Derm Flashcards
Diabetic skin changes
Flexural candidiasis
Yellow patches of skin
Thickened axillary, groin and neck skin
Coeliac disease skin changes
Dermatitis herpetiforms - Very itchy burning blisters on elbow, scalp, shoulders and ankles
IBD skin changes
Erythema nodosum - Tender subcutaneous lumps
Pyoderma gangrenosum - Rapidly growing very painful pustular blisters.
SLE skin changes
Facial butterfly rash
Photo sensitivity
HSV changes
Erythema multiforme - Well defined round lesions on extensor surfaces
Lyme disease chanages & treatment
Erythema migrans - Target like lesion.
Doxycycline
Systemic scleroderma features
CREST Calcinosis Raynauds oEsophageal and gut dysfunction Sclerodactially Telangictasia
Sarcoidosis changes
Yellow firm nodules in skin
Scarring alopecia
Lupus pernio - Diagnostic
Firm subcutaneous nodules.
Actinic keratoses
Pre malignant yellow/white scaly crusts on sun exposed skin. May develop into a SSC
Bowens disease & treatment
SSC in situ. Well defined, slowly growing red scaly plaque with full thickness dysplasia. May progress to SSC
Cryotherapy/Flurouracil
SSC
Ulcerated or crusted firm irregular lesion on sun exposed skin.
Increased risk of metastasis if on lip, ear, non exposed skin, immunosupression.
Need excision
BCC
Commonest skin cancer.
Nodular - Pearl with telangectasic edges
Superficial - Red scaly plaque with raised smooth edge.
Flurouracil/excision
Common metastases to skin (5)
Breast. Stomach and colon Lung GU Lymphoma
ABCDEF of melanoma
Asymmetry Border irregular Colour variation Diameter over 6mm Evolution - changing Funny looking mole
Psoriasis
Hyperproliferation epidermis with proliferation and dilation of vessels in the dermis & t cell and neutrophills
Types of psoriasis (4)
Plaque - Symmetrical well defined red plaque with silver scales on extensor surfaces
Flexural - Plaques in mosts skin folds. Often less scaley and misdiagnosed as fungal.
Guttate - Large numbers of small plaques over trunk and limbs in young. Usually following strep infection
Generalised erythrodermic - May cause systemic upset (fever, increase in WCC and dehydration) - Requires hospital admission.
Nail changes in psoriasis
Pitting
Onycholysis
Thickening
Treatment for psoriasis (5)
Topical corticosteroid (Betnovate) & topical Vit D
Stronger corticosteriod cream (Dermovate) (not more than 8 weeks)
Phototherapy
Methotrexate/isotretinoin
Infliximab/entancerpt
Diagnosing atopic eczema (1+4)
Itchy skin with 3 or more of Onset before 2 years Flexural involvement History of generally dry skin Personal or family history of atopy.
Nb typically spares the nappy area
Eczema herpeticum
HSV infection of eczema causing systemic illness and wheeping blister rash especially round the mouth. Medical emergency
Treatment of eczema
Topical emollients (Diprobase)
Topical corticosteroids
Oral steroids
Azothioprine/methotraxate in severe disease
Mild/Moderate-Potent/Very potent topical steroid
Side effects
Hydrocortisone
Betnovate
Dermovate
Skin thinning, telangectasia, irriversable striae.
Ringworm treatment
Clotrimazole
Candia albicans treatment
Mouth
Skin
Vagina
Nystatin
Clotrimazole
Clotrimazole + pessary (Canistan combi)
Bacteria infections of the skin
Impetigo - S.aureus/pyogenes - Honeycoloured crusts - Fusidic acid cream
Cellulitis - B haemolytic staph and strep - RCDT - Ben Pen
Wart treatment
Cryotherapy/Salicylic acid
Koebner phenomenon
Psorisis developing from a scratch/incision
Auspitz’s sign
Bleeding from psoriasis scales upon removal.
When to seek specialist advice in shingles (3)
Immunocompromised
Pregnant
Ophthalmic involvement
Treatment for acne
Mild
Moderate
Severe
Facial comedomes only
Benzoyl peroxide or isotretinoin
Papules and pustules dominat face and torso
Topical antibiotic + Benzoyl peroxide/istretinoin
or Doxycycline/tetrocyclin or combined oral contraceptive.
Nodules, cysts, scars and inflamation
Refer - Best is high does isotretinoin.
Rosacea
S&S
Treatment
Central facial rash with erythema telenagiectasia, papules pustules (without comedomes), lymphoedema.
Brought on by stress, alcohol, and spices
Mild
Topical metronidazole or azelaic acid
Moderate Oral tetracycline (Erythro if pregnant)
Nb if occular invlovement give ciprofloxacin
Drug reactions presentation
Morbilliform Urticaria Erythroderma Steven Johnsons syndrome Toxic epidermal necrolysis
Morbilliform
Generalised erythematous maclues and papules on the trunk + Mild fever within 1-3 weeks of drug.
Common drugs
Amoxicillin
Cephalosporins
Steven Johnsons syndrome
URTI symptoms 2-3 weeks after starting a drug. Then Painful erythematous paupular rash evolving to form target like lesions. Affects <10% and severe mucous ulceration in >1 spot.
Causative drugs
Sulfonamides, anti epileptics, penicillins
Management
IV Ig, ICU, supportive
Toxic epidermal necrolysis
Flu like sysmptoms evloving to widespead painful rash and necrosis of large areas of the epidermis. >30%
Causative drugs
Sulfonamides, anti epileptics, penicillins, allopurinol
Management
IV Ig, ICU, supportive
Drugs inducing photo sensitivity
Thiazides
Tetracyclines
Amiodarone
Lichen planus 5ps
Purple Puritic Poly angular Planar Papules
Common on wrists, forearms ankles and legs
Treatment steroid
HIV infections
EBV HSV Candidiasis Scabies Syphilis
HIV skin problems
Seborrhoeic dermatits Psoriasis Drug reactions more common Alopecia Fat loss from face and gain on truck Onychomycosis (fugal infection of nail)
Pressure ulcer staging
Non blanching erythema
Partial thickness skin loss
Full thickness skin loss extending into fat
Destruction of muscle/bone/fat
Pressure ulcer treatment
Pressure relieving mattress Regular turning Debride Dressings Optimise nutrition
Scabies
Very itchy rash affecting finger webs. Highly contagious
Treatment - Perimethrin
Scoring system for melanoma
Breslows
