Shared Flashcard Set

Details

Dermatology
Dermatitis
50
Medical
Graduate
12/12/2009

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Cards

Term
What makes up the atopic triad?
Definition
Asthma, Allergic rhinitis, AD
Term
What is the most consistent sx of AD?
Definition
Pruritus
Term
Describe the stepwise progression of the clinical presentation of AD.
Definition
Scratching - excoriation - lichenification - skin breakdown
Term
When does infant AD typ occur?
Definition
2-6mths of age, 50% resolve by 18 mths
Term
What parts of the infant's skin does AD typ affect?
Definition
Cheeks, chin, forehead, and scalp
Term
Describe the rash in infant AD.
Definition
Itchy, red, often w/ scaling. Pruritus makes infant restless.
Term
What parts of the skin does the childhood stage of AD typ. affect?
Definition
Flexural areas - antecubital and popliteal fossae, wrists and ankles
Term
Describe the rash in the childhood stage of AD.
Definition
More dry, less weepy
Term
What aggravates the pruritic sx of AD?
Definition
Perspiration, dry air, cold, stress, harsh fabrics (wool)
Term
When does the adult stage of AD begin?
Definition
At puberty when sx worsen or begin, subsides by age 30
Term
Describe the skin in adult AD.
Definition
Dry, itchy, reddened and cracked - often lichenification
Term
Describe the distribution of skin areas affected by adult AD.
Definition
Can be flexural as in children or more localized (hands, periorbital, or anogenital)
Term
80% of pts w/ AD have elevated ______.
Definition
IgE
Term
Guidelines for dx of AD requires that a pt has ____ of _____ major criteria or __ of __ minor features.
Definition
3 of 4, 3 of 23
Term
What are the major criteria for dx of AD?
Definition
1)Pruritus 2)Affects flexural in adults or extensor/face in infants 3)Chronic or relapsing dermatitis 4)Fam h/o atopic triad d/o
Term
A complication of AD is secondary infection w/ what organisms?
Definition
Staph (primary), strep, or herpes
Term
What are the 5 steps for tx AD?
Definition
1)Education 2)Prevention 3)Mild sx despite routine care 4)Mid-potency steroids and Calcineurin inhibitors 5)Referral
Term
Name 3 ways to prevent flares of AD.
Definition
1)Moisturize (Moisturel, eucerin, Aquaphor, Vaseline) 2)Avoid perfumed soaps/lotions 3)Decrease bathtime
Term
What meds are used to tx AD w/ mild sx depsite daily care?
Definition
1)Mild topical steroids (hydrocortisone) 2)Oral antihistamine (claritin, zyrtec, benadryl)
Term
What are advantages to using Calcineurin to tx AD? what is the mechanism of action? Name 2 ex. Who should not use them?
Definition
No skin atrophy or striae. Stop T cells and mast cells from releasing cytokines. Elidel (Pimecrolimus) and protopic (Tacrolimus). Immunocompromised pts.
Term
When would you use 1st generation Cephalosporins to tx AD?
Definition
Honey crust, pustules, cellulitis, unexpected flares and recalcitrant cases
Term
If MRSA is suspected, what abx are used? The nose is a major reservoir of S. aureus, what would you use?
Definition
Bactrim or clindamycin. Mupiricin (bactroban) applied to the nose.
Term
What is the common name for seborrheic dermatitis in children? Adults?
Definition
Cradle cap. Dandruff.
Term
What is the pathophysiology of seborrheic dermatitis?
Definition
Poss. Malasezia furfur (skin saprophyte) or Pityrosporum yeast. Hyperproliferation of skin/excess oil secretion.
Term
Describe the clinical findings in seborrheic dermatitis.
Definition
Moist papules w/ yellow, greasy scaling, erythema, mild pruritus
Term
Describe the distribution of affected areas in seborrheic dermatitis.
Definition
Lateral side of nose, nasolabial folds, eyebrows, scalp (dandruff)
Term
How is dandruff tx?
Definition
1)Frequent washings 2)Antiproliferative shampoos (T-Gel - Tar), Selsun - Se, Head and Shoulders - Zn) 3)Antifungal shampoos (ketoconazole, ciclopirox)
Term
Name 2 other tx for seborrheic dermatitis (other than shampoos).
Definition
Topical steroids and topical or systemic antifungals
Term
What might you think if a pt has severe seborrheic dermatitis? What other dz is seborrheic dermatitis a common finding?
Definition
HIV (up to 80% of AIDS pt have it). Parkinson's dz.
Term
Describe the appearance of nummular dermatitis.
Definition
Generalized, intensely pruritic coin-shaped patches of eczematous dermatitis
Term
Who is nummular eczema more common in? Describe the distribution of skin affected.
Definition
Adult men. Trunk and LE.
Term
Name 3 tx for nummular eczema.
Definition
Topical steroid (ointment), moisturization, light tx. Very difficult to tx - variable and unpredictable outbreaks.
Term
Who does dyshidrotic dermatitis typ affect? It is AKA?
Definition
Women - early 20's and Men - mid-40's usu. w/ an atopic hx. Pompholyx.
Term
Describe the clinical presentation of dyshidrotic dermatitis. Describe the areas of distribution.
Definition
Intensely pruritic, recurrent, vesicular lesions 1-5mm diameter w/ clear fluid. Palms and soles, lateral aspects of fingers.
Term
What is the tx for dyshidrotic dermatitis? (4)
Definition
1)Wet dressings bid 2)Med. to potent topical corticosteroids 3)Oral antihistamines 4)UVA or x-ray in recurrent cases.
Term
Who does perioral dermatitis typ. affect?
Definition
Young women and children 7mths to 13yrs (girls=boys)
Term
The exact etiology of perioral dermatitis is unknown, but what are 3 possible causes?
Definition
1)Skin intolerance to beauty products 2)Drying agents (benzoyl peroxide, alcohol based products) 3)Bacterial
Term
Describe the clinical presentation of perioral dermatitis and distribution areas.
Definition
Pustules and papules resembling acne around nasolabial folds and chin, sparing the vermilion border
Term
How is perioral dermatitis tx? (3)
Definition
1)Stop heavy moisturizers, steroids, and cosmetics 3)Use mild soap 4)Topical or oral abx
Term
Stasis dermatitis is an eczematous reaction in pts w/ ______.
Definition
Venous insufficiency in lower legs and ankles (medial malleolus)
Term
Describe subacute stasis dermatitis.
Definition
In winter mths legs become dry and scaly, pruritic (itching worsens it), darkening of skin.
Term
What is used to tx subacute stasis dermatitis?
Definition
Topical corticosteroid ointments (II-V) and Lubricants
Term
Describe acute stasis dermatitis.
Definition
Red, superficial, pruritic plaque, may have cellulitis, weeps and dev. crusts.
Term
Describe chronic stasis dermatitis.
Definition
Cyanotic red plaque over medial malleolus, skin thickening, cycles of healing and recurrent attacks (skin remains thick and dark during healing times)
Term
Name 4 tx for acute/chronic stasis dermatitis.
Definition
1)Topical steroids (III-V) 2)Oral abx if cellulitis 3)Wet dressings 4)Compression hose
Term
An eruption that is created by habitual scratching of eczematous dermatitis in a single localized area, AKA neurodermatitis.
Definition
Lichen complex chronicus
Term
Describe the clinical presentation of lichen complex chronicus.
Definition
Very thick oval plaque, usu. just one lesion, severe itching, lichenification.
Term
Tx for Lichen complex chronicus?
Definition
Stop itching!! Topical steroids or oral if severe.
Term
A chronic inflammatory skin dz char. by pruritus, erythema, a prediliction for skin creases and a relapsing course.
Definition
Atopic Dermatitis (AD)
Term
90% of cases of AD present before the age of ___.
Definition
5
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