Derm Flashcards
How is a Squamous Cell Carcinoma typically described?
Hyperkeratotic
Scaly/Crusty
Ulcerated
Non-Healing
Rolled Edges
What are the main risk factors for Skin Cancer?
UV Light
Actinic Keratosis
FHx
Lighter Skin
How is a typical Basal Cell Carcinoma described?
Nodule with:
Pearly Edges
Rolled Edges
Central (Rodent) Ulcer
Central, fine telangiectasia
What are the main subtypes of Basal Cell Carcinoma?
Nodular
Superficial (Flat)
Morpheic (Yellow-Waxy Plaque, Scar Like)
Pigmented (Dense colour)
How is a typical Malignant Melanoma described?
Asymmetrical
Irregular Border
Pigmented
>6mm Diameter
Evolution in its size and shape
What are the main subtypes of Malignant Melanoma?
Superficial Spreading
Nodular (Domed, Rapid growth)
Lentigo Maligna (Flat Lesions, commonly on the face)
Acral Lentiginous (Palms, Soles, Nail Beds)
How would you investigate a suspected skin cancer?
Dermatoscope
Skin Biopsy (Depth for Melanoma Invasion)
CT/MRI/PET for staging
What are Melanocytic Lesions?
Benign neoplasms of melanocytes in the epidermis.
Symmetrical, Flat, Regular Borders.
What does the presence of headaches, worse when coughing and lying down, indicate in a suspected cancer patient?
Presence of brain metastases.
How is Eczema identified?
Hx of Atopy/Immunocompromised
Dry, itchy skin
Erythematous
Flexure Distribution
Lichenification in Chronic Eczema
What are the main subtypes of Eczema?
Atopic Dermatitis (IgE)
Contact Dermatitis (Type IV Delayed Hypersensitivity)
Discoid Dermatitis (Coin, shaped plaques)
Seborrhoeic Dermatitis
Dyshidrotic
Eczema Herpeticum
What is Seborrhoeic Dermatitis?
Yellow, greasy, scaly rash
Distributio: Eyebrows, Nasolabial, Scalp
What is Dyshidrotic Eczema?
Itchy, Painful Blisters
Distribution: Hands and Feet
What is Eczema Herpeticum?
Medical Emergency due to possible Dissemination
Superimposed HSV-1
What is Psoriasis?
Auto-Immune condition characterised by hyperproliferation of keratinocytes.
How is Psoriasis typically described?
Purple, silvery plaques
Dry, flaky skin
Itchy, Painful
Mainly on Extensors/Scalp
What are the nail signs associated with Psoriasis?
Onycholysis
Pitting
Subungual Hyperkeratosis
What are the main subtypes of Psoriasis?
Plaque
Pustular (Hands & Feet)
Guttate (‘Raindrop Plaques’ 2-Wks post-strep)
Flexural
Erythrodermic (Systemic Redness and Inflammation)
How should you investigate a suspected Dermatitis?
Skin-Patch Testing (For Contact Dermatitis. Eg. Nickel & Latex)
Skin Biopsy
What are Cellulitis and Erysipelas?
Bacterial Infections of the skin.
Both are:
Acute in their onset
Painful, Hot, Swollen and Red
How does Cellulitis typically present?
Painful, hot, red, swollen rash
Involving the Dermis and Subcutaneous Tissue
Patchy
How does Erysipelas typically present?
Painful, Hot, Red, Swollen Rash.
Involves the epidermis
Well Dermarcated
Fevers, Rigors
Which organisms most commonly cause Cellulitis?
Strep. pyogenes
Staph. aureus
What are the main complications associated with Cellulitis?
Abscesses
Sepsis
Necrotising Fasciitis
Periorbital Cellulitis
Orbital Cellulitis
How would you investigate Cellulitis/Erysipelas?
Basic Obs
Bloods - FBC, CRP, Cultures
Pus/Wound Swab MCS
CT/MRI for orbital cellulitis
How would you manage a case of Cellulitis/Eryipelas?
Draw around the Lesion
Oral ABx, IV if severe
Typically Flucloxacillin
What is Erythema Nodosum?
Inflammation of subcutaneous fat, as a result of a Type IV Hypersensitivity reaction
What can cause Erythema Nodosum?
Infections - Strep. pyogenes, TB, HIV
Systemic Diseases - IBD, Sarcoidosis, Behcet’s
Drugs - Sulphonamides
Pregnancy
How is Erythema Nodosum typically described?
Bilateral red, tender nodules.
Anterior shins & knees
Don’t ulcerate or scar
What is Erythema Multiforme?
Inflammation of the skin and mucous membranes due to a Type IV Hypersensitivity reaction.
‘Target Lesions’
What can cause Erythema Multiforme?
Infections - HSV, Mycoplasma, HIV
Drugs - Sulphonamides
How is Erythema Multiforme typically described?
Target Lesions - Central Vesicle with a ring of pallor and a ring of erythema.
Tender, itchy, painful
Spread from the hands
What is Molluscum Contagiosum?
Skin Infection due to pox virus (Molluscum contagiosum)
How are Molluscum Contagiosum rashes typically described?
Smooth, umbilicated papules.
Painless & itchy