Derm Flashcards
Eye involvement in molluscum contagiosum warrants what?
Urgent ophthal referral
What conditions are associated with spider naevi?
- Liver disease
- Pregnancy
- COCP
What does a Granuloma annulare look like and where are they located?
Papular lesions that are often slightly hyperpigmented and depressed centrally.
Typically occur on the dorsal surfaces of the hands and feet, and on the extensor aspects of the arms and legs
Management of scalp psoriasis?
NICE recommend the use of potent topical corticosteroids used once daily for 4 weeks. If no improvement after 4 weeks then either use a different formulation of the potent corticosteroid (for example, a shampoo or mousse) and/or a topical agents to remove adherent scale (for example, agents containing salicylic acid, emollients and oils) before application of the potent corticosteroid
Symptoms of CKD?
Lethargy & pallor
Oedema & weight gain
Hypertension
What is telogen effluvian?
Stress induced hair loss
Normal location for venous ulcers?
Above medial malleolus
Features of pemphigoid gestationis
pruritic blistering lesions
often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms
usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy
(oral corticosteroids are usually required)
Signs/Symptoms of lymphoma?
Night sweats
Lymphadenopathy
Splenomegaly, hepatomegaly
Fatigue
Management of chronic plaque psoriasis?
NICE recommend a step-wise approach for chronic plaque psoriasis
regular emollients may help to reduce scale loss and reduce pruritus
first-line: NICE recommend:
a potent corticosteroid applied once daily plus vitamin D analogue applied once daily
should be applied separately, one in the morning and the other in the evening)
for up to 4 weeks as initial treatment
second-line: if no improvement after 8 weeks then offer:
a vitamin D analogue twice daily
third-line: if no improvement after 8-12 weeks then offer either:
a potent corticosteroid applied twice daily for up to 4 weeks, or
a coal tar preparation applied once or twice daily
short-acting dithranol can also be used
Causes of Steven johnson syndrome?
penicillin sulphonamides lamotrigine, carbamazepine, phenytoin allopurinol NSAIDs oral contraceptive pill
Difference in surface area covering in SJS and TEN?
SJS <10% body covering
TEN >30% body covering
Where do keloid scars form?
common sites (in order of decreasing frequency):
sternum, shoulder, neck, face, extensor surface of limbs, trunk
Difference in pityriasis rosea and guttate psoriasis?
Guttate psoriasis = Rash followed by sore throat (strep throat) in teenagers
Pityriasis Rosea = URTI and HERALD PATCH, rash along skin tension lines
What is scarring alopecia and what are the causes?
It is hair loss caused by destruction of hair follicle.
trauma, burns radiotherapy lichen planus discoid lupus tinea capitis*
Management of acne rosacea?
Topical metronidazole may be used for mild symptoms (i.e. Limited number of papules and pustules, no plaques)
Topical brimonidine gel may be considered for patients with predominant flushing but limited telangiectasia
More severe disease is treated with systemic antibiotics e.g. Oxytetracycline
Essentially:
mild/moderate: topical metronidazole
severe/resistant: oral tetracycline (doxycycline).
Management of keloid scars?
Early keloids may be treated with intra-lesional steroids e.g. triamcinolone
Excision is sometimes required
Is there mucosal involvement in Bullous pemphigoid and pemphigoid vulgaris?
No mucosal involvement (in exams at least*): bullous pemphigoid
Mucosal involvement: pemphigus vulgaris
Features of Vitiligo?
well-demarcated patches of depigmented skin
the peripheries tend to be most affected
trauma may precipitate new lesions (Koebner phenomenon)
Difference in incision and drainage and surgical excision?
I&D - relieve Sx temporarily by draining cyst.
Surgical excision - remove permanently.
Risk factor for angular cheilitis?
Oral thrush: infancy, old age, diabetes, systemic corticosteroid or antibiotic use
Dentures, especially if they are poor fitting, and there is associated gum recession
Poor nutrition: coeliac disease, iron deficiency, riboflavin deficiency, zinc deficiency
Systemic illness, particularly inflammatory bowel disease (ulcerative colitis and Crohn disease)
Sensitive skin, especially atopic dermatitis
Genetic predisposition, for example in Down syndrome
Oral retinoid medication: isotretinoin for acne, acitretin for psoriasis.
