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Dermatology > Clinical features & cases of rash > Flashcards

Clinical features & cases of rash Flashcards

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Dermatology Board Prep flashcards
1
Q

Which factors cause/contribute to psoriasis?

A

Genetics, infections, drugs, stress, alcohol

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2
Q

Name a few common medications which can trigger psoriasis

A

Bipolar medication, beta-blockers

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3
Q

What is the most common form of psoriasis?

A

Psoriasis vulgaris (chronic plaque psoriasis)

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4
Q

How does psoriasis vulgaris present?

A

Symmetrically distributed sharply demarcated, scaly, erythematous plaques

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5
Q

Where are the common sites of psoriasis vulgaris?

A

Extensors, scalp, sacrum, hands, feet, trunk, nails

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6
Q

List the types of psoriasis

A

Psoriasis vulgaris, guttate, palmoplantar pustular, nail disease, erythrodermic/widespread pustular

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7
Q

What does guttate psoriasis look like?

A

Small, circular lesions

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8
Q

What is the koebner phenomenon?

A

Psoriasis which arises in areas of trauma

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9
Q

What are the features of psoriatic nail disease?

A

Onycholysis, nail pitting, dystrophy, subungal hyperkeratosis

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10
Q

What are the topical treatments for psoriasis?

A

Vitamin D analogues, coal tar, steroid ointments, emollients

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11
Q

Name two vitamin D analogues

A

Calcipotriol and calcitriol

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12
Q

What are the other (i.e non-topical) treatments for psoriasis?

A

Phototherapy (UVB and PUVA), retinoids, immunosupressants (methotrexate and ciclosporin), fumaric acid ester, immune modulators (TNF blockers, etc)

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13
Q

What is a retinoid?

A

Vitamin A analogue

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14
Q

Psoriasis is associated with obesity. T/F

A

True - there is some improvement of psoriasis with weight loss

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15
Q

Roughly which percentage of psoriasis patients will develop psoriatic arthritis?

A

20%

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16
Q

What is acne vulgaris?

A

Chronic inflammatory disease of the pilosebaceous units

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17
Q

When does acne present? What is the difference between males and females?

A

After puberty. Males present in their later teens while females present in their early teens

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18
Q

How does acne vulgaris present?

A

Comedones, pustules, papules and cysts

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19
Q

What are the secondary features of acne vulgaris?

A

Atrophic & ice-pick scars. Texture changes. Keloid scars (rare)

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20
Q

Describe the acne grading system

A

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

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21
Q

How is acne treated?

A

Avoidance of oily substances and triggers, topical and systemic treatments

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22
Q

What are the topical treatments of acne?

A

Benzoyl peroxide (keratinolytic), retinoids, topical antibiotics

23
Q

What are the systemic treatments of acne?

A

Antibiotics, isotretinoin (oral retinoid)

24
Q

Give an example of a topical retinoid which can be used in the treatment of acne. What is main side effect of this?

A

Adapalene. Drying out of skin

25
Q

Which acne medication initially causes an aggrevation of the acne?

A

Isotretinoin

26
Q

What are the side effects of isotretinoin?

A

Hepatitis, photosensitivity, dry lips, increased cholesterol

27
Q

What precaution must be taken with the prescription of isotretinoin to women of child bearing age?

A

Contraceptive use

28
Q

How can bad medication-induced acne flares be treated?

A

Oral steroids and dapsone (for anti-inflammatory effects)

29
Q

Where does rosacea typically present?

A

Nose, chin, cheeks and forehead

30
Q

How does rosacea present?

A

Papules, pustules and erythema without comedones. Telangiectasia. Rhinopyma

31
Q

Which factors can exacerbate rosacea?

A

Spicy food, alcohol, change in temperature, sunlight

32
Q

In which age group does rosacea typically present?

A

Middle aged

33
Q

How is rosacea managed?

A

Avoidance of aggravating factors and topical steroids, use of high factor sunscreen, antibiotics, isotretinoin (severe), topical vasoconstrictor (for erythema)

34
Q

Which antibiotics are used to treat rosacea?

A

Topical metronidazole, oral tetracylcine (long term)

35
Q

How can telangiectasia be managed? How can rhinopyma be managed?

A

Vascular laser. Surgery or laser shaving

36
Q

A useful reminder to differentiate between bullous pemphigoid and pemphigus vulgaris

A

PemphigoiD - Deeper (DEJ)

PemphiguS - Superficial (intra-epidermal)

37
Q

In which age group does bullous pemphigoid typically present?

A

Elderly patients

38
Q

What is the typical distribution of bullous pemphigoid?

A

Localised to one area or widespread on the trunk and proximal limbs

39
Q

What do bullous pemphigoid blisters look like?

A

Large and tense blisters on normal or erythematous skin which burst to leave erosions

40
Q

Bullous pemphigoid has a high risk of scarring. T/F

A

False - doesn’t scar

41
Q

Describe an atypical presentation of bullous pemphigoid

A

Itchy erythematous plaques and papules

42
Q

What is the nikolsky sign?

A

Slight rubbing of the skin will cause the top layers to slip away from the bottom layers

43
Q

Is the nikolsky sign positive or negative in bullous pemphigoid?

A

Negative

44
Q

What is the likelihood of mucosal involvement in bullous pemphigoid?

A

Un

45
Q

What is the typically distribution of pemphigus vulgaris?

A

Scalp, face, axillae and groin

46
Q

What do pemphigus vulgaris blisters look like?

A

Flaccid and thin-roofed vesicles/bulla which rupture to leave raw areas

47
Q

There is an increased infection risk when pemphigus vulgaris blisters rupture. T/F

A

True

48
Q

Is the nikolsky sign positive or negative in pemphigus vulgaris?

A

Positive

49
Q

What is the likelihood of mucosal involvement in pemphigus vulgaris?

A

High (eyes and genitals)

50
Q

What is the prognosis of pemphigus & pemphigoid? How long does it take the majority of patients to go into remissions

A

Chronic, self-limiting course which can vary in length from months to years. Three to six months

51
Q

What investigations are indicated for pemphigoid/gus?

A

Skin biopsy with direct immunofluorescence or indirect immunofluorescence

52
Q

How are pemphigus/goid treated?

A

Systemic steroids, immunosupressants (methotrexate, azathioprine, ciclosporin, mycophenlate), topical emollients, topical steroids

53
Q

Which treatments are just indicated in pemphigoid?

A

Tetracycline antibiotics, nicotinamide

Dermatology (26 decks)

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