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Derm Flashcards

1
Q

2 commonest disease assoc with SJS

A

Preceding herpes simplex or Mycoplasma pneumoniae infections

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2
Q

How many cutaneous strawberry naevi should raise suspicion for internal lesions?

A

6 or more - need further investigation

AKA haemangioma

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3
Q

What is tinea incognito

A

Fungal skin infection in which the appearance has been altered by inappropriate tx with steroids

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4
Q

A very firm, white or violaceous patch of skin. As it develops it will have a well demarcated red/violaceous edge

A

Morphoea

As the lesions develops the edge will become the same colour as the center of the lesion, it will become very firm with an atrophic glazed surface appearance

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5
Q

Scabies can present with a rash on the body that is similar to eczema but should also have involvement of palms, soles and/or genitals T/F

A

T

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6
Q

Isotretinoin can cause hirsutism T/F

A

F side effect can be diffuse alopecia areata

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7
Q

What labs need to be monitored for a pt on isotretinoin

A

Serum lipids and LFTs - prior to tx, 4 weeks and maybe also 8 weeks

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8
Q

Pregnancy needs to be avoided in a pt on isotretinoin and for 6 months after tx T/F

A

F - For up to one month after tx

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9
Q

Haemangiomas are more common in what race and sex

A

White
Females x3 more common than males
Also more common in preterm infants

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10
Q

% resolution of haemangiomas by age

A

50% 5 yrs
70% 7 yrs
90% 9 yrs

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11
Q

Indications for tx of haemangiomas?

A
  1. Psychological distress
  2. Impinging on vital structures - vision, airway
  3. Ulcerated and bleeding
  4. Secondary infection
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12
Q

Steroids can be used in the tx of haemangiomas T/F

A

True - systemic or intralesional

Also beta blocker; subcut interferon gamma, laser or excision

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13
Q

The majority of haemangiomas are present at birth T/F

A

F - only 30% are present at birth

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14
Q

About half of haemangiomas leave some form of permanent skin change T/F

A

T - eg telangiectasiae, superficial dilated veins, epidermal atrophy

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15
Q

Port wine stain on a limb with associated soft tissue and bony over overgrowth. Can also have venous malformations. Syndrome?

A

Klippel-Trenauay syndrome

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16
Q

Tuberous sclerosis is associated with what skin abnormality?

A 
Hamartomas
Shagreen patches 
Ash leaf macules
Perungual fibromata
Facial angiofibromata
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17
Q

Features of pompholyx

A

Rare in children less than 10 yrs old
Sudden onset of crops of clear vesicles, usually bilateral involving fingers, toes, palms and soles. Often recurrent
Often hx of atopy

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18
Q

When is typical age of onset of epidermolysis bullosa simplex

A

Onset in early childhood, around the time child starts to walk

EB simplex is localised to fiction sites, usually hands and feet

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19
Q

When and where does chronic bullous disease of childhood usually present?

A

Usually > 3 yrs old (note older than EB simplex)
Lesions typically affect the peri anal area and spread to the trunk, thighs, limbs, hands and feet. There may also be mucosal involvement (mouth, genitals, eyes and nose)

AKA linear immunoglobulin A disease

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20
Q

What is the mechanism of action of UBV phototherapy for psoriasis

A

Induction of pyrimidine dimerisation

Note: disease is due to increased cell turn over

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21
Q

Classification of acne?

A

Mild: <20 comedones and < 15 inflammatory lesions (or less than 30 lesions total)
Mod: 20-100 comedones and 15 -50 inflammatory lesions (or 30-125 lesions total)
Severe: > 100 comedones, >50 inflammatory lesions and > 5 pseudocysts (or > 125 lesions total)

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22
Q

Where is dermatitis herpetiform classically?

A

Symmetrically distributed
On the extensor surfaces ( elbows, knees, neck) and back

Note: it is very itchy and comes and goes

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23
Q

Describe the hair loss and scalp findings in alopecia areata?

A

Hair loss is well circumscribed
Scalp is normal

Note: also can be assoc with nail changes.
In tinea capitis there is variable amount of erythema and scaling of the scalp

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24
Q

Presentation of telogen effluvium?

A

Sudden increase in hair shedding, diffusely, 3-4 months after an inciting event such as an illness, pregnancy, loss of loved one or medication.

Note: tx is reassurance only

Other causes of diffuse hair loss are hypothyroidism and Zn deficiency

25
Q

Most common cause of acute urticaria in children?

A

Viral trigger

26
Q

Keratoderma blenorrhagica is highly diagnostic of what disease?

A

Reactive arthritis

Note: they are brown aseptic abscesses on soles and palms

27
Q

What is the typical distribution of chronic bullous disease of childhood?

A

Typically affects the perianal area and spread to the trunk, thighs, limbs, hands and feet

Note: they are small tense blisters on an erythematous background

28
Q

What is the difference between SJS and TEN?

A

The amount of skin involved
SJS <10% (dense dermal neutrophilic infiltrate)
TEN > 30% (minimal to no dermal infiltrate)

Between 10 - 30% is SJS/TEN overlap

Note: erythema multiforme is when there is no mucosal involvement

29
Q

Differentiate vitaligo from piebaldism distribution?

A

Hands and feet are spared in piebaldism

30
Q

Gradually progressive red plaque, annular in shape with crusting and induration at the periphery and scaring at the centre. Tinea corporis vs Lupus vulgaris

A

Lupus vulgaris - most common manifestation of cutaneous TB. Starts as a painless reddish- brown nodules and then progresses to an irregular red plaque and can ulcerate if not treated

Note: tine corporis has a central clearing

31
Q

Papular lesions, symmetrically distributed, spaces trunk. Flat, monomorphous and flesh toned - brown in colour. What pathology?

A

Gianotti- Crosti syndrome (aka papular acrodermatitis of childhood)

32
Q

What is the most common infection associated with Gianotti- Crosti syndrome?

A

EBV

33
Q

What are the most common systemic manifestations of incontinentia pigmenti?

A

Dental changes (pegged teeth)
Nail changes
Alopecia
Retinal detachment due to neovascularisation is a serious complication

Note: derm manifestations have 4 overlapping stages -

  1. inflammatory vesicles and bull associated with eosinophilia (can have similar appearance to herpes)
  2. Warty lesions
  3. “Swirly” brown, bluish-grey pigmentation which first darkens and then slowly faded
  4. Hypopigmentation
34
Q

Recurrent episodes of smooth “glazed” erythema and fine scaling of toes and distal soles with sparing of the interdigital webs. What is the diagnosis and tx?

A

Juvenile plantar dermatosis

Avoid impermeable footwear and apply emollients

35
Q

Erythema nodosum is commonly associated with beta haemolytic strep T/F

A

T - also associated with other infections, sarcoidosis, Behcets, IBD and malignancy

36
Q

Occular features of albinism?

A

Photophobia
Decreased visual acuity/blindness
Nystagamus

37
Q

Albino individuals may be more susceptible to nephrotoxins T/F

A

F - they may be more susceptible to otoxotins due to decreased melanin within the cochlea

38
Q

What is the cause of id reaction/autoeczematization?

Tx?

A

Thought to be a type IV hyper sensitivity reaction to dermatophyte (such as those that cause tinea) or may be associated with a severe contact dermatitis
Tx: continue any anti fungal; symptomatic tx for itch and tapering steroids if severe

39
Q

Which rash is more widespread id reaction or drug reaction?

A

Drug reaction

Note: id reaction lesions begin and remain most prominent on the scalp, face and neck; they may spread to trunk though

40
Q

Hyperlinear palms are often seen in association with what skin condition?

A

Ichthyosis vulgaris

41
Q

Disorder of cornification characterised by dry, plate like (fish like) scales which are typically most prominent over the extensor surfaces of the extremities

A

Ichythosis vulgaris

42
Q

Tx for sebaceous nevus?

A

Elective surgical excision (when old enough to tolerate with local anaesthesia)
Or watchful waiting

43
Q

Where does dyshidrotic eczema typically affect?

A

Form of hand dermatitis –> palms, soles and sides of digits. Typically symmetrical

Note: Characterised by small firm multilocular vesicles and or bullae, pruritic. Associated with hyperhidrosis

44
Q

Spironolactone can be used as 2nd line tx for hidradenitis suppurative T/F

A

T - can be used in females for anti androgen properties. 1st line tx is antibiotics (topical and systemic)

Note: can use systemic steroids for severe cases

45
Q

What does a Wright stain in transient neonatal pustular melanosis show?

A

Neutrophils

Note: more common in darker skinned; pustules with a non erythematous base; often on scalp, neck, chin and trunk, typically rupture after several days, leaving behind a central hyper pigmented macule that is initially slightly scaly in appearance

46
Q

What does a Wright stain in E tox show?

A

Eosinophils

47
Q

What is the treatment of transient neonatal pustular melanosis?

A

Reassurance only

48
Q

Guttate psoriasis is associated with what bacterial infection?

A

Streptococcal infections

49
Q

Biopsy is required for diagnosis of lichen sclerosis T/F

A

F - clinical diagnosis

50
Q

Features of fatty acid deficiency?

A

Reduced growth velocity
Delayed neurodevelopment
Scaly dermatitis
Increased susceptibility to infection and poor wound healing

51
Q

Side effects of long term use of topical steroids?

A

Hypo-pigmentation
Telangiectasias
Atrophy

52
Q

What is the treatment of chronic bullies disease of childhood (aka Linear IgA bulls dermatosis)?

A

Dapsone.

Although tend to have spin remission of disease by puberty

53
Q

Crowe sign is a cutaneous findings associated with what disease?

A

NF 1

It is multiple freckles in the axilla/groin

54
Q

Medications associated with telogen effluvium?

A 
Betablockers
Amphetamines
ACEi
OCP
Retinoids
Li
55
Q

Alopecia areata is associated with a personal or family history of what disease?

A

Thyroiditis

T1 DM

56
Q

Brown skin lesion, appears at puberty, grows in size and becomes hairy about 1-2 yrs after first noted. What pathology and mgmt?

A

Becker nevus - more common in males

Mgmt: cosmetic intervention if desired by pt

Note: can be congenital but more often appear in adolescence

57
Q

Tx of granuloma annulare?

A

Topical steroids
Or watchful waiting - will usually resolve by itself in a period of months to years

Note: lesions are NOT scaly. They are smooth, enlarge slowly and surrounded by raised elevated borders made up of pustules and/or small nodules. Typically on dorsal or lateral surfaces of hands, feet or ankles.

58
Q

Nevus of Ota is commonly associated with___

A

Gluacoma and haemangioma of optic disc

Note: very rarely melanoma. Nevus of Ota aka oculodermal melanocytosis (blueish grey patchy irregular pigmentation in ophthalmic and/or maxillary distribution)

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