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derm Flashcards

1
Q

what are the features of erythema multiforme?

A

Target lesions initially seen on the back of the hands / feet before spreading to the torso.

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2
Q

what is the most common cause of erythema multiforme ?

A

Herpes simplex virus

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3
Q

what drugs cause erythema multiforme

A

Penicillin
Allopurinol
Sulphonamides
Carbamazepine
Oral contraceptive pill
NSAIDs

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4
Q

what are the other causes of Erythema Multiform?

A

Connective tissue disease : SLE
Sarcoidosis
Malignancy
Bacteria like mycoplasma and Streptococcus

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5
Q

what is erythema multiforme major ?

A

It is the most severe form of erythema multiforme and is associated with mucosal involvement

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6
Q

how does erythema nodosum present?

A

Tender, erythematous nodular lesions occurring on the shins primarily

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7
Q

what are the causes of erythema nodosum ?

A

infections such as ( Streptococci, TB, Brucellosis)
Systemic disease : Sarcoidosis, IBD, Behcets
malignancy
drugs such penicillins, sulphonamides COCP
pregnancy

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8
Q

what is guttate psoriasis precipitated by?

A

streptococcal infection 2-4 weeks prior to lesions appearing

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9
Q

What are the features of guttate psoriasis ?

A

Tear drop papules on the trunk and limbs that spontaneously resolve within 2-3 months

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10
Q

What is pityriasis rosea ?

A

Acute, self limiting rash tending to affect young adults presenting with a herald patch followed later by multiple erythematous raised lesions with a minority having a history of a recent viral infection.

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11
Q

what conditions are associated with Acanthosis Nigricans ?

A

type 2 diabetes
GI cancer
Obesity
PCOS
Acromegaly
Cushing’s disease
Hypothyroidism
Prader Willi
drugs like COCP and nicotinic acid

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12
Q

How does Lichen Planus present

A

Itchy papular rash most commonly on palms, soles, genitalia and flexor surfaces with ‘‘white lines’’ pattern

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13
Q

what is the management of Lichen planus?

A

Potent topical steroids
Benzydamine mouthwash

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14
Q

what are the features of rosacea ?

A

affecting the nose, cheeks and forehead
flushing
telangiectasia
this can develop into persistent erythema with papules and pustules

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15
Q

explain the stepwise management of rosacea ?

A

high factor sunscreen
Flushing :topical brimonidine gel
mild to moderate pustules and papules : topical ivermectin
Moderate to severe : Combination of topical ivermectin and oral doxycycline

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16
Q

How does seborrhoeic dermatitis present? How is it managed?

A

eczematous lesions on the sebum rich areas : Scalp, periorbital, auricular and nose.
managed with ketoconazole 2% shampoo
Steroids can be used for short bursts of face and body management.

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17
Q

what are 2 conditions associated with seborrhoeic dermatitis?
What are 2 complications of seborrhoeic dermatitis?

A

HIV , Parkinson’s
otitis externa and blepharitis may develop

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18
Q

what are the different types of acne lesions usually seen in each patient ?

A

Comedones : closed is a whitehead, open is a blackhead

Inflammatory lesions : pustules and papules

nodules and cysts

scars such as ice-pick and hypertrophic scars

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19
Q

what is acne fulminans?

A

Very severe acne associated with systemic upset

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20
Q

how is acne classified?

A

Mild : Open and closed comedones without inflammatory lesions.

Moderate : widespread inflammatory lesions and pustules and papules

Severe acne: extensive inflammatory lesions including nodules, pitting and scarring.

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21
Q

How is mild-moderate acne managed?

A

12 week course of topical combination therapy :

topical adapalene and benzoyl peroxide
topical tretinoin and clindamycin
topical benzoyl peroxide with clindamycin

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22
Q

what is the management of moderate to severe acne?

A

add oral lymecycline / oral doxycycline

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23
Q

what is eczema herpeticum? How does it present? How is it managed?

A

Caused by herpes simplex virus 1 or 2.
Rapidly progressing rash with erosions.
Admit to hospital and treat with IV Acyclovir

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24
Q

what causes pityriasis rosea

A

HHV-7

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25
Q

how does eczema present?

A

Itchy erythematous rash exacerbated by repeated scratching.
typically on the extensor surfaces in kids and flexor surfaces in adults

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26
Q

How is eczema managed?

A

simple emollients
topical steroids ( starting with hydrocortisone, betamethasone, fluticasone, clobetasol)

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27
Q

How does Chronic plaque psoriasis present?

A

Presents as erythematous red scaly plaques covered with a silvery white scale typically seen on extensor surfaces with a clear distinction between normal and affected skin.

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28
Q

what is Auspitz sign

A

If the scale is removed, a red membrane with pinpoint bleeding points may be seen

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29
Q

what are the different types of psoriasis?

A

Flexural : smooth skin
pustular psoriasis : palms and soles

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30
Q

what factors can exacerbate psoriasis

A

trauma
alcohol
drugs such as : Beta blockers, lithium, antimalarials ( hydrochloroquine and hydroxychlorquine), NSAID’s ACEi, Infliximab

31
Q

what is the stepwise management of psoriasis?

A

regular emollients
first line : Potent corticosteroids OD + vitamin D analogue

second line : apply vitamin D analogue twice daily

third line : increase application of potent corticosteroid to twice daily

32
Q

what are the different forms of tinea?

A

Tinea capitis : Scalp
Tinea corporis : trunk, legs or arms
tinea pedis : feet

33
Q

what is actinic keratosis ? How and where does it present ? How do you manage it ?

A

Common premalignant skin developing as a consequence of chronic sun exposure.

features include :

small, crusty or scaly lesions that may be pink, red, brown or the same colour as the skin.

these typically occur on sun exposed areas such as the temples of the head.

Management options include :

sun avoidance and sun cream
Fluoruracil cream
hydrocortisone

34
Q

what are keloid scars?
What are its predisposing factors ?
how do you treat it ?

A

Keloid scars are tumour-like lesions arising from the connective tissue of a scar and extending beyond the dimensions of the original wound.

Predisposing factors include :
ethnicity : more common in people with dark skin
young persons

they are treated initially with intra-lesional steroids
excision is sometimes recquired

35
Q

what are the main organisms causing fungal nail infections?
What are the risk factors for it ?
What are its features?

A

Dermatophytes : Trichophyton
Yeasts : Candida

risk factors include :
Age
DM
Psoriasis
trauma

it presents as ‘‘unsightly nails’’
thickened rough and opaque nails

36
Q

when should early intubation be considered in the management of burns?

A

Smoky inhalation resulting in airway oedema
Consider early intubation

37
Q

How do you manage acne vulgaris in pregnancy?

A

Oral erythromycin

38
Q

How are pressure ulcers graded?

A

Grade 1 : skin is intact with skin discolouration
Grade 2 : partial thickness loss
Grade 3 : Full thickness skin loss but does not extend down to underlying fascia
Grade 4 : Extensive destruction and damage

39
Q

what is the school exclusion advice for Lice

A

not advised

40
Q

what are the treatment options for head lice? When is it recommended?

A

treatment is recommended only if live lice is found.
treatment options include :

Malathion
wet combing
dimeticone
isopropyl
cyclomethicone

41
Q

which bacteria can cause acne vulgaris?

A

Propionibacterium acnes

42
Q

what is the most common malignancy in the lower lip? How is i t managed?

A

SCC
Manage with Mohs micrographic surgery

43
Q

how is treatment of household contacts advised in the management of scabies?

A

household contacts should also be treated with permethrin and receive 2 doses.

44
Q

what are the exclusions regarding impetigo?

A

patients are no longer contagious when they have been on treatment for 48h / all lesions have crusted over.

45
Q

what options are used for the management of scabies?

A

Permethrin 5%
Malathion 0.5%

46
Q

where does eczema primarily occur in infants?

A

face and neck

47
Q

what is the management of urticaria?

A

first line : non-sedating anti-histamines such as loratadine / cetirizine

second line : Sedating anti-histamine like chlorphenamine

prednisolone for severe/ resistant episodes

48
Q

what chart is used to assess burns

A

Lund and Browder

49
Q

How does Bowen’s disease present?

A

red scaly patch, slow growing and occurring on head, neck, lower limbs

50
Q

what are the features of polymorphic eruption of pregnancy ?

A

pruritic condition associated with last trimester with lesions appearing in abdominal striae with peri-umbilical sparing.

51
Q

seborrhoeic dermatitis is due to which fungi

A

Malassezia furfur

52
Q

explain bullous pemphigoid and pemphigus vulgaris?

A

auto-immune condition characterised by itchy tense blisters with no mucosal involvement whereas pemphigus vulgaris key presenting feature is mucosal involvement

53
Q

how does pemphigoid gestations present?

A

rash starting in the peri-umbilical area and causes blisters.

54
Q

what is molluscum contagiosum caused by? How does it present? What is the advice around management ?

A

it is caused by Poxvidiridae.

It presents with characteristic pinkish or pearly white papules with central umbilication appearing in clusters anywhere on the body except palms of hands and soles of the feet.

treatment is generally not required.

55
Q

how is hirsutism assessed and managed?

A

Ferriman-Gallwey scoring system

Managed by weight loss, COCP such as co-copyrindol and yasmin

56
Q

what is the advice given to patients with shingles?

A

People with shingles should be advised that they are infectious until the vesicles have crusted over, usually 5-7 days following onset

57
Q

what is hidradenitis supporativa

A

Hidradenitis suppurativa is a chronic, painful, inflammatory skin disorder is characterized by nodules, pustules, sinus tracts, and scars in intertriginous areas

it occurs most commonly in the Axilla and other areas include inguinal, inner thighs, perineal and perianal areas

risk factors include family history, smoking, obesity, diabetes etc

58
Q

what analgesics can be used in the management of shingles

A

Paracetamol and NSAIDs
neuropathic pain
oral corticosteroids

59
Q

under what circumstances are antivirals not prescribed in shingles?

A

< 50
mild truncal rash only

60
Q

what is milia and how does it present

A

small benign keratin filled cysts typically appearing around the face

61
Q

how does strawberry Naevus present and how does one manage it ?

A

erythematous, raised and multilobed tumours that increase in size until the age of about 6-9 months before regressing.

62
Q

what are the causes of pyoderma gangrenosum?

A

Idiopathic
Auto-immune : UC, Crohns,RA, SLE, PBC
haematological : myeloproliferative, lymphoma, leukaemia
granulomatosis with polyangiitis

63
Q

which structures do antibodies target in pemphigus

A

desmosomes

64
Q

how does one differentiate spider naevi from telagiectasia

A

Spider naevi fill from the centre on pressing while telangiectasia fill from the edge

65
Q

what is erysipelas? How would you distinguish it from cellulitis? How would you manage it ?

A

It is a localised skin infection caused by streptococcus pyogenes and is a more superficial limited version of cellulitis. It can be distinguished from cellulitis as it presents with raised and well-defined borders.
Managed with Flucloxacillin

66
Q

what is seborrheic keratoses? How does it present and how is it managed?

A

benign epidermal skin lesions seen in older people.

features include :

flesh to light brown to black
stuck on appearance - kind of like rotten cauliflower

managed conservatively or removed

67
Q

how are venous ulcers investigated and managed

A

investigations

ABPI ( normal 0.9-1.2)

management

compression bandaging
oral pentocifylline

68
Q

how is hyperhidrosis managed?

A

first line : Topical aluminium chloride
iontophoresis
botolunim toxin - armpits
surgery

69
Q

chondrodermatitis nodularis helicis

A

looks like actinic keratosis but is painful

70
Q

how to distinguish pityriasis rosacea and guttate rosacea

A

pityriasis rosacea : viral infection precedes
guttate psoriasis : strep precedes

71
Q

what is leucoplakia and how does it present?

A

premalignant condition which presents as white, hard spots on the mucous membranes of the mouth. It is more common in smokers.

72
Q

how are toenail infections managed

A

not bothering - leave as is
dermatophyte/ candida

limited involvement : amorolfine topical
more extensive due to dermatophyte : oral terbinafine
more extensive due to candida : oral itraconazole

73
Q

what is the most common cutaneous sign in anti-phospholipid syndrome and how does it present ?

A

Livedo reticularis presenting as purplish lace patterned discolouration

SAQ style flashcards (4 decks)

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