Derm Flashcards
What is Polymorphic eruption of pregnancy?
Typically begins in the third trimester. It often starts within stretch marks on the abdomen, particularly around the umbilicus, before spreading to other areas. The rash is characterised by small red bumps and hives, and it can be very itchy.
Where do you see Wickham Striae?
Lichen plaus
How do we treat lichen planus?
Potent topical steroids
How does lichen planus present?
planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common
How do we treat plaque psoriasis?
NICE recommends a potent corticosteroid (for a maximum of 8 weeks) plus a vitamin D analogue, both once daily, for first-line treatment.
Define severe acne
In severe acne, there are nodules and cysts (nodulocystic acne), as well as a preponderance of inflammatory papules and pustules. There is a high risk of scarring (or scarring may already be evident), and there is likely to be considerable psychosocial morbidity.
How would you manage severe acne?
Consider prescribing an oral antibiotic in combination with a topical drug whilst waiting for an appointment. Benzoyl peroxide or a topical retinoid are recommended as adjunctive treatment for most people. Azelaic acid is an alternative, but avoid the use of topical antibiotics with oral antibiotics
What are milia?
Milia are small, benign, keratin-filled cysts that typically appear around the face. They may appear at any age but are more common in newborns.
What is pityriasis versicolor?
This condition is a common yeast infection of the skin, caused by the fungus Malassezia. The primary symptom includes hypopigmented or hyperpigmented macules and patches on the chest and back. These patches may be pink, tan, brown or white, and they often become more noticeable with tanning, as in this case. In addition, these lesions can sometimes be slightly scaly.
How does dermatitis herpetiformis present?
This patient’s presentation of an intensely itchy, symmetrical vesicular rash on the knees and back of arms is highly suggestive of dermatitis herpetiformis. Dermatitis herpetiformis is an autoimmune skin condition associated with coeliac disease, and it often presents as a pruritic, blistering rash on extensor surfaces such as the elbows, knees, and buttocks.
What is hereditary haemorrhagic telangiectasia?
Hereditary haemorrhagic telangiectasia often presents with multiple telangiectasia and bleeding from the rectum or more commonly, the nose. One of the criteria for diagnosis is the presence of the disease in a first degree relative, which the patient alludes to when the telangiectasia on their lips and tongue is noted.
What is a capillary haemangioma?
These appear as a small red patch which develops in the first month of life, increasing in size until around 9 months and becoming more vascular. They are not present at birth and regress spontaneously. Parents should be reassured that no treatment is needed and there is no sinister cause.
How do we treat impetigo?
Topical hydrogen peroxide, then topical fusidic acid
What is leukoplakia?
Leukoplakia is a premalignant condition which presents as white, hard spots on the mucous membranes of the mouth. It is more common in smokers.
Leukoplakia is said to be a diagnosis of exclusion. Candidiasis and lichen planus should be considered, especially if the lesions can be ‘rubbed off’
Biopsies are usually performed to exclude alternative diagnoses such as squamous cell carcinoma and regular follow-up is required to exclude malignant transformation to squamous cell carcinoma, which occurs in around 1% of patients.
How does guttate psoriasis present?
Guttate psoriasis is a subtype of psoriasis that typically affects children and young adults following infection with Streptococcus sp. (as seen here with this patient’s recent tonsillitis infection). The rash presents acutely with multiple small scaly and erythematous patches of skin appearing over the trunk and limbs. They often have a tear-drop shape.
