Derm Flashcards
What are small flat skin lesions
Macule
What are large flat skin lesions
Patch
What are raised small skin lesions called
papule
What are large raised skin lesions called
Nodule
What is fluid filled lesion called that is less than .5cm
Vesicle
What is a pus filled skin lesion called
Pustule
What is a large fluid filled skin lesion called
Bulla
Buzz words for skin SCC
Hyperkeratotic Scaly/crusty Ulcerated Non-healing Rolled edges
What is a rolled edge to a skin lesion
Like a volcano in that top is raised
What is precancerous form of skin SCC
Actinic keratosis
RFx skin SCC and BCC
UV
FHx
Lighter skin
Immunosuppression
Where do skin SCC invade
Locally to dermis
Where do skin SCC and melanoma metastasise to
Lung
Bone
Liver
Brain
Buzzwords for skin BCC
Central fine Telengiectasia Nodule Pearly and rolled edges Central ulcer
What is another word for central ulcer in skin BCC
Rodent ulcer
Where do BBC metastasise
They dont normally
What is invasion of skin BCC
Very slow
Local into dermis
What are the 4 types of skin BCC
Nodular
Morpheic- scar like with yellow waxy plaque
Pigmented- dense colour with specks of colour
Superficial- flat shape
Buzzwords for melanoma skin characteristics
A-E Asymmetry Border- irregular Colour- pigmented Diameter- >6mm Evolution- odd developing shape and size
What can happen to melanomas
Crust over
Itchy
Ulcerate
Bleed
What are 4 types of melanoma
Superficial spreading
Lentigo maligna- flat lesions on face in elderly
Nodular- domed shaped, rapid growth
Acral lentiginous- seen on palms, soles and nail beds of non caucasians
Initial bedside test for skin cancers
Dermatoscope
Blood tests for skin cancer
Calcium
ALP
LFTs
Imaging for skin cancers
CT/MRI/PET to image
Biopsy
What is breslow thickness
Looks at how deep melanomas have invaded- done on biopsy
Indicator for prognosis
What are melanocytic naevi
Benign neoplasms of melanocytes
When do melanocytic naevi develop
Congenital- happens during teenage years
How is a melanocytic naevi described
Symmetrical
Flat
Regular borders
What separates melanomas for melanocytic naevi
Doesnt bleed, itchy, ulcerate or crust over
What is other word for eczema
Dermatitis
What type of conditin is eczema
Inflammatory not autoimmune
Where does atopic eczema occur on body
Flexor surfaces
How is eczema described
Dry skin
Itchy
Erythematous
What is lichenification
Thickened skin
What is long term appearance of eczema
Lichenification
What are RFx for atopic eczema
Atopy FHx or PMHx
Filaggrin gene mutation
Triggers for eczema
Soap, shampoo Food allergies Pollen House dust mites Pets
What can cause contact dermatitis
Nickel and latex
How does discoid dermatitis appear
Coin shaped lesions
What is distribution of seborrheic dermatitis
Around scalp, eyebrows, nasolabial area- cradle cap
What is distribution of dyshidrotic dermatitis
Palms and plantars
What is medical emergency eczema
Eczema herpeticum as can disseminate
What causes eczema herpeticum
Normally HSV-1
How are psoriasis lesions described
Purple silvery plaques
Dry and flaky
Itchy and painful
What is distribution of psoriasis
Extensors and scalp
Psoriasis nail changes
Onocholysis
Pitting
Subungual hyperkeratosis
Triggers of psoriasis
Stress
Smoking
Alcohol
What are subtypes of psoriasis
Guttate Flexural Pustular Erythodermic Plaque- most common that is typically described
How does guttate psoriasis appear
Rain drop plaques
When do you get guttate plaques
2 weeks post strep
Where do you get flexural plaques
Body folds- axilla, groin, perianal area
What happens in pustular psoriasis
Plaques and pustules all over feet and hands
What is the medical emergency of psoriasis
Erythodermic- end up on ITU most likely
What happens in erythodermic psoriasis
Systemic body redness and inflammation
What is danger of erythodermic psoriasis
Temperature dysregualtion
Electrolyte imbalances
Bedside test for contact eczema
Skin patches on back
What is blood test for atopic eczema
IgE RAST
What is skin test for eczema
Skin prick- done on arm
What bacteria most commonly causes cellulitis
Strep pyogenes
Staph aureus
How do cellulitis and erysipelas lesions present
Acute onset Painful Hot Swollen Red
Difference between cellulitis and erysipelas in terms of site
Dermis and sub cut tissue affected in cellulitis
Epidermis is only affected in erysipelas
Difference between cellulitis and erysipelas in terms of borders
Cellulitis much more patchy whereas erysipelas is well dermacated
Sysetmic features of erysipelas and cellulitis
Systemic features more common in erysipelas- fevers and rigors
What is sepsis more common in cellulitis or eysipelas
Cellulitis
RFx for cellulitis and erysipelas
Wounds and uclers
Bites
IV cannula
Immunosuppressed
Complications of cellulitis
Abscess SEPSIS Necrotising fasciitis- surgical emergency Periorbital cellulitis Orbital cellulitis
Management of periorbital cellulitis
IV ABx
Mangement of orbital cellulitis
IV ABx
Surgical decompression as vision can be affected
Investigations for cellulitis and erysipelas
Bedside - skin swa MCS Bloods - FBC- high WCC - CRP- high - blood cultures
When is only time would do imaging in cellulitis
Orbital cellulitis- CT/MRI
Conservative management of cellulitis and erysipelas
Draw around lesion
Oral fluids and, painkillers
Monitor obs
Medical management of cellulitis and erysipelas
Oral abx- flucloxacillin
IV abx- co-amoxiclav
When is only time give IV abx cellulitis and erysipelas
Severe or near eyes
Why would you admit a cellulitis or erysipelas patient
High HR
High RR
Low BP
GCS in bin
What is erythema nodosum
Inflammation of erythema nodosum
Causes of erythema nodosum
Infections - TB - HIV - Strep pyogenes Systemic disease - sarcoid - behcets - IBD Drugs - sulphonamides Pregnancy
Characteristics of erythema nodosum lesions
Bilateral
Tender
Red
What is erythema multiforme
Inflammation of the skin and mucous membranes- TIV hypersensitivity
Causes of erythema multiforme
Herpes
Mycoplasma
HIV
Sulphonamides
What is distribution of erythema multiforme
Start on hands then spread
How does erythema multiforme appear
Target lesions with central vesicle
Ring of pallor
Ring of erythema
Symptoms of erythema multiforme
Prodrome of fever and aches
Tender
Itchy
Painful
What are target lesions with prodrome of fever and aches
Erythema multiforme
Most common cause of erythema multiforme
HSV 1-2
What are 2 types of erythema multiforme
EM minor- skin
EM- major- skin and mucosas
Molluscum contagiosum lesion
Smooth papule
Umbilicated
Painless but itchy
Risk factors for molloscum contagiosum
Immunocompromised
Transmission of molloscum contagiosum
Swimming pools
Sex
Investigations for erythema nodosum, multiforme and molloscum contagiosum
HIV
Test for underlying cause
What is key risk factor for SqCC skin
Immunosuppression