure

Ointments; therefore are less commonly associated with allergic reaction

- ointments tend to be more greasy

164

What is ichthyosis vulgaris

- skin may appear normal at birth but most symptoms appear by 5yo
- can affect all parts of the body including face and scalp while the bends of the arms and legs are typically spared
- Pals are typically excessively lined
- associated with atopic dermatitis

165

What is angular cheilitis

Common inflammatory condition affecting the corners of the mouth or oral commisures
- treatment with lip balm or thick emollient +/- topical steroids

166

What are the causes of angular cheilitis

most commonly an irritant contact dermatitis from drool or spit often seen in down syndrome and associated with atopic dermatitis

Rare causes include:
- anemia
- nutritional deficiency (zinc)

167

What is onychomadresis

nail shedding may arise in severe or bullous lichen plans or acute and severe systemic illness

168

What foods are associated with acne flares

Milk
Foods with a high glycemic index

169

What is the concern for SLE patients that may be elgible for light box therapy

May exacerbate the SLE

170

What is the treatment for granuloma anulare

Steroid injection
potassium iodide
light therapy
cyclosporin

often may be self limiting

171

What are campbell de morgan spots

Cherry angiomas

172

what are naevus araneous

spider angiomas

173

What is telogen effluvium

temporary hair loss due to the shedding of resting or telogen hair after some shock to the system. New hair continues to grow

174

What is anogen effluvium

hair shedding is due to the interruption of active or anagen hair growth (drugs, toxins, inflammation) such as alopecia areata

Anogen hair has a pointed or tapered tip

175

What labs should e drawn for patients with alopecia areata

thyroid
vitamin D
Vitamin B-12
Folic acid

176

Leprosy can mimic a fixed drug eruption, what additional stain should be done

stain for AFB

177

Psoriasis is associated with an increased risk for what other pathologies

HTN
Stroke

178

What is EAC

Erythema Annulare Centrificum:
-the lesion will be annular with central clearing but will often have a trailing scale.

179

What is acquired keratoderma

Presents with thickening of the skin of the palms and soles

180

What is a known trigger for gutate psoriasis

strep throat; be sure to get an ASO titer.

ASO > 200 is diagnostic

181

What nail finding is associated with alopecia areata

nail pitting

more uniform than the nail pitting that is associated with psoriasis

182

Grovers disease

Transient akantholytic dermatosis:

skin condition that affects the chest and back
- most often in men over 50
- presents with small red papules that may blister, crust or erode

183

What is a fibrous papule

- firm bump that most often appears on the nose
- often resembles a flesh colored dermal nevus
- it is a benign lesion, but needs to be separated from a BCC

184

What is an angiokeratoma

- small dark red raised papules often presenting with scale
- composed of dilated capillaries

185

What is the treatment for bed bugs

Lesions will appear with the typical "breakfast, lunch and dinner" lesions

only treat symptomatically with topical steroids

- replace linens and check for cracks and crevices around the bed.

186

What is the set up for PDT

Photodynamic therapy (Blue light)

1. Pre clean with acetone
2. cover face with ALA kerastick
3. Sit in light box for 16:40
4. Avoid sun for 48 hours

187

What is a short term treatment for rosacea

Afrin sprayed in a cotton ball then applied to the affected areas

188

What is a newer treatment for rosacea

Mirvaso (bromonidine)

- an alpha adrenergic agonist

189

What is lichen sclerosus

a chronic skin disorder that most often affects the genital and perianal areas. It usually persists for years, and can cause permanent scarring.

no known cure, although most people are substantially improved and quite comfortable with treatment. The condition was previously known as lichen sclerosus et atrophic us.

More common with redundant skin over the penis of an uncircumcised man

190

What does the term lichenoid signify for histopath evaluation

lymphocyte bands at the DEJ

191

Aldera

Imiquimod

192

Laser treatment for warts

pulse dye and vascular laser can be used for the treatment of warts

193

EPS

Elastosis perforans serpiginosa (EPS) is a rare skin disorder in which abnormal elastic tissue fibre passes from the papillary dermis (inner layer of skin) to the epidermis (outer layer of skin). This is described as transepithelial elimination and results in a group of small reddish bumps

194

What ingredient in eucerin and aquaphor may cause an adverse reaction

lanolin

195

Where is lanolin derived from

A wax secreted by wool bearing animals