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72 Cards in this Set

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multiple lesions blending together
confluent or coalescent
flat discoloration < 1cm
macule
circumscribed area of skin edema
wheal
narrow linear crack into epidermis, exposing dermis
fissure
vesicle-like lesion with purulent content
pustule
flat discoloration >1cm
patch
raised lesion, >1cm, may be same or different color from surrounding skin
plaque
netlike cluster
reticular
loss of epidermis and dermis
ulcer
loss of skin markings and full skin thickness
atrophy
skin thickening usually found over pruritic or friction areas
lichenification
in a ring formation
annular
Grams of topical cream or ointment needed for a single application to the hands?
2g
Grams of topical cream or ointment needed for a single application to an arm?
3g
Grams of topical cream or ointment needed for a single application to the entire body?
30-60g
example of a patch:
vitiligo
example of a papule:
raised nevus
example of vesicle:
varicella (fluid-filled, <1cm)
example of purpura:
petechiae, ecchymosis (lesions caused by RBCs leaving circulation and becoming trapped in skin)
example of nodule:
epidermal cyst (raised lesion, >1cm, usually mobile)
example of excoriation:
pruritic skin disease (marks made by scratching)
greatest topical med. absorption from which part of the body?
face
topical medication vehicle with maximum absorption?
ointment
most permeable skin of body for topical med absorption:
face, axillae, genital (palms and soles are almost non-absorbable)
amount of topical med in grams needed for one application to a leg:
6g
topical corticosteroids:
are vasoconstrictive (their potency is based upon this), anti-inflammatory, immunosuppressive; best applied and covered with occlusive dressing
low potency topical corticosteroids:
hydrocortisone (0.5%, 1%, 2%)
triamcinolone acetonide 0.01%
mid-range topical corticosteroids:
betamehtasone dipropionate, augmented 0.05%
high potency topical corticosteroids:
fluocinolone acetonide 0.2%
Super-High potency topical corticosteroids:
betamethasone dipropionate 0.05% ointment or gel
antihistmines MoA:
block activity at histamine-1 receptor sites
Low potency topical corticosteroids:
hydrocortisone 0.5%, 1%, 2%
midrange potency topical corticosteroids:
betamethasone dipropionate, augmented 0.05%
High potency topical corticosteroids:
fluocinolone acetonide 0.2%
super-high potency topical corticosteroids
betamethasone dipropionate, augmented 0.05%, gel, ointment
1st gen antihistamines:
cross BBB readily, sedation and other anticholinergics effects: drying of secretions, visual changes, urinary retention
causative agent in non-bullous impetigo:
GABHS, Staph Aureus
mupirocin / Bactroban spectrum is:
select G+
common oral antibiotic for tx of MRSA cutaneous infection:
TMP-SMX
At what point can a child with impetigo return to school after beginning antimicrobials?
24 hours
impetigo:
peak in 2-5y/o; usually GABSA or Staph Aureus; localized; bullous type from S. Aureus; non-bullous type from Streptococcus; improve personal hygiene; mean duration 10d; tx for small topical area with mupirocin / Bactroban; tx for numerous lesions PO dicloxacillin, 1st or 2nd gen cephalosporin, azithromycin or clarithromycin (all are stable in presence of beta-lactamase; good against G+)
MRSA immune to % of mupirocin:
50% resistance
in case of erythromycin resistant strains of S. Aureus and S. pyogenies use:
HG TMP-SMX and clindamycin
Lithium contributes to:
acne vulgaris
acne lesions that respond best to topical antibiotics are:
inflammatory lesions
tx of rosacea:
metronidazole gel / MetroGel
best candidate for isotretinoin / Accutane:
cystic lesions who has used various therapies with little effect
follow which labs with isotretinoin use:
pregnancy status, hepatic enzymes, TG's
always ask about suicideality / depression change
acne vulgaris:
Propionibacterium acnes overgrowth leading to inflammatory reaction
tx of acne vulgaris, benzoyl peroxide:
benzoyl peroxide: low risk of skin irritation; agains P. acnes; usually with a topical antibiotic
tx of acne vulgaris with tretinoin / Retin-A:
increases epidermal cell turnover, transforms closed to open comedones; takes 6 weeks, photosensitizing
tx of acne vulgaris with oral abx:
clindamycin, erythromycin (macrolides), tetracycline (tetracyclines), azithromycin (, etc.; for moderate papular inflammatory acne; often needed long-term
tx of acne vulgaris with topical abx:
clindamycin, erythromycin, tetracycline; against P acnes, anti-inflammatory; for mild-moderate inflammatory acne vulgaris; less effective than oral abx
OCP use in tx of acne:
reduction in ovarian androgen production, decreased sebum production
tx of acne vulgaris with isotretinoin / Accutane:
inhibits sebaceous gland function, for tx of non-responsive CYSTIC acne; 4-6m; many SE's: cheilitis, conjunctivitis, hypertriglyceridemia, xerosis, photsenstiviity, TERATOGEN; women must use 2 birth control methods
SE's of isotretinoin / Accutane:
pseudo tumor cerebri. altered mood, suicideality, cheilitis, conjunctivitis, hypertriglyceridemia, xerosis, photsenstiviity, TERATOGEN; women must use 2 birth control methods
acne-inducing medications:
lithium and phenytoin / Dilantin
tx of cat bite:
Pasteurella multocida: oral amox-clavulante 500-125 3xd OR cefuroxime 0.5 g 2xd
1st degree burn:
affected sin blanches with ease
2nd degree burn:
blisters and a raw, moist surface
3rd degree burn:
white and leathery surface
anterior head % of skin surface:
4.5%
posterior torso % of skin surface:
10%
anterior thigh % of skin surface:
9%
palmar surface BSA measurement is approximately %?
1%
traits of a burn that can be treated outpatient include:
small (<10% BSA), minor (2nd degree or less), NOT a high-functioning area such as the hand or foot, of less cosmetic consequence (not the face or head)
tx of outpatient burns:
topical abx like mafenide acetate / Sulfamylon or silver suladiazine / Silvadene; petroleum gauze dressing
Rule of Nines:
for estimating BSA affected by burn; ant arm 4.5%, post arm 4.5%, ant thigh 9%, post thigh9%, ant head 4.5%, post head 4.5%, ant toss 10%, post torso 10%, palmar hand 1%
atopic derm:
Type I hypersens. reaction (IgE Abs occupy receptor sites on mast cells to release histamine), apply Lubricants!, COMMON SITES: flexor surfaces on adults; face on infants
tx for atopic derm:
pimecrolimus / Elidel: topical immunomodulator (block T-Cell stim. by APC's and inhibit mast cell activation); increase CA risk; acute: interned-potency topical corticosteroid; cool, wet dressings, avoid offending agents; in Atop Derm, the pruritus is often worse than the pain; give antihistamine at night to aid in sleep --> hydorxyzine / Atarax (Cetirizine / Zyrtec is a less sedating metabolite of hydroxyzine)
atopic derm also has increased incidence of which diseases?
allergic rhinitis, allergic gastroenteropathy, allergy-based asthma
atopic derm AKA
eczema