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105 Cards in this Set

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hyperirritable skin, rough, red plaques, pruritic, exudative or lichenified eruptions, w/o thick scale, hx of allergies, onset in childhood
atopic dermatitis
treatment of atopic dermatitis
gentls skin care, avoid drying, always emollient after bathing, topical steroids sparingly to taper, tacrolimus or pimecrolimus cream, systemic steroids only for most severe cases
erythema, edema, pruritis, often e/ vesicles and bullae, followed by weeping/crusting, secondary to contact with chemical or allergic irritant
contact dermatitis
tx of contact dermatitis
topical steroid may be sufficient, systemic steroid usually required, protect from irritant
erythema, edema, papular and pustular lesions, erosions, oozing, involving perigenital and perianal inner aspects of thighs and buttocks
diaper dermatitis
tx of diaper dermatitis
prevention by keeping intertiginous areas dry, powder with miconazole, castellani's pain for sx relief, topical antifungals, judicious short term use of topical glucocorticoids
chronic, pruritic, inflammatory, coin shaped plaques, grouped small papules and vesicles on erythematous base, commonly on the lower legs of males during the winter months
nummular eczematous dermatitis
tx of nummular eczematous dermatitis
moisturize skin after bath or shower, topical glucocorticoids, crude coal tar, PUVA or UVB 311-nm therapy
mainly young women, unknown etiology, aggravated by topical glucocorticoids, erythematous papules on erythematous background around mouth
perioral dermatitis
acute or chronic paulosquamous dermatitis, often coexists with psoriasis, dry scales, oily yellow scrugg, usually face, scalp, sternum
seborrheic dermatitis
tx of seborrheic dermatitis
mild topical corticosteroid, shampoo with zine pyrithione or selenium, tar shampoo for mild cases
secondary to chronic venous insufficiency in the lower extremities, inflammatory papules, scaly, crusted erosions, pigmentation, stippled with recent and old hemmorrhages
stasis dermatitis
tx of stasis dermatitis
compression stockings, avoid trauma to area, intralesional triamcinolone if painful, consider venous sclerotherapy
tapioca vesicles, may coalesce, scalinga and fissuring may follow, palms and sides of fingers, associated with pruritis, appearance in the third decade, lifelong recurrences
dyshidrosis
tx of dyshidrosis
topical and systemic corticosteroids, avoid anything that irritates the skin especially wet chores
self perpetuating scratch/itch cycle, exaggerated skin lines overlying a thick well circumscribed scaly plaque, hyperpigmented, prediliction for nape of neck, wrists, external surfaces of forearms, lower legs, scrotum, vulva
lichen simplex chronicus
tx of lichen simplex chronicus
superpotent topical steroids, w/ or w/o occlusive dressing to avoid scratching
localized hair loss in round or oval areas, no visible inflammation of the sknin in hair bearing areas, scalp most common presenting site, autoimmune disease, spontaneous remission common
alopecia areata
tx of alopecia areata
psychological support, intralesional steroid injection, systemic steroid
common progressive balding, occurs through comined effect of genetic predisposition and action of androgen on scalp hair follicles
androgenic alopecia
androgenic alopeica tx
oral finasteride, topical minoxidil, antiandrogens (in women), hairpiece, surgical implantation or scalp reduction
caused by tinea unguium, more common in immunocompromised and diabetics,
onycomycosis
treamtent of onycomycosis
debridment, topical antifungals, prophylaxis, systemic (terbinafine, itraconazole)
erythema and swelling with retraction of periungual tissue
paronychia
agent of infection for tinea versicolor
malassezia
hypopigmented, light brown, or salmon colored macules, confirmed by direct microscope examination of hyphae and spores
tinea versicolor
tinea versicolor tx
topical antifungals
infectious agent of tinea corporis/pedis
t rubrum
acute or chronic inflammatory dermatosis characterized by flat-topped pink violaceous, shiny, pruritic papules (4 p's papule, purple, polygonal, pruritic)
lichen planus
lichen planus tx
topical steroids, systemic steroids, PUVA photochemotherapy
acute self limited exanthematous, characterized by slightly inflammatory, oval papulosquamous lesions on the trunk and proximal areas of the extremities
pityriasis rosea
pityriasis rosea tx
often nothing, steroids for itching
common chronic skin d/o, typically characterized by erythematous papules and plaques with a silver scale, m=w, all races and ages equal
psoriasis
two peaks of age of onset for psoriasis
20-30 and 50-60
etiology of psoriasis
complex immune mediated disease in which t-lymphocytes play a central role
psoriasis tx (mild to moderate dz)
topical glucocorticoids and emollients, alternatives (tar, retinoids-tazarotene, calcipotriene)
tx for mild to moderate psoriasis of facial/intertriginous areas
tacrolimus or pimecrolimus
tx of severe psoriasis
phototherapy or systemic retinoids, methotrexate, cyclosporine, or bilogical immune modifiers (alefacept, efalizumab, etanercept, or infliximab)
acute inflammatory skin disease, <10% bsa loss, usually caused by drug, often targets mucosal surfaces
stevens johnson syndrome
tx for stevens johnson
stop drug, nutritional and fluid support, high dose steroid?
acute inflammatory skin disease, >30% bsa loss, usually caused by drug
toxic epidermal necrolysis
mortality % of toxic epidermal necrolysis
30%
tx of toxic epidermal necrolysis
stop drug, >25% bsa requires burn unit, nutritional and fluid support, high dose steroid?, IvIg
sudden onset symmetric erythematous skin lesions, may be macular, papular, urticarial, bullous, purpuric, target lesions with clear centers and concentric rings or "iris" lesions
erythema multiforme (minor)
most common cause of erythema multiforme minor
herpes simplex
tx of erythema multiforme minor
topicals not very effective, benadryl/kaopectate for oral lesions, usually resolves in 2-6 weeks
tx of bullous pemphigoid
systemic prednisone wither alone or combo with azathiprine, mild cases(dapsone), very mild cases (topical steroid)
benign neoplasms
epidermoid cyst, seborrheic keratosis, actinic keratosis, keratoacanthoma, lipoma, dermatofibroma, skin tag
occurs secondary to traumatic implantation of epidermis into the dermis, accumulation of keratin withing the cyst cavity, appears as dermal nodule most often in the palms, soles and fingers
epidermal inclusion cyst
tx of epidermal inclusion cyst
excision
most common of the benign epithelial tumors, hereditary, appear after age 30
seborrheic keratoses
discrete, dry, rough, adherent scaly lesions, occur on areas of habitual sun exposure
actinic keratoses
actinic keratoses tx
cryo, 5-flourouricil cream, imiquimod, retinoids, facial peels, laser surgery photodynamic therapy,
pseudocancer, isolated nodule usually on the face, mimics scc, uniquely rapid growth, spontaneous remission over several month
keratoacanthoma
keratoacanthoma tx
surgical excision, rule out scc, systemic retinoids/methotrexate
soft, rounded, lobulated, composed of fat cells, movable against the overlying skin, especially on the neck, trunk, and extremities
lipoma
button like dermal nodule, usually on the extremities, may be tender, if pigmented may mimic melanoma
dermatofibroma
tx of dermatofibroma
surgical removal not usually indicated, resulting scar less cosmetically acceptable, cryosurgery often effective
sof, skin colored, tan or brown, round or oval dedunculated papilloam,
acrochordon aka skin tag
tx of acrochordon
snip, electrodessication, cryosurgery
most common skin d/o in america, disease of pilosebaceous follicles, retention hyperkeratosis, increased sebum production
acne vulgaris
organism responsible for acne vulgaris
propionibacterium acnes
acne vulgaris tx
topical retinoids, benzoyl peroxide, topical antibiotics, oral antibiotics, oral isotretinoin, hormonal and corticosteroid therapy
chronic facial disorder, neurovascular component (telangiectasias), actiniform component (inflammatory papules), glandular component (rhinophyma)
rosacea
flushin exacerbated by temp, hot drinks, spicy food, sunlight, exercise, alcohol, emotions and hormonal flux, rosy hue to cheeks, forhead, chin or entire face, pt may complain of burning or stinging
rosacea
rosacea tx
topical metronidazole, systemic tetracycline/minocycline/doxycycline, refractory w/ metronidazole or amoxicillin
most common pathogen for folliculitis
s. aureus
tx for persistant folliculitis
warm compresses 3x daily, topical mupirocin
pearly papule, erythematous patch, nonhealing ulcer in sun exposed area, usually fair skinned pts with hx of sun exposure, often hx of bleeding, most common form of cancer
basal cell carcinoma
nonhealing ucler or warty nodule, skin damage due to long term sun exposure, may arise from an actinic keratoses, common on skin of organ transplant recipients
squamous cell carcinoma
most malignant tumor of the skin
melanoma
what is one of the most important diagnostic factors for malignant melanoma
enlargment
tx for melanoma
total excisional biopsy, sentinal node biopsy, lymphadenectomy as indicated, adjuvant therapy with IFN-alpha-2Bb
velvety thickening, hyperpigmentation, chiefly in axillae and other folds, often associated with endocrine d/o, obesity, drug admin, or malignancy
acanthosis nigricans
acquired light or dark brown hyperpigmentation, occurs in exposed areas, most often face, results from exposure to sun, may be associated with pregnancy or hormonal contraceptives
melasm
melasma tx
hydroquinone, azelaic acid, flucinolone, tretinoin
wheals, superficial, well defined, transient edematous papules and plaques, angioedema involves dermis and subq tissue, acute, recurrent or chronic
urticaria
tx of urticaria
prevent exposure, antihistamines, prednisone if angioedema, danazol for long term use if hereditary
development of totally white macules completely absent of melanocytes, may be associated with thyroid disease
vitiligo
vitiligo tx
sunscreens, cosmetic coverup, topical steroids, topical photochemotherapy, PUVA, narrow band uvb, tacrolimus or pimecrolimus
barely visible papules to nodules to confluent masses, anogenital or oral mucosa or skin, caused by hpv, if present in birth canal may be transmitted to newborn
condyloma accuminata
tx of condyloma accuminata
cannot eradicate hpv, iniquimoid cream, pdofilox solution, cryosurgery, podophyllin, tca, surgery, electrocautery, laser
grouped vesicles on an erythematous base
herpes simplex
herpes simplex tx
prevent by avoiding skin to skin during outbreakes, topical acyclovir, oral antiviral, foscarnet for severe cases, imiquimod cream
self limiting epidermal viral infection, skin colored papules, umbilicated,
molluscum contagiosum
tx of molluscum contagiosum
resolves spontaneously w/o scarring in up to 2 years
hpv infected keratinized skin, discrete benign epithelial hyperplasia
verrucae
verrucae tx
spontaneous resolution in months to years, salicylic acid, imiquimod cream, cryosurgery, electrosurgery, laser, curretage
90% of cases occur in children, 98% of adults have been infected, disseminated pruritic vesicles
varicella zoster
mortality rate of varicella zoster
1/50,000 cases (100 deathsa annually)
acute, diffuse, spreading, edematous, suppurative inflammation, systemic symptoms
cellulitis
hypersensitivity to antigens from infectious agents/drugs, postcapillary venules, inflammation, fibrinoid necrosis, palpable purpura
vasculitis
tx of vasculitis
antibiotics, prednisone, cytotoxic immunosupressives
distinct type of superficial cutaneous cellulitis, marked dermal lyphatic vessle involvment, painful, bright red, raised, edematous, indurated plaque, advancing raised boders, sharply marginated
erysipelas
erysipelas usually cause by what infectious agent
group a beta-hemolytic strep
crusted erosions or ulcers, most common in children, superficial infection of the epidermis
impetigo
impetigo is most commonly caused by what infectious agent
staph aureus, and staph pyogenes
tx of impetigo
mupirocin, systemic antibiotics
painful red nodules (no ulceration), anterior aspect of legs most common site, slow regression over several weeks, women more than men,
erythema nodosum
erythema nodosum tx
identify underlying cause, nsaid, topical potassium iodide, bedrest if extremely painful, systemic steroids select cases
consist of multiple furuncles in adjoining follicles
carbuncles
abscesses mostly caused by what infectious agent
staph aureus
tx for padiculosis
pyrethrins, malathion, lindane
tx of scabies
permethrin cream, lindane
spider bite tx
glucocorticoids, antimicrobial agents