DERM 2 Flashcards

1
Q

acne where
mild
mod
severe

A

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

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2
Q
acne treatment if need contraception
1. 
2. 
3. 
4. 
ABs if affected by what
A

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

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3
Q

side effects of isotretinoin

A

tetragenic, dry skin and lips, irritating, increased lipids, depression

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4
Q

psoriasis koebers phenom is what
symptoms
treatment

A

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

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5
Q

how common is psoriatic arthritis in psoriasis

A

15%

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6
Q

guttate psoriasis in who
caused by what
symptoms
treatment

A

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

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7
Q

rosacea caused by what
thickening of skin called what
symptoms
treatment

A

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

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8
Q

pityriasis raea what is it and in who
what plays role
symptoms
treatment

A

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

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9
Q

bullous pemphigoid is where and ABs against what
symptoms
ix
treatment

A

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

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10
Q

bullous phemphigous is what
symptoms
ix
treatment

A

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

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11
Q

dermatitis herptiformis is what
strong assoc with what
skin biopsy
treatment

A

papillary dermal microabcesses, itch, symmetrical, wlbows/knees, bum

coeliac

deposition of IgA in granular pattern in upper dermis

gluten free diet. dapsone

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12
Q

melanoma ABCD

symptoms

A

asymmetry, border, colour, diameter, evolution

atypical pigment network, irregular straks, white regression zones with hairpin vessels

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13
Q

superficial spreading melanoma
in who
symptoms

A

commonest. M- trunk. F-legs
macule with irregular border and colour. increase in size over years before developing nodule with surrounding macular pigmentation

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14
Q

nodular melanoma
who
symptoms

A

oder any body site develop rapidly

no surrounding pigmentation, some colour, ulcerated, bleeding

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15
Q

latina malignant melanoma is what

in who

A

invasive melanoma developed within alentigo meligna

elderly. chronically damaged skin

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16
Q

acralientigous melanoma symp and where

A

palms/soles/nails pigment extension in nails

hutcherson sign

17
Q

amelaaocytic melanoma

A

absent/minimal pigmentation

18
Q

dermatofibroma

A

some possible to insect bites

first to touch. increased pigment around rim. deep (dermal). brown/grey. firm nodule

19
Q

melanoma breslow
follow up
treatment

A

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

20
Q

naevi due to what
i bad copy of MRCI
two copies
congenital naevi

A

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

21
Q

acquired naevi childhood
adolescene/early adulthood
adults

A

junction. cluster cells at DEJ
compound. group of cells in dermis and DEJ

intradermal - entire dermal

22
Q

dysplastic naevi

A

> 6cm, assym border, in situ

sporadic: not inherited. risk of melanoma
familial: FH of melanoma (100% risk). high penetrance atypical naevi

23
Q

halo naevi

A

peripheral holes of depigmentation

inflam regression - over run by lymphocytes

24
Q

blue naevi

A

entirely dermal

pigment rich dendritic cells. mimic melanoma

25
Q

spitz naevous

A

<20s
mimic melanoma
majority benign

26
Q

akitnic lentigines

A

increased melanin and basal melanocytes
age/liver spots relates to UV exposure
epidermal elongated ridges

27
Q

sebborheic keratosis

A

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

28
Q

skin type 1
4
5
6

A

always burns never tans
never burns, always tans
brown
black

29
Q

xeroderma pigmentosum

A

defect in 1 of 7 nucleotides

median age 8 yo. photosensitivity. skin cancer on exposed UV sites. neuro degen

30
Q

albinism

navoid basal cell carcinoma

A

gorlins syndrome - ADom