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Year 2 > Clinical dermatology cases > Flashcards

Clinical dermatology cases Flashcards

1
Q

What are the key areas to consider in any skin condition?

A

Distribution
Morphology
Secondary features (e.g arthritis)

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2
Q

Psoriasis often starts in childhood. T/F

A

False - psoriasis is largely a disease of adulthood

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3
Q

Psoriasis is a chronic condition. T/F

A

True

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4
Q

What are the causes of psoriasis?

A

Genetic, stress, infection, Koebner phenomenon

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5
Q

What is the commonest form of psoriasis?

A

Chronic plaque psoriasis/psoriasis vulgaris

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6
Q

What are the typical features of plaque psoriasis rash?

A

Symmetrical distribution
Scaly, erythematous plaques (+/- silvery scale)
Sharp borders

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7
Q

Which sites does plaque psorasis commonly affect?

A 
Extensors
Nails
Hands, feet
Trunk
Scalp
Sacrum
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8
Q

List the types of psoriasis

A

Guttate
Palmoplantar pustulosis
Nail disease
Erythrodermic/widespread pustular

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9
Q

What does guttate psoriasis look like?

A

Small, circular plaques

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10
Q

What are the features of psoriatic nail disease?

A

Pitting, onycholysis, dystrophy, subungal hyperkeratosis

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11
Q

How common is erythrodermic/widespread pustular psoriasis?

A

Uncommon

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12
Q

What is the koebner phenomenon?

A

Psoriasis arising from an area of trauma

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13
Q

What are the common treatments for psoriasis?

A

Vitamin D analogues
Coal tar
Topical steroids

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14
Q

List some vitamin D analogues

A

Calcipotriol

Calcitriol

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15
Q

What are the specialist treatments for psoriasis?

A 
Narrowband UVB and PUVA
Retinoids
Immunosuppressants 
Fumaric acid ester
Immune modulators
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16
Q

Alcohol can trigger psoriasis. T/F

A

True

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17
Q

Obesity and psoriasis can be linked. T/F

A

True

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18
Q

Guttate psoriasis often follows which respiratory infection?

A

Steptococcus

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19
Q

What is acne vulgaris?

A

Chronic inflammatory disease of the pilosebaceous unit

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20
Q

When does acne vulgaris present?

A

In adolescents (younger in females, older in makes)

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21
Q

Is there a genetic component to acne vulgaris?

A

Yes

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22
Q

What is the pathogenesis of acne vulgaris?

A

Pore occlusion –>
Colonisation of duct –>
Dermal inflammation –>
Increased sebum production

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23
Q

What are the common sites of acne vulgaris?

A

Face, upper back and chest

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24
Q

What is found in acne?

A

Comedones, pustules, papules, cysts

25
Q

What are the secondary features of acne?

A

Atrophic scars, ice-picking, hypertrophic

26
Q

How is acne graded?

A

Mild - scattered papules, pustules and comedones
Moderate - numerous papules, pustules and mild scarring
Severe - cysts, nodules, significant scarring

27
Q

How is acne treated locally?

A

Benzoyl peroxide
Topical vitamin A/retinoids
Topical antibiotics

28
Q

How is acne treated systemically?

A 
Antibiotics
Oral retinoids (isotrenitoin)
29
Q

What is a side effect of isotrenitoin?

A

Initial flare of acne

30
Q

What is a retinoid used in acne?

A

Adapalene

31
Q

Where is rosacea usually distributed?

A

Nose, chin, cheeks and forehead

32
Q

How does rosacea typically present?

A

Papules, pustules, erythema without comedones

Facial flushing

33
Q

What can exacerbated rosacea?

A

Temperature
UV exposure
Dietary (spicy food)
Alcohol

34
Q

In which age group does rosacea typically present?

A

Middle aged

35
Q

What is rhinopyma?

A

Thickening of the sebaceous tissue of the nose

36
Q

How can you reduce the aggravating factors in rosacea?

A

Dietary avoidance
Wear sunscreen
Avoid topical steroids (make worse in long term)

37
Q

What is steroid rosacea?

A

Rosacea induced by potent topical steroids

38
Q

Which antibiotics may be prescribed in rosacea?

A

Topical metronidazole

Oral tetracycline

39
Q

When might isotretinoin be used in rosacea?

A

Low doses can be used in severe rosacea

40
Q

How can telangectasia be treated?

A

Vascular laser

41
Q

How can rhinopyma be treated?

A

Surgically

Laser shaving

42
Q

What is the memory aid to differentiate between bullous pemphigoid and pemphigus vulgaris?

A

Bullous pemphigoid - split is Deeper through DEJ

Pemphigus vulgaris - split is Superficial, Intra-epidermal

43
Q

In which age group does bullous pemphigoid typically present?

A

Elderly

44
Q

What is the typical distribution of bullous pemphigoid?

A

Localised to one area

Widespread on the trunk and proximal limbs

45
Q

What is the typical appearance of bullous pemphigoid blisters?

A

Large, tense bullae (normal or erythematous skin) –> bursts to leave erosions

46
Q

Does bullous pemphigoid scar?

A

No

47
Q

How may bullous pemphigoid first present?

A

Itchy, erythematous plaques/papules

48
Q

Is bullous pemphigoid Nikolsky negative or positive?

A

Negative

49
Q

Mucosal lesions are typical in bullous pemphigoid. T/F

A

False

50
Q

What is the typical distribution of pemphigus vulgaris?

A

Scalp, face, axillae and groin

51
Q

What is the typical appearance of pemphigus vulgaris?

A

Flaccid, thin roofed vesicles/bullae –> ruptures to leave raw areas

52
Q

Is infection risk increased in bullous pemphigoid or pemphigus vulgaris?

A

Pemphigus vulgaris

53
Q

Is pemphigus vulgaris Nikolsky negative or positive?

A

Positive

54
Q

Mucosal lesions are typical in pemphigus vulgaris. T/F

A

True

55
Q

Where are the mucosal blisters in pemphigus vulgaris found?

A

Eyes, genitals

56
Q

What is the prognosis for 1) pemphigoid and 2) pemphigus

A

If treated both conditions are chronic but self-limiting over a period of months-years. Untreated pemphigus has a high mortality rate due to the infection risk.

57
Q

What investigations are indicated in suspected cases of pemphigus and pemphigoid?

A

Skin biopsy with direct immunofluorescence

Indirect immunofluorescence

58
Q

How is pemphigus and pemphigoid treated?

A

Systemic steroids (mainstay)
Immunosuppression (methotrexate, azathioprine)
Tetracycline antibiotics (pemphigus specific)
Topical emollients
Topical steroids

Year 2 (72 decks)

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