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Y3 MedEd > Derm > Flashcards

Derm Flashcards

1
Q

What are the three skin cancers

A

Squamous cell carcinoma
Basal cell carcinoma
Melanoma (+melanocytic lesions)

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2
Q

What are the infectious causes of skin lesions (5)

A 
Cellulitis 
Erysipelas
Erythema nodosum
Erythema multiforme
Molluscum contagiosum
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3
Q

What are the three types of lesions

A

Flat
Fluid filled
Raised

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4
Q

What are the 2 types of flat lesions

A

Macule (small)

Patch (large)

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5
Q

What are the 3 types of fluid filled lesions

A

Vesicle - blister <0.5cm in diameter
Pustule
Bulla - blister more than 0.5cm in diameter

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6
Q

What are the 2 types of raised lesions

A

Papule - less than 0.5cm diameter

Nodule - more than 0.5cm in diameter

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7
Q

Define SqCC

A

cancer of keratinocytes in epidermis

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8
Q

What does the epidermis consist of (3 main things)

A

SqC
Basal cells
Melanocytes

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9
Q

RF of SqCC (4)

A

UV light
Actinic keratosis (pre-cancerous condition)
FHx
Lighter skin

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10
Q

Describe the lesion in SqCC (5)

A

Hyperkeratotic

Scaly/Crusty

Ulcerated

Non-healing

Rolled edges

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11
Q

Invasion of SqCC and ability to metastasise

A

Local invasion (e.g. into dermis)

Can metastasise

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12
Q

Define basal cell carcinoma

A

cancer of keratinocytes in epidermis (in stratum basale

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13
Q

RF of BCC (3)

A

UV light
FHx
Lighter skin

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14
Q

Describe the lesion in BCC (5)

A

Nodule

Pearly edges

Rolled edges

Central ulcer
(rodent ulcer)

Central fine
telangiectasia

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15
Q

What are the four sub-types fo BCC and describe each

A

Nodular - most common
Superficial - flat shape
Morpheic - yellow waxy plaque, scar like
Pigmented - coloured

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16
Q

Define melanoma

A

cancer of melanocytes in epidermis

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17
Q

RF of melanoma (3)

A

UV light
FHx
Lighter skin

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18
Q

Invasion of BCC and ability to metastasise

A

Slow growing
Local invasion
(e.g. into dermis)

DOESN’T TYPICALLY METASTASISE

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19
Q

Invasion of melanoma and ability to metastasise

A

Local invasion (e.g. into dermis)

Can metastasise

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20
Q

Describe the lesion in a melanoma (9 (5+4))

A

Asymmetry

Border
(irregular)

Colour
(pigmented)

Diameter >6mm

Evolution
(size/shape)

May bleed, itchy, ulcerate, crust over

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21
Q

Subtypes of melanoma (4)

A

Superficial spreading - most common
Lentigo maligna - flat lesions on (elderly)
Nodular - domed shape, rapid growth
Acral lentiginous - palms, soles and nail beds, most common in non-caucasians

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22
Q

Which population is more prone to acral lentiginious

A

Non-caucasians

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23
Q

Which population is more prone to lentigo maligna

A

elderly

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24
Q

Which skin cancers are urgent referral vs routine referral

A

Melanoma - urgent referral
SqCC - urgent referral
BCC - routine referral

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25
Q

What is used to measure melanoma invasion

A

Skin biopsy

(Clark Level/Breslow Thickness

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26
Q

Define melanocytic lesion

A

BENIGN neoplasms of melanocytes in epidermis

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27
Q

Describe a melanocytic lesion (3 and 4 things they do not do)

A

Symmetrical

Flat

Regular borders

(i.e. not ABCDE)

Does not bleed, itchy, ulcerate, crust over

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28
Q

What should you be aware of with melanocytic lesions

A

Rarely can transform into melanoma

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29
Q

What is a sign of chronic eczema

A

Lichenification

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30
Q

RF of eczema (4)

A 
PMHx/FHx of atopy
      Food allergies
      Hay fever
      Asthma
Immunocompromise
31
Q

6 subtypes of eczema

A 
Atopic dermatitis
Contact dermatitis
Discoid dermatitis
Seborrheic dermatitis
Dyshidrotic 
Eczema herpeticum
32
Q

What type of reaction is atopic dermatitis and which Ig and where does it occur

A

Type I hypersensitivity
(Ig-E mediated)

Flexures

33
Q

What type of reaction is contact dermatitis and what are common causes

A

Type IV hypersensitivity
(delayed)

Often nickel/latex

Two types:
Irritant and allergic

34
Q

Common population of discoid dermatitis and what do the lesions look like

A

Middle-aged/elderly

Coin-shaped plaques

35
Q

Describe seborrhoea dermatitis and the distribution

A

Yellow, greasy scaly rash

Distribution: eyebrows, nasolabial, scalp (cradle cap)

36
Q

Describe dyshidrotic (pompholyx) and the distribution

A

Itchy/painful blisters

Distribution:
palms + plantars
i.e. hands + feet

37
Q

What causes eczema herpeticum (type of virus)

A

MEDICAL EMERGENCY
(Can disseminate)

Superimposed HSV-1

38
Q

Which is AI, eczema or psoriasis

A

Psoriasis

39
Q

Define psoriasis

A

auto-immune condition characterised by hyperproliferation of keratinocytes

40
Q

RF of psoriasis

A

PMHx/FHx of psoriasis

41
Q

Triggers of psoriasis (3)

A

Stress
Smoking
Alcohol

42
Q

Oncholysis DDx (4)

A

Psoriasis
Fungal infection
Trauma
Thyrotoxicosis

43
Q

Describe lesions in psoriasis and distribution

A

Purple, silvery
plaques

Dry, flaky skin

Itchy/painful

Distribution:
Extensors/scalp

44
Q

Nail signs of psoriasis (3)

A

Onycholysis
Pitting
Subungual hyperkeratosis

45
Q

Most common type of psoriasis

A

Plaque

46
Q

What can triggers the onset of guttate psoriasis

A

Often 2 weeks post-Strep

47
Q

What are the subtypes of psoriasis (5)

A 
Plaque
Pustular AKA palmo-plantar
Guttate
Flexural
Erythrodermic
48
Q

Describe guttate psoriasis

A

Raindrop plaques

49
Q

Describe erythrodermic psoriasis

A

Systemic body redness and inflammation

Often temperature dysregulation, electrolyte imbalances

Requires hospitalisation

50
Q

Ix for psoriasis (4)

A

Physical examination
Basic observations

Skin patch testing (contact dermatitis)

Skin biopsy

Usually clinical diagnosis

51
Q

Usual causative pathogens of cellulitis and erysipelas

A

often strep pyogenes, or staph aureus

52
Q 
Cellultis:
Site
Borders
Systemic symptoms?
Sepsis?
A

Dermis, subcutaneous tissue

More patchy

Less common

More common

53
Q 
Erysipelas:
Site
Borders
Systemic symptoms?
Sepsis?
A

Epidermis

Well demarcated

Fevers, rigors

Less common

54
Q

Complications of cellulitis

A 
Abscess
Sepsis (emergency)
Necrotising fasciitis (emergency)
Periorbital cellulitis (emergency)
Orbital cellulitis (emergency)
55
Q

Ix for cellulitis and erysipelas

A 
Physical examination
Basic observations (e.g. sepsis)

Bloods:
FBC
CRP
Blood culture

Pus/wound swab MCS

CT/MRI
(if orbital cellulitis – identify
posterior spread of infection)

56
Q

Mx of cellulitis and erysipelas (conservative 3, medical)

A

Draw around lesion (to see if it grows or shrinks)
Monitor observations
Oral fluids

Medical
Oral ABx (e.g. flucloxacillin)
IV ABx (if severe)
57
Q

Admit cellulitis for which

A 
Sepsis
	High HR	
	High RR	Low BP
Confusion
	AVPU
	GCS
58
Q

Infectious causes of erythema nodosum (3)

A

Strep pyogenes
TB
HIV

59
Q

Systemic disease causes of erythema nodosum (3)

A

IBD
Sarcoidosis
Behçet’s disease

60
Q

Drug causes of erythema nodosum

A

Sulphonamides

61
Q

Non-infectious/systemic disease/drug causes of erythema nodosum

A

Pregnancy

62
Q

Description of erythema nodosum (3) and distribution and 2 things it does not do

A

Bilateral nodules

Tender

Red/purple

Distribution:
Anterior shins
Knees

Does not ulcerate
Does not scar

63
Q

Define erythema multiform

A

inflammation of skin and mucous membranes – type IV hypersensitivity

64
Q

Infectious causes fo erythema multiforme (3)

A

Herpes (HSV)
Mycoplasma
HIV

65
Q

Drugs causes fo erythema multiforme

A

Sulphonamides

66
Q

Symptoms of erythema multiforme

A

Prodrome

(fever, aches)

67
Q

Describe the lesion in erythema multiforme (4)

A

Target lesions
(Central vesicle/crust
Ring of pallor
Ring of erythema)

Tender/itchy/pain

68
Q

Distribution of erythema multiforme

A

Often start on hands

Then spreads

69
Q

Define molluscum contagiosum

A

skin infection due to pox virus (molluscum contagiosum virus)

70
Q

RF of molluscum contagiosum

A

Immunocompromise (e.g. HIV)

Atopic eczema

71
Q

Describe the lesion in molluscum contagious (4)

A

Smooth papule
Umbilicated

Often painless
Often itchy

72
Q

Is molluscum contagiosum contagious

A

Yes. It’s in the name lol

73
Q

Do children need exclusion from school for molluscum contagiosum

A

No

Y3 MedEd (34 decks)

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