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Finals Revision - Last Min > Derm > Flashcards

Derm Flashcards

1
Q

Treatment of scalp psoriasis?

A

Potent steroids for 4 weeks

If no improvement, consider using something to break up adherent scale (salicylic acid/oils) and a different formulation of potent steroid (shampoo/mousse)

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2
Q

Red papule with surrounding capillaries which blanch on pressure?
Causes?

A

Spider naevi

Liver disease, COCP, pregnancy (increased oestrogen)

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3
Q

Acne treatment ladder?

A
  1. topical retinoid/benzoyl peroxide
  2. Combination topical therapy - retinoid/benzoyl peroxide/abx
  3. Oral antibiotic - tetracycline (or erythromycin in pregnancy, breastfeeding, young) WITH topical retinoid or benzoyl peroxide - at least 3 months
  4. WOMEN only - COCP or co-cyrindiol (dianette) - increased risk of VTE compared to COCP, 3 months max
  5. Oral isotretinoin
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4
Q

3 types of BCC?
typical description?
Type of referral?
Management options?

A

Nodular, superficial, infiltrative

Pearly skin coloured papule with telangiectasia which ulcerates in centre, with picket fence border

Routine referral

Leave alone
Surgical removal - conventional or Mohs
Topical: imiquimod/5-FU

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5
Q

Atopic eczema distributon in infants vs children and adults?

Yellow, weeping crust over eczema?

A

infants - face and extensor surfaces (napkin area and flexural surfaces spared)

Older - flexural surfaces esp wrist, cubital fossa, popliteal fossa and ankles

GAS infection

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6
Q

Most common cause of erisypelas?

When is Rx given IV?

A

Strep Pyogenes

Facial - cavernous sinus drainage - need to avoid

Also give IV if Staphylococcal Scalded Skin Syndrome

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7
Q

Apart from shins, where else can erythema nodosum happen?
Causes?
How long to heal?

A

Forearms, thighs

No cause (60%)
Infection - strep, TB
Sarcodosis
IBD
Behcet's
Malignancy
Pregnancy
Drugs - penicillins, COCP

Heals in 6 weeks without scarring

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8
Q

Keratoacanthoma?

Management?

A

Benign epithelial tumour more common in elderly

initially smooth dome-shaped papule that rapidly grows to become a crated centrally filled with keratin

Spontaneous regression within 3 months but scars. However, should be excised immediately to rule out SCC - this also prevents scarring

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9
Q

5 types of melanoma?

A

Superficial spreading - long radial growth phase, most common

Nodular - straight into vertical growth phase, bad prognosis

Acral lentigous - on palms/soles/subungal

Amelanotic - no pigment

Lentigo maligna - melanoma in-situ - very slowly progressive but may at some stage develop into malignant

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10
Q

Management of suspected melanoma?

Exception?

A

Excision biopsy - remove entire lesion

Lentigo maligna - can be large - take biopsies from darkest areas - topical imiquimod can give histological clearance

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11
Q

Breslow thickness relation to and excision margins?

A

<1mm - 1cm

1-2mm - 2 cm

2-4mm - 2-3cm

> 4mm - 3cm

<1mm = >95% 5-year survival
>4mm = <50%
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12
Q

Most molluscum contagiosum can just be left - when is referral needed? (3)

A

HIV with extensive lesions - HIV specialist

Eyelid margin or ocular - ophthalmologist

Adults with Anogenital - GUM to ensure it’s not something else

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13
Q

What vitamin deficiency causes pellagra?

What drug can cause it?

A

B3 - niacin
(3D’s - dermatitis, diarrhoea, dementia/depression)

Isoniazid - stops the conversion of tryptophan to niacin
Most common in alcoholics

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14
Q

Nail changes in psoriasis? (4)

A

Present in 80-90% with arthropathy

  • Pitting
  • Onycholysis
  • Subungal hyperkeratosis
  • Loss of nail
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15
Q

Pyoderma gangrenosum?

A

Initially small red papule, develops into deep, red, necrotic ulcer with violaceous border

Idiopathic 50%
Assoc w IBD, SLE, RA, blood cancers and PBC

Oral steroids

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16
Q

Pyogenic granuloma?
Who in?
Management?

A

Usually after trauma in young/pregnant women

Initially small red/brown spot, within days-weeks is raised spherical lesion, may bleed profusely or ulcerate (haemangioma)

Oral mucosal lesions common in pregnancy

Pregnancy-assoc spontaneously resolve post-partum
Otherwise, curettage and cauterisation

17
Q

What drugs CANNOT be prescribed with isotretinoin and why?

A

Tetracyclines - raised ICP

18
Q

Purple cutaneous nodule in immunosuppressed pt?

A

Kaposi sarcoma

19
Q

When might shingles cause facial palsy?

A

Ramsay Hunt Syndrome

Ear lesions and facial paralysis, can cause vertigo and deafness as well

20
Q

Excision margins for SCC?

A

If <2cm - 4mm margins

If >2cm - 6mm margins

Mohs microsurgery in high-risk pts or cosmetically important sites

21
Q

Strawberry naevus progression?

If Rx required eg blocking visual field?

A

Capillary haemangioma

Not present at birth, usually develops rapidly in first month of life

Increases in size until about 6-9 months, then starts to regress. 95% resolve by 10 years of age

May bleed, ulcerate or obstruct visual fields

If Rx required:

  1. Propanolol
  2. Topical timolol
  3. Oral steroids
22
Q 
Which HPV viruses cause:
- warts?
- genital warts?
- oral and cervical cancer?
Treatment of warts?
A

Warts: 1-4

Genital warts: 6/11

Cancer: 16/18/33

Rx: Salicylic acid, cryotherapy, podophyllum, imiquimod

Podophyllum/cryotherapy 1st line genital

23
Q

Porphyria cutanae tardis presentation?
Enzyme deficiency?
Woods lamp?

A

Middle aged men, common with liver disease (alcohol, hep, cirrhosis, haemochromatosis)

Blistering lesion on sun exposed sites that heal with scarring and hyperpigmentation

Uroporphyrinogen decarboxylase

Shines pink instead of blue

24
Q

Erythropoeitic porphyria presentation?

Enzyme deficiency?

A

AD disorder seen in children
May be no rash but will be painful burning and itching when exposed to sun - kid may scream in sun

Ferrochealatase

25
Q

Junctional vs compound naevi?

A

Junctional = flat

Compound = raised

26
Q

Widespread sunburn-like rash over body, including lips, with fever and sepsis?
What can cause this in women?

A

Staph toxic shock syndrome

Tampon use

Finals Revision - Last Min (12 decks)

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