derm Flashcards
1
Q
what is the treatment for syphilis?
A
IM benzylpenicillin
2
Q
how does lymes disease present?
A
early= erythema migrant (expanding 'bullseye' target lesion) late= arthritis, neuropathy and encephalopathy
3
Q
what is the treatment Lyme disease?
A
doxycycline
4
Q
who is chickenpox more severe in and what should they be given?
A
- extremes of age, pregnant and immunocompromised
- These groups may be given zoster immune globin (ZIG) and acyclovir
5
Q
what causes chicken pox?
A
-varicella zoster
6
Q
what is shingles treated with?
A
-acyclovir
7
Q
who is shingles more common in?
A
-elderly
8
Q
what causes shingles and chicken pox?
A
varicella zoster
9
Q
what is this?
A
shingles
10
Q
what is the treatment for herpes simplex virus (HSV)?
A
topical/ oral acyclovir
11
Q
what is the treatment for human pappilomavirus (viral warts)?
A
-regular topical keratolytic (salicylic acid) or cryotherapy
12
Q
what is molluscum contagious?
A
- pexvirus, fleshy, pearlescent nodules
- contagious
- common in children
- can be sexually transmitted
- self limiting/ cryotherapy is the treatment
13
Q
what is herpangina, investigations and treatment?
A
- a sudden viral illness commonly seen in children
- causes painful oral mucosal blistering
- diagnosed using swab/stool PCR diagnosis
- is self limiting
14
Q
what causes herpangina?
A
coxsackie virus
15
Q
what causes hand, foot and mouth disease?
A
coxsackie enterovirus
16
Q
how does hand, foot and mouth present?
A
- discolored lesions on hands, feet and mouth
- presents in children and family outbreaks
17
Q
what is erythema infectiosum also known as?
A
slapped cheek disease
18
Q
how does erythema infectiosum (slapped cheek disease) present?
A
-slapped cheek appearance and macular rash
19
Q
what causes erythema infectiosum and how is it diagnosed?
A
- Parovirus B19
- diagnosed with IgM blood test, can also cause chronic anaemia which may be seen in blood test
20
Q
what is orf?
A
-self limiting infection from farm animals-causes a firm fleshy nodule and is common in farmers
21
Q
what is this?
A
ring worm
22
Q
how is different types of ring worm named?
A
named according to site: Tinea corpis= body Tinea barbae= beard Tinea cruris= groin Tinea pedis= feet Tinea capitis= head Tinea unguium= nails
23
Q
what is candida and how does it present?
A
- GI commensal which grows in moist skin
- irritating, peeling, erythematous rash with satellite lesions
oral candidiasis= white, creamy, pseudomembranous plaques, common after oral antibiotics
thrush= vaginal candidiasis
24
Q
who is vaginal candidiasis common in?
A
diabetics
25
what is used to treat ring worm?
topical terbinifine
26
what is used to treat candidiasis?
topical azole/ nystatin
27
how does scabies present?
- widespread itchy rash that is worse at night
| - curved burrows
28
what is scabies?
-infestation with sarcoptes scabiei
29
what is the treatment for scabies?
-topical permethrin overnight
30
what is the treatment for lice?
-dimeticone wash
31
are melanocytes naevi malignant or benign?
-benign proliferation of melanocytes
32
describe a junctional melanocytes naevi?
- involves the DEJ
| - pigmented macule
33
describe a compound melanocytic naevi?
- involves the DEJ and dermis
| - raised/pigmented
34
describe a intradermal melanocytes naevi?
- involves the dermis
| - raised non pigmented
35
describe an atypical melanocytes naevi?
-large/irregular/varies pigment
36
what is sebhorrhoeic keratosis?
-common benign lesion in elderly that has a rough/warty, stuck on appearance
37
what are solar lentignes?
- common benign lesion in the elderly
| - pigmented patches on sun exposed sites
38
what are some pre malignant lesions that can progress to a SCC?
- bowen's disease
| - actinic keratosis
39
what is actinic keratosis?
-rough/scaly/erythematous patch that can progress to BCC/SCC
40
what is Bowen's disease?
-slowly enlarging erythematous, scaly patch that can progress to SCC (SSC in situ)
41
what is the treatment for actinic keratosis and Bowen's disease?
-removal (cryotherapy/curettage)+/- topical 5 fluorouracil/imiquimod
42
what is lentigo maligna?
-changing pigmented macule with irregular border/pigmentation that can lead to a melanoma (melanoma in situ)
43
what is the treatment for lentigo maligna?
-excision
44
what cells do basal cell carcinomas arise from?
basal cells
45
what is a risk factor for BCC?
-repeated sunburn
46
how do BCC present?
- nodular-painless
- slow growing
- pearly
- aborising vessels
- central ulceration
47
are BCC or SCC more likely to metastasise?
- BCC has low metastatic risk but invades local tissue ('rodent ulcer')
- SCC higher metastatic risk
48
what is the treatment for a BCC?
-excisional biopsy
49
what is the treatment for SCC?
excisional biopsy (+/- chemo/radiotherapy)
50
what cells do SCC arise from?
suprabasal cells
51
what are risk factors for SCC?
- chronic sun exposure
| - transplant
52
how do SCC present?
- painful
- fast growing
- hyperkeratotic
- bleeding
- inflamed
- poorly defined
53
where do melanomas arise from?
melanocytes
54
what are risk factors for melanoma?
- sun damage
- family history
- immunosuppression
55
what are the two phases of melanoma growth?
1. Radial where it grows horizontally
| 2. Vertical where it grows vertically (this allows metastasis)
56
how is malignant melanoma diagnosed?
```
ABCDE approach
Assymetrical
Border irregular
Colour variable
Diameter >6mm
Evolution/change
```
57
what are the different types of malignant melanoma?
- superficial spreading (most common)
- lentigo maligna melanoma (arises wihin lentigo maligna)
- nodular melanoma
- acral lentiginous (affects nails/palms/soles)
58
what is used to determine prognoses of malignant melanoma?
-Breslow thickness (top of granular layer to base of tumour measured in mm)
59
what is erythema nodosum associated with?
Sarcoidosis
| -tender, erythematous nodules on legs
60
what is necrobiosis lipodica?
yellow/brown/red patches on legs associated with diabetes
61
what is acanthosis nigricans?
-skin thickening/pigmentation in flexural area associated with diabetes
62
what is dermatitis herpetiformis?
-immunobullous disease characterised by itchy vesicular rash and is associated with coeliac
63
what is a heliotrope rash?
-red/purple rash around the eyelids associated with dermatomyositis
64
what is sclerodactyly?
-digit skin thickening associated with systemic sclerosis
65
what is a malar/butterfly rash?
-erythema on cheeks and bridge of nose associated with SLE
66
what causes an arterial ulcer?
poor arterial blood supply
- hypertension
- smoking
- obesity
- PVD
67
how does an arterial ulcer present differently than a venous ulcer?
arterial ulcer= punched out and painful
| venous ulcer= commoner, painless and on medial malleolus
68
what is the treatment for an arterial ulcer?
- hygiene, analgesia, vascular surgery
| - should avoid compression!!
69
what causes a venous ulcer?
- poor oxygenation secondary to venous hypertension
| - peripheral oedema, stasis dermatisis, lipodermatosclerosis
70
what is the treatment for a venous ulcer?
- compression
- diuretic
- support stockings for life
71
what is the pathophysiology of pemphigus vulgaris?
- IgG autoantobodies attack desmoglein 3
- desmogleins responsible for desmosomal attachments
- affects epidermis
72
what does histology show for pemphigus vulgaris?
-blisters within the epidermis
73
what will immunoflourescence show for premphigus vulgaris?
- honeycomb arrangement
| - corresponds to desmoglein on outer cell surface
74
how does pemphigus vulgaris present?
- itchy rash and superficial blisters/erosions and mucosal ulcers
- Nikolskys sign positive (top layers slip away when rubbed)
- potentially fatal
- usually presents in adulthood
75
what is the treatment for pemphigus vulgaris?
- prednisone and immunomodulators
| - immunomodulators are methotrexate, azathioprine, ciclosporin
76
what is the pathophysiology behind bullous pemphigoid?
- IgG autoantibodies attack hemidesmosomes
| - hemidesmosomes anchor basal cells to the basement membrane
77
what is the histology of bullous pemphigoif?
sub epidermal blisters
78
what would the immunoflourescence show for bullous pemphigoid?
linear arrangement
79
how does bullous pemphigoid present?
Causes large, itchy tense bullae. Usually presents in elderly. Nikolsky’s negative.
80
what is the treatment for bullous pemphigoid?
Localised:topical superpotent steroids
Widespread: prednisolone +/- immunomodulators
81
what type of mutation is NF1?
-autosomal dominant mutation of NF1 gene
82
what are skin signs for NF1?
- neurofibromas
- cafe au lait patches
Eyes- lisch nodules, optic glioma
83
what mutation is tuberous sclerosis?
-autosomal dominant/sporadic mutation of TSC1 or TSC2
84
what type of tumours does NF1 cause?
benign tumours of nervous tissue
85
what type of tumours does tuberous sclerosis cause?
-benign tumours of various organs
86
how does tuberous sclerosis present?
- ash leaf macule, periungal fibromas, shagreen patches
- cortical tubers can cause epilepsy
- can cause kidney, heart and lung tumours
87
what is associated with IBD?
erythema nodusum
88
treatment acne
