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CMT-uno > vesicular dermatoses/pustular disorders > Flashcards

vesicular dermatoses/pustular disorders Flashcards

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1
Q

HSV1

Clin Man

primary & recurrent

A

Primary infection: most commonly asymptomatic, but may cause tonsil pharyngitis or gingivostomatitis

Recurrent infection: prodromal symptoms within 24 hours of reactivation of virus followed by the development of
grouped vesicles on an erythematous base that crossed over prior to healing

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2
Q

HSV1

Dx and Tx

A

▸ Diagnosis : PCR (most sensitive and specific)
▸ Treatment: Valacyclovir 2g bid x 1 day

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3
Q

HSV2

Clin Med

A

▸ Painful genital ulcers often preceded by prodromal symptoms
▸ Multiple, shallow, tender grouped 2–4 mm vesicles on an erythematous base that progressed to vesicle pustules, erosions, and
alterations +/- inguinal lymphadenopathy

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4
Q

HSV2

Dx and Tx

A

Diagnosis : PCR (most sensitive and specific)
Tzanck smear: multinucleated giant cells - classic but not specific

▸ Treatment: Valacyclovir, acyclovir, famciclovir

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5
Q

Herpes Zoster

Clin Man

A

▸ Prodrome: fever, malaise, sensory changes followed by rash
▸ Rash: unilateral, the secular dermatomal eruption of painful, grouped vesicles or bola on an
erythematous base that does not cross midline
▸ Boards: thoracic and lumbar roots are most commonly affected

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6
Q
A

HSV1

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7
Q
A

HSV2

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8
Q
A

herpes zoster

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9
Q

zoster

Tx, prevention

A

Treatment: Valacyclovir, acyclovir, famciclovir within 72 hours of onset
▸ Topical analgesics
▸ Education: no longer infectious once lesions crust over
▸ Immunocompromised: VZV immune globulin to exposed individuals

Prevention : Shingrix vaccine - reduces the risk of postherpetic neuralgia

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10
Q
A

Atopic dermatitis

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11
Q

atopic dermatitis

general
Triad

A

Rash due to defective skin barrier susceptible to drying, leading to pruritus and inflammation
▸ Atopic triad: Eczema + Allergic Rhinitis + Asthma

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12
Q

atopic dermatitis

triggers

A

heat, perspiration, allergens, contact irritants

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13
Q

atopic dermatitis

Dx

A

clinical

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14
Q

atopic dermatitis

clin man
Hallmark

A

▸ Hallmark: pruritus, xerosis
▸ Erythematous, scaly, ill-defined papules or plaques. Most common flexor creases in older children
and adults.
▸ Nummular: sharply-defined discoid or circular coin-shaped lesions especially on hands, feet,
extensor surfaces

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15
Q

atopic dermatitis

Tx 3- and severe

A

First-line: topical corticosteroids with emollient use. Antihistamines for itching

Moderate-Severe: dupilumab

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16
Q

contact dermatitis

general

A

Inflammation of the epidermis and dermis from Direct contact between a substance in the surface
of the skin – either irritant or allergic

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17
Q

contact dermatitis

irritant

A

most common type – caused by chemical, alcohol, or cream exposure
▸ Pathophysiology: Nonimmunologic reaction – immediate

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18
Q

contact dermatitis

Allergen

A

nickel most common, poison ivy, metal, chemicals, detergent, cleaners, prolonged water
exposure

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19
Q

contact dermatitis

Dx

A

clinical. Patch testing may identify potential allergens to prevent future exposures

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20
Q
A

contact dermatitis

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21
Q
A

contact dermatitis

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22
Q

contact dermatitis

clin man

A

Erythematous papules or vesicles with linear or geometric distribution. often associated
with localized intense pruritus, stinging, or burning

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23
Q

contact dermatitis

Tx
If extensive?

Study These Flashcards
A

Identification and avoidance of irritants is the most important aspect
▸ First line: topical corticosteroids + General measures
▸ General measures: Cool compresses, oatmeal baths, skin emollients
▸ Severe/extensive: oral corticosteroids – 10 day prednisone taper recommended

24
Q

DYSHIDROTIC ECZEMA / POMPHOLYX

general

Study These Flashcards
A

Recurrent, pruritic, vesicular rash affecting the palms and our soles most commonly affecting young adults

25
# DYSHIDROTIC ECZEMA / POMPHOLYX triggers
sweating, emotional stress, warm and humid weather, metals
26
# DYSHIDROTIC ECZEMA / POMPHOLYX Clin Man
Sudden onset of the development of pruritic “tapioca like “small tense vesicles on the soles, palms, and/or fingers Followed by desiccation, desquamation, papules, scaling, lichenification, and erosions may occur
27
# DYSHIDROTIC ECZEMA / POMPHOLYX Dx and Tx Mild\mod and severe
Treatment: ▸ Mild-moderate: topical corticosteroid ointment preferred ▸ Severe: oral corticosteroids, potent topical corticosteroid ▸ General measures: use of lukewarm water, fragrance free & sensitive skin products, frequent use of emollients, wearing gloves during household chores
28
DYSHIDROTIC ECZEMA / POMPHOLYX
29
# IMPETIGO general
Highly contagious superficial vesicopustular skin infection most commonly found in children
30
Impetigo
31
# impetigo risk factors
Poor personal hygiene, poverty, crowding, warm and humid weather, skin trauma
32
# impetigo classification
Nonbullous - most common type, typically caused by staphylococcus aureus, group a streptococcus. Presents as papules, vesicles, and pustules with weeping and later development of honey color, golden crust, primarily on exposed surfaces of the face and arms ▸ Bullous - most commonly caused by staphylococcus aureus. Vesicles form large bulla rapidly that rupture and develop a thin, varnish-like crust ▸ Ecthyma - ulcerative pyoderma caused by group a strep – rare
33
# impetigo Dx and Tx Mild and extensive
Diagnosis: clinical ▸ Treatment: ▸ Mild: mupirocin TID x 10days + good skin hygiene ▸ Treat household members, make sure to treat nasal cavities ▸ Extensive disease: cephalexin, dicloxacillin
34
# impetigo complications
Complications ▸ Common cause of cellulitis – 10% ▸ Acute glomerulonephritis – 1-5%
35
# Acne Vulgaris general
Inflammatory skin condition associated with papules, pustules involving the pilosebaceous unit
36
# acne vulgaris 4 main factors
four main factors – follicular hyperkeratinization, increased sebum production, Cutibacterium acnes overgrowth, inflammatory response
37
acne vulgaris
38
Rosacea
39
# Rosacea General
Chronic acneiform skin condition most commonly affecting adults, typically lighter skin phototypes ▸ Etiology is unclear – persistent vasomotor instability, capillary vasodilation, and abnormal pilosebaceous activity
40
# rosacea triggers
alcohol, changes in weather, spicy foods, sun exposure (chocolate, and citrus)
41
# rosacea clin man
Macular erythema, telangiectasia, possible papules and or pustules – there are **no comedones** Some patients develop rhinophyma – overgrowth of the dermis and sebaceous glands on the nose Ocular – ocular erythema, tearing, foreign body sensation, burning, itching
42
# rosacea Dx and Tx SIM + severe
Diagnosis: clinical Treatment: ▸ Mild-Moderate: topical metronidazole, topical ivermectin cream, topical sulfacetamide ▸ Moderate-Severe: oral antibiotics (doxycycline) + topical agent ▸ Facial erythema : topical brimonidine ▸ Telangiectasia: laser therapy
43
# Milia general
Skin eruption due to keratin retention and sebaceous material in the pilosebaceous follicles within the dermis
44
# Milia Clin man
▸ 1–3 mm pearly, white – yellow papules especially seen on cheeks, forehead, chin and nose
45
# Milia Tx
▸ Treatment: Observation ▸ Can be manually extracted or treated with liquid nitrogen if desired for cosmetic reasons
46
milia
47
milia
48
# folliculitis general
▸ Superficial hair follicle infection or inflammation ▸ Staphylococcus aureus most common, other gram positive organisms ▸ Recent hot tub use? Think Psuedomonas aeruginosa
49
folliculitis
50
# folliculitis risk factors
More common in men, prolonged use of antibiotics, topical steroids
51
# folliculitis clin man
Solitary or clusters of perifollicular papules/pustules with surrounding erythema on hair bearing skin
52
# folliculitis Tx First line and severe
▸ First Line: topical mupirocin, clindamycin +benzoyl peroxide, erythromycin ▸ Severe: oral cephalexin or dicloxacillin
53
# perioral dermatitis age group affected
20-45 females
54
# perioral dermatitis risk factors
History of topical corticosteroid use or fluoridated toothpaste
55
# perioral dermatitis clin man
▸ Erythematous group papules or pustules which may become confluence into plaques with scales ▸ Spares the vermilion border ▸ May affect the periorbital or paranasal skin
56
# perioral dermatitis Tx PEM If extensive?
▸ First line: Topical pimecrolimus, metronidazole, or erythromycin + elimination of topical corticosteroids, irritants ▸ Oral: tetracyclines if extensive or refractory

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