Dermatology Lecture 5

What is another name for atopic dermatitis?

Eczema

What layers does atopic dermatitis cause acute/chronic inflammation of?

Epidermis and dermis

Atopic dermatitis is associated with a personal or family history of allergies, asthma, and/or atopic dermatitis

True or False?

True

When does the onset of atopic dermatitis (eczema) usually happen?

Childhood

Atopic dermatitis (eczema) may spontaneously resolve in childhood

True or False?

True

Atopic dermatitis symptoms include dry skin and itching, but what causes them to worsen?

Frequent bathing

What has lesions with poorly defined erythematous patches, plaques, and papules with or without scales?

Atopic dermatitis

Scratching atopic dermatitis lesions causes what sort of lesion?

Excoriations

Lichenification is what?

Thickening of skin

Hyperpigmentation is what?

Skin becomes darker

Long-term rubbing/scratching of atopic dermatitis lesions causes lichenification, alopecia, and hyperpigmentation

True or False?

True

Alopecia is what?

Hair loss

What is this?

Atopic dermatitis

What are the most common affected areas for atopic dermatitis in pediatric patients?

Face, neck, elbows, wrists, groin, knee, and ankles

What symptom of atopic dermatitis is this (Leathery)?

Lichenification

Non-pharmacologic help for atopic dermatitis is education (avoid rubbing/scratching), bathe every other day or less, avoid irritants (use mild soap in warm baths/showers), moisturize frequently with hypoallergenic moisturizer, and watch for signs of a secondary infection

True or False?

True

What are the 3 medications used to treat atopic dermatitis?

Antihistamines, topical corticosteroids, and systemic corticosteroids

Antihistamines include what drugs?

Benadryl, Zyrtec, and Atarax

Topical corticosteroids include what drugs?

Hydrocortisone and triamcinolone

Systemic corticosteroid are used for what kind of acute eczema?

Severe and generalized

What severe corticosteroids are used for severe and generalized acute eczema?

Prednisone and methylprednisolone

What is an acute or chronic inflammatory reaction to substances that come in contact with the skin?

Contact dermatitis

What causes the hypersensitivity reaction in contact dermatitis

Chemical irritant or an allergen

Lesions appear as well-defined plaques of erythema and edema with vesicles in contact dermatitis

True or False?

True

Contact dermatitis lesions are linear or with artificial patterns, isolated or localized to one region

True or False?

True

In contact dermatitis, what is the nature of lesions (use sciency name with how they feel)?

Pruritic

What does pruritic mean?

Itchy

What is this?

Contact dermatitis

A few initial ways to help treat contact dermatitis are to identify and remove offending agents and to wash the area with mild soap and water

True or False?

True

What solution is put on contact dermatitis as a wet dressing?

Burrow’s solution

How often can Burrow’s solution be put on a contact dermatitis patient?

BID-QID

What are the other 2 names for Burrow’s solution?

Aluminum acetate and Don Burrow solution

What is used to treat pruritus of contact dermatitis?

Antihistamines

What can be prescribed to help non-severe contact dermatitis?

Topical corticosteroids

What can be prescribed to help severe/generalizes reactions of contact dermatitis?

Oral corticosteroids

For non-severe contact dermatitis how often and for how long are topical corticosteroid given

BID x 2-3 weeks

What is the acute inflammation caused by blockages of the sebaceous glands and their associated hair follicles with sebum and desquamated cells?

Acne

Acne is typically accompanied by an overgrowth of bacteria called what?

Propionibacterium acnes

What factors can increase your chance of acne?

stress and occlusion/pressure on the skin

What is a comedome?

Clogged hair follicle

What is another name for a closed comedome?

White head

What does it mean for a comedome to be closed ?

Pore completely blocked

What does it mean for a comedome to be open?

Pore open to the air

What is another name for an open comedome?

Black head

What is this?

Acne

You should wash twice a day with anti-bacterial soap (Dial soap) to help with mild acne

True or False?

True

What are 2 types of drugs and 1 drug that is useful in treating mild acne?

Topical antibiotics, benzoyl peroxide, and topical retinoid

What is a topical retinoid useful in treating mild acne?

Retin-A

What are 2 topical antibiotics useful in treating mild acne?

Clindamycin and erythromycin

How should you treat moderate acne?

Oral antibiotics

Name 4 oral antibiotics useful in treating moderate acne?

tetracycline, minocycline, doxycycline, and erythromycin

What should you give for severe acne?

Isotretinoin (Accutane)

Basal cell carcinoma occurs from prolonged sun exposure and is the most common skin cancer

True or False?

True

Basal cell carcinoma grows fast or slow?

Slow

Basal cell carcinoma may be locally aggressive, but has a limited ability to metastasize

True or False?

True

What skin cancer has lesions that are firm papules or nodules, translucent or “pearly in color” and with a depressed center?

Basal cell carcinoma

Basal cell carcinoma is more prominent with people with a history of what?

Scabbing and bleeding

Where does Basal cell carcinoma most often appear as isolated lesions?

Head, neck, and trunk

What is this?

Basal cell carcinoma

What is the second most common skin cancer?

Squamous cell carcinoma

Squamous cell carcinoma (like basal cell carcinoma) occurs from exposure to sunlight and ionizing radiation

True or False

True

Squamous cell carcinoma grow faster or slower than basal cell lesions?

Faster

What skin cancer is with lesions that are indurated papule, plaque, or nodule, and may have a central crusted area and a firm elevated margin?

Squamous cell carcinoma

Basal cell carcinoma and squamous cell carcinoma can appear identical, so a tissue sample is necessary

True or False?

True

What is this?

Squamous cell carcinoma

What is the most deadly skin cancer?

Melanoma

What skin cancer involves an increase of melanocytes?

Melanoma

Risk factors for melanoma include a family history and sun exposure

True or False?

True

Melanoma’s most common early symptom is itching, but most are asymptomatic

True or False?

True

Later symptoms of melanoma are tenderness, bleeding, and ulceration

True or False?

True

What does melanoma often do when not caught early (the same reason why it is very deadly)?

Metastasize

What is the ABCDE of melanoma?

Asymmetry, border, color, diameter, and evolution

What is this?

Melanoma

What is a rare and aggressive type of skin cancer that form in the top layer of the skin?

Merkel cell carcinoma

What skin cancer has unexplained lumps, especially ones that itch, hurt, or grow in size?

Merkel cell carcinoma

Where are Merkel cells located (the specific location and in what layers of skin)?

nerve endings in epidermis and dermis

Merkel cells help with what?

Touch

Merkel cell carcinoma is sensitive to treatments like radiation and immunotherapy

True or False?

True

What is this?

Merkel cell carcinoma