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derm 2 Flashcards

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1
Q

Other term for pityriasis versicolor + etiology

A
  1. Tinea versicolor

2. Superficial fungal infection

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2
Q

treatment of pityriasis versicolor

A

Antiseborrheic shampoos or lotions (selenium sulfide or ketoconazole)

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3
Q

Treatment of epidermal inclusion cyst/sebaceous cyst

A

Excision, not I&D (need to remove epithelial lining)

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4
Q

Treatment of dermatitis herpetiformis

A

Dapsone to induce remission + gluten free diet for long term control

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5
Q

Dermatitis herpetiformis clinical features

A

small tense papules + Vesicular + extremely pruritic, so excoriations on elbows, knees, buttocks

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6
Q

Dermatitis herpetiformis diagnosis

A

skin biopsy (IgA deposition)

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7
Q

Dermatophyte infection clinical features

A

annular scaly patch (don’t necessarily have to have central clearing)

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8
Q

Treatment of tinea pedis

A

Topical Azole or terbinafine cream BID for 2-4 weeks (avoid oral azoles)

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9
Q

Differential for lower extremity ulcers

A

PAD, DM2, *venous stasis ulcers

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10
Q

Treatment of venous stasis ulcer

A

Compression therapy

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11
Q

Location + clinical features of venous stasis ulcers

A
  1. Distal lower leg (particularly medial aspect of the ankle)
  2. Irregular border + surrounding hyperpigmentation + thickened surrounding skin and subcutaneous tissues + surrounding varicose veins and edema
  3. Result from minor trauma, medical procedure, or acute stasis dermatitis flare
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12
Q

Porphyria cutanea tarda clinical features

A

Skin fragility + small, easily ruptured vesicles in sun-exposed areas, which then rupture, forming erosions, dyspigmentation, scarring. mainly hands

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13
Q

Common initial site of involvement with pemphigus vulgaris

A

Oral mucosa

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14
Q

What to evaluate patients with seborrheic dermatitis for?

A

HIV (not hyperlipidemia) (extremely common among patients with HIV)

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15
Q

Cause of Xanthoma?

A

secondary to dyslipidemia, different subtypes associaed with hypercholesterolemia and hypertriglyceridemia

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16
Q

Eruptive xanthomas clinical features

A

Rapid onset of numerous yellow papules with surrounding erythema + extensor surfaces of extremities and buttocks

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17
Q

Eruptive xanthoma association

A

hypertriglyceridemia

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18
Q

Tuberous xanthoma association

A

familial hypercholesterolemia

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19
Q

Tuberous xanthoma vs. eruptive xanthoma

A

Tuberous are larger (up to 3 cm)

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20
Q

Management of actinic keratosis that recurrs after cryotherapy

A

Biopsy (may be a basal or SCC), never proceed directly to wide local excision for BCC or SCC

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21
Q

Other skin manifestation of amyloidosis

A
  • yellow waxy papules and plaques around eyes (look like xanthomas)
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22
Q

Treatment of pruritic urticarial papules and plaques of pregnancy (PUPPP)

A

Topical steroids (topical steroids are safe in pregnancy)

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23
Q

AK management vs basal cell

A
  • basal cell = wide local excision
  • AK = cryotherapy and surgical procedures, are the primary approach for isolated lesions [3]. Field-directed therapies, such as topical fluorouracil, imiquimod, and PDT, are particularly useful for treating areas with multiple AKs.
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24
Q

Pemphigus vulgaris diagnosis

A
  • punch biopsy with immunofluorescent staining
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25
Miliaria presentation
- lesions ranging from small, thin-walled vesicles (miliaria crystallina) to erythematous papules and pustules (militia rubra) - flesh colored papules and or pustules (miliaria profunda)
26
keratosis pilaris cause + clinical features
- retained keratin from plugged hair follicles - pruritic or pustular lesions in upper arms (most common), face, trunk, and lower extremities - worse in cold and dry climates
27
folliculitis presentation
- erythematous, pustular eruption | - lesions can be asymptomatic or cause significant pruritus and pain
28
treatment of miliaria
sweat reduction with cool baths, compresses, or light and loose clothing
29
Presentation of poorly differentiated SCC
IF poorly differentiated -- fleshy, soft, granulomatous papules and nodules - can ulcerate, bleed, become necrotic, or cause pain and pruritus
30
pyogenic granuloma presentation
- small red papule that grows rapidly over weeks to months + friable and can bleed with minor trauma
31
When you can discontinue cervical cancer screening
- prior adequate screening + no significant RF's for cervical cancer (immunosuprresion, multiple sexual partners, tobacco use or STI hx, history of HSIL)
32
larva migrans clinical features
- serpigenous red or brown lesion (due to larva migration) + pruritic + commonly from sand and soil in Caribbean, Africa, Southeast Asia * hookworm infection
33
larva migrans treatment
Ivermectin
34
cutaneous leishmaniasis presentation
- red papule that forms an ulcer with granulomatous tissue at the base with raised margins
35
swimmers itch presentation
- pruritic maculopapular rash within hours of exposure to contaminated water + rash limited to areas exposed to water * caused by schistosome
36
Sweet syndrome presentation
- abrupt onset of painful erythematous lesions (papules, plaques, or nodules) + *febrile - think rash + fever (without evidence of infection or failed antibiotics) = sweet - often preceding infection
37
Treatment and management of sweet syndrome
- Dramatic response to topical (mild sweet syndrome) or systemic steroids - Age appropriate cancer screening
38
lichen planus treatment
topical high-potency steroids
39
associations of lichen planus
hep C
40
lichen planus diagnosis
- mainly clinical (if uncertain punch biopsy)
41
other patients with greater than 5mm PPD induration who need treatment
- nodular or fibrotic changes on CXR (consistent with previously healed TB)
42
Next step after positive PPD
CXR to rule out active infection
43
SJS and TEN presentation
- acute flu-like syndrome - rapid onset macules, vesicles * necrosis and sloughing of epidermis * mucosal involvement
44
Drugs that can cause SJS and TEN
- allopurinol - abx (sulfonamides) (bactrim) - anticonvulsants (carbamazepine, lamotrigine, phenytoin) * NSAIDs - sulfasalazine
45
Other triggers for SJS and TEN
- mycoplasma - vaccination - GVHD
46
SCC clinical features
tender, bleeding, or ulcerated papules, plaques, or nodules = sun-exposed areas or areas of chronic inflammation
47
Association of porphyria cutanea tarda
- hep c
48
diagnosis of porphyria cutanea tarda
- high serum/urine uroporphyrin level
49
Treatment of porphyria cutanea tarda
- phlebotomy (it is a disorder of heme synthesis) | - treat HCV if present
50
Lab features of porphyria cutanea tarda
mildly elevated liver enzymes + iron overload
51
Pityriasis rosea clinical features
- salmon-colored plaques involving trunk, neck, and proximal limbs * begins with single large lesion (herald Patch)
52
Pityriasis rosea treatment
- reassurance (self limited)
53
Guttate psoriasis clinical features + vs. pityriasis
- scaly plaques + following streptococcal infection | * no herald patch (vs. pityriasis)
54
Treatment of seborrheic dermatitis
- antifungals + steroids
55
guttate psoriasis clinical features
Psoriasis + following streptococcal infection
56
nummular eczema clinical features
round papules and plaques + highly pruritic
57
treatment of guttate psoriasis
phototherapy
58
solar purpura clinical features
elderly patient + easy bruising limited to forearms and hands
59
Behcet clinical features
- recurrent genital + oral ulcers *ulcers lead to scarring + ocular lesions + acne + pathergy + asymmetric arthritis + renal disease + GI (nausea, abdominal pain) * may have limited ulcer disease * commonly misdiagnosed has having genital herpes * may not state person is from endemic area
60
oral leukoplakia clinical features
- white patches or plaques over the oral mucosa - can't be scraped off - patient with smoking and drinking history
61
appearance of oral SCC
- nodular, erosive, ulcerative lesions with surrounding erythema or induration
62
Treatment of aphthous ulcers (aphthous stomatitis)
topical steroids
63
necrobiosis lipoidica diabeticorum clinical features
- asymptomatic, annular yellowish plaques on the shins in a diabetic patient - granulomatous
64
necrobiosis lipoidica diabeticorum treatment
- high potency steroids or intralesional steroids
65
Treatment of tinea versicolor
topical therapy (ketoconazole, terbinafine, selenium sulfide)
66
AK presentation
rough, scaly, erythematous macules or papules
67
Indications for biopsies of AKs
- unclear dx - large (greater than 1 cm) - indurated, ulcerated, tender, or rapidly growing - not responding to therapy
68
treatment of viral conjunctivitis
- warm or cold compresses
69
treatment of bacterial conjunctivitis
- erythromycin or azithromycin drops - polymyxin-trimethoprim drops * if contact lens: quinolone drops
70
Treatment of crusted scabies
- oral ivermectin
71
Initial treatment of psoriasis
- *high potency* topical steroids (safe to use on extensor surfaces because won't induce significant skin atrophy) - topical vitamin D derivatives
72
treatment of severe plaque psoriasis
- phototherapy | - systemic therapy
73
treatment of facial and intertriginous psoriasis
- topical tacrolimus | - low-potency steroids
74
high potency steroids
betamethasone | clobetasol
75
venous lakes clinical features
- gray-blue-purple nodules on lips and ears of old people that disappear when compressed
76
management of chronic venous stasis ulcers
- aspirin (accelerates ulcer healing) + compression
77
Association of skin tags
- insulin resistance, dm2 | - pregnancy
78
Association of recurrent herpes zoster
HIV
79
Management of keratoacanthoma
- biopsy (difficult to distinguish KA from SCC)
80
Basal cell carcinoma clinical features
* slow growing - pearly, rolled border - overlying telangiectasia
81
dermatitis herpetiformis presentation
* pruritic - papules, vesicles and bullae - extensor surfaces of elbows, knees, back, and buttocks * see photo online
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