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GP rotation > Derm 2 - Emergencies and skin infections > Flashcards

Derm 2 - Emergencies and skin infections Flashcards

1
Q

Urticaria, angioedema and anaphylaxis are examples of which type of hypersensitivity reaction?

A

Type 1 hypersensitivity reaction - IgE-mediated

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2
Q

List some common triggers of urticaria/angioedema/anaphylaxis:

A 
Foods: Nuts, shellfish, dairy
Drugs: Penicillin, contrast media, NSAIDs, morphine, ACEi
Insect bites
Contact: Latex
Autoimmune
Hereditary (angioedema)
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3
Q

How does urticaria present?

A

Itchy wheals

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4
Q

How does angioedema present?

A

Swelling of dermis, tongue and lips

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5
Q

How does anaphylaxis present?

A
  • Bronchospasm
  • Facial/laryngeal oedema
  • Hypotension
  • Wheeze
  • Cyanosis
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6
Q

What is the management of urticaria?

A
  • Trigger avoidance
  • Anti-histamines
  • Corticosteroids if severe acute
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7
Q

What is the management of angioedema?

A
  • Trigger avoidance

- Corticosteroids

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8
Q

What is the management for anaphylaxis?

A
  • Trigger avoidance
  • Adrenaline - 500 ug
  • Hydrocortisone - 200 mg
  • Chlorphenamine - 10mg
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9
Q

List some causes of erythema nodosum:

A
  • Sarcoidosis
  • Strep throat
  • TB
  • Pregnancy
  • Malignancy
  • IBD - Crohns/UC
  • Chlamydia
  • Leprosy
  • Drugs: COCP, Sulphonamide abc, NSAIDs
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10
Q

Describe the lesion seen in erythema nodosum:

A

Discrete tender nodules on the shins/ankles

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11
Q

What is Stevens-Johnson syndrome?

A

Acute skin reaction (type 4 hypersensitivity reaction) causing mucocutaneous necrosis, often triggered by drugs.

  • Blistering skin
  • Mouth ulcers
  • Sore, ulcerating eyes
  • Diarrhoea
  • Cough
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12
Q

What is Toxic Epidermal Necrosis?

A

Acute widespread skin and mucosal necrosis in reaction to a drug - type 4 hypersensitivity reaction.
>30% mortality

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13
Q

Name the serious complication of atopic eczema, characterised by extensive crusty papule, blisters and erosions:

A

Eczema herpeticum

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14
Q

What is the infective agent causing eczema herpeticum? What is the treatment?

A
  • Herpes simplex virus

- Aciclovir

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15
Q

Differentiate between cellulitis and erysipelas:

A 
Cellulitis = bacterial infection of deep subcutaneous tissue
Erysipelas = Bacterial infection of dermis and upper subcutaneous tissue, which has a well-defined, red raised border.
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16
Q

What are the common infective agents causing cellulitis and erysipelas?

A
  • Strep pyogenes

- Staph aureus

17
Q

Which antibiotics should be given for cellulitis/erysipelas?

A
  • Flucloxacillin or Benzylpenillin
18
Q

What is tinea corporis?

A

Tinea infection of trunk and limbs.

- Itchy, circular lesions, with clearly defined, raised scaly edge

19
Q

What is tinea cruris?

A

Tinea infection of groin and natal cleft

- Itchy

20
Q

What is tinea pedis?

A

Athlete’s foot = moist scaling and fissuring in toewebs

21
Q

What is tinea manuum?

A

Tinea infection of the hand

Scaling and dryness in palmar creases

22
Q

What is tinea capitis?

A

Patches on scalp of broken hair, scaling and inflammation

23
Q

What is tinea unguium?

A

Tinea infection of nail

- Yellow, thickened, crumbly nail

24
Q

What is the treatment for a tinea infection?

A
  • Correct predisposing factors ie moist environment
  • Topical antifungal - Terbinafine
  • Oral antifungal - Itraconazole
25
Q

Why shouldn’t topical steroids be used on tinea infections?

A

Lead to tinea incognito

26
Q

What is pityriasis versicolor?

A

Scaly brown patches on upper trunk which fail to tan on sun exposure

27
Q

Hyperpigmentation and hyperkeratosis of skin folds…

A

Acanthosis nigricans

28
Q

What conditions is acanthosis nigricans associated with?

A 
Gastric cancer
Insulin resistance:
- Hyperinsulinaemia
- Cushing's
- Acromegaly
- PCOS
29
Q

What is the infective agent in scabies?

A

Sarcoptes scabiei

30
Q

What are the presenting features of scabies?

A

Extremely itchy rash, widespread tiny red spots and scratches, particularly in skin folds
May resemble eczema

31
Q

What is Permethrin used to treat?

A

Scabies infestation

32
Q

What is the management of scabies?

A
  • Topical insecticide: Permethrin 5%
  • Advise all close contacts to get tx
  • Wash and dry bedding, towels and clothes >60’C

GP rotation (4 decks)

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