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derm Flashcards

1
Q

What are the main types of psoriasis?

A 
Guttate
Plaque
Seborrhoeic
Flexural
Erythrodermic
Palmar-plantar pustular
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2
Q

How is psoriasis typically managed first line?

A

Avoid stress, smoking, alcohol.
Emollients
Topical corticosteroid and vitamin D analogue (e.g calcipotriol)

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3
Q

What nail signs are found in psoriasis?

A

Pitting
Beau’s lines
Onchycholysis

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4
Q

What score is used to determine the most appropriate treatment in psoriasis?

A

Psoriasis area and severity index (PASI)

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5
Q

Name two systems for staging melanoma

A

Clarkes level

Breslow thickness

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6
Q

What is the name of scaly spots on sun-damaged skin?

A

Acitinic (solar) keratosis

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7
Q

What is Bowen’s disease?

A

Intraepidermal SCC/ SCC in situ

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8
Q

What causes alopecia areata?

A

Autoimmune

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9
Q

How does alopecia areata present?

A

Patches of hair loss
Non-scarring
Affects young children/adults
Usually regrows

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10
Q

What sign is suggestive of alopecia areata?

A

Exclamation mark hairs

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11
Q

Causes of scarring alopecia

A

Trauma (injury, surgery, radiation)
Infection
Lupus

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12
Q

What is the diagnosis of a young man presenting with frontal hair thinning and receeding of crown?

A

Androgenic alopecia

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13
Q

Which conditions are associated with alopecia areata?

A 
Vitiligo
pernicious anaemia
ITP
diabetes
Addison's
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14
Q

What is a macule?

A

Flat area of altered colour (e.g. freckle)

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15
Q

What is a patch?

A

Large area of altered colour (e.g. port wine stain)

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16
Q

Papule?

A

Solid, raised lesion < 0.5cm in diameter

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17
Q

Nodule?

A

Solid, raised lesion >0.5cm in diameter

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18
Q

Plaque?

A

Palpable scaling lesion > 0.5cm in diameter

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19
Q

Vesicle?

A

Raised, clear fluid filled lesion < 0.5cm in diameter

pustule if contains pus

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20
Q

Bulla?

A

Raised clear fluid filled lesion > 0.5cm in diameter

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21
Q

What is hypertrichosis?

A

Non-androgen dependant pattern of excessive hair growth (e.g in pigmented naevi)

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22
Q

What does koilonychia? (spoon shaped nails suggest)

A

Iron deficiency anaemia

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23
Q

Name the cells found in the skin

A

Keratinocytes
Langerhans cells
Melanocytes
Merkel cells

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24
Q

Name the epidermal layers

A

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basale

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25
Q

Causes of erythema nodosum

A

Group A strep, primary TB, pregnancy, malignancy, sarcoidosis, IBD, chlamydia, leprosy

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26
Q

What are the risk factors for necrotising fasciitis?

A

DM!
Malignancy
Abdo surgery

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27
Q

What is bullous pemphigoid presentation?

A

Tense blisters on erythematous base

Preceeded by itchy rash

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28
Q

What causes bullous pemphigoid and who does it affect?

A

caused by autoantibodies

Mainly affects elderly

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29
Q

How does pemphigus vulgaris present?

A

Easily ruptured painful blisters

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30
Q

Which age group does pemphigus vulgaris mainly affect?

A

Middle aged

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31
Q

How are venous ulcers treated?

A

Compression bandages

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32
Q

How are arterial ulcers diagnosed?

A

ABPI <0.8

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33
Q

What is the definitive management for arterial ulcers?

A

Vascular reconstruction

34
Q

What are Wickhams striae?

A

Lacy white streaks found on oral mucosa in lichen planus

35
Q

How is lichen planus treated?

A

Potent topical corticosteroids

Topical calcineurin inhibitors (e.g. tacrolimus etc)

36
Q

6Ps of lichen planus?

A

Papules, polygonal, purple, planar, pruritic, plaques

37
Q

What skin changes are associated with chronic venous insufficiency?

A

Lipodermatosclerosis
Stasis dermatitis
Venous ulcer

38
Q

What are the side effects of oral retinoids?

A 
Dry skin/lips/eyes
Disordered liver function
Hypercholesterolaemia
Myalgia
DEPRESSION
TERATOGENICITY
39
Q

What test is important before starting oral retinoid?

A

PREGNANCY TEST

must be on contraception for 1 month before starting

40
Q

Indications for ASOT test (anti-streptococcal antibody)

A

Rheumatic fever
Post-strep glomerulonephritis
Scarlet fever
Erysipelas

41
Q

What should you test for in an adult suffering badly from molluscum contagiosum?

A

HIV

42
Q

What does malassezia infection of the skin cause?

A

Pityriasis versicolour

43
Q

How do you diagnose scabies?

A

Microscopy of skin scrapings

44
Q

What are the adverse effects of topical steroids?

A

Cutaneous atrophy
Telangectasia
Striae
Cataracts

45
Q

What is the tx for seborrheic dermatitis?

A

Topical antifungal cream (ketoconazole) and mild-moderate steroid

46
Q

What condition do you suspect in a middle aged man with multiple itchy nodules worse on the outer aspects of the body?

A

Nodular prurigo

47
Q

Which self-limiting condition affecting children and young adults is preceded by a herald patch and followed by generalized rash over the torso?

A

Pityriasis rosea

48
Q

Shiny white, sore, itchy lesions affecting the genital area is likely to be what?

A

Lichen sclerosis

49
Q

How is lichen sclerosis treated?

A

Short course potent corticosteroids

50
Q

What condition causes abscesses and scarring affecting apocrine pilosebaceous follicles?

A

Hidradenitis suppurativa

51
Q

What is the first line tx for acne vulgaris?

A

Topical retinoid + benzoyl peroxide (keratolytic)

52
Q

Which condition fisrt presents as flushing of face and is then followed by diffuse erythema and papules/pustules?

A

Rosacea

53
Q

Use of what medication is linked to triggering/exarcerbating rosacea

A

Steroids

54
Q

What tx can be prescribed for rosacea?

A

Metronidazole/azelaic acid cream

55
Q

Define erythroderma

A

Redness of greater than 90% body surface

56
Q

Causes of erythroderma

A

Eczema, psoriasis, drugs

57
Q

Comps of erythroderma

A

High output cardiac failure
Hypothermia
AKI (fluid depletion)

58
Q

What is the most common trigger of erythema multiforme?

A

HSV

59
Q

What is pyoderma gangrenosum assoc with?

A

IBD, RA, haematological malignancy, liver disease

60
Q

what is acanthosis nigrans assoc with?

A

Insulin resistance, obesity. paraneoplastic syndromes

61
Q

Give 3 tx for bowens disease

A

5-fluorouracil
Cryotherapy
curretage

62
Q

Name a steroid in each potency

A

Mild - hydrocortisone
Moderate - eumovate
Potent - betnovate
Very potent - dermovate

63
Q

Systemic side effects of oral steroids

A 
(SHIP DOC)
Cushings
HTN
Immunosuppression
Psychosis
DM
Osteoporosis
Cataracts
64
Q

Define eczema

A

Chronic, relapsing inflammatory skin condition characterised by itchy, erythematous scaly patches typically affecting the flexor surfaces of children/adults

65
Q

What is the main ix for contact dermatitis?

A

Patch testing

66
Q

What is RFs associated with acne?

A

Puberty
PCOS
Cushings
steroid use

67
Q

Types of melanoma

A

Superficial spreading
Nodular
Lentigo maligna melanoma
Acral

68
Q

How is bullous pemphigoid treated?

A

Wound dressings

Steroids

69
Q

How is scabies treated?

A

Topical permethrin

70
Q

Define Steven-Johnson syndrome?

A

Mucocutaneous necrosis of <10% body surface

71
Q

Define toxic epidermal necrolysis

A

Mucocutaneous necrosis (>30% body) with systemic symptoms

72
Q

What sign is present in TEN?

A

Nikolsky sign (sloughing of skin with pressure)

73
Q

Comps of TEN?

A

dehydration, infection, sepsis, multi-organ failure

74
Q

What organism most commonly causes nec fasc?

A

Group A haemolytic strep (S.PYOGENES)

75
Q

Causes of systemic itch

A 
Renal (CKD)
Cholestatic
Polycythaemia rubra vera
Endocrine (thyroid)
Malignant (e.g. HL)
76
Q

What are the treatments for actinic keratosis?

A

Cryotherapy
Curretage
5-fluorouracil

77
Q

Which fungus is responsible for seborrheic dermatitis?

A

Malassezia

78
Q

What are the features of neurofibromatosis type 1?

A 
6 or more café au lait spots
Axillary freckling
Lisch nodules
Neurofibromas
Optic glioma
LD
79
Q

What are the features of tuberous sclerosis?

A 
Angiofibromas
Ash leaf macules
Periungal fibromas
Shagreen patches
Seizures
80
Q

Which drugs cause TEN?

A

ANTIEPILEPTICS
allopurinol
NSAIDs

81
Q

How is pityriasis versicolor diagnosis confirmed?

A

Yellow green fluorescence on wood lamp

med (25 decks)

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