Term
| Name the 3 stages of the hair growth cycle. |
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Definition
| 1)Anagen (growth-2-6yrs) 2)Catagen (involution -2-3wks) 3)Telogen (rest - 2-3mths) |
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Term
| What is telogen effluvium? |
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Definition
| Generalized hair loss beginning 2-3mths /p causal event, affects no more than 50% of hair, lasts ~4wks |
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Term
| Name 4 things that cause telogen effluvium. |
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Definition
| 1)Illness 2)Childbirth 3)Crash diets 4)Drugs (Bblockers, Vit A, Coumadin/heparin) |
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Term
| How is telogen effluvium tx? |
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Definition
| Stress reduction, biotin, iron, silica, minoxidil |
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Term
| What is androgenic alopecia? |
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Definition
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Term
| Describe the pathophysiology of androgenic alopecia. |
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Definition
| DHT binds to follicle androgen receptors causing progressive shortening of anagen cycles and minituraziation of follicles |
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Term
| Androgenic alopecia does not occur in men w/ an absence of _____. |
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Definition
| 5 alpha-reductase type II |
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Term
| Name 4 tx for androgenic alopecia. |
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Definition
| 1)Surgery 2)Minoxidil (Rogaine) 3)Finasteride (Propecia) 4)Laser |
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Term
| Describe the mechanism of action of rogaine. Propecia? |
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Definition
| Rogaine inc. duration of anagen phase enlarging miniaturized follicles. Propecia blocks 5 alpha-reductase type II stopping conversion of testosterone to DHT. |
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Term
| A localized, often patchy, self-limited hair loss that is autoimmune in etiology. Diffuse fine nail pitting can also occur. |
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Definition
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Term
| Name 4 tx for alopecia areata. |
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Definition
| 1)Anthralin cream 2)Topical Minoxidil 3)Intralesional glucocorticoid injection (Kenalog) 4)Oral or topical steroids |
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Term
| What are the most common pathogens that cause onchomycosis? |
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Definition
| T. rubrum and T. mentagrophytes (also can be candida and mold) |
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Term
| What is the most common pattern of onchomycosis infection? What is the physical appearance? |
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Definition
| Distal subungal. Distal nail plate turns yellow/white and begins to thicken. |
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Term
| Describe the physical appearance of nails w/ proximal subungal onchomycosis infection. |
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Definition
| Growth begins at the proximal nail plate (cuticle) and grows outward to the matrix and nail plate |
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Term
| Describe the nail w/ white superficial onchomycosis infection. |
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Definition
| No thickening, nail is powdery, dry, and soft. |
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Term
| Candida onchomycosis infection is seen almost exclusively in _____. Describe the nail. |
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Definition
| Chronic mucocutaneous candidiasis. Nail turns thick and yellow brown. |
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Term
| Name 3 oral tx for onchomycosis. Which one works best for candida? |
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Definition
| 1)Terbinaine (Lamisil) 2)Itraconazole (Sporanox) 3)Fluconazole (Diflucan) - Candida |
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Term
| Name 2 topical tx for onchomycosis. What surgery can be used? |
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Definition
| 1)Penlac (for superficial ifxn) 2)Urea (chem. nail avulsion - keratolytic. Surgical nail avulsion. |
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Term
| A painful swelling of lateral and proximal nail folds in which pain is immediately relieved /p drainage. |
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Definition
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Term
| What is the typ. infectious agent in paronychia? |
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Definition
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Term
| Name 2 tx for acute paronychia. |
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Definition
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Term
| What occurs in chronic paronychia? |
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Definition
| Inflammatory dz typ. /p exposure to contact irritants involving sev. fingers in which the nail plate becomes dystrophic. |
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Term
| Nam4 4 tx for chronic paronychia. |
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Definition
| 1)Avoid irritants 2)Keep hands dry 3)topical steroids 4)Oral diflucan |
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Term
| What causes acute urticaria? How long is it present? |
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Definition
| Allergens trigger histamine release, mediated by IgE. <6wks. |
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Term
| What are common triggers of acute urticaria in adults? Children? |
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Definition
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Term
| Tx for acute urticaria? (4) |
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Definition
| 1)Oral H1 antagonist 2)H2 antagonist for resistance 3)Avoid allergens 4)Sys. steroids |
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Term
| What is chronic urticaria? |
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Definition
| present >6wks, lesions lasting >24hrs, autoimmune rather than allergic |
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Term
| Tx for chronic urticaria? |
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Definition
| 1)2ng gen. H1 anta. 2-4X normal 2)H2 if resistance 3)Sys. steroids 4)Stop all non-essential meds and OTC 5)Cyclosporin 6)Allergist referral |
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Term
| What is a fixed drug eruption (FDE)? |
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Definition
| Hypersensitivity rxn caused by almost any drug of any admin. route |
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Term
| Describe the clinical presentation in FDE. |
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Definition
| Dev. 30min to 8hrs /p taking drug,begins as edematous papule or plaque from a few mm to 20cm, a/w recur at the same cutaneous or mucosal site |
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Term
| What happens in a FDE if the offending drug continues? |
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Definition
| the inflammation intensifies, turns dusky red, violaceous or brown, may crust, desquamate or blister |
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Term
| What are favored sites of FDE? |
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Definition
| Hands, feet, face, and genitalia. Unkown reason - drug not detected at lesion site. |
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Term
| What drugs cause a FDE lesion on the penis? On the face, limbs, and trunk? |
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Definition
| Tetracycline and ampicillin. Aspirin. |
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Term
| Describe the clinical presentation of erythema multiforme. |
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Definition
| Targetoid, sometimes w/ central vesicles, bulla, or purpura. It is common, acute, and self-limited. |
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Term
| What are common sites affected by erythema multiforme? |
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Definition
| Distal extremities, dorsal hands, and extensor forearms. May invlove palms, trunk, and mucous membranes of the mouth and genitals. |
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Term
| What is erythema multiforme commonly associated w/? |
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Definition
| HSV or mycoplasma infxn. May also be caused by malignancy, pregnancy, or drugs. |
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Term
| Desribe the clinical presentation of Stevens-Johnson syndrome. |
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Definition
| Abrupt onset w/ high fever, myalgia, malaise, HA, arthralgia and ocular involvement. Painful stomatitis, hemorrhagic bulla over lips, mouth, and genitals. |
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Term
| Tx for steven-johnson syndrome? |
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Definition
| Prednisone, acyclovir (or other antovirals) |
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Term
| A medical emergency that dev. as a rxn to drugs, infxn, XRT, or vaccinations? |
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Definition
| Toxic epidermal necrolysis |
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Term
| What are the prodromal sx of toxic epiderma necrolysis? |
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Definition
| Fatigue, N/V/D, and angina |
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Term
| Describe the progression of skin lesions in toxic epiderma necrolysis. |
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Definition
| Begins as morbilliform rash and lg. tender areas of skin, progresses to blistering resembling extensive 2nd degree burns |
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Term
| Name 4 tx for toxic epiderma necrolysis. |
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Definition
| 1)Cyclosporin 2)Cyclophosphamide 3)Plasma exchange 4)Burn center tx |
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