Derm Pharm
What is the most commonly used OTC acne treatment? What is its mechanism of action?
Benzoyl peroxide; antibacterial treatment agains c. acnes
Psoriasis is a __________ mediated inflammatory disease characterized by _______ proliferation
T lymphocyte; keratinocyte
Actinic keratoses are caused by _________ and can progress to __________
sun damage; squamous cell carcinoma
What are the two layers of the dermis?
Papillary and reticular
You have a patient who has a history of severe acne and comes in complaining of dark marks on their face after the initial breakout resolves. You suspect ______________ and will prescribe _______ to accelerate resolution
Postinflammatory hyperpigmentation; topical retinoid (and azeleic acid)
What are the four factors for pathogenesis of acne vulgaris? What is the only medication that targets all four?
Excess sebum, keratinization, bacterial growth, inflammation; isotretinoin (Accutane)
topical; phototherapy or systemic
What is castle testing?
genetic testing of a tumor to determine its aggressiveness
Terminology:
flat lesions <1cm:
flat lesions >1cm:
raised lesions <1cm:
raised lesions >1cm
macules
patches
papules
patches
You have a pregnant patient with acne who desires treatment. What three primary medications should you consider for use in this patient?
erythromycin, clindamycin, azelaic acid
Which topical medication should not be used as monotherapy and shows better efficacy when combined with retinoids or benzoyl peroxide?
clindamycin
What are the super high potency topical corticosteroids?
Thrombosed capillaries are seen in _______ but not _______
warts; callouses
Distribution of lesions is:
Configuration of lesions is:
location on the body
how the lesions are arranged/related to each other
A patient presents with a suspicious mole measuring approximately 13 mm. What is the best form of biopsy to perform?
Saucerization/Scallop (for moles >10mm)
What are the side effects of minocycline?
headache, dizziness, skin discoloration
Topical vitamin D analogs include ________ and _________. The MoA is inhibition of ________ _________. There is a rare possibility of ________ if used incorrectly.
calcipotriene and calcitriol; keratinocyte proliferation; hypercalcemia
Tinea versicolor is caused by:
Symptoms include
overgrowth of yeast on skin
no symptoms, only visually bothersome
what is the difference between atrophy and erosion?
atrophy is thinning of the epidermal, dermal, subcutaneous tissue
erosion is loss of the epithelium from injury or vesicle unroofing
Your patient has small linear vesicles on erythematous bases. What are some questions you need to ask or physical exam findings to consider to further stratify the diagnoses?
When using topical steroids for treatment of contact dermatitis, high potency preparations should be used for ___________, while low potency should be used for ___________
high penetration (face, axilla, groin)
The retinoid of choice for moderate-severe psoriasis is ________. What are the three main adverse effects?
acitretin; hypertriglyceridemia, hepatotoxicity, teratogenicity
Scabies bumps are most commonly seen on the _________(two words) of wrists, ________ (3 words) of hands, and ________ (1 word) feet
flexor aspects; interdigital web spaces; dorsal
What is the function of filaggrin and where is it found? What sort of conditions result from mutations in filaggrin?
Filaggrin retains water within keratinocytes and is found in the granular layer of the epidermis. Mutations cause atopic dermatitis and other atopic diseases
You see a patient complaining of flushing and papule and pustules on their face with a background of erythema. They mention their symptoms are exacerbated when drinking alcohol. What do you suspect? What is first line treatment?
Rosacea; topical metronidazole
What is the mechanism of action of Winlevi (clascoterone)
topical anti-androgen; directly targets sebum by inhibiting androgen activity in the sebaceous glands
Random drug names that I hate!
Systemic PD4 inhibitor:
Topical PD4 inhibitor:
Aryl hydrocarbon receptor antagonist:
Apremilast (Otezla)
Zoryve (Roflumilast)
Vtama (tapinarof)
Melanoma is the most serious form of skin cancer and has multifactorial causes including (name 3 for points)
sun exposure/tanning beds
skin type
family history of melanoma
personal history of melanoma
number of moles
history of atypical or dysplastic nevi
What structures make up the pilosebaceous unit? What is the inflammatory condition related to this unit?
hair follicle, sebaceous glands, apocrine sweat glands, arrector pili muscle
acne vulgaris
You see a patient with red, well-demarcated scaly patches with NO scaling. You suspect tinea. What will you do to confirm diagnosis? What is the treatment for the suspected condition?
KOH under microscope; topical anti fungal (ketoconazole or naftifine cream)