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My General Practise > Derm > Flashcards

Derm Flashcards

1
Q

Koebner phenomenon

A

linear eruption at site of trauma

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2
Q

annular

A

circle or ring

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3
Q

discoid/ nummular

A

coin lesion

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4
Q

purpura

A

bleeding into skin, doesnt blanch on pressure

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5
Q

macule

A

freckle

flat area of altered colour

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6
Q

patch

A

large flat area of altered color or texture, vascular malformation

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7
Q

papule

A

xanthomata

raised solid lesion < 0.5cm in diameter

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8
Q

nodule

A

pyogenic granuloma

raised solid lesion > 0.5cm in diameter

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9
Q

plaque

A

palpable scaling lesion over 0.5cm in diameter

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10
Q

excoriation

A

loss of epidermis following trauma

eczema

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11
Q

lichenification

A

roughening of skin with accentuation of skin markings

rubbing in eczema

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12
Q

scales

A

flakes of stratum corneum

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13
Q

types of melanomas & epidemiology
SUPERFICIAL SPREADING: 50-75%
NODULAR: 15-35%

A

LENTIGO MALIGNA MELANOMA: 5-15%

ACRAL LENTIGINOUS MELANOMA: 5-10%

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14
Q

melanoma 5 yr survival rates

A 
STAGE 1 (T <2MM THICK, N0, M0) - 90%, 
STAGE 2 (T>2MM THICK, N0, M0) – 80%, 
STAGE 3 (N≥1, M0) – 40- 50%,  
STAGE 4 (M ≥ 1) – 20-30%
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15
Q

granuloma annulare

A

SLOW-GROWING RINGS OF SMALL, FIRM, FLESH-COLORED TO RED PAPULES WITH CENTRAL INVOLUTION
CHILDREN AND YOUNG ADULTS
A/W DIABETES
No Tx needed mostly

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16
Q

pyogenic granuloma

A

BENIGN, VASCULAR, DOME-SHAPED PAPULE OR NODULE.
YELLOW TO RED, RAPIDLY GROWING LESION WITH MOIST TO SCALY SURFACE
SECONDARY TO TRAUMA OF SKIN OR MUCOUS MEMBRANES
TREAT WITH CURETTAGE AND CAUTERISATION

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17
Q

actinic keratosis

A

ERYTHEMATOUS, SCALY, ROUGH PAPULES OR PLAQUES +/- ADHERENT YELLOW CRUST
CAN PROGRESS TO SQUAMOUS CELL CARCINOMA
INCLUDING CRYOTHERAPY/CURETTAGE AND CAUTERY, EXCISION, TOPICAL TREATMENTS (5-FLUOROURACIL OR IMIQUIMOD)

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18
Q

Bowens disease

A

INTRAEPIDERMAL SQUAMOUS CELL CARCINOMA

IRREGULAR SCALY PATCH – ULCERATION

NON HEALING LESION

CAN PROGRESS TO SQUAMOUS CELL CARCINOMA

TREATMENT OPTIONS INCLUDE CRYOTHERAPY, SUPERFICIAL SKIN SURGERY, TOPICAL TREATMENT (5-FLUOROURACIL OR IMIQUIMOD THERAPY), PHOTODYNAMIC THERAPY

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19
Q

keratoacanthoma

A

1-2.5CM DOME-SHAPED PAPULE OR NODULE WITH A CENTRAL KERATIN-FILLED CRATER

RAPIDLY GROWS (6-8 WEEKS) AND MAY LOOK LIKE A SQUAMOUS CELL CARCINOMA

MOST COMMON ON SUN-EXPOSED SKIN

MAY INVOLUTE ON ITS OWN LEAVING A SCAR

TREATMENT IS EXCISION

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20
Q

HYPERKERATOTIC, SKIN-COLORED TO ERYTHEMATOUS PAPULE, NODULE, OR PLAQUE

SCALING ULCERATION CRUSTING

A

SCC

SECOND MOST COMMON SKIN CANCER
SUN-EXPOSED SKIN
5% METASTASISE LIP OR EAR
MORE AGGRESSIVE IN IMMUNOSUPPRESSED PATIENTS
Tx mohs micrographic surgery,
radiotherapy
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21
Q

WAXY, PEARLY, TRANSLUCENT PAPULE WITH TELANGIECTASIA AND ULCERATION
VERY RARELY METASTASISES

A

NODULAR BCC IS THE MOST COMMON BCC

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22
Q

4 types of BCC

A

nodular
superficial
pigmented
morpheaform

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23
Q

BCC tx

A

SURGERY (INCLUDING MOHS MICROGRAPHIC SURGERY), RADIOTHERAPY, TOPICAL TREATMENTS (5-FLUOROURACIL OR IMIQUIMOD),
CRYOTHERAPY

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24
Q

PAPULES OR VESICLES ON AN ERYTHEMATOUS BASE

A

dermatitis

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25
Q

atopic eczema

A

develops in early childhood, resolves in teenage years

a/w FHx of asthma, allergic rhinitis, atopy

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26
Q

Eczema complications

A

SECONDARY BACTERIAL INFECTION EG IMPETIGINISED CRUSTY WEEPY LESIONS OR SECONDARY VIRAL INFECTION EG ECZEMA HERPETICUM)

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27
Q

eczema in infants

A

face and extensor surfaces

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28
Q

eczema in children and adults

A

flexor surfaces

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29
Q

atopic dermatitis tx general

A

AVOID KNOWN EXACERBATING AGENTS, FREQUENT EMOLLIENTS +/- BANDAGES AND BATH OIL/SOAP SUBSTITUTE

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30
Q

atopic dermatitis tx topical

A

STEROIDS* FOR FLARE-UPS; TOPICAL IMMUNOMODULATORS (E.G. TACROLIMUS, PIMECROLIMUS)

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31
Q

atopic dermatitis tx oral

A

ANTIHISTAMINES FOR SYMPTOMATIC RELIEF, ANTIBIOTICS (E.G. FLUCLOXACILLIN) FOR SECONDARY BACTERIAL INFECTIONS, AND ANTIVIRALS (E.G. ACICLOVIR) FOR SECONDARY HERPES INFECTION

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32
Q

atopic dermatitis tx phototherapy & immunosuppressants

A

ORAL PREDNISOLONE, AZATHIOPRINE, CICLOSPORIN

33
Q

mild topical steroids

A

hydrocortisone

hydrocortisone acetate

34
Q

moderate topical steroids

x2-25 as potent as hydrocortisone

A

clobetasone butyrate

triamcinolone acetonide

35
Q

potent topical steroids

x100-150 as potent as hydrocortisone

A

betamethasone valerate
betamethasone dipropionate
hydrocortisone 17-butyrate
Mometasone furoate

36
Q

V potent topical steroids

x600 as potent as hydrocortisone

A

clobetasol propionate

betamethasone dipropionate

37
Q

Seborrheic dermatitis

A

YEAST PITYROSPORUM OVALE, COMMON, AFFECTS 3-5% OF THE POPULATION
WHITE-YELLOWISH GREASY SCALE ON ERYTHEMATOUS PATCHES OR PLAQUES. INDISTINCT MARGINS.
CRADLE CAP in infants

38
Q

Seborrheic dermatitis Tx

A

BABY SHAMPOO

ADULT KERATOLYTICS, TOPICAL ANTI-FUNGALS, TOPICAL STEROIDS OR TOPICAL TACROLIMUS

39
Q

INFLAMMATION AND DEPOSITION OF HEME RESULTS IN THE ECZEMATOUS LESIONS
PROXIMAL TO THE MEDIAL MALLEOLUS

A

Stasis Dermatitis- Venous Eczema

40
Q

Stasis Dermatitis- Venous Eczema Tx

A

SUPPORT STOCKINGS, LEG ELEVATION, WEIGHT REDUCTION, EMOLLIENTS AND TOPICAL STEROIDS

41
Q

SHARPLY DEMARCATED PRURITIC, ERYTHEMATOUS PLAQUES WITH OVERLYING SILVER SCALE
SCALP, ELBOWS, KNEES (EXTENSOR)

A

psoriasis

42
Q

psoriasis complications

A

ARTHRITIS (5-8% OF PATIENTS), SECONDARY INFECTION, ERYTHRODERMA, PSYCHOLOGICAL AND SOCIAL EFFECTS

43
Q

psoriasis precipitating factors

A

INCLUDE TRAUMA, INFECTION (EG TONSILLITIS – CAN CAUSE “GUTTATE” PSORIASIS), DRUGS, STRESS, ALCOHOL

44
Q

auspitz sign

A

pinpoint bleeding upon removal of scale in psoriasis

45
Q

Tx topical

A

VITAMIN D ANALOGUES, TOPICAL CORTICOSTEROIDS, COAL TAR PREPARATIONS, DITHRANOL, TOPICAL RETINOIDS, KERATOLYTICS AND SCALP PREPARATIONS

46
Q

Tx phototherapy

A

UVB AND PHOTOCHEMOTHERAPY I.E. PSORALEN+UVA

47
Q

Tx oral

A

METHOTREXATE, RETINOIDS, CICLOSPORIN, MYCOPHENOLATE MOFETIL, FUMARIC ACID ESTERS, BIOLOGICAL AGENTS (E.G. INFLIXIMAB, ETANERCEPT, EFALIZUMAB)

48
Q

topical tx for mild acne

6 weeks

A

BENZOYL PEROXIDE AND TOPICAL ANTIBIOTICS (ANTIMICROBIAL PROPERTIES), AND TOPICAL RETINOIDS (COMEDOLYTIC AND ANTI-INFLAMMATORY PROPERTIES)

49
Q

oral tx for moderate to severe acne

A

ORAL ANTIBIOTICS OR ANTI-ANDROGENS (IN FEMALES). ORAL RETINOIDS (FOR SEVERE ACNE)

50
Q

ERYTHEMA, FLUSHING AND PAPULES

RHINOPHYMA (ESPECIALLY MEN)

A

acne rosacea

51
Q

acne rosacea

A

AVOIDANCE MEASURES, TOPICAL THERAPIES (EG METRONIDAZOLE GEL), ORAL ANTIBIOTICS (EG TETRACYCLINE ANTIBIOTICS), ORAL ISOTRETINOIN IF RESISTANT

52
Q

CRUSTED GOLDEN LESIONS

A

IMPETIGO

TREAT WITH TOPICAL ANTI-BACTERIALS

53
Q

CELLULITIS – INVOLVING DEEP SUBCUTANEOUS TISSUES – MOSTLY LOWER LIMBS

A

TREAT WITH ORAL ANTIBIOTICS EG FLUCLOXACILLIN

54
Q

2-5MM FLESH-COLORED PAPULES WITH CENTRAL UMBILICATION

CLEAR SPONTANEOUSLY WITHIN 6-9 MONTHS

A

MOLLOSCUM CONTAGIOSUM

POX VIRUS, CHILDREN, CONTACT/TRAUMA

55
Q

PARVOVIRUS B19
CHILDREN AGED 3-12 FADES SPONTANEOUSLY
PREGNANT WOMEN RISK OF FOETAL HYDROPS IN FIRST HALF OF PREGNANCY

A

ERYTHEMA INFECTIOSUM
SLAPPED CHEEK
FIFTH DISEASE

56
Q

OVAL, MINIMALLY ELEVATED, PRURITIC, SCALING PATCHES, PAPULES, AND PLAQUES. TANNISH PINK/SALMON COLOURED

IDIOPATHIC (POST-VIRAL?) SELF-LIMITING INFLAMMATORY LESIONS, OCCUR MOST COMMONLY IN YOUNG ADULTS IN THE COOLER MONTHS

MOST COMMONLY OVER TRUNK IN A “CHRISTMAS TREE” PATTERN (FOLLOWS SKIN LINES)

HERALD PATCH IS INITIAL, LARGE, SINGLE LESION FOLLOWED BY GENERALIZED RASH DAYS TO WEEKS LATER.

SELF-LIMITED CONDITION THAT RESOLVES OVER 6-8
WEEKS. MANAGEMENT OF SYMPTOMS: ANTI-HISTAMINES, MOISTURIZERS

A

PITYRIASIS ROSEA

57
Q

FEW TO HUNDREDS OF SKIN LESIONS ERUPT WITHIN A 24-HOUR PERIOD
HERPES SIMPLEX VIRUS

A

ERYTHEMA MULTIFORME

58
Q

FUNGAL SKIN INFECTIONS

A

DERMATOPHYTES (TINEA/RINGWORM), YEASTS (E.G. CANDIDIASIS, MALASSEZIA), MOULDS (E.G. ASPERGILLUS)

59
Q

ITCHY, CIRCULAR OR ANNULAR LESIONS WITH A CLEARLY DEFINED, RAISED AND SCALY EDGE

A

TINEA CORPORIS

60
Q

FUNGAL SKIN INFECTIONS Dx

A

KIN SCRAPINGS, HAIR OR NAIL CLIPPINGS (FOR DERMATOPHYTES); SKIN SWABS (FOR YEASTS)

61
Q

FUNGAL SKIN INFECTIONS Tx

A

TOPICAL ANTIFUNGAL AGENTS (E.G. TERBINAFINE CREAM)

ORAL ANTIFUNGAL AGENTS (E.G. ITRACONAZOLE) FOR SEVERE, WIDESPREAD, OR NAIL INFECTIONS

62
Q

TINY RED INTENSELY ITCHY BUMPS ON THE LIMBS AND TRUNK

A

Scabies

63
Q

Scabies tx

A

PERMETHRIN X 8 HRS

64
Q

PINK WHEALS (TRANSIENT), MAY BE ROUND, ANNULAR, OR POLYCYCLIC

A

ACUTE URTICARIA

65
Q

ulcer in malleolar area

A

venous

66
Q

ulcer in pressure and trauma sites, pretibial, supramalleolar, distal points

A

arterial

67
Q

ulcer in pressure sites

soles heels toes metatarsal heads

A

neuropathic

68
Q

large shallow irregular ulcer

exudative & granulating base

A

venous

69
Q

small sharply defined deep ulcer

necrotic base

A

arterial

70
Q

granulating base ulcer +/- callus

A

neuropathic

71
Q

leg oedema, haemosiderin, melanin, lipodermatosclerosis, atrophie blanche

A

venous

72
Q

cold shiny skin
weak PP
hair loss

A

arterial

73
Q

peripheral neuropathy

A

neuropathic ulcer

74
Q

normal ABPI 0.8 - 1

A

arterial

75
Q

ABPI under 0.8

doppler studies and angiography

A

arterial

76
Q

ABPI under 0.8

xray to exclude osteomyelitis

A

neuropathic

77
Q

compression bandaging tx for venous but CI in

A

arterial ulcers

78
Q

Neuropathic ulcer tx

A

wound debridement
regular repositioning
footwear
nutrition

My General Practise (8 decks)

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