-
Ointment
water in oil
(fn) hydrates, greasy
-
Cream
Oil in water
(fn) hydrate, variable
-
Lotion
Powder in water
(fn) drying, cosmesis
-
Solutions
water, alcohol, propylene, glycol
-
Gel
Solution that melts on contact with skin
(fn) drying
-
-
-
SPF
Burn time with cream divided by burn time without cream on
-
Sun Protection Mneomnic
"Seek, Slip, Slap, Slop"
- Seek Shade
- Slip on a shirt
- Slap on a hat
- Slop on sunscreen
-
Side effects of topical steroids
- Local
- -atophy
- -purpura
- -thin skin
- -perioral dermatitis
- -steroid acne
- -rosacea
- -contact dermatitis
- -tachyphylaxis (tolerance)
- Systemic
- -suppression of HPA axis
- (if high potency like clobetasol, large area, long time or under occlusion)
-
Side effects of systemic steroids
-
Erythema Nodosum Ddx
NODOSUM
- No cause - 40%
- Drugs (slfonamides, OCP)
- Other infx (GAS+)
- Sarcoidosis
- Ulcerativ colitis and Crohns
- Malignancy (leukemia, Hodgkin's lymphma)
-
Pruritus Ddx
SCRATCHED
- Scabies
- Cholestasis
- Renal
- Autoimmune
- Tumorours (ca)
- Crazies
- Hematology (polycythemia, lymphoma)
- Endocrine thyroid, parathyroid, iro ndef)
- Drugs, Dry skin
-
Uncommon Causes of ulcers
CHIP IN
- Cancer, Chromosomal
- Hemoglobinopathy
- Inflammatory
- Pyoderma gangrenosum
- Infections
- Necrobiosis lipoidica diabeticonum
-
Itchy Eruptions in Kids
UC-SCAB
- Urticaria
- Contact dermatitis
- Scabies
- Chicken pox
- Atopic dermatitis
- Bites
-
Urticaria Ddx
DAM HIVES
- Drugs / foods
- Allergic
- Malignancy
- Hereditary
- Infection
- Vasculitis
- Emotions
- Stings
-
-
Purple
- Pruritic
- Polygonal
- Peripheral
- Papules
- Penis (periphery)
-
For dermatoscopy, 7 point checklist....
Need >3 for melanoma
- Major (Ap Av BW) - 2pt each
- -Atypical pigment network (blue, white)
- -Atypical vascular network
- -Blue white veil
- Minor (BDRS) - 1pt each
- -Irregular blotches
- -irrecular dots + globules
- -Regression streaks
- -Irregular Streaks
-
Patterns and Distribution
- Acral - hands/feet
- Annular
- Follicular
- Guttate - drop like
- Koebner - isomorphic
- Morbilliform
- Reticular
- Satellite
- Target (iris)Discrete
- Clustered
- Linear
- Confluent
- Dermatitic
-
Types of cysts
- Epidermal cyst
- Pilar Cyst (Trichelemmal)
- Dermoid cyst
- Ganglion cyst
- Milium (pl = milia)
-
Dimple sign
Found on legs>arms>trunk
Dermatofibroma
(dermatoscopy) hypopigmented centerally
- ddx:
- Dermatofibrosarcoma protruberans
- Malignant melanoma
- Kaposi's sarcoma
- Blue nevus
-
Skin tags, aka...
- Acrochordons
- Fibroepithelial polyps
- Soft fibrromas
- Pedunculated lippofibromas
- Cutaneous papillomas
-
Types of Actinic Keratoses
- Erythematous: typical AK
- Hypertrophic: thicker, rough papule/plaque
- Cutaneous horn: firm hyperkeratotic outgrowth
- Actinic chelitis: confluent on lip
- Pigmented: flat, tan-brown, scaly plaque
- Spreading pigmented
- Proliferative
- Conjunctival
-
Corns vs Plantar warts
- Corn
- -firm papule with central translucent cone shaped hard keratin core, pain with direct P, esp dorsolateral 5th toe
- Plantar warts
- -bleed when pared
- -pain with lateral P
- -thrombosed vessels give plantar warts a black speckled central appearance not seen in corns
-
Hemangiomas vs Vascular Malformations
- Hemangiomas
- -spon't resolution
- -tx: propranolol or topical corticosteroids (Timal) if superfical
-
Why are open comedones black?
- Oxidized melanin
- (NOT dirt)
-
Acne exacerbating factors
- Systemic meds - lithium, phenytoin, steroids, halogens, androgens, iodides, bromides, danazol
- Topical agents - steroids, tars, oints, oily cosmetics
- Mechanical P / occlusion
- Emotional stress
-
Mech of Action:
a) Clindamycin, Erythromycin
b) Benzoyl peroxide
c) Adapalene (differin), Tretinoin (Retin-A)
d) Diane 35 (cyproterone acetate ethinyl estradiol)
e) Isotretinoin (Accutane)
f) BenzaClin gel
g) Benzamycin
-
a) inhibit protein synthesis
- b) protein oxidant with bactericidal effect
- c) comedolytic)
- d) anti androgenic, incr levels of sex hormone binding globulin (SHBG), decr circulating plasma levels of androgens
- e) inhibits sebaceous gland fn and keratinization
- f) 1% clindamycin, 5% benzoyl peroxide
- g) 3% erythromycin, 5% benzoyl peroxide
-
Dose for oral tetracyclilne
- Tetracycline 500mg po OD -BID
- ***don't use with isotretinoin (risk of pseudotumor cerebri)
- -need 3-6months until see result
Erythromycin 500mg po BID
-
Tx for Perioral Dermatitis
- 1) Metronidazole 0.75% gel (metrogel) to area BID
- OR
- 2) Tetracycline 500mg po OD -BID
-
Types of Rosacea
- -Erythromatotelangiectatic
- -Papulopustular
- -Phymatous
- -Ocular
- -variant = granulomatous
-
Top ten allergens (via North American Contact Derm Gr)
- 1) Nickel sulfate - jewerly, buckles
- 2) Neomycin sulfate - topical Abx
- 3) Balsam of Peru - fragrance material
- 4) Fragrance mix
- 5) Thimerosal - common preservative, in vaccines, contact lens solution, cosmetics
- 6) Sodium gold - jewellery, dentistry
- 7) Formaldehyde - gas
- 8) Quaternium-15
- 9) Cobalt chloride - hard metal in cosmetics, jewellery, buttons, tools
- 10) Bacitacin - topical Abx
-
Woronoff's Ring
Blanched halo that surrounds psoriatic lesions a/f topical or phototherapy tx.
-
Dovonex vs Dovobet
Dovonex - calcipotriol (Vit D derivative)
Dovobet - calcipotriene + betamethasone diproportionate
-
PSORIASIS: presentation and pathoPSL
- P - pink papules/plaques/pinpt bleed (Ausptiz sign), physical injury (Koebner phen)
- S - silver scale//sharp margins
- O - onycholysis / oil spots
- R - rete ridges with regular elongation
- I - itch
- A - arthritis/abscess/autoimmune
- S - Stratum corneum with nucei
- I - immunologic
- S - stratum granulomsum absent
-
Mech of Biologics
-mab
-rcept
- - mab = monoclonal Ab
- - rcept = receptor
-
PemphiguS VUlgaris vs
Bullous PemphigoiD
- PV = Superficial
- BP = Deep
-
Ddx for Urticaria
DAM HIVES
- D - drugs and foods
- A - Allergic
- M - Malignancy
- H - hereditary
- I - infectious
- V - vasculitis
- E - emotions
- S - stings
-
Approach to Vasculitis
- 1. Hx and P/E
- 2. if lesions <24hrs, attacks <6wks = ACUTE, no inv, referral for allergy testing
- 3. If <24hrs lesions, but attacks >6wks, CHRONIC, inv: CBCd, UA, ESR, LFTs
- 4. if lesions >24hrs, Vasculitis = bx of lesion and referral to derm
-
Raynaud's Phenomenon Ddx
COLD HAND
- C - cryoglobulins / cryofibrinogens
- O - obstruction / occupational
- L - lupus or other CTD
- D - DM, drugs
- H - hematologic problems (PCV, leukemia)
- A - Arterial problems
- N - neurologic problems
- D - disease NYD, idiopthic
|
|