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Dermatology
study for Internal medicine boards
58
Medical
Professional
01/07/2012

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Term

Prurigo nodularis-

Hyperkeratotic hyperpigmented nodule arising from repeated picking/scratching, surrounding hypopigmentation

Definition
[image]
Term
morbilliform rash
Definition
2-5mm macaulopapular truncal rash, often from vancomycin, penicillins, cabamazepine, allopurinol. Tx with antihistamines and topical steroids. Also caused by EBV/CMV if given ampicillin or amoxicillin
Term

clobetasol

betamethasone dipropionate

Definition
high potency topical steroids
Term
hydrocortisone 0.5%
Definition
lowest potency topical
Term
asteatotic eczema
Definition
winter itch- anterior shins old people, porcelin dry cracsk, worse with frequent bathing, soaps. Tx emolliants
Term
eyelid dermatitis
Definition
allergic contact dermatitis, but occuring on eyelids from exposure elswhere
Term
venous stasis ulcer
Definition
[image]
Term
venous stasis dermatitis
Definition
treat with low-mid potency topical steroid, compresssion therapy, unna boots
Term
atopic dermatitis
Definition
involving flexures, pruritis, red, crusted papulovesciular plaques
Term
atopic dermatitis diagnosis
Definition
IgE elevations, eosinophils, history of allergies
Term
atopic dermatitis treatment
Definition
once daily topical steroids; tacrolimus for face and intertriginous areas (wont cause atrophy), emollients
Term
eczema herpiticum
Definition
widespread localized dissemination of HSV infection
Term
dyshidrotic eczema
Definition
palms and sides of fingers - recurrent episodes of tapioca-like itchy vesicles
Term
pigmented purpuras
Definition
superficial capillaritis causes cayenne-pepper like pigmented patches of skin on extremities, leaving behind permenant hyperpigmentation. Tx with low-potency steroids
Term
pigmented purpura
Definition
[image]
Term
lichen planus
Definition
autoinflammatory condition, pruritic, polygonal papules with surrounding white lines (Wicham striae) associated with liver disease. Tx with topical steroids.
Term
lichenoid drug eruption
Definition
ACE-I, thiazides, furosemide, gold, antimalarials, d-penicillamine, b-blockers
Term
guttate psoriasis
Definition
drop-like lesions, often post-strep, and in children
Term
localized pustular psoriasis
Definition
palmar/soles, often triggered by TNFa inhibitors
Term
localized pustular psoriasis
Definition
[image]
Term
psoriasis treatments
Definition
calcipotriene/betamethasone, tazarotene, anthralin, phototherapy
Term
psoriatic arthritis treatment
Definition
MTX with etanercept, infliximab, or adalimumab
Term
erythema multiforme
Definition
acute recurrent targetoid erythematous mucocutaneous eruption following acute infection or drug, most common HSV
Term
erythema multiforme treatment
Definition
symptomatic, give valtrex to prevent HSV recurrence, can give steroids for symptoms
Term
severe cutaneous adverse reactions (SCAR) to drugs
Definition
confluent erythema, skin pain, facial edema, fever, LAD, mucosal involvement, hypotension/dyspnea, necrosis--> all bad signs
Term
fixed drug eruption
Definition
hyperpigmented annular lesions that reoccur repeatedly in same location, etiology tetracyclines, sulfas, flaagyl, barbituates, OCPs
Term
dermatomyositis-like eruptions
Definition
hydroxyurea, statin--> gottron papules,
Term
sweet syndrome
Definition
acute febrile neutrophilic dermatosis--> caused by imatinib, OCPs, GCSF, ATRA. Tx with oral steroids
Term
subacute cutaneous lupus erythamatosis
Definition
caused by HCTZ, CCBs, ACE-I, looks like discrete red papular lesions with scaly plaques
Term
AGEP - acute generalized exanthematous pustulosis
Definition
acute widespread pustules, fever, leukocytosis, eosinophilia 2/2 b-lactams, fluoroquinolones, antimalarial, sulta, diltiazem. Self-limited
Term
DRESS
Definition
Drug reaction with eosinophilia and systemic symptoms- facial edeam, fever, arthralgias, LAD, LFT elevtaions, lymphocytosis, 2/2 anticonvulsants, abacavir, sulfa, allopurinol. Associated with HHV6.
Term
DRESS Tx
Definition
Tx with oral steroids, IVIG. Also might get hypothyroidism!
Term
DRESS
Definition
[image]
Term
pityriasis rosea
Definition
papulosquamous eruption with herald patch salmon scaly periphery, then subsequent eruption. Associated with HHV6-7 reactivations. self-limited. can have mild flulike sx.
Term
acne therapy
Definition
topical retinoids --> benzoyl peroxide --> topical Abx --> if on trunk or severe then add oral Abx --> then isotretinoin
Term
topical abx for acne
Definition
must be combined with benzoyl peroxide to prevent resistence
Term
OCPs for acne
Definition
require hyerandrogenism to be indicated, takes 5 cycles, give with topicals
Term
hidradenitis suppurativa
Definition
seterile abscess and sinus tract formation in groin/axillary region, recurrent and painful, treat with topical clindamycin
Term
perioral dermatitis
Definition
papular eruption around mouth, occuring with inhaled steroids, tx stop steroid, topical antibiotics
Term
dermatophytosis treatment
Definition
given topical antifungal (clotrimazole, miconazole, terbinafine, ciclopirox). NO steroid because may induce deep ifn
Term
widespread dermatophyte ifn tx
Definition
oral itraconazole or griseofulvin.
Term
Dx of onchomycosis
Definition
PAS staining of clipping more sensitive than KOH. Must confirm first before treating because 1/2 of cases are nonfungal
Term
proximal nailbed onchomycosis
Definition
must test for HIV, orals are needed for Tx
Term
tinea versicolor
Definition
small light-brown truncal macules on anterior chest caused by malassezia furfur. Tx with selectium lotion or keoconazole shampoo
Term
tinea versicolor
Definition
[image]
Term
bactrim
Definition
excellent against MRSA but limited spectrum against beta-hemolytic strep, so not first choice for abscess.
Term
MRSA abscess treatment
Definition
by culture, otherwise clinda, tetracyclines, rifampin-containing regimens
Term
impetigo
Definition
honey-colored crusts, S aureus superficial infection. can treat mild with topical bacitracin and soaking off crusts
Term
MRSA treatment
Definition
clindamycin, doxycycline, TMP-SMZ
Term
ecthyma
Definition
supercifical punched out ulcer with yellow ulcer, strep infection. increased in AIDS/IVDU. Dx oral dicloxacillin and topical mupiricin
Term
eczema herpeticum
Definition
disseminated cutaneous HSV infection spread by skin breakdown, example in pts with atopic dermatitis
Term
molluscum contageosum
Definition
Tx. physical destruction
Term
HPV 16, 18
Definition
cancer causing, forms flat hyperpigmented macules rather than condyloma
Term
wart Tx
Definition
first line topical salycilic acid, or don't treat. Cryotherapy is only if compliance is a problem
Term
chigger bite
Definition
along clothing lines, treat with topic steroid, camphor/menthol
Term
scabies
Definition
treat with whole body topical permethrin creatm, repeat 1 week later. itching lasts several weeks after. refractory- ivermectin
Term
lice treatment
Definition
topical pediculicides. second line- lindane
Term
skin biopsy or small wound
Definition
keep moist with petrolatum, bacitracin does not help, and increases risk of contact dermatitis
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