Derm Flashcards
Vitiligo- associated conditions?
type 1 diabetes mellitus
Addison’s disease
autoimmune thyroid disorders
pernicious anaemia
alopecia areata
Scarring vs non-scarring alopecia?
itchy papular rash on her palms, extending onto the flexor aspect of the forearms.
White lines are visible across the surface of the rash.
what is it? tx?
lichen planus
purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface.
potent topical steroids are the mainstay of treatment
think !!! -lichen sclerosus: itchy white spots typically seen on the vulva of elderly women
hair loss following stressful period e.g. surgery?
Telogen effluvium is the loss and thinning of hair in response to severe stress
severe acne: predominantly papular/pustular with nodules and scarring.
tx?
oral abx (tetracycline, oxytetracycline, doxycycline, or lymecycline ) and topical benzoyl peroxide
Hereditary haemorrhagic telangiectasia
describes features of Basal cell carcinoma?
rolled, pearly edges with telangiectasia on the inferior border of the lesion
Psoriasis: management
Topical steroid + topical calcipotriol
Rosacea (sometimes referred to as acne rosacea) presentation and tx (mild vs moderate)?
Erythema nodosum causes:
infection?
systemic?
drugs?
think CARBAMAZEPINE
Drugs cause this?
erythema multiforme
Squamous cell carcinoma most common risk factors?
Dermatitis herpetiformis
explain rash?
pathophysiological process
formation of IgA antibodies
Zinc deficiency features?
name a rash that develop acutely over several days 1-2 weeks after a streptococcal infection
(this patient has just had bacterial tonsillitis, which is typically caused by group A streptococcus infection).
GUTTATE PSORIASIS
Teardrop
Keratoacanthoma dx via GP
mx
urgent derm referral
narrowband ultraviolet B light and psoralen + ultraviolet A light (PUVA) used in secondary care mx for psoriasis- ADVERSE EFFECT?
3-year-old son who suffers from eczema
eczema has become a lot worse this week
He has developed widespread itchy blisters all over his body: including his face, torso, arms and legs.
dx? tx?
Eczema herpeticum is a serious condition that requires IV antivirals
26-year-old woman presents with a recurrent, intensely itchy rash on the palms of her hands.
they tend to occur every summer.
Pompholyx eczema may be precipitated by humidity (e.g. sweating) and high temperatures
three-week history of an itchy rash over the face and upper chest
PMx: HIV for which he is poorly compliant
rash? tx
Seborrhoeic dermatitis - first-line treatment is topical ketoconazole
stress ulcer that can occur after severe burns?
stress ulcer that occurs in the aftermath of severe head trauma.
Curling’s ulcer is a stress ulcer that can occur after severe burns
Cushing’s ulcer is a stress ulcer that occurs in the aftermath of severe head trauma.
rash in pregnancy?
50 yo
symmetrical erythematous lesions are found with an orange peel texture.
Grave’s disease, orange peel shin lesions - pretibial myxoedema
A 23-year-old female presents with red, thickened skin on the soles. On closer inspection a crop of raised lesions are seen.
Palmoplantar pustulosis
22-year-old man presents with a 3 cm area of hyperkeratotic skin on the heel of his right foot. A number of pinpoint petechiae are seen in the lesion.
Mosaic wart
excessively smelly feet. On examination he has white skin over the sole of the forefoot bilaterally. Small holes can be seen on the surface of the affected skin.
Pitted keratolysis
Acute onset of tear-drop scaly papules on trunk and limbs
guttate psoriasis
Itchy
single well-demarcated, erythematous circular patch with a raised edge and central hypopigmentation. Combined with the history of itch, the most likely diagnosis is tinea corporis (ringworm).
causes include Trichophyton rubrum and Trichophyton verrucosum (e.g. From contact with cattle)
bullous pemphigoid vs pemphigus vulgaris
pemphigus vulgaris: blisters are flaccid and easily ruptured when touched.
15-year-old female presents to ambulatory care with a painful pruritic rash that has rapidly worsened over the last 10 hours.
On examination, she has a monomorphic rash with punched out erosions over her cheeks and bilateral dorsal wrists. She is admitted for IV antivirals and observation.
?
Eczema herpeticum is a primary infection of the skin caused by herpes simplex virus (HSV)
itchy white spots typically seen on the vulva of elderly women
Lichen sclerosus
allergic contact dermatitis
dx?
skin patch test
mild acne, open and closed comedones (blackheads and whiteheads)
tx?
Prescribe a topical retinoid (tretinoin, isotretinoin, or adapalene) or benzoyl peroxide (especially if papules and pustules are present) as first-line treatment.
azelaic acid if both topical retinoids and benzoyl peroxide are poorly tolerated.
common complications of seborrhoeic dermatitis
Otitis externa and blepharitis
78 year-old woman presents with a poorly healing area of skin on her ankle.
shallow ulcer anterior to the medial malleolus.
dx?
tx?
Venous ulceration
Keloid scars tx?
early keloids may be treated with intra-lesional steroids e.g. triamcinolone
……..are a vascular birthmark that do not spontaneoulsy resolve
port of wine stain
Scalp psoriasis - first-line treatment?
topical potent corticosteroids
Molluscum contagiosum
cause? tx?
virus (MCV), a member of the Poxviridae family.
Reassure people that molluscum contagiosum is a self-limiting condition.
Spontaneous resolution usually occurs within 18 months
benign, painful nodule on the ear, more common in men than women?
Chondrodermatitis nodularis
bilateral erythematous lesions on her shins surrounded by telangiectasia
Necrobiosis lipoidica
Pyogenic granuloma is a relatively common benign skin lesion.
factors may exacerbate psoriasis:
trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine),
NSAIDs and ACE inhibitors,
infliximab
withdrawal of systemic steroids
classic descriptions for polycythemia?
Nail changes that may be seen in psoriasis
pitting
onycholysis (separation of the nail from the nail bed)
subungual hyperkeratosis
loss of the nail
first-line for hyperhidrosis
Topical aluminium chloride
serious cutaneous form of T-cell lymphoma that can present like eczema or psoriasis
Mycosis fungoides
Acne vulgaris in pregnancy- oral abx choice?
oral erythromycin
sebaceous cyst mx?
Surgical excision of sebaceous cyst as a whole structure is required to prevent reoccurrence
Scabies is caused by
mx?
mite Sarcoptes scabiei
Toxic epidermal necrolysis (TEN presentation?
what causes it?
potentially life-threatening skin disorder that is most commonly seen secondary to a drug reaction.
positive Nikolsky’s sign: the epidermis separates with mild lateral pressure
Bullous pemphigoid skin biopsy?
immunofluorescence shows IgG and C3 at the dermoepidermal junction
Impetigo mx?
topical fusidic acid if hydrogen peroxide not suitable
extensive: oral flucloxacillin
oral erythromycin if penicillin-allergic
actinic keratosis
dimples when pressure is applied.
dermatofibromas,
Pemphigoid gestationis vs Polymorphic eruption of pregnancy
Pemphigoid gestationis: BLISTERS - 2ND, 3RD TRIMESTER
Polymorphic eruption of pregnancy is not associated with blistering- 3RD TRIMESTER
Dermatophyte nail infections MX>
oral terbinafine
Acne vulgaris: management
Should be avoided due to an increased risk of drug-induced lupus and hyperpigmentation?
Oral minocycline
Acne vulgaris: management
most likely to affect the hepatic metabolism of other medications
Oral erythromycin
