'cosmetic' Flashcards
what type of disease is alopecia areata
autoimmune
how many patient will have hair regrowth in alopecia areata
50% 1 year, 80-90% eventually
mx alopecia areata
topical steroids // topical minoxidil // phototherapy // dithranol // immunotherapy
what are port wine stains
vascular birth marks, deep red or purple, do not sponatenously fade but become darker and raised over time
mx port wine stains
laser therapy
what are salmon patches
vascular birth mark at birth // pink, blotchy, on forehead or eyelid or neck // fade over time
how common are salmon patches
50% babies
what are spider naevi
flat, under the skin papule surrounded by capillaries // blanch under pressure // on upper part of body
how to differentiate spider naevi from telangectasia
press on them –> spider naevi fill from centre vs telangectasia from the edge
assoc spider naevi
liver disease, pregnant, COCP
what is a sebacous cyst
proliferation from epidermal cells in dermis (epidermoid), or from hair follicle (pilar)
where do sebacoues cysts usually occur
scalp, ears, face, upper arm
mx sebaceous cyst
excision
what are actinic lentigenes
UV spots - flat macular areas of pigment
what are melanocytic naevi
dark birth marks
type of melanocytic naevi
usual, dysplastic, halo, blue
where do keloid scars form
connective tissue of a scar and extend beyond the wound
RF keloid
dark skin + young
most common keloid locations
sternum –> shoulder –> neck –> face –> extensors –> trunk
what type of incisions reduce risk of keloids
relaxed tension lines
mx keloids
intra-lesional steroid eg triamcinolone // excision
1st line mx hyperhidrosis
aluminium chloride preparation
other mx hyperhidrosis
iontophoreses // botulinum injection (armpit) // surgery - endoscopic thransthoracic sympathectomy
SE surgery for hyperhidrosis
compensatory swelling
first aid mx heat burns
within 20 mins irrigate with cool water for 10-30 mins, cover in cling film
what is wallaces rule of 9’s assessing burns
head + neck = 9% // each arm = 9% // ant leg = 9% // post leg = 9% // ant chest = 9% // post chest = 9% // ant abdo = 9% // post abdo = 9%
most accurate chart for burn extent
lund and browder
appearance superficial (1st degree) burn
red, painful, no blister
appearance partial thickness (superficial dermal) burn
pale pink, blistered, slow cap refill
appearance partial thickness (deep dermal) burn
white, some patches of non-blancing erythema, reduced sensation, pain on deep pressure
appearance full thickness burn
white, brown, black, no blisters, no pain
what is the TBSA assessment
palmar surface = roughly 1% of body (not that accurate)
which burns need referall
all deep dermal + full thickness // superficial burns >3% TBSA in adults or >2% in kids // face, hand, feet, genitalial, circumference burns // inhalation injury // electrical or chemical
complications severe burns
inflamm cytokenes / / hypovolaemic shock from loss of fluid // catabolic // immunosuppressed // bacterial translocation from the gut // Curling ulcers (peptic) // ARDS // protein loss
ABCDE mx severe burns
A consider intubation of inhalation, deep burns to face or neck // C = IV fluid if 10% burn kids, 15% adult // C = catheter if 5% burn kid, 10% burn adult
what are escharotomies + when are they indicated in burns
division of encasing of burn tissue to improve ventilation or relieve compartment syndrome // circumferential, full thickness torso and limb burns
when is fluid resus indicated post burn
> 15% body adult or >10% child
what formula is used for burn fluid resus
Parkland
what fluid should be used in burn resus
crystalloid only eg hartman’s
formula burn resus
4ml x (total burn surface % x body weight kg) // 50% in first 8 hours, 50% next 16
resus end point burns
UO 0.5 - 1
after 24 hours of burns resus what fluids are given
colloid infusion + maintenance cytstalloid (dextrose - saline)
what is a Keratoacanthoma
deep red lesion that grow quickly over a few days –> necroses + fall off
Pyogenic granuloma presentation
granulation growth at trauma site –> ulcer + bleed on contact –> curettage + cautert
