Derm Flashcards
First line Rx for acne vulgaris
TOP Benzoyl peroxide BD
Derm signs and ABs and Dx test for Dermatomyositis
Purple rash on eyelids (heliotrope rash)
Macular rash on back/shoulders (shawl sign)
Red papule over knuckles (Gottron’s papules)
Anti-Mi2 + Anti-Jo
Dx: Muscle bx
Intensely itchy vesicular rash on elbows, shoulders, ankles, scalp
Dx and Rx
Dermatitis herpetiformis ~Coeliac disease
Rx: Dapsone
Tender, reddened well defined area on cheek (+/- legs)
Dx + Rx
Erysipelas
Rx: Fluclox
Scaly, red, slow growing plaque, refractory to psoriasis treatment
Dx+Rx
SCC
Rx:
cryotherapy
topical 5-fluorouracil cream
First line psoriasis Rx
Topical vD analogue + Topical potent steroid eg. betametasone
Facial hirsutism Rx
TOP Eflornithine
Itchy, patchy alopecia with defined scale
Dx + Ix + Rx
Tinea capitis
Woods lamp: green/blue fluorescence of hairs
Rx: Oral antifungal
First line Rx for eczema
TOP emollient + TOP mild steroid eg. hydrocortisone 1%
If signs of infection, TOP roid+ABx preparation
Seborrheic dermatitis features and Rx
Red scaly rash affecting forehead and eyebrows, nasolabial folds, cheeks, flexures
~eczematous lesions on sebum-rich areas
Rx:
Neutrogena shampoos
Face+body: mild roid/antifungal combo eg. Daktacort
Oral retinoids SEs
Hair loss
Nose bleeds
Sore lips
Dry MM
Healthcare worker with vesicles on nails
Herpetic whitlow ie. herpes/viral finger nail infection due to exposure to oral secretions
Derm treatment that can stain skin/clothes
Dithranol or tar preparations
How to prevent recurrence of SCC
Sunscreen
no affect with BCC
Pink, slightly pigmented scaly plaque <5cm, no other lesions
Dx + initial Ix + Rx
Bowen’s disease
Skin Bx
Rx: cryotherapy, excision or curettage
Itchy round scaly lesions on back
Dx, Ix and organism
Tinea
Trychophyton/Microsporum/Epidermophyton
Skin scrapings/nail clipping
Organism in pytriasis versicolor
Malassezia furfur
Red lump near ear/neck/trunk appearing at 3 weeks of age
Prog?
Capillary haemangioma/strawberry naeuvus
Grow until 1yo, regress by 4-5yo
New rash in 3 day old:
erythematous rash with pinpoint papules on face/trunk limbs
Prog?
Erythema toxicum aka neonatal urticaria ~2-14/7
Spontaneous improvement
Port-wine stain description and Rx
Malformed capillaries under skin of face
May remain unchanged ie. can then treat with LASER
flat grey, brown, black areas on sun-exposed areas in 80yo
age spots/liver spots
Paediatric trichotillomania features
Hair pulling causing alopecia Pulling hair of others/objects Increased periods of stress/anxiety Denying hair pulling GI disturbance
Discoid lupus features + Rx
20-40yo woman
multiple mildly pruritic scaly red patches
face, neck, back of hands
some around lips and oral
(sun exposed areas)
When heal, leave hypo/hyperpigmented area
Rx:
TOP potent steroid
TOP fluocinonide
If systemic needed: hydroxychloroquine
NB. Differs from discoid eczema as this affects extremities (not face/scalp) and leaves hyper pigmented areas
AK Rx
If few: cryotherapy with eg. liquid nitrogen
If single but incessant and persistent despite therapy: excise + histology
NB. AK can precede SCC
If multiple: TOP 5-FU cream
Scabies organism, features, Rx
Sarcoptes cabiei “human mite”
Itchy, widespread papular erythematous rash in hairless areas
+/- background of steroid use
Rx: permethrin
SJS vs Erythema multiforme
SJS involves mucosa at presentation with blistering/bullous lesions
Derm referral ABCDE criteria for MM
Asymmetry Border - irregular Colour - irregular Diameter >6mm Evolving
If 3 present, refer to Derm
What is cutaenoua larva migrant and Rx?
Hookworm
Caused by direct contact with hookworm ova in cat/dog faeces
Features:
Threadlike areas of erythema/inflammation
Pruritic++
Rx: topical albendazole/mebendazole
Itchy inflammatory nodule with black opening on skin + eosinophilia
Dx + Rx
Tungiasis - blood stream infection of flea
Rx: direct removal of flea
or topical bendazole
Pubic louse organism
phthirius pubis
Glucagonoma associated with which skin lesion
Necrolytic migratory erythema (extremities, abdo, buttocks)
Multiple pedunculated hyper pigmented lesions in someone with lung ca
Leser-Trelat sign: SKs in someone with lung ca
Fungal nail infections/Onychomycosis
- most common cause
- DDx
- Rx6
90% dermatophytes: trychophyton rubrum
DDx:
- yellow nail S
- psoriasis
- repeated trauma
- lichen planus
Rx: if dermatophyte: oral terbinafine -> itraconazole - hands 6 weeks to 3 mo - feet 3-6mo if fungal: topical antifungal - if severe, oral itraconazole DO NOT TREAT UNTIL CONFIRMED BY MICRO
Seborrheic dermatitis
- organism
- associations
- complications
- rx
Mallasezia furfur
Assocs: HIV + PD
Complications: blepharitis, OE
Rx: Face and body: • Topical antifungal • Topical steroids • (recurrence is common) Scalp: • Head and Shoulders (Shampoo with Neutrogena) • Ketonazole
Pityriasis versicolor
- organism
- associations
- features
- rx
Mallesezia furfural
Assocns:
cushings
maln
immunosup
Ftrs:
o Hypopigmented patches on trunk (mainly)
o May be more noticeable post sun tan
o +/- scale w/ itch
Rx: top antifungal eg. ketoconazole shampoo
Acne rosacea Rx
Mild: Top Met
Severe: Sys Oxytetracycline
Erythroderma causes:
o Psor o Ecz o Lymphoma/leukaemia o Idiopathic o Drug eruption
Sebaceous cyst Rx to PREVENT recurrence
surgical excision
Drugs causing photosensitivity:
o Sulphonylureas o Sulphonamides, tetracyclines, cipro o Amiodarone o Thiazides o Some NSAIDs
Seborrheic dermatitis in children “cradle cap” ~yellow scale
?Rx:
Mild/moderate: baby shampoo and oils
Severe: topical steroid
NB. Majority spontaneously resolve by 8mo
Dermatomyositis can be a malignant manifestation of which cancers
lung, breast, ovarian
Features of pyogenic granuloma
Associations
Rx
Fast-growing Spherical Bleeds/ulcerates Dark ~pregnancy, trauma
Rx:
Usually spontaneous regression post-partum
Otherwise can curettage, excise, cauterise or cryotherapy
BCC Referral ?when/how
o Generally referred routinely for excision
o Unless when delay may cause damage eg. eyelids, nasal ala = urgent referral
Bullous Pemphigoid vs Pemphigus
Bullous pemphigOid = nO mucosal involvement
PemphigUs = mUcosal involvement
Painless white plaque on tongue with fine striae
Lichen plants
Wickham’s striae pathognomic
