Derm Flashcards
Itchy, raised lesions on wrists, white lacy pattern in oral cavity
Tx?
Lichen planus
Oral = wickam strie
Tx - potent topical steroids
Benzydamine mouthwash
Intensely itchy, bullous rash on elbows, knees, ankles, buttocks
Dermatitis herpetiformis (coeliac)
Dx - skin biopsy
Tx, no gluten, dapsone
tender erythematous nodules on shins (+ thighs/forearms)
associations?
Erythema nodosum
Inf - strep, TB
Systemic - sarcoid, Behcets, IBD
Malig/lymphoma
Drug - penicillin, sulphonamide (co-trim), COCP
Erythematous, well-demarcated, scaly rash over cheeks + bridge of the nose
Malar (butterfly) rash
Often SLE
Reticulated erythematous patches with hyperpigmentation and telangiectasia
Erythema ab igne
Old women
Slowly growing, red, scaly plaque
Bowens disease - a precursor for SCC
non-itchy macular rash over the whole of body (inc soles and palms), systemic features
Penile ulcer previously
Tx?
Secondary syphilis
Tx = IM BenPen
Plaque psoriasis tx
1- potent corticosteroid OD + Vit D analogue (calcitriol) OD (4w)
2 - Vit D analogue BD
3- potent steroid BD OR coal tar prep / dithranol (stains clothes)
Scalp psoriasis Tx
Potent topical steroid OD (4w)
Face/flexural/genital psoriasis Tx
mild/moderate steroids OD/BD for max 2w
Palmar psoriassis Tx
Emolients 1st line
Then steroids if nil improvement
erythema with overlying pustules on chin, nose, forehead and cheeks
Flushing, telengiectasia
Acne Rosacea
Flushing first, then persistent erythema and overlying pustules or papules
Worsened by sunlight and alcohol
Complications - blepharitis
Tx acne rosacea
predom flushing/erythema - topical brimonidine (PRN)
mild/mod papules/pustules - topical ivermectin/ topical metronidazole/ topical azeleic acid
Mod-sev papules/pustules - topical ivermectine + doxy (40mg OD 8-12w)
Mild acne Tx
12w course:
- topical adapalene + benzoyl peroxide
- topical tretinoin + clindamycin
- topical benzoyl + clinda
Topical benzoyl can be used as monotherapy
Mod acne Tx
12w course:
-top adepalene + benzoyl
- topical tretinoin + clindamycin
- topical adapalene + benzoyl + doxy/lymecycline
- topical azeleic + doxy/lymecycine
Red, scaly eczematous lesions on cheeks, scalp, eyebrows, nasolabial folds, flexures
Tx, asso, comp
Seborrhoeic dermatitis
Tx - topical antifungal - eg ketoconazole shampoo, topical steroids (for short periods)
Asso - HIV, Parkinsons
Comp - blepharitis, otitis externa
golden, crusted lesions around the mouth
Impetigo
Tx - hydrogen peroxide 1% cream
Extensive - oral fluclox/erythro
Exclude from school till lesions crusted OR 48 hours after starting abx
Target lesions (concentric rings of erythema with central pale area) on extremities progressing to trunk, mild itching
Asso
Erythema multiforme #
Most common = HSV
Inf - mycoplasma, strep
Drugs - penicillins, Co-Trim, carbamazz, NSAID, COCP
SLE, sarcoid, malig
Pinkish/pearly white papules with centra umbilication
Molluscum copntageosum
Cause by MC Virus
directly/indirect contact transmission
Nil Tx, self resolve in 18mo
If itching - emolient + mild steroid
if looks infected - fusidic acid
Brown velvety plaques in neck/axila/groin
Acanthosis nigrans
T2DM, GI cancer, PCOS, obesity, COCP
scaly papules on trunk/limbs
throat inf 2-4 previously
Guttate psoriasis
‘tear drop’ papules
Spontaneously resolve in 2-3 mo, topical tx
multiple, erythematous, raised lesions with fine scale around etches (ring like appearance)
Preceded by single round patch on trunk
Pityriasis Rosea
Self limiting - resolves after 6w
monomorphic punched out erosions (circular, depressed, ulcerated lesions)
rapidly progressing painful rash
Eczema herpeticum
Tx - admit for IV Abx
Strawberry naevus
Presentation,. Tx
(capillary haemangioma)
Not present at birth - develop rapidly - increase in size till 6-9 months then regress over next few years
If Tx req - topical propranolol
