Dermatology Disorder – Flashcards
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What is the antibiotic therapy for abscess?
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TMP-SMX or Clindamycin or Micoycleine + Rifampin
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What are the distinguishing features of necrotizing fascitis?
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erythema with blister, crepitus, diabetic with foot cellulitis and signs of systemic toxicity pernieal cellulitis with abrupt onset and rapid spread (fournier's gangrene)
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What is the txt for nec. fasc?
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1. surgical debridment 2. empirical: impienen + vancomycin strep: penc G and maybe clindamycin clostr: pen. G + clindamycin
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Which drug should you NEVER use isotrentinoin with?
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tetracycline- cause pseudotomor cerebri
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what are the side effects of isotretinioin?
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teratogenic hepatotoxic
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what is the txt regimen for acne?
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1. retinoids 2. antibiotics + benzyl peroxide
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What is the classic presentation of rosacea?
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middle aged pt facial redness with telangiectasis at nose and cheeks facial flushing with spicy foods, alcohol, temp. inflammatory papules, cysts simlar to acne but no comedones ocular blepharitis rhinopyema
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what are the txt options for rosacea?
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metrogel tetracycline
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In which people do you give acyclovir for varicella?
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1. older than 12 years 2. household contacts 3. taking oral or inhaled steroids (ASTHMA)
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what meds are used in the txt of postherpatic neurlagia?
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pregabalin gabapentin lidocaine pathces capsacin cream
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which HPV types cause skin warts? which cause genital warts?
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skin warts: HPV 1-4 genital warts: HPV 6 and 11
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what are the characteristic features of tinea versicolor?
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lesions don't tan don't apper scaly but scale when scraped KOH: hypahe and spores (spaghetti and meatballs)
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what is the txt for pediculosis capitits (lice)?
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permethrin cream
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what is txt for pediculosis pubis ?
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permethrin cream Malathion or ivermectin sexual partners need to be treated
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When should antibiotics be used for txt of skin abscesses?
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If abscess > 5cm of if patient has diabetes, uses steroids, or immunosupppresed
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What med. is preferred in the txt of scabies?
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Permethrin
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What are the characteristic features of necrotizing fascitis?
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1. unexplained severe pain in absence of cellulitis 2. erythema with blistering or bullae 3. crepitus in cellulitis 4. cellulitis in perineum
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What is the txt for dry gangrene vs wet?
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Dry: autoamputation, txt vascular diseae Wet: Debridement with possible amputation (must do surgery)
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What is the time frame in the txt of Varicella?
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Within first 72 hours
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What is the appearance of mullouscum contagiousum?
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shiny papules with central umbilication < 5cm
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What is the txt for Mulloscum?
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Self resolves but can try imquimoid or cryotherapy
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What is the txt for tinea capitis?
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Oral griseofulvin itraconazole terginafine
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What is the txt for Rosacea?
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Topical: 1. Sulfacetamide 2. Metrondiazole Systemic: 1. Tetracyclines 2. Doxycycline 3. Minocycline 4. isotretinoin
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What is the txt for Hidraintis Supprativa?
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Incision and Drainage Antibiotics (cephalosporins initially)
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How do you txt Impetigo?
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Wash area and remove crust Topical antibiotics- Mupriocin*** sytemic antibiotcs if pt is in daycare
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What can be used to txt shingles?
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Acyclovir, famciclovir, Valcyclovir
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What study can be done to diagnose herpes simplex type 1?
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Tzanck smear- will reveal multiucleated giant cells
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obese, diabetic pt with pruritic rash underneath her breasts. What diagnostic study can be used to diagnose this?
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Intertrigo 2/2 canidida KOH prep will see pseudohyphae
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A pt presents with erythema mulitforme what meds. are the most common offenders?
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Penicillins Sulfonamides OCP NSAIDs Anti-convulsants
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What are the distinctions between erythema multiforme, stevens-johnson, toxic epidermal necrolysis?
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EM: mild, no mucous involvement, no sloughing of skin SJ: 30% skin sloughed
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What is the classic presentation of pityriasis rosea?
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herald patch followed by several days later by christmas tree rash
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What is the txt for pityriasis rosea?
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self-limited
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What are the clinical features of pityriasis versicolor?
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hypopigmented will scale when scraped KOH prep--> spagehetti with meatballs,
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Waht is the txt for pityriasis versicolor?
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1. Topoical anti-fungals for 2 weeks (terbinafine) 2. Selenium sulf. shampoo, Ketoconazole (oral)
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What is the classic presentation of lichen planus?
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pruritis, purple, polygonal papules + plaques, flexor surface + extremiites
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what is the txt for seborrheic dermatitis?
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topical selenium sulfide coal tar shampoo ketoconazole
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What are the txt options for psoriasis?
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topical steroids (DO NOT give Oral) calcipotriene ( vitamin D3 analog) Tazarotene coal tar salicyclic acid UV therapy Soriatane Kenalog (steriods) injection Anti-TNA agents (enberel) methotrexate cylcosporine
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KOH prep shows hyphae. what oral agents are available to treat this condition?
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Ketoconazole fluconzaole itraconazole
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What is the txt for Scabies?
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permethrin cream oral ivermectin
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What causes tinea versicolor?
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malassezia furfur
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When treating pediculous with Malathion, what symptoms might suggest Malathion toxicity?
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Organophosphate: lacrimation, salivation, diarrhea, muscle excitation
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Pt takes Phenytoin. Starts to develop malaise, fever, headache, and a rash. skin is red and sloughing off in some areas. How should this be treated?
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stevens-johnson or TEN stop drug IV fluids corticosteroids analgesics admit pt to burn center Immunoglobulins might be needed
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Pt with Psoriasis. What do you expect to find on skin biopsy?
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thickned epiderms with nucleated cells in stratum corneum. absent stratum granulosum increased ESR negative RF
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What infections are associated with Erythema multiforme and what does the rash look like?
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Herpes Simplex and Mycoplasma Pneumonia see Target lesions can txt HSV with acyclovir
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What are the two most important ways to prevent and treat decubitus ulcers?
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1. adequate hydration 2. turn patient
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What diseases are associated with increased incidence of Seborrheic Dermatitis?
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parkinson's HIV psoriasis immunocompromised pts dementia
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What infections are associated with increased likelihood of lichen planus?
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Young pts: HIV Older pts: Hepatitis C
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What does the biopsy of squamous cell carcinoma show?
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anaplastic epidermal cells extending to Dermis
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Where are the most common places Melanoma metastasize to?
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Lung Brain GI
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How thick is Melanoma when it starts to metastasize?
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>0.76 mm
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What is txt for pemphigus vulgaris?
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High dose systemic steroids Azathrioprine or Cyclophosphamide
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What is txt for bullous pemphigoid?
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Topical steroids
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Most common type of Melanoma?
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Superficial spreading
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Non-pigmented melanoma?
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amelanocytic
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Dark papule on the legs or trunk that bleeds with minor traua?
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Nodular melanoma
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occurs on palms, soles, or under nails?
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acral lengtignous
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Dark lesion larger than 6mm with irregular, asymetric borders?
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superficial spreading
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What is the txt for Melasma?
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Hyroquinone Flucinolone + hydroquinone + tretinoin
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What comorbities are associated with Vitiligo?
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autoimmune disorder-graves, hashimotos'
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What is the txt for Vitioligo?
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corticosteroids
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purple red on face that does not regress with age?
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port wine stain
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infant with bright red lesion that regresses over months to years?
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strawberry hemangioma
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benign small red papule that appears on skin with age?
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cherry hemangioma
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bright red papule with radiating blanching vessels?
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spider angioma
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blue compressible mas that does not regress?
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Cavernosus hemangioma
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red pink nodule on child that is often confused with melanoma?
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spitz nevus
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black velvety plaques on flexor surface and intertriginous areas?
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Acanthosis Nigracans
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Circular rash with central clearing on the trunk or arms?
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tinea corporis
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What is the classic appearance of basal cell carcinoma?
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pearly papule with telangiectasia
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What is the classic appearance of squamous cell cancer?
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papule or ulcer with scaling or keratinization, regular or disordering appearance, can be painless or painful
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What is the classic appearance of porpyrina cutanea tarda?
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blister on sun exposed area assoicated with hypertricosis or hyperpigmentation hepatitic C
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What are the txt options for actinic keratosis?
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5-FU, Imiquimoid, cryotherapy
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What txt options are available for androgenic alopecia?
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Finasteride MInoxidil spironolactone
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What are the possible underlying causes of alopecia areta?
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syphilis pernicious anemia lupus chronic active hepatitis thyroid addisons
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What do the antibodies target in bullous pemphigoid and pemhigus vulgaris?
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BP: anti-hemidesomosomes (basement membrane, dermal-epidermal junction) PV: anti-desomosome
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melanoma that grows only vertically?
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nodular
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melanoma that is longstanding pre-cancerous before dermal invasion?
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lentigo maligna
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melanoma with lateral growth before vertical invasion?
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superficial spreading
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a hairy homeless man man with blisters. elevated LFT's. what enzyme is deficient?
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Porphyria cutanea tarda def. in hepatic urophorphyrinogen decarboxylase
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pt with hypo-pigmentation of skin on her skin. what endocrine test will you order?
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Vitiligo check TSH
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What txt is indicated in pt with strawberry hemangioma?
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nothing-regresses over time
