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ICA > Common Skin Conditions > Flashcards

Common Skin Conditions Flashcards

1
Q

Clinical features of atopic eczema/dermatitis

A
  • Pruritus
  • flexural
  • can occur in response to triggers
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2
Q

What is atopic eczema/dermatitis?

A

Dry itchy inflammed skin
Erythema
Flaking

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3
Q

Common history of atopic eczema/dermaitis

A
  • often begins in childhood
  • atopy
  • family history
  • recent change in soaps, fabric softeners etc.
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4
Q

Presentation of eczema

A
  • dry, red, itchy patches of skin
  • often in flexor surfaces, face + neck
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5
Q

What could be a trigger for atopic eczema/dermatitis?

A

Smoke
Soap
Perfume
Excessively dry skin

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6
Q

Diagnosis of atopic eczema/dermatitis

A

Clinical diagnosis

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7
Q

Treatment of atopic eczema/dermatitis

A
  • education + support
  • avoidance of triggers
  • systemic therapy
  • topical: emollients, soap substitutes, steroids, phototherapy
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8
Q

Treatment of eczema flares

A
  • thicker emollients
  • topical steroids
  • wet wraps
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9
Q

two types of emollients + examples

A

_Thin creams_
- E45
- cetraban cream
- aveeno cream
- eparderm cream
.
_Thick, greasy emollients_
- 50:50 ointment
- cetraban ointment
- epaderm ointment
- hydromol ointment

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10
Q

What advice should be given to a patient for emollient use?

A
  • least to most effective: lotions > creams > ointments
  • wash and dry hands thoroughly
  • apply in the direction of hair growth
  • if in a pot, do not use your fingers to remove - instead use a clean spoon or stick
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11
Q

Stepwise steroid ladder from weakest to most potent

A
  • hydrocortisone 0.5%, 1%, 2.5%
  • eumovate
  • betnovate
  • dermovate
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12
Q

What advice should be given to patients for topical steroid use?

A
  • wash and dry hands thoroughly
  • apply finger tip amount for area represented by both palms
  • avoid using with emollients as it will dilute the steroid + reduce the effectiveness
  • week on, week off schedule
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13
Q

What is eczema herpeticum?

A

viral skin infection in patients with eczema caused by herpes simplex virus or varicella zoster virus

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14
Q

Presentation of eczema herpeticum

A
  • widespread, painful, vescicular rash
  • lethargy
  • fever
  • reduced oral intake
  • lymphoadenopathy
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15
Q

Management of eczema herpeticum

A

viral swabs of vesicles
aciclovir

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16
Q

Describe acne vulgaris

A

Formation of comedones, papules, pustules, nodules + cysts due to inflammation of pilosebaceous units

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17
Q

Causes of acne vulgaris

A
  • increased sebum production
  • excessive deposition of keratin in pores/pilosebaceous unit
  • overgrowth of cutibacterium acnes
  • pro-inflammatory chemicals released in skin
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18
Q

Diagnosis of acne vulgaris

A

Clinical diagnosis

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19
Q

Management of acne vulagris

A
  • topical benzoyl peroxide
  • topical retinoids
  • topical antibiotics e.g. clindamycin
  • oral antibioitcs e.g. lymecycline
  • COCP
  • oral retinoids as last line option e.g. isotretinoin/roaccunate - contraception needed in females
  • consider psychological impact
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20
Q

Why is contraception needed if a woman is on isotretinoin?

A

it is highly teratogenic

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21
Q

Mechanism of action of isotretinoin/roaccutane

A

it is a retinoid
reduces sebum production
reduces inflammation
reduces bacterial growth

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22
Q

Side effects of isotretinoin/roaccutane

A
  • dry skin + lips
  • photosensitivity
  • depression, anxiety, aggression
  • suicidal ideation
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23
Q

What is the most effective combined contraceptive pill for acne + why?
Why is it not prescribed long term?

A

Co-cyprindiol (dianette)
due to its anti-androgen effects
Risk of thromboembolism

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24
Q

Common history of psoriasis

A
  • chronic skin condition
  • equally in men + women
  • often between 20-30s + 50-60s
  • genetic predisposition
  • relapsing + remitting
  • identify triggers or iatrogenic cause
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25
Q

Describe psoriasis

A
  • White flaky scales
  • raised rough plaques
  • often over extensor surfaces + scalp
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26
Q

Name and describe 3 specific signs suggestive of psoriasis

A
  • auspitz sign: small points of bleeding when plaques are scraped off
  • koebner phenomenon: development of psoriatic lesions to areas of skin affected by trauma
  • residual pigmentation of the skin after the lesions resolve
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27
Q

Associated changes/conditions of psorasis

A
  • psoriatic arthrisits
  • nail psoriasis > pitting, oncholysis, thickening, ridging
  • psychological implications e.g. depression, anxiety
  • increased risk of melanoma (SPF use)
28
Q

Diagnosis of psoriasis

A

Clinical diagnosis

29
Q

Types of psoriasis

A
  • plaque psoriasis
  • guttate psoriasis
  • pustular psoriasis
  • erythrodermic psoriasis
30
Q

Cause of psoriasis

A
  • chronic autoimmune condition
  • T cell cytokine production is stimulated > keratinocytes proliferation
  • rapid generation of new skin cells > abnormal build up + thickening of skin in those areas
31
Q

Management of psoriasis

A
  • dovobet + enstilar: potent steroid + vitamin D analogues
  • topical steroids
  • topical calcipotriol (vitamin D analogues
  • topical tacrolimus in adults
  • phototherapy with narrow band UVB light
  • methotrexate, cyclosporine or retinoids if severe
32
Q

Presentation of erythema nodosum

A
  • red, raised, inflamed, subcutaneous nodules across both shins
  • nodules can be painful + tender
33
Q

Causes of erythema nodosum

A

NODOSUM
- NO cause
- Drugs
- Over counter prescriptions
- Sarcoidosis + Streptococcus
- Ulcerative colitis + Crohn’s disease
- Materinity Mycobacterium

34
Q

Investigations if a person has erythema nodosum + why

A
  • inflammatory markers
  • throat swab - for strep infection
  • chest X ray - for sarcoidosis or TB
  • stool microscopy + culture- for salmonella or campylobacter
  • faecal calprotectin - for IBD
35
Q

Management of erythema nodosum

A
  • investigations to find underlying conditions/cause
  • rest + analgesia
36
Q

Describe urticaria (hives)

A
  • Central swelling of variable size (red or white) with area of erythema
  • Itchy
  • Wheels
  • Wide distribution (often)
  • Fleeting nature, with skin returning to normal within 1-24 hours
  • Associated with angio odema + flushing
37
Q

Pathophysiology of urticaria

A

Mast cell degranulation + histamine release > increased capillary permeability + leakage of fluid into surrounding tissue

38
Q

Types of urticaria

A

acute urticaria (often allergies)
chronic urticaria (autoimmune)

39
Q

Treatment of urticaria

A
  • identify + avoid trigger
  • general education
  • H1 antihistamines fexofenadine
  • add on H2 antihisatmine ranitidien if persists
  • oral steroids for severe flares
40
Q

What is molluscum contagiosum?

A
  • Viral skin infection
  • Small firm spots that have a dimple in the middle
  • Often in children
  • Due to pox virus
  • self limiting
41
Q

Treatment of molluscum contagiosum

A

Self limiting

42
Q

What is shingles?

A
  • Viral skin incfection
  • Due to herpes zoster virus
  • Painful rash
  • Tingling sensation prior to rash
  • Vesicles in dermatomal pattern
43
Q

Treatment of shingles

A
  • Antivirals
  • Avoiding particular patient groups e.g. immunosuppressed, patient, not had chickenpox
44
Q

What is hand, food and mouth disease?
presenation

A
  • caused by coxsackie A virus
  • starts with typical URTI symptoms
  • 1-2 days later mouth ulcers appear
  • then red blistering spots across the body
45
Q

Management of hand, foot + mouth disease

A
  • Supportive management with adequate fluid intake, simple analgesia
  • highly contagious education for avoiding transmission
46
Q

Types of viral skin infections

A

Shingles
Molluscum contagiosum
hand food + mouth

47
Q

Types of bacteria skin infections

A

Impetigo

48
Q

What is impetigo

A
  • Bacterial skin infection
  • highly contagious
  • due to staph aureus or strep pyogenes
  • in areas of broken skin
49
Q

What is impetigo caused by?

A

Staph aureus (golden crust formation)
Strep pyogenes

50
Q

management of impetigo

A
  • topical mupirocoin antibiotic cream
  • oral flucloxacillin if severe or widespread
  • hydrogen peroxide cream if in one area (not commonly used)
  • education on hand hygiene, avoid sharing towels + cutlery
  • off school until lesions have healed
51
Q

Types of fungal skin infections

A

Dermatophytosis infection

52
Q

What is dermatophytosis infection?

A
  • superficial fungal infection
  • spread by direct contact
53
Q

Treatment of dermatophytosis infection

A
  • topical antifungals
  • advice: wash towels often, keep skin dry
54
Q

Types of skin cancer

A

Malignant melanoma
Squamous cell carcinoma
Basal cell carcinoma

55
Q

Main cause of malignant melanoma

A

UV light exposure

56
Q

Risk factors of malignant melanoma

A

Pale skin
Red/blonde hair
Lots of freckles
Family history
Sun exposure

57
Q

Treatment of malignant melanoma

A

Surgery
Radiotherapy if spread
Avoid prolonged sun exposure + use sun protection

58
Q

What is malignant melanoma?

A

Cancer from melanocytes

59
Q

What is squamous cell carcinoma characterised by?

A
  • abnormal + accelerated growth of squamous cells
  • in areas exposed to sun
  • non healing ulcer
60
Q

Treatment of squamous cell carcinoma

A
  • referral to specialist for skin biopsy to confirm
  • avoid prolonged sun exposure + use sun protection
  • surgery to remove lesion
  • teach patient how to check their skin for new/changing lesions + taking photos of them with tape measure if found
61
Q

Most common type of skin cancer

A

Basal cell carcinoma

62
Q

What does basal cell carcinoma look like?

A
  • shiny skin coloured bump
  • is translucent
  • glossy looking
63
Q

Compare the age demographic effected between squamous and basal cell carcinoma

A

Squamous: middle age or older
Basal: older adults

64
Q

Cause of basal cell carcinoma

A

When one of the skin’s basal cells develops a mutation in its DNA
Often due to UV radiation

65
Q

Management of basal cell carcinoma

A
  • referral to specialist for skin biopsy to confirm
  • avoid prolonged sun exposure + use sun protection
  • surgery to remove lesion
  • teach patient how to check their skin for new/changing lesions + taking photos of them with tape measure if found

ICA (13 decks)

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