DERM 2 Flashcards
acne where
mild
mod
severe
face, upper back, chest wall: comedones open blackheads closed = whites, pustules, cysts
scattered papules, pustules, predom comedones
numerous papules, pustules and mild atrophic scarring
all the above and cysts, nodules and significant scarring
acne treatment if need contraception 1. 2. 3. 4. ABs if affected by what
combined, dinette, clomifine citrate
benzyl peroxidase or azealic acid, adalapene
add on topical ABs - erythromycin or clinda/clotrimazole
PO oral ABs with topical agents - benzyl/isotretinoin. Erythromycin/oxytatracyclin 500mg BD for at least 3 months
Oral isotretinoin
COC - decreased efficacy
side effects of isotretinoin
tetragenic, dry skin and lips, irritating, increased lipids, depression
psoriasis koebers phenom is what
symptoms
treatment
new lesions arise at site of trauma
symmetrical elbows, knees, hands, feet, trunk, arms, scalp. well demarcated red plaques. no ooze. nails: pitting, oncholysis, oil drop sign (yellow-red discolouration)
regular emollients. topical vit D analogues - calcipotriol, tacalcitol. coal tar. retinoids: dithranol, tazarotene. steroids for flare up: metnovate, hydrocortisone
phototherapy UvB first PUVA second
PO methotrexate. ciclosporin. retinoids systemic. biologics
how common is psoriatic arthritis in psoriasis
15%
guttate psoriasis in who
caused by what
symptoms
treatment
children and adolescent
precipitated by strep pharyngitis 2-4w prior to lesions appearing
tear drop papules on trunk and limb
most cases resolve spontaneously within 2-3 months. topical agents. UVB phototherapy
rosacea caused by what
thickening of skin called what
symptoms
treatment
dedox mite. F>M
rhinophyma
nose, chins, cheeks, forehead: papules, pustules, erythema, no comedones, persistent flushing, exacerbated by sudden change in temp, alcohol and spicy foods
decreased aggravating factors
1. topical metro BD for 6-9 weeks. Azeliac acid 1% for sensitive skin
2. tetracycline PO/oxcytetracycline/erythromycin 500mg BD for 6-12 weeks
3. isotretinoin low dose if fever
rhinoplasty - surgery/laser shaving
pityriasis raea what is it and in who
what plays role
symptoms
treatment
acute self limiting rash in young adults.
HHV 7
herald patch usually on trunk followed by red oval scaly patches parallel to longer lines - fir tree
self limiting - disappears after 4-12 weeks
bullous pemphigoid is where and ABs against what
symptoms
ix
treatment
deep through DEJ. ABs against hemidesmasone
plaques, papules, itchy erythemous blisters burst -> erosions, no scarring, localised to 1 area or widespread on trunk and prox limbs
nicosky neg
topical tetracycline. topical emolliants/steroids. systemic -PO pred, aziathroprine
bullous phemphigous is what
symptoms
ix
treatment
split superficial. ABs against desmoglein 3
scalp face axilla groin mucosal involvement. flaccid vesicles - thin roofed lesions rupture -red raw marks
nicosky pos - skin biopsy and IF -> chicken wire looks
high mortality in untreated. topical/systemic steroids. remission 3-6 months. chronic self limiting months - years
dermatitis herptiformis is what
strong assoc with what
skin biopsy
treatment
papillary dermal microabcesses, itch, symmetrical, wlbows/knees, bum
coeliac
deposition of IgA in granular pattern in upper dermis
gluten free diet. dapsone
melanoma ABCD
symptoms
asymmetry, border, colour, diameter, evolution
atypical pigment network, irregular straks, white regression zones with hairpin vessels
superficial spreading melanoma
in who
symptoms
commonest. M- trunk. F-legs
macule with irregular border and colour. increase in size over years before developing nodule with surrounding macular pigmentation
nodular melanoma
who
symptoms
oder any body site develop rapidly
no surrounding pigmentation, some colour, ulcerated, bleeding
latina malignant melanoma is what
in who
invasive melanoma developed within alentigo meligna
elderly. chronically damaged skin
acralientigous melanoma symp and where
palms/soles/nails pigment extension in nails
hutcherson sign
amelaaocytic melanoma
absent/minimal pigmentation
dermatofibroma
some possible to insect bites
first to touch. increased pigment around rim. deep (dermal). brown/grey. firm nodule
melanoma breslow
follow up
treatment
granular layer to deepest point of invasion <1mm 5YS 95-100% <4mm 50%
mets 5%
follow up for 5 year due to risk of recurrence/mets
excision 1cm lateral for every 1mm deep
LN biopsy
naevi due to what
i bad copy of MRCI
two copies
congenital naevi
melanocytes which have failed to migrate or unigrate in utero
freckles. red hair and freckles
2-20cm. >20cm large
large: 10-15% risk of melanoma
slightly raised. become more elevated as child grows
acquired naevi childhood
adolescene/early adulthood
adults
junction. cluster cells at DEJ
compound. group of cells in dermis and DEJ
intradermal - entire dermal
dysplastic naevi
> 6cm, assym border, in situ
sporadic: not inherited. risk of melanoma
familial: FH of melanoma (100% risk). high penetrance atypical naevi
halo naevi
peripheral holes of depigmentation
inflam regression - over run by lymphocytes
blue naevi
entirely dermal
pigment rich dendritic cells. mimic melanoma
spitz naevous
<20s
mimic melanoma
majority benign
akitnic lentigines
increased melanin and basal melanocytes
age/liver spots relates to UV exposure
epidermal elongated ridges
sebborheic keratosis
can be mistaken for melanoma
v common in ageing skin benign proliferation of epidermal keratinocytes
face trunk brown/black. greasy lesion. stuck on appearance
lester treletigon - éruptif appearence
skin type 1
4
5
6
always burns never tans
never burns, always tans
brown
black
xeroderma pigmentosum
defect in 1 of 7 nucleotides
median age 8 yo. photosensitivity. skin cancer on exposed UV sites. neuro degen
albinism
navoid basal cell carcinoma
gorlins syndrome - ADom
