Derm Flashcards
Linear crusted leisons a few milimeters in length and intense itching pathognomic of? Usual locations? Rx
Scabies
Webbing of fingers / toes and nipples
Permethrin
Single very itchy area with serpiginous (wavey) tracks? Caused by? Most common body part?
Cutaneous Lava migrans
Hookworm
Foot
BCC prognosis post excision?
100% -
[Usually takes over 5 years to met]
Most common skin Ca? What does it look like
BCC
-Ulcer with a rolled edge
-Prominent fine blood vessels around edge
- Pearly / waxy nodule on skin
Suspected BCC referral speed?
Can be routine rather than usual urgent for Ca
What is Imiquimod?
Topical Rx option for BCCs
What is Vismodegib used for?>
Used for Rx of metastatic BCCs
[Targets hedgehog pathway signaling]
Surgery for BCC called
Mohs - Gets complete margin control
Tense itchy blisters in pregnancy? Basic Ix rx
Pemphigoid of pregnancy
Skin biopsies + immunofluorescence
Oral pred if bad
Urticated and plaques which are very itchy in pregnancy and SPARING umbilicus
Polymorphic eruption of pregnancy
Bullos pemphigoid description? Antibodies? Usual Ix/Rx? If bad?
Tense blisters
IgG Hemidesmomosal [BP180/BP230]
Biopsy + immunofluorescence
Oral pred
[Add Azathioprine / cyclosporin /mycophenolate]
Bullos pemphigoid description? Antibodies? Usual Ix/Rx? If bad?
Tense blisters
IgG Hemidesmomosal [BP180/BP230]
Biopsy + imunoflourescence [and blood imunoflourescence] will show IgG/C3 deposition
Oral pred [Add Azathioprine / cyclosporin / mycophenolate]
Cafe-au-lait patches + armpit freckles ? chromosome? When do these lesions get more pronounced and why?
Neurofibromatosis type 1
Chromosome 17 - Dominant inheritance
In pregnancy as usually oestrogen responsive
How is NF2 different to NF1? Characteristic finding? Chromosome
NF2 usually has CNS Lesions eg. swhanomas / meningiomas
Bilateral acoustic neuromas -> Tinnitus/deafness/vertigo
Chromosome 22 [for NF2]
Facial angiofibromas, periungual (toe/finger nail) fibromas and ‘ash leaf spots’?
How to see these best?
Tuberous sclerosis
Woods ultraviolet lamp
Small brown nodules on iris seen in what? called?
NF1
Lisch nodules - seen on slit lamp
Excoriated symmetrical papules on extensor surfaces of knees elbows, buttocks and back?
Commonly associated with?
Gene?
Diagnostic tests?
Rx?
Dermatitis herpetiformis [nothing to do with herpes]
Coeliac. Both are due to a gliardin [gluten] allergy
HLA DQ2, HLA DQ8
TTG antigen + skin biopsy [will show microabscesses in dermal papillae, granular IgA deposits]
[Can use endomysial antibody if TTG weakly positive]
Gluten free diet
Oral dapsone
Dematitis herpetiformis and don’t stick to gluten free diet risk developing?
Non Hodgkin lymphoma
Most common antibody in SLE? 2 others that are more specific but less sensitive?
Anti nuclear antibody
Anti-Ds DNA
Anti Sm
Anti-ccp antibody
Rheumatoid arthritis
[Present in 50-75%, indicates more agressive disease]
An anti-mitochondrial antibody found in?
Primary biliary cholangitis (90%)
Also found in SLE, though less frequent
Anti-smooth muscle antibody? other thing found in this condition?
Autoimmune hepatitis
IgG predominant polyclonal HyperGammaGlobulinaemia [found in 85%]
Rx rosacea
Topical metronidazole / azeliac acid
[can use oral tetracycline
Resistant cases may need isotrenatoin]
Bromonidine gel used for
Severe rosacea
Anti-ribosomal P antibodies in?
Cerebral SLE
cANCA ? common features with this
Granulomatosis with polyangitis
Sinusitis, renal vasculitis, mononeritis
Pulm haemorrhage later in disease
Super common DMARD in SLE arthritis
Hydroxychloriquine
Recurrent arterial / venous thrombosis + fetal loss
Antiphospholipid syndrome
Endocarditis / focal neurological lesions in lupus usually have which antibody
Anti-phospholipid
In SLE what does low C3/C4 levels indicate
Lupus nephritis
SLE with vital organ involvement Rx ? If refractory disease?
Steroids + immunosupression
[Azathioprine / methotrexate]
Plasma exchange + ritixumab
Yellow papules on skin [usually on neck]- looks like a plucked chicken?CV findings? Were else does it affect?
Pseudoxanthoma elasticum
Skin, Eyes, Cardiac
[Does sometimes give GI bleeding too!]
Mitral valve prolapse
Premature CV disease Eg CAD/claudication
What might you see in eyes of someone with Pseudoxanthoma elasticum? skin ?
Angiod streaks [dark red streaks by retinal vessles]
-> visual loss
Skin looks yellow and like plucked chicken
Symmetrical skin pigmentation on cheeks in women is called and usually seen in?
Melasma
Pregnancy
Target lesions (concentric rings) ? most commonly seen in?
Erythema multiform
Infection - Herpes/mycoplasma most common
[Also seen as a drug reaction some times - eg valproate, penicillin]
Target lesions (concentric rings) ? most commonly seen in?
Erythema multiform
Infection - Herpes/mycoplasma most common
[Also seen as a drug reaction some times - eg valproate, penicillin]
Pathogen causing a red, tender skin leison with induration and a sharply defined, rapidly progressing border
Strep pyogenes
Group A Beta haemolytic strep
ANIMALS in history -> Bald patch on scalp increasing in size caused by?
If no animals in history?
Rx of tinea capits?
Microsporum canis
Trichophyton tonsurans
[Both fungal infections causing tinea capitis]
Systemic antifungals
Microsporum canis characteristic finding on woods lamp?
Bright green fluroescence
What is Onychomycosis
fungal infection of nail
Key Ix if people have recurrent fungal infections
GTT
- as often the presentation of diabetes
pulmonary infiltrates + Halo sign on CT
Aspergillous
Cryptococcal meningitis. Staining on CSF?
India staining
Annular erythematous lesion with overlying scaling seen in?
Tinea Corporis
Recurrent skin infections usually mean s. aureus is producing what?
PVL
Staph aureus produces what in rapid bad food poisoning?
Enterotoxin
Toxic shock syndrome means s. aureus is producing what?
TSST-1
S Aureus producing these things usually leads to what?
1- PVL
2- Enterotoxin
3- TSST-1
1- PVL - recurrent skin infections
2- Enterotoxin - food poisoning
3- TSST-1 - toxic shock
Sandfly bite -> which infection? Usually presents as? Rx?
Leishmaniasis
Solitary ulcer
Sodium Stibogluconate
visceral leishmaniasis always has what?
Hepatosplenomegaly
Itchy flat topped papular rash on wrists and ankles. White ‘lacy’ or lined pattern of rash [often in mouth] is called what?. What is koebner phenonomen?
Lichen plannus
Whickam’s striae
Where rash colonises site of trauma a few days later
Vesicular eczema which affects soles, palms and fingers
pompholyx
Management of lichen planus
Topical steroids / tacrolimus
Oral steroids if bad
->UVB phototherapy / dmards
Plum coloured skin lesions [usually in haem onc]
Sweet’s syndrome
[sweet plums]
What is bowens disease
Slow growing scaly erythematous patches related to long term sun exposure
[may progress to SCC]
What are actinic keratosis
rough patches often itchy related to sun exposure
What is 5-flurorouracil cream used for
actinic keratosis or bowens
[Usually just cut them out if needed / cryotherapy]
Melanoma found on sole of the foot / pam ?
Acral lentiginous melanoma
[ACRA i just stood on something]
Most common melanoma
superficial spreading
Dark pigmented melanoma? found where ?
Nodular
Usually agressive and fast growing
Usually on legs/ trunk
Slowly expanding irregularly pigmented macule usually found in older people
Lentigo maligna melanoma
How does melanoma metastasise
through lymph
What determines prognosis of melanoma
breslow thickess
Lesions which usually found on legs start as papules/pustules which then breakdown into painful necrotic ulcers
Pyoderma gangrenosum
Bar legs where is a common place to get pyoderma gangrenosum
By stoma sites in pts with IBD
Differentiate PBC and PSC
Both have obstructive LFTs
PBC - anti-mitochondrial antibodies
PSC - link to IBD
PBC, how to confirm diagnosiss? initial therapy?
Liver biopsy (+anti-mitochondrial antibody)
ursodeoxychoic acid
[can add obeticholic acid if not working]
May need liver transplant in long run
clustered pearly papules with a central umbilicus. Often found in kids and immunocompromised? caused by? Usual Rx
Molluscum contagosum
pox virus
No treatment in immunocompetent
Photosensitive dermatitis, diarrhoea and dementia=? Cause?
What is the common cause of the cause?
Rx?
Pellagra
Due to niacin (vit D3) deficiency [DDD due to D3 deficiency]
Carconoid syndrome
[Serotonin production -> negative feedback on D3 production]
Niacin replacement
Rx of carcinoid eg somatostatin analogue Eg ocretide
Dermatitis lesions which appear overnight. Especially if Hx of self harm or psychiatric
Dermatitis artefacta
Viral infection -> large scaly oval patch -> similar smaller patches
Pityriasis rosea
Purpuric rash on buttocks and lower legs. Abdominal pain and vomiting (+/- GI bleed)? Usual age? Any other features? Management?
Henoch-schonlein-purpura
Usally 15-19 years old
Usually get renal involvement (nephritis / nephrotic syndrome)
Usually triggered by a respiratory infection
Usually supportive but may need pred
What is deposited in affected organs and raised in HSP?
IgA
Purpuric rash in HSP - what are the platelets saying?
Normal. Purpuric rash is not due to thrombocytopenia
Drug for dermatitis herpetiforms
Dapsone
3 classes of drug that exacerbate psoriasis
B blockers
Antimalarials
Lithium
Streptococcal infection leads to which classical rash
Guttate psoriasis
What does pustular psoriasis look like? Key association with pustuar psoriasis on palms / soles?
Sheets of small yellow pustules on a red background
Smoking
What does guttate psoriasis look like? Key association?
Acute eruption of drop like leisons
Streptococca infection
What happens to psoriasis during preg and post partum?
Gets better in pregnancy
Worse post partum
Name a few topical options for psoriasis
Coal tar - useful for thick plaque psoriasis
Dithranol
Vit D analogues
Taraztoene - Retinoid (think TARAtogenic)
Steroids
Vid D analogue name
Calcipotriol
What is second line (after topical) for Rx of psoriasis?
When is it recommended first line?
Phototherapy
If >10% BSA, Nail bed psoriasis, or general high stress Eg question mentions someone going wild as they’ve got psoriasis face
First line DMARD for psoriasis? What do you have to monitor 3 monthly?
DMARD if for short term or need rapid control?
Methotrexate (Blocks DNA synthesis)
P3NP - Used to monitor liver fibrosis
[Psoriasis3NonthlyPlease]
Ciclosporin (inhibits t-lymphocyte transcription of IL-2)
Key side effects of ciclosporin
Renal toxicity
Hypertension
Odd thing to monitor with retanoids Eg acitretin? Another common side effect
Triglyceride levels
Mucocutaneous side effects
Biologics are 3rd line psoriasis. name a -mab that is given as an infusion? Sub cut? how to they work?
INFliximab - INFusion
Adalibumab - Sub cut
TNFa inhibitors
How does etanercept work?
Human protein fusion of the TNF receptor
Binds to TNFa and blocks it
[given sub-cut]
Name a couple key associations with psoriasis longer term….
CV - Eg MI / Stroke / Venous thromboembolism
Athropathy
Gout
Lymphoma
Skin Ca (not melanoma)
Malabsorbtion - UC / Crohns
Nails have a green discolouration means what infection?
Pseudomonas
What is Onycholysis? Key associations?
Nail separates from nail bed
Psoriasis
Fungal
Nail Onycholysis, pustual, hyperkeratosis =
psoriasis
Nail onycholysis, discolouration, thickening =
Fungal
Nail thinning, longitudinal depressions
Lichen planus
Nail pitting, thickening and ridging (sandpaper nail)
Alopecia areata
Nail onycholysis, coarse pits, cross-ridging
Dermatitis
Name 3 things that cause koebner phenomenon
Psoriasis
Lichen planus
vitiligo
warts
Molluscum contagiosum
Name 3 things that cause koebner phenomenon. what is it?
Psoriasis
Lichen planus
vitiligo
warts
Molluscum contagiosum
These things develop over areas of trauma
What is erythroderma
Severe skin inflammation covering most of body
Itchy small blisters. Biopsy shows IgA immunoflourescene =
Dermatitis herpetiformis
Monitoring with dapsone ?Used for
Can cause polyneuropathy, haemolysis + liver issues
Monitor bloods + LFTs
Dermatitis herpetiformis
General pathology of inflam plaque in psoriasis
Activated T-Lymphocytes into the epidermis
->Activate keratinocytes
-Get upregulation of TNFa, IL-2 and Interferon gamma
Which IL key in psoriasis? Gout / Stills?
IL-17 / IL-22- psoriasis
[Don’t forget TNFa of course]
IL-1 - gout and stills
Key risks for amiodarone>?
Photosensitive
Hepatic / pulm fibrosis
Thyroid disorders
3 parts of melanoma that actually change prognosis
Thickness
Ulceration
Lymph node micrometastisis
Red / violaceous [violet] periorbital rash
Papules over knuckles
Nail fold inflammation
Proximal myopathy [rarely involuntary muscles Eg swallowing]
=?
Which antibody is diagnostic?
Common association? Drug association?
Dermatomyositis
Anti-Mi-2 [ONLY found in 30%)
Many have an underlying Ca
Penicilliamine
Anti-jo-1 found in? Key association?
Polymyositis
Pulmonary fibrosis
Rx dermatomyositis
Pred
Aza/ciclo if not repsponding
What is cheiroathropathy ?
Arthropathy associated with long-term diabetes and microvascular complications
-> Frozen shoulder / carpal tunnel
->Thickened swollen skin over fingers
Questions mentions decades history diabetes and thick skin
cheiroathropathy
pencil-in-cup deformity on XR
Psoriatic athropathy
2 most common causes of erythroderma ? What is it?
Psoriasis
Eczema
General term for any inflammatory skin condition which affects >90%
[Others include drug eruption / pityriasis rubra pilaris / cutaneous lymphoma]
photosensitive blistering rash commonly triggered/ sustained by alcohol? Other triggers? Apart from avoiding sun/ using suncream what is the mainstay of Rx? drug you can sometimes use?
Porphyria cutanea tarda (PCT)
Oestrogen, HepC, HIV
Phlebotomy to avoid Porphyrin deposits in liver- guided by ferritin levels
Hydroxychloroquine
Porphyria cutanea tarda (PCT) - how to spot the pathogenesis if in question
deficinecy of uroPORPHYIN decarboxylaze.
Ie the answer is there….
[Investigations also are for serum/urinary PROPHYRINs -these make urine red]
first line (if Non topical) management of rosacea?
Oral tetracycline
Erythema nodosum sometimes idiopathic… Name a few associations
IBD
Sarcoid
Strep/Tb infections
COCP / some Abx eg tetracycline / penicillin
Pregnancy
Malignancy
Area of skin depigmentation, usually in hot countries and associated with areas that get sweaty / covered by clothes? Casued by? Rx?
pityriasis versicolor
Malassezia globosa
Topical antifungal
What causes ring worm? rx?
Trichophyton Rubrum
Topical antifungal
Herald red patch -> multiple others with no other Sx and normal blood =?
Pityriasis rosea
[treatment conservative and usually just clears by 12 weeks]
[Rosea for red patch ]
Smooth circular patches of hair loss - may feel tingly?
Itchy scalp with patches of hair loss + scaling?
Alopecia acreta
Tinea capitis
What is male hair loss pattern called
Androgenetic alopecia
Drug Rx of alopecia acreta?
Topical steroids / minoxidil
What is the term for generalised hair loss over scalp and usually occurs a couple months after high stress / malnutrition / child birth?
Telegen effluvium
What white cell is raised in toxic epidermal necrolysis?
Eosinophils
Score system for severity of SJS/TEN
SCORETEN
Exclamation mark hairs
Alopecia areata
Areas of depigmented skin patches often with little patches of hair loss? Assoc with? Important blood test?
Rx?
Vitiligo
Autoimmune conditions
Thyroid function tests
Usually just conservative
-Can use topical steroids / phototherapy however often just persists
Lichen planus or lichen sclerosis in koebner phenomenon
P for P
Planus for phenomenon
Depigmented itchy skin lesions with increased peripheral nerve growth and raised inflam markers
Mycobacterium leprae
Itchy wheals (raised) lesions which keep coming up? Flare Rx? Long term? If that isn’t working?
Hives (urticaria)
Antihistamines +/- steroids for flare
Longer-term antihistamines usually at least 2 with an increased dose and then can add in an LRA (montelukast)
->ciclosporin / tacrolimus
->Finanlly omalizumab if all else fails (mab at IgE)
Diagnosis of pseudoxanthoma (chicken skin)
Skin biopsy
Diagnose Marfan’s
Fibrillin 1 gene testing
Bar psoriasis and nail fungal infections what systemic disease causes onycholysis
Thyrotoxicosis
Acanthosis nigrans is? associated with what ok and what bad thing?
Hyperpigmented velvety skin in skin folds
Insulin resistance
Gastric Ca
Area of erythema which then rapidly develops into multiple pus-filled papules? Assoc with?
PLEVA
EBV (this if uni student) with sore throat / atypical lympcytes on blood film
Toxoplasmosis
HIV
CMV
Staph/strep
[AKA there will be a clue in question for which one it is causing it]
Cancer + blistering rash = ? Antibodies associated?
Paraneoplastic pemphigus
anti-**plakin
First line Rx early syphilis
single IM Ben pen 2.4g
Eczema -> massive pustular eruption with yellow crusting (mostly in areas where eczema has prev been) =? Rx?
What if a localised reaction over eczema site?
Eczema herpeticum (herpes simplex / zoster)
Acyclovir
Staph -> fluclox
90% fungal nails caused by
Tricophyton rubrum
Pale atrophic plaques on vag =?
Rx?
If on penis tends to affect? Usually need?
Risk?
Lichen sclerosis
Topical steroids
Foreskin and glans (gets called balantis xerotica obliterans)
- circumsision
Small risk developing Squamous cell Ca
Differentiate lichen planus and sclerosis on a vag?
Both can itch
Slcerosis can be pale and atrophic (like a scar)
Planus - more Painful and coloured (Purple)
PPP
Fat - alcohol as trigger and rash in sun areas = ? Other trigger bar alcohol?
porphryia cutanea tarda
Oestrogen
Usual Rx in porphryia cutanea tarda
Avoid sun / alcohol.
Stop COCP
Plebotomy if ferrin >600
Can use hydroxychloroquine if less and prefer [mobilised porphyrins from liver -> excreted in urine]
Needs HIV / HepC rx
Diabetes, peripheral neuropathy. Large waxy yellow lesion on shin with ulceration
Necrobiosis lipoidica
Which lymphoma usually on skin (especially men aged 60)? What are the 2 types?
Cutaenous T-cell lymphoma
Mycosis fungoities and sezary syndrome
When are atypical lymphocytes with cerebriform nuclei seen?
Sezary syndrome (sezary cells)
Intensley itchy rash on flexural surface eg wrist. Koeberners phenomenom. Violet papules with white streaks ? IxRx?
Lichen planus (purple papules)
Usually no Ix and no Rx and will just get better
Red scaling rash in sun-exposed areas. Bald patches on the scalp. Scarring and pigmentation change =? Rx?
Discoid lupus
ANA = WILL BE NEGATIVE
Need sun protection
One of few indications for HIGH strength steroids for face
->Hydroxycloriquine / acretin
Diabetes with small erythermatous papules which coalesce into an area of erythema
Granuloma annulare
Which conditions are associated with pyoderma gangrenosum?
Necrotic ulcers are GRIMP
Granulomatous with polyangitis
Rhem A
IBD
Myeloproliferative disorders / lymphoma
PBC
Differentiate pyoderma gangrenosum and erythema nodosum
Pyoderma - deep ulcerating necrotic ulcers. Demonstrate cribriform pattern of scarring
Erythema - Painful erythematous lumps
-Eg TB, sarcoid, strep, IBD
Talk about pemphigus differences to pemphigoid
Pemphigus - oral lesions common,
Blisters may have all been scratched away as superficial and fragile.
Antidesmoglein antibodies
First line Ix contact dermatitis? What type of hypersensitivity reaction is contact dermaitits
Patch testing
Type IV
Whats most important Ix for Dx of NF1
Slit lamp of eye
Otherwise physical exam and FHx
Australian. Painless lesion on penis which then turns into a heaped-up ulcer? The biopsy will show? Rx?
Granuloma inguinale
Donovan bodies
Doxy / co-trimoxazole
Sore genital ulcers with ragged edges and painful swollen inguinal lymph nodes? Caused by which bug
Chancroid
Haemophilus ducreyi
Which antihypertensive worsens psoriasis? Other drugs?
b blockers
Lithium
Antimalrials
Diagnosis of leprosy? Stab at recognising Rx?
Skin biopsy
->Zheil neilson / Fite staining
Dapsone, rifampacin and clofazimine
Strong family history. Warty lesions on chest / back / scalp. Nail dystrophy ? Rx if needed?
Dariers disease
acitretin if needed
Presents as pemphigus but the mucosa are unaffected and blisters all crusted
Pemphigus foliaceus
Bar Vit D3 (niacin) which other deficiency leads to dermatitis but without as predominant depression/dementia symptoms and more effects on nails.
Zinc
T1DM. Symmetrical areas of hypopigmentation = ?
What if there was a textural change and asymetrical?
Vitiligo
Morphoea (may be hypo or hyper pigmented)
Which drugs are known to trigger pemphigoid
Furosemide
ACEi
NSAIDS
Penicillamine
post EBV now have a papular rash covering chest / Abdo. Rx?
Topical tacrolimus
[Ideally don’t use steroids over a large area in young people]
Pemphigus biopsy
IgG / Complement deposits / antidesmoglein 1 and 3
differentiate pemphigus Vulgaris and pemphigus follicularis on antibodies
Vulgaris - desmoglein 1 and 3
Follicularis - Desmoglein 2
What is henna tattoo which causes allergic reaction
PPD
Necrobiosis lipoidica Rx
Very poorly responsive to treatment - non-proven to work as it is due to small vessel damage and necrosis of dermal collagen
What is positive nickolsky sign in SJS
Pressure on skin causes blistering within hours
Acne flow chart Rx
Topical eg Benzyl perioxide then topical retinoid
Topical abx
Oral Abx x 2
Oral retiniod
Dermatitis, dementia and diarrhoea =? If other extra symptoms eg raised aLT what might have caused it?
Vit B3 - Niacin
[There B3 D’s in this condition]
Carcinoid syndrome - tryptophan used to make serotonin and non left for conversion to Vit B3
Which rash do 1/3 of people with new Ca present with
Dermatomyositis
Lifestyle Rx of rosacea
Stopping drinking
Acute intermittent porphyria
Inheritance of what?
Presentation?
Key biochem fidning?
Dominant inheritance of deficiency in porphrobilinogen
Neuropsychiatric / GI disturbance. Dark red urine (porphyrins)
Often SIADH
Acute intermittent porphyria
Rx?
Prevention of cyclic attacks?
Dextrose oral / IV
IV haemin
Haem arginate
Can use GnRH analogues eg goserelin in women
Acute intermittent porphyria monitoring? risk?
yearly uroporphyrins and LFTs
Liver US when >50 as risk of HCC
Mucocutaneous leishmaniasis Rx
Sodium Stibogluconate
2 main causes of angioedema in absence of urticaria
ACEi
C1esterase deficiency
Rx hand eczema which is resistant to oral steroids and super potent topical steroids
Alitrenitoin
[Or ciclosporin if CI’d]
Herald patch -> Christmas tree pattern of salmon pink rash
Pityriasis roseacea
Which drug causes onchyolysis?
Tetracyclines Eg doxy
eczema with erythema and pustule formation + yellow crusting Rx ? When would you suspect viral?
Topical Abx and continued topical corticosteroids
If herpeticum it would mention vesicles, not pustules
[So long as systemically well]
Fat man with erythematous plaque and scaling border on inner thigh Dx?Ix? Rx?
Tinea Cruris
Skin scrapings
Topical antifungals
When is the ink test used?
Scabies - ink onto hands then wipped off and it stays in the burrows
Paraneoplastic pemphigus usually which Ca?
Non-hodgkins lymphoma
Symmetrical maculopapular rash on trunk and limbs which is pale pink and not itchy. Mucosal erosions. Generalised muscle and joint pains/lymphadenopathy? What are the plaques which form in the flexures called?
Secondary syphilis
Condylomata lata
Symmetrical maculopapular rash on trunk and limbs which is pale pink and not itchy. Mucosal erosions. Generalised muscle and joint pains/lymphadenopathy? What are the plaques which form in the flexures called?
Secondary syphilis
Condylomata lata
Drugs causing photosensitivity
QR STAND
Q- Quinine, Quinolones, Quinidine
R- Retinoids
S- Sulphonamides, Sulfonylureas
T- Tetracyclines, Thiazides
A- Amiodarone
N- NSAID’S– Ibuprofen, naproxen, celecoxib
D- Dapsone
When is a lesion melanoma until proven otherwise
Asymmetry
Border is irregular
Colour varies throughout
Diameter >6mm
Evolving / growing
Most effective intervention for molluscum contagiousosum
Cryotherapy
tender red nodules on shins in pregnant
eRYTHEMA NODOSUM
Peri-stomal pyoderma Rx
Topical tacrolimus
Velvity dark patch on lip and in neck folds? Key associations
Acanthosis nigrans
Cushings, acromegally or other insulin resistant
Gastric adenocarcinoma , Endometrial Ca
