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Derm Flashcards

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1
Q

phemigus vulgaris basics

A

antibodies to desmosomes (desmoglein)
(+) nikolsklys sign
(+) oral mucosa involvement

30-50 y/o

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2
Q

dx and tx of phemphigus vulgaris

A

dx - biopsy - thin walled blister, cells all over the place
—> IF - throughout slide

tx - steroids then mycophenolate or rituximab

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3
Q

bullous phemigoid

A

abs against hemidesmosomes
60-80 y/o
(-) nikolskys sign, (-) oral mucosa

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4
Q

dx and tx of bullous phemphigoid

A

dx - intact epithelium, IF - BM lights up

tx - steroids (systemic), topical (if local)

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5
Q

dermatitis herpetiformis

- path -

A
  • celiac sprue
  • IgA deposition in the dermis

every pt with this dz has celiacs disease

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6
Q

dermatitis herpetiformis presentation

A

vesicular lesions
extensor surfaces
especially the buttock

pt will have celiac symptoms

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7
Q

dx and tx of dermaitis herpetiformis

A

1st - antibodies to antitransglutaminase, anti endomyseal

2nd - EGD -> biopsy
neutrophilic abscess

tx - avoid gluten

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8
Q

Porphyria cutanea tarda

A

path - uroporphyrinogen

pt - blisters on sun exposed areas, hairy, easy blistering on the dorsum of the hand

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9
Q

dx and tx of porphyria cutanea tarda

A

dx - woodlamp - turns coral red

tx - avoid sun exposure

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10
Q

insults that can cause cutanea tarda

A

hep c
hemachromatosis
recent OCPs

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11
Q

seborrheic dermatitis

A

autoimmune dz, malazzi

rash, flakes, face - where there is hair = rash
areas without hair will not have rash

tx - selenium shampoo

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12
Q

psoriasis

pathophys

A

autoimmune T helper cells

abundance of keratinocytes

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13
Q

psoriasis

presentation

A

erythematous patch with silver scale that bleeds when picked

extensor surfaces, gluteal fold
nail pitting
onchymycosis

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14
Q

dx and tx of psoriasis

A

dx - clinical

tx - UV light first –> topical steroids

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15
Q

sketchy lymphoma kinda hx and new psoriasis always

A

biopsy to rule out lymphoma

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16
Q

pityriasis rosea

A

self limiting
herald patch - oval well demarcated
- white ppl - salmon colored
- dark ppl - hyperpigmented

spares - palms and soles

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17
Q

lichen planus

A

purple palpable raised
lacy white line network

tx - topical steroids

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18
Q

medications that cause lichen planus

A

ace- i
thiazides
diuretics

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19
Q

atopic dermatitis

A

allergies, asthma, atopy,

pt - symmetric licheniefication, AC fossa, popliteal fossa and extensors

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20
Q

tx of atopic dermatitis

A

avoid trigger –> emollients –> topical steroids

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21
Q

contact dermatitis

A

type IV HSR
poison ivy, nickel, latex

tx - avoid trigger, topical diphehydramine

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22
Q

stasis dermatitis

A

path - peripheral edema, skin stretched overtime

edema, erythema, darkens (treebarkish) - bilaterally

tx - diuretics, compression stockings, elevate legs

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23
Q

stasis dermaitis is associated with

A

malleolar ulcers (stasis ulcers)

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24
Q

hand dermatitis

A

too much hand washing - health care workers, food industry

tx - stop it dont use harsh soaps

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25
urticaria | pathophys
type I HSR mast cell degranulation IgE cross links mat cells --> histamine release --> capillary dilates --> leaky fluid
26
pt presentation of urticaria
annular red papule that does blanche
27
dx of urticaria
anaphylaxis --> hypotension --> IM epi no ^^^ --> steroids + H1 + H2 antihistamines
28
drug rxn rash
pink morebiliform rash that is symmetric and widespread (7-14) days after medication tx - stop offending drug - antihistamines (mild) steroids (mod-severe)
29
erythema multiforme path and presentation
path - immune complex mediated | pt - targetoid lesion, acral sights - knees, palms, faces sights
30
MCC of erythema multiforme
HSV, Drug Rxn, Syphillis
31
tx of erythema multiforme
topical steroids
32
steven johnson syndrome
degeneration of basal layer dusky <10% tx - stop all meds --> burn unit --> pray
33
TEN
same as SJS except >30% F/U - oral and ophtho involvement
34
drugs that can cause SJS/TEN
sulfa drugs PCN cephalosporins antiretrovirals anticonvulsants
35
staph scalded skin syndrome
staph infection that attacks desmosomes infant --> febrile illness --> sloughing of skin --> starts in the skin folds
36
tx of staph scalded skin syndrome
Naficillin
37
Mole
benign from melanocytes R/o - ABCDE
38
seborrheic keratosis
benign - kertinocytes large greasy stuck on appearances dx - if chronic - clinical vs if new - biopsy
39
keratocanthoma
SCC that spontaneously resolves after 6wks
40
Kaposi sarcoma
HHV 8 AIDs pt Purple lesion tx- treat aids its gets better
41
actinic keratosis
premalignant lesion of keratinocytes erythematous lesion with sand paper like scale yellow to brown color hx of sun exposure
42
tx of actinic keratosis
biopsy --> cryoablation --> 5 FU
43
Squamous cell carcinoma
path - malignant lesion of keratinocytes MC location - lower lip 90% flesh colored lesion with ulceration sun exposure hx
44
dx and tx of SCC
dx - biopsy | tx - resection - dont be shy as it can metastasize
45
tinea versicolor
fungus, malezzia scaly macules of varying color areas that dont tan
46
dx and tx of tinea versicolor
KOH prep (sphaghetti + meatballs) tx - selenium shampoo or ketoconazole
47
vitelligo
path - AI distinction of melanocytes pt - sharply demarcated patches that are completely white
48
dx and tx of vitilligo
dx - woodslamp - bx absence of melanocyte tx - local high potency topical steroids ---> extensive --> UV light
49
albinism
path - AR, decrease tyrosinase activity, cant make melanin pt - white fair hair eyes skin tx - keep out of sun
50
prealbinism
melanocytic migration or white furlock
51
ash leaf spots
tuberous sclerosis congenital defect check for shagreen patches (blood vessels) or adenoma sebacaie
52
dx and tx of ash leaf spots
dx - woodslamp --> CT scan tx - nothing they have MR szs and die young
53
kid thats albino and has funny smell and orange crystals in diaper
PKU
54
androgen alopecia
path - 5 Dihydrotestosterone pt - circular patch that starts at back of head and circles and go forward
55
tx of androgen alopecia
minoxidil | finasteride
56
alopecia areata
path - AI destruction of hair follicle ``` pt - patch well circumscribed can be anywhere exclamation point (hair thins out as it goes down to follicle) ```
57
tx of alopecia areata
steroids
58
tinea capitis
path - fungal infection (trichophyton tonsurans) pt - well circumscribed patch of hair loss with equal length
59
dx and tx tinea capitis
dx - KOH prep tx - oral griseolfulvin
60
traction alopecia
path - pull hair too tight pt - woman, braid, ponytail dx - clinical tx - none
61
trichotillomania
path - OCD, PTSD pt - pulls hair out, compulsion, hair in different length s dx - clinical tx - OCD
62
stages of hair
1) anogen - growth 2) catogen - progression 3) telogen - resting 4) Exogen - shedding 5) back to anogen
63
Anogen effluvium
takes growing hair to shedding phase
64
Telogen effluvium
takes growing hair --> telogen phase
65
Impetigo
path - strep or staph kid, honey, crusted lesion on face dx - clinical tx - amoxicillin (allergy --> clinda) complication --> glomerulonephritis, No RF
66
Erisypelas
path - strep pt - adults, infection of lymphatics, dark red well defined, indurated, climbing up the limb dx - clinical tx - Amoxicillin
67
Acne path
propronium bacteria hyperkeratinoziation sebaceous glands
68
acne ladder tx
1) topical retinoids - comedones 2) + benzyl peroxide - inflammed, pustules 3) + abx (doxy) - refractory, severe 4) Isotenion (teratogenic AF)
69
tinea pedis and tinea cruris tx
topical antifungals
70
tinea corporis
body well described, circumscribed moderate scaling with central clearing tx - antifungall topical
71
onchymycosis (nails)
oral terbenafine dx - via KOH first
72
acne vulgaris | pathogenesis
obstruction of sebaceous follicles by sebum --> leads to the proflieration of proprionbacterium
73
risk factors for acne vulgaris
young pubertal male cushing syndrome oily complexion androgens
74
rosacea
reddening of face (forehead, nose, cheeks) 30-50 y/o cacausian women
75
tx of rosacea
topical metro (gel form)
76
irritant contact dermatitis
ACUTE rapid onset more common detergents, handwashing (chemical or physical)
77
allergic contact dermaitis
delayed type IV HSR poison ivy, nickle, latex rash appears 1-2 wks after med - 1st exposure hours to days - subsequent exposures
78
acute stages of contact dermatitis appearance
erythematous papules and vesicles that are oozing | also maybe edema
79
chronic stages of contact dermaitis appearance
crusting thickening scaling
80
pityriasis rosea
xmas tree pattern oval lesions herald patches - papulosquamous eruption spontaneously remits 6-8wks
81
causes of erythema mutiforme
meds (sulfa MCC) PCN HSV - acyclovir - recurs
82
lichen planus
pruritic, poygonal, purple, flat toped papules wrists shins oral mucosa, genitalia, tx - glucorticoids
83
most common STD
``` codyloma acuminata (HPV) 6,11 strains ```
84
molloscum contagiosum
self limited viral infection - caused by poxvirus small papules (2mm to 5mm) with central umbilication highly contagious
85
tx of scabies
permethrin
86
scabies
interdigits of the fingers extremely pruritic - worse at night extremely contagious
87
basal cell carcinoma
most common skin cancer sun exposure, fair skinned ppl NOSE = most common site pearly smooth, pink papule tx - resection
88
marjoin ulcer
SCC arising from a chronic wound such as previous burn scar tends to be very aggressive
89
most important prognostic indicator for melanoma
depth of invasion
90
melanoma
ABCDE changing mole MC presentation MC site is BACK advanced lesions present with itching and bleeding
91
vitiligo is associated with
DM hypothyroidism Addisons disease pernicious anmeia
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