Derm

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Author:
bbeckers88
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108771
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Derm
Updated:
2011-10-13 17:16:25
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Derm Test
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Cards for test 1
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  1. integumentary system
    • a covering
    • includes skin and everything found in it
  2. functions of skin
    • protection
    • retains H2O
    • regulates temperature
    • vitamin D
    • sensory organ
    • excretion of toxins
  3. epidermis
    active basal cell layer (melanocytes)
  4. dermis
    • sweat glands
    • blood vessles
    • sebaceous glands
    • nerve endings
    • vitamin D synthesis
  5. subcutaneous layer
    fat- if it collects too rapidly and stretches out the collagen and elastin= cellulite
  6. a derm history should include:
    • location
    • duration
    • triggers
    • relieving/aggrevating factors
    • quality
    • constitiutional symptoms
    • timing
    • weak chronic illness syndrome
  7. physical exam should include:
    • type, shape, arrangement, distrobution
    • feeling
    • general appearance of the patient
  8. Age of onset of acne
    12-25 (mainly 16-18)
  9. frequency of acne
    79-95% of 16-18 year olds
  10. body distrobution of acne
    face, trunk, arms, back, upper chest, shoulders
  11. pathogenic factors of acne
    • bacteria
    • sebum chemistry
    • sebum quantity
    • keratinocyte hyper proliferation, shedding, and clumping
    • terrain
  12. acne common differentials
    • raised papules
    • postules
    • nodules
    • open comedones-black heads
    • closed comedones- white heads
  13. acne treatment
    • change the sebum (low glycemic diet)
    • bacteria- antibiotics
    • B6 for menstral acne
    • detox- sauna
    • botanicals supplements
  14. how could you tell acne apart from the following:
    • face: staph aureus, foliculitis, pseudofoliculitis brabae, rosacea, perioral dermatitis
    • trunk: pityrosporum folliculitis, pseudomonas folliculitis, staph aureus foliculitis, keratosis pilaris
    • single painful cyst: staph abscess, furuncle, rupture inclusion cyst, dental sinus cyst
  15. age of onset of rosacea
    30-50
  16. frequency of rosacea
    14% in women, 5% in men
  17. distrobution of rosacea
    FACE ONLY!!! mainly central
  18. common differentials of rosacea
    • erythema, telangiectasia, papulopostule, nodules, rhinothyma
    • NO comedones
  19. natural med etiology for rosacea:
    terrain, genetics, poor digestion, toxic bowels
  20. Rosacea is aggrevated by:
    hot liquid, spicy food, alcohol, sun, niacin
  21. what other symptoms are common with rosacea?
    • migraines 3x more common
    • occular symptoms
  22. treatment of rosacea:
    • ID and avoid triggers
    • anti-inflammatory/elimination diet
    • digestive enzymes
    • probiotics
    • niacinamide moisturizer
  23. be able to differentiate rosacea from the following:
    • papule/postule: acne, perioral dermatitis, folliculitis, mites
    • flushing: seborrheic dermatitis, SLE, dermatomyositis
  24. Age of onset of perioral dermatitis
    16-45 years, mainly women
  25. distrobution of perioral dermatitis:
    papulopostules on an erythematosus base around the mouth
  26. perioral dermatitis is aggreavted by:
    floride and NA lauryl sulfate in toothpaste
  27. symptoms of perioral dermatitis:
    occasional itching, burning, and tingling
  28. treatment of perioral dermatitis
    topical and systemic
  29. be able to differentiate perioral dermatitis from:
    algeric contact dermatitis, atopic deratitis, seborrheic dermatitis, rosacea, acne vulgaris, steroid acne, fungus, staphylococcus infection
  30. distrobution off hidradenitis suppurativa
    axila, sometimes scalp and pilonidal sinuses
  31. hidradenitis suppurativa is caused by:
    chronic, suppuration, fibrous tissue of apocrine gland
  32. early symptoms of hidradenitis suppurativa:
    • erythema
    • burning
    • itching
    • discomfort
    • hyperhidrosis
  33. mild hidradenitis suppurativa
    • solitary nodule
    • no abscess
  34. moderate hidradenitis suppurativa
    • multiple recurrent nodules
    • pain and discharge
    • abscess formation
  35. severe hidradentitis suppurativa
    • diffuse abscess formation
    • chronic draining sinus tract
    • chronic inflammation
  36. conservative management of hidradenitis suppurativa
    • like acne
    • loose clothing
    • warm compress
    • zinc
    • anti-inflammatory/elimination diet
  37. be able to differentiate hidradenitis suppurativa from:
    furuncle, carbuncle, lymphadenitis, rupture inclusion cyst, cat-scratch disease, lymphogranuloma venereum, donovanosis
  38. acute eczema/dermatitis
    blisters, intense itch
  39. subacute eczema/dermatitis
    dry, redness, scaling, slight-moderate itch
  40. chronic eczema/dermatitis
    thickened skin, fissuring
  41. types of contact dermatitis
    irritant and allergic
  42. predisposing factors for irritant contact dermatitis
    • decreased protective lipid barrier on hands
    • light colored skin
    • history of atopic dermatitis
    • mechanical irritant
    • 80% of all dermatitis
    • mainly on hands
  43. prevention of irritant contact dermatitis
    • avoid irritant (protective clothing)
    • cloth diapers for diaper dermatitis
    • barrier creams
    • change job
  44. topical treatment of irritant contact dermatitis
    • inflammed- use powder
    • dry- wet soaks with colloidal oatmeal
    • exudative- wet gauze
    • honey, olive oil, and beeswax
  45. oral treatment for irritant contact dermatitis
    corticosteroids
  46. course of irritant contact dermatitis
    • 1. healing within 2 weeks
    • 2. healing within 6 weeks if chronic
    • 3. occupational- only 1/3 have complete remission
  47. distrobution of irritant contact dermatitis
    anywhere on the body where the irritant touched
  48. distrobution of allergic CD
    • where the irritant touched
    • common sites: face, neck, forearm, lower leg, top of foot, arm pit, necklace areas, watch areas, bra straps, underwear
  49. allergic CD is what type of hypersensitivity
    type IV (delayed)
  50. allergic CD usually appears after how long?
    24-48 hours after contact but up to 4-10 days
  51. how long can it take to become reactive to an allergen?
    up to a year
  52. top 5 allergens
    • 1. nickel sulfate
    • 2. neomycin sulfate
    • 3. balsam of peru
    • 4. fragrance mix
    • 5. thimerosal
  53. allergic CD due to plants (APD)
    • sensitization and dermatitis occur 7-10 days after first exposure
    • dermatitis can occur in <12 hours after second exposure
  54. what % of individuals are sensitized to Toxicodendron haptens?
    70%
  55. what are two signs of APD
    • linear lesions
    • acute vesicles
  56. management of APD
    • prevention
    • identify and avoid plants
    • wash entire body with water (no soap!)
    • barrier creams
    • trim fingernails
    • blow dry lesions
    • calamine
    • burows solution
    • cool compress
    • oatmeal, starch, vinegar
    • aloe gell
  57. course of poison oak (APD)
    • rash begins quickly
    • lasts 3-4 days
    • clears within next 5 days
    • 1-2 weeks total with or without treatement
  58. atopic dermatitis
    • inflammation of dermis/epidermis
    • unknown cause
  59. frequency of atopic dermatitis
    • increasing in western world
    • 7-15% of general population
  60. pathogenic factors of atopic dermatitis
    • genetics
    • terrain
    • immune dysfunction
    • epidermal barrier dysfunction
    • IgE mediated hypersensitivity
  61. distrobution of atopic dermatitis
    face, popliteal fossa, front of elbows
  62. features of atopic dermatitis
    • pruritus
    • typical distrobution
    • chronic relapsing dermatitis
    • family history
    • keratosis pilaris (can exsist on its own)
  63. infantile atopic dermatitis
    • 2 months-2 years
    • 50% of cases begin here (90% by age 5)
    • face, scalp, extensor surface
    • lesions red, finely vesicular, oozing, crusted, and extremely pruritic
    • secondary infections
  64. childhood atopic dermatitis
    • 2-12 years
    • antecubital and popliteal fossae, posterior neck
    • near 80% develop allergic rhinitis
    • 30-50% develop asthma

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