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Y6 Senior Med COPY LaLz > Derm > Flashcards

Derm Flashcards

1
Q

what is the difference between SJS and TEN

A

SJS is LESS THAN 10% of skin involvement
TEN is >30% skin involvement

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2
Q

what can cause SJS/TEN

A

Drug reaction

Never Press Skin As it Can Peel (nikolsky sign)

NSAID
Phenytoin
Sulphonamide
Allopurinol
IVIG
Carbamazepine
Penicillin

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3
Q

what does SJS look like

A

scalded skin over extensive area
systemically unwell

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4
Q

what is Nikolsky sign

A

epidermis separates at mild pressure

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5
Q

hoow doo you manage SJS

A

stop precipitating factor, ITU, IVIG

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6
Q

what is seborrhoeic dermatitis

A

chronic dermatitis caused by proliferation of a normal skin inhabitant, the fungus Malassezia furfur

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7
Q

How does seborrhoeic dermatitis present

A

eeczematous lesion of sebum rich areas (dandruff on scalp)

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8
Q

mx for seborrheic erma

A

Zinc (head and shoulders) and tar (neutrogena T) for scalp disease
topical antifungalls if on body

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9
Q

what does impetigo look like

A

gold crust appearance

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10
Q

what is the bacteriuim that causes impetigo

A

staph aureus

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11
Q

how do you manage impetigo

A

hygiene measures
topical HYDROGEN PEROXIDE 1% cream> 2% fusidic acid cream
give oral fluclox if widespread

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12
Q

How do you manage mild acne first line

A

benzoyl peroxide and / or topical retinoid and / or topical abx

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13
Q

what abx can you give for acne

A

topical clindamycin 1%

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14
Q

what is second line for mild acne

A

azelaic acid

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15
Q

how do you manage severe acne firist line that does not respond to topical

A

Oral ABX (max 3m) + BPO / retinoid

Abx is lymecycline or docy

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16
Q

what do you refer to dermatologist for if they have acne

A

for isotrenitoin oral

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17
Q

side effects of roaccutane

A

dryness, teratogenic
hair thinning
photosensitivity
low mood and suicide ideation

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18
Q

what is the acne that middle aged people get called

A

acne rosacea

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19
Q

describe acne rosacea

A

middle aged peopple
flushing
symmetrical rash on nose, cheeks, foreheaad and telangectasia
persistent pustopapular erythema

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20
Q

how do you manage acne rosacea

A

Mild/moderate: topical metronidazole
Severe: oral tetracycline

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21
Q

what causes pytiriasis versiccolor

A

malassezia furfur

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22
Q

what does pytiriasis versiccolor look like

A

hypopygmented patches
mild pruritus
after a SUNTAN

TRUNK affected

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23
Q

how is pytiriasis versiccolor different to vitiligo

A

vitiligo is in pripheeries and a lot more confluent

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24
Q

how can you reverse vitiligo

A

with topical steroids
but only if applied early

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25
Q

what causes pityriasis rosea

A

HHV7

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26
Q

sx of pityriasis rosea

A

recent viral infection
herald patch on trunk
erythematous oval scaly patches (fir tree appearance(

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27
Q

how do you treat pityriasis rosea

A

you dont its self limiting

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28
Q

what are the types of psoriasis that you can get

A

plaque - most common, with well demarcated red scaly patches
guttate
pustural
flexural

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29
Q

what is guttate psoriasis due to

A

strep infection

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30
Q

what does guttate psoriasis look like

A

teardrop lesions on the back

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31
Q

how do you manage psoriasis

A

corticosteroid and vit D analogue

consider emollients
phototherapy, photochemotheray

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32
Q

where does psoriasis occur

A

ON EXTENSOR surfaces

33
Q

where does eczema occur

A

on FLEXOR surfaces

34
Q

sx of eczma

A

dry skin
itching
redness
may become infected

35
Q

how do you manage eczema

A

emollients
topical corticosteroids

fluclox oral if infected

36
Q

how do you manage scabies

A

Permethrini x2, wash off after 8 hours
treat al household contacts

37
Q

how do you manage headlice

A

malathion (which is second line for scaabies)

38
Q

what does tinea look like

A

ringed appearance
kerion
red or silver rsh

39
Q

tinea management

A

topiocal or oral antifungals
e.g. TERBINAFINE , clotrimazole

40
Q

how do you mnag shingles

A

analgesia (paracetamol + NSAID)
antivirals (PO acyclovir)

41
Q

describe lichen planus

A

purple pruritic papular polygona rash
itchy
on palms, soles, genitalia, flexor surfaces of arms

42
Q

hhow do you manage lichen planus

A

TOPICAL steroids (clobetasone)

43
Q

what is lichen sclerosus

A

itchy white spots seen on vulva of elderly

44
Q

hwow do you manage cellulitis

A

FLUCLOX if mild
CO AMOX if sevre

45
Q

how do you tell erysepelas apart from cellulitis

A

erysipelas is well demarcated

46
Q

list the steroid ladder

A

Help Carol Become a Medic
1. Hydrocortisone
2. Clobetasone butyrate
3. Betamethasone
4. Mometasone

47
Q

what causes bullous pemphigoid

A

ANTIBODIES againsst BM (at dermoepidemal junctin)

48
Q

sx of bullous pemphigoid

A

TENSE bullae
itchy
NO oral involvement

49
Q

Ix bullous pemphigoid

A

immunofluorescence (IgG, C3 at dermoepidermal junction)

50
Q

how do you maage bullous pemphigoid

A

oral corticosteroids

51
Q

Pemphigus vulgaris cause

A

Antibodies against desmosomes (superficial)

52
Q

sx pemphigus vulgaris

A

flaccid blisters
ORAL involvement

53
Q

whatg is an actinic keratosis

A

pre-malignant skin condition for SCC

54
Q

how does actinic keratosis present

A

small, crusty/scaly, on sun exposed area

55
Q

Who and how do you manage actinic keratosis

A

GP if simple, urgent 2ww if immunosuppressed

  • fluorouracil cream + topical hydrocort
  • topical diclofenac
  • topical imiquinod
56
Q

which areas are 9% of body for burns fluid calc

A

Head+neck
each arm
each anterior leg
each posterior leg
anterior chest
post chest
ant abdo
post abdo

57
Q

whaat is hidroadenitis suppurativa

A

chronic inflamm occlusion of pilosebaceious units > prevent keratinocytes from properly shedding

58
Q

how does hidroadenitis suppurativa present

A

recurrent boiils in intertriginous areas (axilla, neck, thighs, ingluinal, breast) > plaques, scarring

59
Q

how do you manage hidroadenitis suppurativa

A

good hygiene, loose clothing, smoking cessation
Acute: steroids, fluclox
chronic: clindamycin (topical), lymecycline (PO)

60
Q

how long should the corticosteroid breaks be (at least) in psoriasis

A

4 weeks

61
Q

causes of erythema multiforme

A

infection (90%)
- HSV ***most common
- mycoplasma

drugs
- NSAID
- penicillins
- sulphonamides, sulphonylureas
- nitrofurantoiin

62
Q

describe erythema multiforme appearance

A

target lesions
initially on back of hands / feet, then torso
upper limbs more likely than lower limbs
pruritus occasionally

63
Q

what is erythroderma

A

rash that involves >95% of the body

64
Q

causes of erythema nodosum

A

SORE SHINS

Streptococci, mycoplasma, EBV
OCP
Rickettsia
Eponymous Behcets

Sulphonamides, penicillins
Hansen’s disease (leprosy)
IBD
NHL
Sarcoid and TB

65
Q

what is the single most important prognostic factor for melanoma

A

breslow thickness

66
Q

side effectss of topical corticosteroids

A

thin sskin
skin depigmentation (esp if dark skin)
excessive hair growth

67
Q

what exacerbates psoriasis

A

trauma
alcohol
drugs (beta blockers, lithium, antimalaria, NSAID, ACEi, infliximab)
withdrawal from steroids

68
Q

what does a BCC look like

A

rodent ulcer: pearly papule with telangectasia
ulcerates at the center to leave a crater

69
Q

where do pygenic granulomas occur

A

after a small skin lesion e.g. a cut

70
Q

what is a pyogenic granuloma

A

reactive proliferation of capillary blood vessel

71
Q

what do pyogenic granulomas do if you touch them

A

bleed on contact

72
Q

how long are shingles infectious for

A

until they have crusted over (usually around one week)

73
Q

how long must you exclude from school someone wiht shingles

A

until lesions fully crust ovr OR 48 hours from start of antibiotics

74
Q

explain features of dermatitis herpetiformis

A

itchy vescicular lesions on EXTENSOR SURFACES (knees, buttocks, elbows)

75
Q

what is hirsutism

A

male like hair pattern in women (= androgen dependent hair growth)

76
Q

most common cause of hirsutism

A

PCOS

also cushings, CAH, androgen therapy

77
Q

causes of acanthosis nigricans

A

T2DM / obesity , PCOS, acromegaly, Cushing’s
GI cancer

78
Q

how do you manage pyoderma gangrenosum

A

ORAL steroids first
becuase it has high potential to spread rapidly

Y6 Senior Med COPY LaLz (29 decks)

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