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20 Cards in this Set
- Front
- Back
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shingles
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Herpes zoster due to eruption of latent VZV. dermatomal distribution of grouped vesicles preceded by pain/burning.
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HSV
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grouped vesicles on an erythematous base on mouth or nose (HSV1) or genitals (HSV2) that usually recurs in same place.
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how to differentiate HSV from Shingles
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direct fluorescent AB test. Scrape base of vesicle, get results in 48 hrs.
in the clinic can do PCR to differentiate HSV1, HSV2, VZV very quickly. |
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Tzanck prep
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bedside scraping and microscopic exam. Can't differentiate VZV vs HSV
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Viral culture
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can do if fluid is present. Takes 1-3wks. Gold standard for HSV, less helpful for VZV.
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tx for HSV
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oral acyclovir is cheap and effective. can be used in pregnancy. Topical is $$$, famciclovir and valcayclovir $$ but easier dosing.
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dyshidrotic eczema
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itchy vesicopapules on palms, soles, sides of fingers. leave behind mahogany mark, may have hx of atopic dermatitis, coexisting tinea pedis
Clinical dx. |
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treating dyshidrotic eczema
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potent topical steroids
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Chicken pox
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primary VZV infection w/ diffuse vesicles on erythematous base, various stages of healing.
dx by PCR, DFA, Tzanck |
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pemphigus vulgaris
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AutoAB to desmogleins 1/3 >> superficial bullae and erosions in elderly.
-dx is direct immunofluorescence |
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bullous pemphigoid
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AutoAB to hemidesmosome >> deep tense bullae on itchy base in elderly
-BPAG2 AB via direct immunofluorescence |
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urticaria
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hives, vascular rxn of skin characterized by wheals surrounded by a blanchable red halo. Cardinal sx is itching.
swelling of upper dermis can be acute/chronic |
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causes of urticaria
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idiopathic, post viral, strep, helminthes, food rxn, drug or infusion rxn
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chronic urticaria
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can be physical (pressure, heat, water, exercise), cholinergic (heat or emotion), chronic AI
Lasts >6wks |
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dermatographism
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most common physical urticaria; sharply localized edema w/in seconds after skin is rubbed
**Jimmy Chen |
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urticaria pathogenesis
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mast cell is major effector; Ag binds IgE on mast cell >> degranulation, histamine release >> H binds H1 and H2 receptors >> arteriolar dialation, venous constriction, increased cap perm
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evaluating urticaria
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clinical dx based on hx, exam of active lesions. Allergy tesitng not helpful.
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treating urticaria
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oral H1 antihistamines are firstline for chronic/acute
-first generation diphenhydramine/hydroxyzine: cause sedation -2nd generation loratidine are less sedating |
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Angioedema
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same mechanism as urticaria but occurs in the deep dermis. Affects tongue, pharynx, larynx, bowels. May be painful/burning, not itchy. Can last for days.
-ABC assessment! |
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anaphylaxis
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serious allergic rxn w/ rapid onset. May have no skin lesions.
**ABC |
