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37 Cards in this Set

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alopecia areata
- well demarcated, non-scarred areas of hair loss
- AI mediated, suspect in those with other AI diseases; or young man with random well demarcated spot of balding in the non-androgen alopecia related areas
- often also see nail pitting
- tx: intralesional CS
tinea capitis
- young kids
- erythema, boggy, scaly, black, pustules, cervical LAD
keratoacanthoma
- common on cheek
- low grade malignancy similar to SCC
- solitary, firm, round, skin-colored or reddish plaque that develops into nodule with central keratin plug
verruca vulagaris
- looks similar to seborrheic keratosis
BCC
- usually red
- rare in age < 40
seborrheic dermatitis
- erythematous scaling plaques and patches w/ indistinct margins
- commonly on scalp, central face, ears, chest, back, axilla, pubic area
- may be secondary to malassezia furfur, but don't need fungal scrapings to dx
- young college guy --> HIV testing
tinea versicolor
- adolescents, young adults
- mildly pruritic
- hypopigmented, light brown, salmon colored macules
- topical antifungals
treatment of acne during pregnancy?
- cat B: topical azeleic acid or clindamycin, erythromycin
- cat C: benzoyl peroxide, sodium sulfacetamide
- cat D: AVOID oral tetracycline, retinoids
sporotrichosis
- fungus infx seen in outdoorsy people
- papular lesion over sight of innoculation --> ulcerates --> NON-purulent d/c
- spreads lymphatically --> oral itraconazole
blastomycosis
- inhalation
- acute PNA spreading to bone, skin, GU
actinomycosis
- only found in humans, not in the environment
- cervicofacial disease
- slow growing and destructive
- multiple abscesses, fistulae
coccidiomycosis
- inhalation
- chest pain, fever, cough, hemoptysis
- initial primary sx: erythema nodosum
tx of herpes zoster
- acyclovir for 5-7 days
- if rx w/in 48hours of eruption then can length and pain
- oral prednisone accelerates healing and decreases pain and useful in Bell's palsy but don't use in DM, glaucoma, HTN, etc)
herpes zoster infectiousness
- no contact precautions needed in community
- yes contact precautions if pt in hospital
- must hospitalize and isolate if immunocompromised or disseminated herpes zoster until lesions crusted over
pressure ulcers
- stage 1: blanching/erythema
- stage 2: partial loss of epidermis, dermis or both
- stage 3: may extend to fascia
- stage 4: very deep, full thickness to bone or muscle
- tx with moistened gauze
hair loss in secondary syphilis
- "moth-eaten" appearance, significant scarring
pt with psoriasis
- get skin biopsy to dx - hyperplasia, neutrophil infiltration, thin or absent granular layer
tinea capitis
- microsporum canis infection
- +Wood's UV lamp
- ddx trichophyton tonsurans infection with is (-) Wood's UV lamp
lichen planus
- immune mediated skin d/o
- skin, nails, mucosa (mouth, GU area)
- skiny, pruritic, polygonal shaped violacious papules with lacy pattern
- do punch biopsy, not skin scrapings: hyperkeratoic, acanthosis
- associated with liver disease so test for hep C
drugs the exacerbate psoriasis
- beta blockers, antimalarial, NSAIDs, ACE-I, lithium
sun screen
- reduces incidence of basal and squamous cell carcinoma, but not melanomas
tinea versicolor
- multiple small circular maculae in either white, pink, brown
- yeast infection
- common in summer
- tx terbinafine, clotrimazole, ketoconazole
tx of pityriasis rosea?
- oral erythromycin
side effect of doxycyline?
- photosensitizing agent --> bad sunburn
side effect of isotretinoin?
- hyperTG --> pancreatitis
- check TG, TC, LFTs before initiating and at least monthly
porphyria cutanea tarda
- painless blisters, increased fragility of the skin on dorsal surfaces of hands, facial hypertrichosis and hyperpigmentation
- triggered by ingestion of substances (Ethanol, estrogen (OCP))
- dx by elevated urinary uroporphyrins
- tx: phlebotomy or hydroxychloroquine
dermatitis herpetiformis
- pruritic papules and vesicles on the elbows, knees, buttockes
- secondary to gluten-sensitive enteropathy that may be subclinical
impetigo
- pruritic, honey-colored macules, vesicales, bullae on the face and other exposed parts
- staph or strep A
pityriasis rosea
- self-limiting, unknwon etiology
- single primary plaque with fine collarette scale
- fine, scaling papules and plaques in christmas tree distribution
tretionin
- reduces fine wrinkles, mottled hyperpigmentation, roughness of facial skin, appearance of brown spots
Onychomycosis
- must confirm with scrapings, if negative then culture
- tx with oral terbinafine or itraconazole; ketoconazole and griseofulvin are rarely used now b/c lengthy tx and adverse effects
actinic keratosis predisposes to which cancer?
- squamous cell
- it's a pre-malignant condition
psoriasis
- erythematous, well-defined plaques covered by thick silvery scales
- tx: for cosmetic purposes can rx topical high-potency corticosteroids = betamethasone (low potency = hydrocortisone for face area)
- tx if severe is methotrexate
rosacea tx
- topical metronidazole w/ or w/out course of oral abx
- if refractory try isotretinoin
rosacea is associated with?
- chalazion: granulomatous inflammation of eye gland -- painless, pea-sized nodule within eyelid
endophthalmitis
- corneal ulcers and ocular infections with pseudomonas, yersinia, mycobacterium
tx of acne
- first line is topical retinoid
- moderate or mild refractory is treated with topical retinoid and benzoyl peroxide or topical abx
- severe or mod refractory is tx with 1) topical retinoid, benzoyl peroxide, and topcial abx; or 2) systemic abx plus topical retinoid or benzoyl peroxide
- systemic abx are not typically used exclusively
- most severe: systemic abx and topical retinoid or benzoyl peroxide ---> no response then oral isotretinoin