Prefix, Root, Suffix Medication Class

TOP. NSAIDS = Used to treat inflammatory diseases (non-steroidal anti-inflammatory)

-crolimus NSAID
-borole NSAID
TOP. RETINOIDS = Used to treat acne, fine lines, wrinkles, dyspigmentation

Tretin-; tretin Retinoids [Isotretinoin/Acitretin = oral; tretinoin = topical]

-tene Retinoids
TOP. ANTIFUNGALS = Used to treat fungal infections: Pseudomonas
-azole Antifungals [tbh mix of both]
-fine Antifungals
Nystatin Antifungals
Ciclopirox olamine Top. Antifungal
Tolnaftate Top. Antifungal
SYSTEMIC ANTIFUNGAL = Used to treat severe fungal infections
-nazole (fluconazole + itraconazole) Oral Antifungal
TOP. CORTICOSTEROIDS = Used to treat dermatitis or steroid-responsive dermatoses
-onide Top. Corticosteroid LOW
-asone Top. Corticosteroid MEDIUM + HIGH
-olone Top. Corticosteroid MEDIUM/HIGH
-asol Top. Corticosteroid ULTRA HIGH
SYSTEMIC CORTICOSTEROID = Used to treat severe dermatitis conditions + paired w/ topicals (start LOW)
Pred; pred- Oral Corticosteroid
TOP. ANTIBIOTICS = Used to treat bacterial infections (Low side effects = safe for pregnancy in 1st trimester)
-mycin Top. Antibiotic
-dapson Top. Antibiotic
-cin Top. Antibiotic
SYSTEMIC ANTIBIOTIC = Used to treat severe bacterial infections (DO NOT prolong)
-cycline Oral Antibiotic
-cillin Oral Antibiotic
ceph- Oral Antibiotic
sulfa- Oral Antibiotic ex: Trimethoprim-sulfamethoxazole
SYSTEMIC ANTIHISTAMINE = oral use only for derm; Used to treat pruritic sensations or allergy-type disease
-atadine Oral Antihistamine
-ramine Oral Antihistamine
-zine Oral Antihistamine [Only think for DERM = hydroxyzine, cetirizine]
SYSTEMIC ANTI-VIRAL = Used to treat viral diseases: HSV, VSZ, HHV...
-vir Oral Anti-viral (ex: valacyclovir)

Dermatitis, Eczema, ACD/ICD:

TREAT W/ TOP. Reduce skin dryness, avoid irritants, and reduce skin inflammation
CORTICOSTEROIDS
Acneiform Diseases Generally think RETINOIDS
Acne Vulgaris Comedones =
1. OTC Differin/retinoid cream + Mineral SPF 30 Sunscreen
2. Top. Benzoyl peroxide, top. Azelaic acid, top. Salicyclic acid [think BAS]
Papular/Pustular Acne =
MILD
1. Top. Retinoid + top. Antibiotic + benzoyl peroxide wash
2. Top. Azelaic acid [Think RAbBA]
MODERATE TO SEVERE
1. Top. Retinoid + top. Antibiotic + benzoyl peroxide wash
2. Nonresponsive: Add oral antibiotic! [Doxycycline preferred]
SEVERE
1. Consider Isotretinoin (Accutane) [NOT for Pregnancy – retinoids usually not recommended:
antibiotic could be safe in mild acne]
Acne Rosacea Erythematotelangiectatic rosacea: commonly treated with intense pulsed light and pulse dye laser, some alpha-
agnoists (brimonidine (Mirvaso) or oxymetazoline to reduce diffuse-centrofacial erythema
Papulopustular rosacea: topical metronidazole gel/cream
Ocular rosacea: lid hygiene, cyclosporine ophthalmic drops (Restasis) and Oral tetracyclines if not responding
Phymatous rosacea: doxycycline and isotretinoin (accutane) (if not working: will need surgical removal but will
reoccur)
Perioral Dermatitis Topical Tacrolimus/pimecrolimus (NSAIDs) & topical GEL antibiotic (-cin) or azelaic acid for papules
DIVA GORL -Oral antibiotics if treatment fails
Folliculitis Malassezia folliculitis: topical ketoconazole cream
Gram-negative folliculitis: oral ampicillin/trimethoprim or isotretinoin
Hot tub folliculitis: oral ciprofloxacin AND vinegar/water soaks
MILD Infectious folliculitis: topical clindamycin and/or chlorhexidine wash
MODERATE-SEVERE Infectious: oral abx depending on organism involved

Bacterial Diseases Generally think ANTIBIOTICS

Impetigo Bullous and non/bullous
1. Vinegar/water soak
2. Topical antibiotics- mupi rocin or retapamulin
Ecthyma
1. Systemic antibiotics- dicloxacillin, cephalexin
If MRSA (uncommon)
1. Doxy, clindamycin or trimethoprim-sulfamethoxazole (TMP-SMZ) -> or shay’s way: TMZ lol
Furuncles and carbuncles
Abscess
1. I&D all non-draining
2. If MRSA: doxy, clindamycin, or TMP-SMZ
1. I&D all non-draining
2. TMP-SMZ
3. If MRSA: doxycycline, clindamycin

Cellulitis Mild
1. Dicloxacillin, cephalexin
Severe
1. Injection or IV
MSSA- Naficillin, cefazolin
MRSA- Clindamycin, doxycycline, TMP-SMZ

Recurrent
1. Strep- penicillin, erythromycin
2. Staph- clindamycin, TMP-SMZ
Erysipelas 1. Penicillin, dicloxacillin, keflex [Oral antibiotic]
2. For penicillin ALLERGIC patients: clindamycin, erythromycin (if strep) [top. Antibiotic]
Hidradenitis suppurativa Stage I
1. Top. Clindamycin 1% solution/gel
Stage II
1. Oral antibiotic
2. Oral retinoids
Stage III
1. Oral antibiotic
2. Oral retinoids
Acute paronychia w/o abscess: Warm water soaks + top. abx
W/ abscess: I&D, warm water soaks
Chronic paronychia Top. Abx OR tacrolimus
syphilis Primary, secondary, tertiary: IM penicillin as first; doxy as second for 2 weeks

Fungal Diseases
ALL HAIR AND NAILS
TINEA [groin not included]
OTHER TINEAS + tinea
versicolor, + Intertrigo
Generally think ANTIFUNGALS (Confirm with a KOH due to liver side effects)
Nystatin is not effective for dermatophyte disease
1. Oral antifungal
1. Topical antifungal: clotrimazole 1% cream or terbinafine 1% cream/gel
2. Oral antifungals can be considered [Adults]
** For cruris = drying powder can be used
*** Difference btw tinea versicolor + others is that it’s NOT contagious

Cutaneous Infestations USE PERMETHRIN! -> KILL!!!

Scabies Permetrin 5% cream
Pediculosis Capitis: Permetrin 1% cream
Corporis: dispose infested clothes
Pubis: Permetrin 1 or 5% cream

Papulosquamous Diseases
Psoriasis
Pityriasis Rosea
*herald patch & Christmas tree Severe: moderate strength corticosteroids, UV light, prednisone
pattern
Seborrheic Dermatitis
*cradle cap
Cutaneous Lichen Planus
Generally think TOPICAL corticosteroids only [NEVER ORAL CORTIOCOSTEROIDS]
Tx based on Rule of 9’s and stop aggravating medications in general
Plaque/Guttate: ultra-high corticosteroids
Inverse: low potency corticosteroids
Moderate Psoriasis (10-30% BSA): UVB and/or systemic agents
Severe Psoriasis: (30+% BSA): UVB and if fail then systemic agents (methotrexate)
Treatment generally not necessary
Face/intertriginous areas: ketoconazole cream
Scalp: ketoconazole shampoo
Eyelids: J&J baby shampoo
Treatment based on taming pruritus
Ultra-high corticosteroids and oral antihistamines
OBSERVE FOR SKIN ATROPHY
Viral Diseases Generally think ANTIVIRALS for HSV VSZ (curettage for MC, cryo for warts, supportive for
viral/nonspecific viral exanthems)
Molluscum Contagiosum (MCV) Treatment is self-limiting
If no improvement: curretage = Adults/crytotherapy = Kids
Herpes Simplex IMMUNOCOMPETENT PTS: Valcyclovir or Acyclvoir
If a recurrence and milder then, do not have to treat
Herpes Zoster (shingles) Acyclovir or Valcyclovir within 72 hours of onset
If postherpetic neuralgia: antidepressants
Varicella Zoster Virus (chicken Antivirals and symptomatic treatment (antihistamines, acetaminophen etc)
pox) DO NOT GIVE CHILDREN ASPIRIN
Measles (Rubeola) Isolation and Symptomatic treatment
Rubella (German Measles) Isolation and Symptomatic treatment
Erythema Infectiosum Symptomatic treatment
Roseola Infantum Symptomatic treatment
Hand/Foot/Mouth Disease Symptomatic treatment
(Coxsackie)
Nonspecific Viral Exanthems Symptomatic treatment
ALL VERRUCAE + 1. Top. Salicylic acid + cryotherapy
Condyloma Acuminatum 2. Inflammation Inviting agents
** Careful w/ either on pts w/ sensory deficits as they can’t tell if they are getting hurt
** NO ELECTRODESSICATION

Drug Eruptions Generally think STOP THE DRUG (antihistamines for pruritic ones, pemphigus ones use
prednisone – oral corticosteroid)
Drug induced Exanthem High strength topical corticosteroids and oral antihistamines
Fixed Drug Eruption High strength topical corticosteroids and oral antihistamines
Reactive erythema ACUTE: avoid allergen and 1 from each:
(urticaria) - Antihistamines
- EPI-PEN If concern for angioedema
CHRONIC: antihistamines
If no improvement then add NSAID
ANGIOEDEMA: antihistamine, tapering prednisone, EPI-PEN
ANGIOEDEMA & 1. Antihistamines
ANAPHYLAXIS 2. Oral cortico. If unresponsive [prednisone] ^^
Erythema Multiforme Mild: topical corticosteroids and antihistamines
Mouth ulcers: high potency corticosteroid GEL and mouthwashes
Steven-Johnsons Syndrome Early Tx: Prednisone BEFORE bullae and stop early if no improvement
Advanced: ER for hydration and nutrition
Toxic Epidermal Necrolysis Early Tx: Prednisone BEFORE bullae and stop early if no improvement
Advanced: ICU treatment preferably burn unit
Bullous Pemphigoid Mild: ultra-high corticosteroids
Mucosal: Prednisone
Pemphigus Prednisone
REQUIRES SYSTEMIC THERAPY
Photodermatitis Supportive treatment with cool compresses, emollients, oral analgesics
AVOID DOXYCYCLINE
Melasma Topical hydraquinone cream/retinoids
Avoid sunlight and decrease estrogen
** Note: SJS/TEN (before bullae), Bullous pemphigoid, pemphigus -> all use prednisone!

Benign Lesions Generally want to surgically remove benign (also shave Bx if you suspect MM) Note: I&D can
recur
Seborrheic Keratosis Not necessary but cryotherapy is 1st choice
Papulosa Nigra Electrodessication -> better than cryotherapy in dark skinned pts
Dermatofibroma Cosmetic removal, but could scar even worse
If protruding lesion, then cryotherapy
Acrochordon Elective removal w/ forceps + scissors
Neurofibroma Cosmetic removal
Lipoma Painless – leave it alone
PAIN – surgically remove it
Milia Cysts Self-limiting or Top. Retinoids (like acne)
Epidermal inclusion cysts Only inflamed: inj. Triamcinolone steroid + I&D + surgical removal
Lentigo Observe for ugly duckling phenomenon -> advise mineral SPF 30 sunscreen
• Note: Café au lait, Becker nevi, and Dermal melanocytes have no Tx -> just observe
I guess
Melanocytic Nevi All the nevis!!
Flat/junctional nevi Refer to derm, USE SUNBLOCK
Compound nevi
Intradermal nevi
Acquired atypical nevi
Acral nevi
Nail Matrix nevi

Acquired and Congenital Bx any large lesions! = suspect of MM

Vascular Lesions
Cherry angioma Not needed
Small – electrocauterize w/ 1% lidocaine
Large – shave excision + electrocauterize
Laser removes superficial
Pyogenic Granuloma Shave excision + electrocauterize w/ 1% lidocaine

Pre-Malignant Lesions
Actinic Keratosis (solar) 1. Liquid N for few lesions; field treatment for many lesions
2. Phototherapy for RESISTANT lesions
Keratoacanthoma Electrodessication + curettage

Melanoma TUMOR THICKNESS IS IMPORTANT PROGNOSIS; if >4 mm = 30% survival; ABCDE ->
determines malignancy!
Stage 0 – in situ
Stage I + II – localized invasive cutaneous disease
Stage III – lymph node involvement
Stage IV – distant metastatic disease
Superficial spreading MM REFER to dermatologist + oncologist -> excision depends on tumor thickness
Nodular MM
Lentigo MM
Acral Lentiginous MM

BCC + SCC
BCC: REFER to dermatologist + EXCISION on trunk/extremities or Mohs excision on face, scalp, ears
Nodular FOLLOW UP 6 months to 1 year
Morpheophorm
Pigmented
SCC:
Cutaneous
Invasive
BCC: Cryosurgery + electrodesiccation + curettage
Superficial