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Flashcards in Skin Lesions/Skin Conditions Deck (40):
1

Treatment of mild comedonal acne vulgaris

Topical retinoid or benzoyl peroxide

2

Treatment of mild to moderate inflammatory acne

Topical retinoid, benzoyl peroxide, or antibiotic

3

Treatment of moderate to severe inflammatory acne

Topical retinoid or benzoyl peroxide or oral antibiotics

4

Treatment of severe nodulocystic acne

Oral retinoid (derm referral), topical benzoyl peroxide, or oral antibiotic

5

If limited response after 3 months antibiotic therapy....

Increase does, change medication, or refer to derm

6

Follicular plug

Excessive keratin in an inactive hair follicle>>resulting in rough, cone-shaped elevated papules

7

Teratogenic

Can disturb the development of the fetus; increased risk of spontaneous abortion, birth defects

8

Adverse effects of oral isotetinoin

dry skin, lips, nose, mouth, pruritus, epitaxis, conjunctivitis; increased intracranial pressure, pancreatitis, IBS, premature epiphyseal closure, hyperlipidemia

9

Telangiectasia

Condition in which widened venules cause threadlike red lines or patterns on the skin (spider veins)

10

Differential diagnoses of acne

Peri-oral dermatitis, keratosis pilaris, rosacea, steroid folliculitis

11

Rosacea clinical presentation

Skin: papules and pustules, erythema, telangiectasia
Nonskin: mild conjunctivitis, redness of sclrea, blepharitis, telangiectasia of lid

12

Differential diagnoses of rosacea

Staphylococcal folliculitis, pustular tinea, systemic lupus erythematous, perioral dermatitis

13

Classification of rosacea

Erythematotelangiectatic (erythema and telangiectasia on nose and cheeks)
Papulopustular (erythema with papules and pustules on nose and chin, erythematous patches on cheeks)
Phymatous (facial erythema, scattered pustules and papules on forehead, nose, cheeks, chin; thick, oily skin; rhinophyma)

14

Stage 1 pressure ulcer

Nonblanchable erythema

15

Stage 2 pressure ulcer

Loss of epidermis w/ or w/o true ulceration; ulcer shallow with a pink to red wound be without slough

16

Stage 3 pressure ulcer

Full-thickness (into subcutaneous or beyond) loss w/o underlying muscle, tendon, or bone exposure

17

Stage 4 pressure ulcer

Full thickness with underlying bone, tendon, or muscle exposure

18

Unstageable pressure ulcer

Covered with debris or eschar which does not allow depth assessment

19

Diffuse hair loss (telogen effluvium)

Reversible; caused by chemo or other meds (lithium, warfarin, beta-blockers, retinoids, interferon, amphetamine); initial labs - TSH, hemoglobin/hematocrit, iron

20

Patterened hair loss

Miniaturization of individual hair follicles/shaft due to effects of dihydrotestosterone, hyperandrogenism; topical minoxidil, oral finasteride, hair transplant

21

Circumscribed (non-scarring) alopecia

Autoimmune process in which T-lymphocytes surround hair bulb deep in dermis; no inflammation

22

Scarring alopecia

Irreversible; active lesions with scalp inflammation and eventually scalp scarring; lichen planus and discoid lupus cause

23

Characteristics of psoriasis

-Occurs at any age
-chronic relapsing skin disease
-sharply demarcated plaques
-silvery scales
-+ Auspitz sign
-extensor surfaces (may be on palms and soles)

24

Symptoms and associated disease with psoriasis

-Guttate psoriasis can be triggered by streptococcal infection
-onycholysis and pitting of nails
-Koebner
-psoriatic arthritis

25

Pathogenesis of psoriasis

Increased proliferation and shedding of keratinocytes

26

Treatment of psoriasis

Topical retinoids and steroids
UV light

27

Characteristics of lichen planus

-skin, hair, nails and mucous membranes (especially oral mucosa) may be affected
-insatiable itching
-can occur abruptly or secondary to drug
-flexor surfaces

28

Symptoms and associated disease of lichen planus

-violaceous and hyperpigmented polygonal papules and plaques
-Wickham striae (thick hyperkeratotic plaque with white lacelike pattern)
-Koebner
-oral squamous carcinoma rare

29

5 Ps of lichen planus

Pruritic
Planar
Polygonal
Purple
Papules/plaques

30

Treatment for lichen planus

-Self-limited resolves in 8-12 months
-first line is topical steroids

31

Seborrheic dermatitis characteristics

-Common, chronic inflammatory papulosquamous disease
-any age; peaks in adolescence
-linked to Pityrosporun(Malassezia) yeast
-favors areas with sebaceous glands (scalp margins, central face, presternal areas)

32

Seborrheic dermatits symptoms and associated diseases

-moist, transparent to yellow, greasy and scaling with coalescing red patches and plaques
-locations: eyebrows, base of eyelashes, nasolabial folds and paranasal skin, external ear canals
-flexural skin (skin on skin)
-seborrheic blepharitis
-cradle cap

33

Seborrheic dermatitis treatment

-topical antifungals
-antidandruff shampoo or soaps containing zinc pyrithione (ZNP)

34

Acute atopic dermatitis

Poorly defined erythematous patches, papules, and plaques with or without scale. Skin may be extremely dry, cracked, and scaly.

35

Chronic atopic dermatitis

Lichenification results from repeated rubbing or scratching; Fissures

36

Atopic dermatitis characteristics

-Usually begins in infancy
-Characterized by dry skin and pruritus; consequent rubbing leads to increased inflammation and lichenification and to further itching and scratching: itch-scratch cycle
-skin barrier dysfunction
-Often associated with a family history of AD, allergic rhinitis, and asthma
-Most experts believe there is a genetic basis for AD (80% concordance in monozygotic twins), influenced by environmental factors
-Staph aureus exotoxins may trigger

37

Location of atopic dermatitis

Predilection for the flexures, front and sides of the neck, eyelids, forehead, face, wrists, and dorsa of the feet and hands. Generalized in severe disease.

38

Exacerbations of atopic dermatitis

-Skin Barrier Disruption: decrease of barrier function and increased transepidermal water loss.
-Infections: S. aureus secondary infection is often present in severe case

39

Special populations of atopic dermatitis

-Children: affects the cubital and popliteal fossae, neck, and face
-Adults: lichenification and exoriations

40

Atopic dermatitis management

-optimal skin care (hydration, topical, unscented moisturizers)
-NO ANTIHISTAMINES
-Antibiotics if secondary infection suspected
-wet-wrap therapy