Derm Flashcards
Hutchinsons sign
malignant melanoma sign on nail
Acral lentiginous
SCC risk factors
sun
actitinic keratosis and bowens
immunosuppression (kidney transplant, HIV)
Smoking
marjolins ulcer
xeroderma pigmentosum
Poor prognosis SCC
poorly differentiated tumor
>20mm in diameter
>4mm deep
immunosupression for whatever reason
Acral lentiginous melanoma sx
dark skin
non sun exposed areas eg nails palms soles
bob marley!
Cherry hemangioma other name and pathophys
campbell de morgan spots
abnormal proliferation of capillaries
Cherry hemangioma sx and tx
mc with advancing age
erythematous papular lesions
1-3mm
non blanching
not on mucous membranes
no tx - benign
upper lip carcinoma
BCC
lower lip carcinoma
SCC
BCC presentation
waxy pearly pap –> nod
+ telangiectasis
may later form central crater w rolled edges
SCC presentation and association
erythematous, thickened, scaling nodule
ulceration
asscociated w actinic keratosis and bowens
MC mets in melanoma
lung mets
then brain and liver
koebner phenomenom
skin lesions over the sight of inury ie injection site happens in
psoriasis
vitiligo
warts
lichen planus
lichen sclerosis
auspitz sign
scales that bleed when picking (psoriasis)
Gottrons papules
roughened red papules over the knuckles mainly, are seen in dermatomyositis
scalp psoriasis 1st line tx
potent topical corticosteroids
guttate psoriasis presentation
acute onset tear drop scaly papules on trunk and limbs
post strep throat
Hairy leukoplakia
EBV-associated white lesion on the side of the tongue, and is considered indicative of HIV
Keratoderma blennorrhagica
waxy yellow brown papules on palms and toes
symptom of reactive arthritis
reactive arthritis triad
can see, pee or climb a tree
conjunctivitis
urethritis
arthritis
what is tinea corporis
ringworm
lichen planus 1st tx
topical betamethasone 0.1%
or clobetasol
what is pellegra and what is it caused by
naicin (vit B3) deficiency caused by isonizid and more common in alcoholics
3 features of pellegra
dermatitis
diarohoea
death
dermatitis of pellegra
brown scaly rash on sun exposed sites
casal’s necklace if around neck
pemphigoid gestationis
pruritic blistering lesions
peri-umbilical region, later spreading to the trunk, back, buttocks and arms
oral corticosteroids
Discoid lupus erythematosus presentation
erythematous plaques on the face
behcets triad
Oral Ulcers
genital ulcers
anterior uveitis
actinic keratosis tx
topical
diclofenac
5-fluorouracil
imiquimod
verucca tx
salicylic acid
lice tx
malathion
primary herpes simplex infection presentation
incubation period
malaise
fever
extensive painful oral ulceration
with submandibular lymphadenopathy
2-20 days
ketoconazole adverse affect
gynecomastia
other name for spider naevi and what is it
spider angioma
central red papule w surrounding papule
how to tell telangiectasia from spider naevi
by pressing on them
Spider naevi fill from the centre,
telangiectasia from the edge .
spider naevi caused by
liver disease
pregnancy
COCP
atheletes foot other name and what what bug causes it
tinea pedis
dermatophytes like Trichophyton rubrum
What is athelets foot
a common fungal infection of the skin on the feet.
The image provided likely shows macerated, scaling skin between the toes, which is characteristic
atheletes foot tx
Topical Miconazole
what is bowens disease and tx
SCC in situ affecting epidermis
if left can become invasive - 5-fluoracil
What does bowens look like
red, scaly, crusted patch on sun-exposed areas of the body
how to differentiate SCC and bowens
SCC ulcerates, grows faster nd may bleed
Severe burn and brisk haematemesis
Curlings Ucers (gastric)
Scabies tx
permethrin cream
pt and all close contacts two doses
cream whole body one week apart
allergic contact dermatitis ix
patch testing
what is ezcema herpeticum who cops & tx
HSV 1 or 2
Young kids w atopic eczema
life threat!! admit for IV acyclovir
erythema marginatum is?
rash associated with rheumatic fever
(one of major criteria)
fungal infection when oral/topical treatment
scalp (tinee capitis)
nail (onchomycosis)
= oral terbinafine
corporis (body)
cruris (genital)
pedis (athelets foot)
= Topical
impetigo tx when topical hydrogen peroxide unsuitable
topical fusidic acid
electric high voltage burns =
tx
rhabdomyolosis –> acute tubular necrosis
aggressive ive fluids
Circumfential burn =
compartment syndrome
salmon patch
flat pink self resolves
scabies sign
linear burrows
livedo retularis
SLE
diseases that have koebner phenomenon
psoriasis
vitiligo
molluscum contagiosum
warts
lichen planus
lichen sclerosis
what is pompholyx
ezcema on hands and on feet precipitated by humidity and sweating and high temps
pompholyx presentation n mx
small blisters on hands and toes
super itchy sometimes burning sensation
cool compress
emollient
topical steroids
arterial ulcer presentation
burning in leg
over bony prominences
deep, dry, punched out ulcer
atopic eruption of pregnancy presentation
MC dermatosis in pregnancy
2nd/3rd tri
itchy erythematous papules
face neck chest and extensor surfaces of the limbs
benign
dermoid cyst and tx
embryo remnants
skin hair follices sweat glands etc lined by hair and squamous epithelium
often in midline
dumbell shape if linked to deeper structures
causes of livedo reticularis
MC idipathic
SLE
polyarteritis nodosa
antiphospholipid
alopecia areata presentation
well demarcated patches of hair loss
broken ‘exclamation mark’ hairs on edge
used to calculate IV fluid vol post for 24hrs postburn
parkland formula
erythema ab igne
Path
presentation and cause
over exposure infrared
reticulated erythematous patches
hyperpigmentation
talengiectasia
caused by open fires n hot water bottles
erythema ab igne inc risk for
skin scc if cause not tx
non sedating anti histamine
cetrizine
sedating antihistamine
chlorphenamine
1st line urticaria
non sedating antihistamine
then sedating
sti ulcers
painful: herpes(mc) or chancroid
painless: syphillis more common than lymphogranuloma venereum
genital herpes cause
HSV type 2
cold sores
HSV type 1
genital herpes tx
valaciclovir 10 days
1st line chronic plaque psoriasis
topical betamethasone and topical calcipotriol
one in morning and one in night
(potent top sterioud and vit d analogue)
most commonly affected dermatome in shingles
t1-l2
break between topical steriod course in psoriasis pt
4 weeks
lupus pernio asociation
sarcoidosis
tx of MRSA carrier once identified
nasal mupirocin 2% in white soft paraffin tds for 5 days
skin chlorhexidine gluconate od 5 days
apply all over but esp axilla, groin, perineum
eczema findings
erythematous
scaly
excoriations
lichenification
crust and weeping if infected
ezcema tx
emmolients
topical steroids
sedating antihistamines
paste bandaging
more severe
tacrolimus (calcineurin)
phototherapy
oral steroids
immunosuppresants - steroids azathioprine methotrexate
types of psoriasis
chronic plaque
guttate
flexural
pustular
erythrodermic
where else to check for psoriasis
scalp
nails
other extensor surfaces
1st line topical psoriasis tx
emmolients
steroids clobet for face n flexures bet for trunk and limbs
vit d analogue - calcipotriol
vit a anal - dithranol. taxarotene
coal tar
scalp psoriasis tx
mild = coal tar shampoo
severe flare = potent steroid
then scale removal agent ie salicylic acid or emollient
then vit d analogue
moderate psoriasis ie 2nd and 3rd line tx
2nd line phototherpy (UVB –> PUVA+UVA)
3rd line
methotrexate
ciclosporin in flares
acitretin
if still unresponsive = biologics
psoriasis when to refer to dermatologist
Suspected generalised pustular psoriasis (emergency)
- Suspected erythrodermic psoriasis (emergency)
- Uncertainty about diagnosis
- Extensive involvement / more than 10% of body surface area affected
- Moderate or severe disease
- Resistance to topical drug treatments in primary care
- Intolerance to topical drug treatments in primary care
- Significant impact on physical, psychological or social wellbeing
psoriatic arthritis when is pain worst
in the morning
erthema multiforme
target lesions palms soles and limbs
1-2 wks after either ifxn or dx ie
SNAPP
sulphonanamides
NSAIDs
allopurinol
penicillin
phenytoin
common places onhead for scc
ear lip
shingles complication
post herpertic neuralgia
pressure sores grade
g1 - non blanchinh erthema over intact skin
g2 - partial thickness skin loss
g3 - full thickness skin loss extending to sc fat
g4 - extensive destruction with involvement of muscle bone and supporting tissue
rf pressure sores
smoking
obesity
cvd disease
neuro deficit
poor nutrition
immobilty
pressure sore mx
nutrition
abx if infxn
regular dressings
pain relief
positioning
pressure releiing mattress/chair
