DERM Flashcards
shingles mx
Infectious until vesicles have healed over
Simple analgesia
Antivirals within 72hr
Features of stevens johnson syndrome
.the rash is typically maculopapular with target lesions being characteristic
may develop into vesicles or bullae
Nikolsky signis positive in erythematous areas - blisters and erosions appear when the skin is rubbed gently
mucosal involvement
systemic symptoms: fever, arthralgia
Medicines causing erythema nodosum
penicillins
sulphonamides
combined oral contraceptive pill
Causes of spider naevi
liver disease
pregnancy
combined oral contraceptive pill
Features of lichen planus vs sclerosis
planus:purple,pruritic,papular,polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common
sclerosus: itchy white spots typically seen on the vulva of elderly women
Erythema nodosum f eatveres
symmetrical, erythematous, tender, nodules which heal without scarring
most common causes are streptococcal infections, sarcoidosis, inflammatory bowel disease and drugs (penicillins, sulphonamides, oral contraceptive pill)
Necrobiosis lipoidica diabeticorum features
shiny, painless areas of yellow/red skin typically on the shin of diabetics
often associated with telangiectasia
What is Bullous
Pemphigoid?
autoimmune condition causing sub-epidermal blistering of the skin. This is secondary to the development of antibodies against hemidesmosomal proteins BP180 and BP230.
How does Bullous
Pemphigaid
present?
itchy, tense blisters typically around flexures
the blisters usually heal without scarring
no mucosal
involvement
Bullous
Pempligoid
skin biopsy
shows?
immunoflorescence lst D C3 at dernmo epidermal
juncker
Bulloas
pemphigord
rex?
Steroids
derm ref
Rosacea
mx
Erythema/flushing → topical brimonidine gel
Mild/mod papules or pustules: topical ivermectin
Mod/severe papules/pustules: topical ivermectin and oral doxy
Laser therapy for rhinophyma or prominent telangdctasia
Chronic plaque psoriasis mx
- top steroid and calcipotriol
- top calcipotriol BD
- Steroid BD
Acne Mx
- topical combo
- topical tX and oral ly mecycline or doxy
3.oral retinoid
C hasto be
derm)
Erythema nodosum features
inflammation of subcutaneous fat
typically causes tender, erythematous, nodular lesions
usually occurs over shins, may also occur elsewhere (e.g. forearms, thighs)
usually resolves within 6 weeks
lesions heal without scarring
Causes if erythema nodosum
infection
streptococci
tuberculosis
brucellosis
systemic disease
sarcoidosis
inflammatory bowel disease
Behcet’s
malignancy/lymphoma
drugs
penicillins
sulphonamides
combined oral contraceptive pill
pregnancy
Chronic plaque psoriasis secondary care mx option of choice
Oral methotrexate is first line,maprticuarky if associated joint disease
UVB light 3x weekly
Scalp psoriasis management
potent topical corticosteroids used once daily for 4 weeks
Face flexural and genital psoriasis mx
mild or moderate potency corticosteroid applied once or twice daily for a maximum of 2 weeks
Eczema herpetivum
severe primary infection of the skin by herpes simplex virus 1 or 2.
more commonly seen in children with atopic eczema
monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter are typically seen.
As it is potentially life-threatening children should be admitted for IV aciclovir.
What is vitaligo
autoimmune condition which results in the loss of melanocytes and consequent depigmentation of the skin. It is thought to affect around 1% of the population and symptoms typically develop by the age of 20-30 years.
Associated conditions
type 1 diabetes mellitus
Addison’s disease
autoimmune thyroid disorders
pernicious anaemia
alopecia areata
Management of vitaligo
sunblock for affected areas of skin
camouflage make-up
topical corticosteroids may reverse the changes if applied early
there may also be a role for topical tacrolimus and phototherapy, although caution needs to be exercised with light-skinned patients
What is ballous pamphgoid
Or to immune blistering disorder that primarily affects the elderly
Tense blisters on the skin.
No mucosal involvement.
whatis pemphigus vulgaris
mucosal involvement
blisters and erosions involving both the skin and mucous membranes
EpidermoIysis Bullosa
fragility and blister formation in response to minor trauma
at birth or during early childhood,
Actinic keratosis vs bowens
Actinic keratoses may develop on any sun-exposed area, not just the forehead and temple. Bowen’s disease tends to be isolated and well demarcated.
Exacerbating factors for psoriasis
trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids
