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F year medicine facts > derm > Flashcards

derm Flashcards

1
Q

what is les trelat sign

A

sudden multiple sebborheic keratosis

indicative of cancer

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2
Q

sebborheoic keratosis rx

A

cyrotherapy and curettage

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3
Q

dermatofibroma rx

A

only excise if sx

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4
Q

dermatofibroma description

A

firm elevated nodules like buttons. peripheral ring of pigmentation
often in those with hx insect bites or trauma

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5
Q

describe epidermal cysts

A

cysts with central punctum
contains caseous keratin
dermal inflammation

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6
Q

where do you get pyogenic granulomas and what do they look like

A

red often on finger

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7
Q

what are keratocanthomas

A

epidermal tumours with central necrosis and ulcers

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8
Q

what are acitinic keratosis

A

red and silver papules or patches scaly, with conical base and red base

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9
Q

rx acitinic keratosis

A

cryo, 5FU (5% diclofenac or imiquimod) or none if nor bothering

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10
Q

bowens disease is in which part of the skin

A

epidermis

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11
Q

what can keratocanthomas develop to

A

scc

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12
Q

what diameter of melanocytic naevi is suspicious for ca

A

7mm

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13
Q

where are superficial spreading melanomas commonly found. what is there cause

A
  • LL

- intermittent high intensity UV exposure

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14
Q

cause of nodular melanoma

A
  • intermittent high intensity UV exposure. most common trunk
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15
Q

cause of lentigo maligna melanoma

A
  • cumulative UV exposure in elderly
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16
Q

kaposis sarcoma rx

A

radiotherapy and resection

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17
Q

drugs that cause IgE reactions

A

ET is a nuisance because he pees a lot and has cell phone, a pen and a strong muscle;

  • NSAID
  • Sulphonamides
  • Penicillin
  • Muscle relaxants
  • Diuretics
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18
Q

what kind of rash do you get with toxic erythema and how long does it take to manifest after drugs taken

A
  • maculopapular

- within 2 weeks

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19
Q

drugs that cause urticaria

A
  • nsaids
  • ace-i
  • pen and ceph
  • codeine and morphine
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20
Q

which drugs give you widespread eythroderma

A

cages give you erythroderma;

  • carbamezapine
  • Allopurinol
  • Gold
  • Sulphonamides
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21
Q

what is a fixed drug eruption

A
  • skin reaction of blistery style rash at same site on skin everytime a specific drug is taken
  • leaves purply hyperpigmentation and re erupts at same site on re exposure to drug
  • arrive over few hrs from exposure
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22
Q

drugs that commonly cause fixed drug eruptions

A
  • PTSA
  • Paracetemol
  • Tetracycline
  • Sulphonamides
  • Aspirin
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23
Q

commonest cause of erythem multiforme

A

HSV

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24
Q

prodrome to erythema multiforme sx

A

fever, coryza

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25
Q

ix for drug reactions particualrly SJS and TENS

A
  • biopsy - epidermal detachment
  • FBC, U and E, ABG, LFT; can cause resp compromise if mucosal involvement in U/L airways
  • blood cultures to rule out TSS and SSS; staph/ strep cultures
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26
Q

How to treaet TEN

A
  • derm/ burns unit
  • IV supportive care for haemodynamic stability
  • STM dexamethasona pusle therapy, IVIG
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27
Q

define SJS

A
  • Mucucutaneous necrosis with at least 2 mucosal sites involved
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28
Q

presentation of SJS

A
  • Resp sx 2-3 / 52 after starting drug. approx 2 days before a rash that effects <10% body
  • painful erythematous macules –> target lesions
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29
Q

cause of SJS

A
  • Drugs
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30
Q

common cause of TENs

A
  • drugs
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31
Q

sx of TEN

A
  • extensive skin and mucosal necrosis and systemic toxicity
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32
Q

what is nikolskys sign

A

sloughing off epidermal layer when pressure applied to erythema or blisters

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33
Q

SJS drugs causes

A

PABENS-TG cause SJS -

  • Penicillins
  • Anti - epileptics
  • Antimalarials
  • BB
  • NSAIDs
  • Suphonamides
  • thiazides
  • GOLD
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34
Q

Drugs that cause TEN

A 
CAANMPS -BTG
- Cephalosporins
- Anti-epileptics
Anti-malarials
- Allopurinol
- NSAIDs
- Penicillins
- Sulphonamides
- BB
-thiazides
- Gold
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35
Q

difference between SJS and erythema multiforme

A

erythema multiforme is the precursor and in SJS there is extensive necrosis

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36
Q

difference between SJS and TEN

A

TEN has sytemic toxicity and is full thickness necrosis.

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37
Q

cause of death in TENS and SJS

A
  • Sepsis
  • Electrolyte abnormalty
  • organ failure
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38
Q

3 phases of follicle cycle for growth

A
  • anagen ; long growing phase
  • catage - short regressing
  • telogen - resting/shedding phase
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39
Q

3 types of hair

A
  • lenugo; coarse long in fetus
  • vellus; fine and short, whole body
  • termina; eyebrows, scalp, lashes, pubic
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40
Q

impetigo causes

A
  • GAS

- Staph

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41
Q

impetigo rx

A
  • GAS = pen v
  • Staph = fluclox
  • usually fusidic acid 2% is enough, then mupirocin. if extensive then above abx given
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42
Q

what are the stay at home rules for kids with impetigo

A
  • stay home till lesions crust
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43
Q

difference between staphylococcal scalded syndrome and bullous impetigo

A
  • SSS is systemic.
  • BI = local

both caused by staph; toxin A = local. Toxin B = systemic

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44
Q

what age group is SSS seen in most

A
  • infancy and early childhood
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45
Q

SX of SSS

A

Few hrs to days - worse over the face, neck. axillae and groin

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46
Q

how long does it take to recover from SSS

A
  • 5-7/7
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47
Q

rx SSS

A
  • Fusidic acid, erythromycin
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48
Q

RF for erysipelas and cellulitis

A
  • immunsupression
  • ulcers
  • wounds
  • toeweb iretrigo
  • minor tinea pedis
  • lymphoedema
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49
Q

what causes erysipelas in DM

A

Staph

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50
Q

what causes erysipelas normally

A
  • GAS
51
Q

what causes folliculitis

A

strep

52
Q

what is a furuncle and what is the rx

A
  • boil
  • infected hair follicle
  • oral fluclox and I and D
53
Q

What is nec fascitis

A
  • rapidly progressive necrosis of subcutis and fascia = rapidly spreading
  • check for gas ins subcut fascia in XR
54
Q

rX NEC FASC

A
  • Fluids
  • high dose abx - meropenem and clindamycin
  • surgical debridement
55
Q

what is special about ptyrisis versicolor in terms of sx

A
  • scaly pale brown patches on upper trunk that fail to tan on sun exposure
56
Q

what makes pityriasis versicolour worse

A
  • steroids
57
Q

treatment of pitryriasis versicolour

A
  • ketoconazole shampoo or topical antifungalm pigmentation
58
Q

what causes pityriasis versiclour

A
  • fungus; mallasezia furfur
59
Q
  • Scabies rx
A
  • permethrin - apply at night from neck down and wash in morning
60
Q

what is the commonest bed bug

A
  • cimex lectularius
61
Q

what to do bed bug bites look like

A
  • pruritic, erythematous, oedematous papules - central punctum
62
Q

rx bed bug bites

A

nothing as self limiting after 7/7

or mild steroid cream/ .antihistamine if itchy

63
Q

where do you find sebborhoeic dermaittis

A
  • scalp
  • eyebrows
  • nasolabial folds
  • cheeks
  • flexures
64
Q

cause of seborrheoic dermaittis

A
  • skin yeasts overgrowths e.g. malassaezia.

- more severe in HIV patients

65
Q

rx sebborhoeic dermatitis

A
  • mild topical steroids/ antifungals = daktocort/ ketoconazole shampoo
66
Q

which t cells induces ige response in eczema

A

th2

67
Q

eczema diagnostic criteria

A
  • <2yrs of age
  • flexural involvement in the past
  • personal hx or fhx if <4yrs of age
  • visible flexor dermatitis

to dx need ithcy skin +3/>3

68
Q

side effects of aciclovir

A
  • GI upset
  • LFT abnormalitiyes
  • neurological abnormalities
  • haem
69
Q

h1R antagonist names

A
  • cetirizine
  • loratadine
  • chlorphenamine
70
Q

name the two retinoid that can be given for acne, psoriasis and disorders of keratinisation

A
  • isotretinoin

- acitretin

71
Q

SE retinoids

A
  • LFTs disorders
  • depression
  • dryy skin. lips. eyes
  • high cholesterol and TG
  • myalgia
  • arthralgia
  • teratogen
72
Q

what should you do about contraception if on retinoids

A

be on contraception 1 month before, during and 1 month after if iso.

be on it for 2 yrs after if acite

73
Q

why are retinoids used in skin disorders

A
  • encourages prompt surface skin cells turnover and binds to receptors to modify follicular keratinisation; tretinoin
74
Q

what does molluscum contagiosum look like

A
  • pearly white papules with central umbillication

- rx - aciclovir

75
Q

define erythroderma

A
  • widespread erythema and dermatitis affecting >90% body surface
  • scaly and oedema
  • sytemically unwell with LNA and malaise
76
Q

erythroderma rx

A
  • derm refer
  • emollients
  • wet wraps
  • topical steroids
77
Q

how to treat eczema herpeticum

A

IV aciclovir

78
Q

atopic ecczema rx ladder

A
  1. emollients and lifestyle
  2. topical
    - steroids
    - tacrolimus (steroid sparing but causes burns, pruritus and acne)
    - antihistamines to prevent itching
  3. phototherapy
  4. systemic agents; steroids, ciclo, azithro, metho
  5. biological agents; dupilumab
79
Q

SE ciclosporin

A
  • hepatotoxic
  • nephrotoxic
  • fluid retention
  • gingivitis
  • IGT
80
Q

SE azathipprime

A
  • myelosupression
  • N and V
  • pancreatitis
  • non melanoma sc
81
Q

psoriasis - triggering drugs

A
  • Stop the heart; BB and ACE-i
  • stop the pain - NSAids
  • stops me going insane - Lithium
  • stop the inflame - steroids, interforons, TNF
  • stop the bac with a tic tac - tetracyclines
  • stop the bites from the mites = antimalarials
82
Q

treatment ladder psoriasis

A
  1. emollients + steroids + vit D analogue. max 4/52 streoids
  2. vit D analogues BD
  3. Potent steroids 4 weeks OR coal tar
  4. short acting dithranol +/- refer
  5. in secondary care - phototherpay
  6. methotrextate, ciclosporin, retinoids esp if joints involved
83
Q

why does vit d analogue help in psoriasis

A
  • inhibit hyperproliferation of epidermis and differentiation of kertatinocutes
84
Q

vit d analogue SE

A
  • Itchy
  • erythema
  • burning
  • paraesthesia
  • dermatitis
85
Q

phototherapy MOA in psoriasis

A
  • apoptosis
  • reduced cytokines
  • promote suppression
86
Q

SE retinoids

A
  • teratogen
  • dry skin
  • mucosa
  • increase dlipids
  • lower glucose
  • increase LFT
87
Q

what happens to foetus exposed to retinoids

A

foetal retinoids syndrome

  • growth delay before and after birth IUGR
  • Craniofacial abnormalities
  • hydrocephalus
  • TOF
88
Q

what are the 4 types of psoriasis and which are an emergency

A
  • guttate - kids, post strep
  • plaque - silvery
  • erythrodermic - emergency
  • pustular - not infectious but emergency +/- systemic upset
89
Q

what cells cause autoimmune issues of psoriasis

A

TH17

90
Q

guttate psoriasis most commonly appears on which part of the body

A

trunk and limbs

91
Q

what are the koebner and auspitz phenomenon

A
  • koebner = areas of trauma get plaques

- auspitz - attacked areas bleed if scratched

92
Q

what type of nose do you have in systemic sclerosis

A

beak shaped

93
Q

what are the two types of porphyria

A
  • acute

- cutanea tarda

94
Q

symptoms of acute porphyria

A
  • hepatic porphyrias
  • CNS - muscles weakm seizure, mental disturbance
  • abdo pain; vomit
  • cardiac arrythmia
  • acute neuropathy
95
Q

symptoms of cutanea tarda

A
  • dermatitis; photosensitive
  • blisters
  • skin necrosis and gums
  • itchy and swelling and increased hair growth on forehead
96
Q

IBD common skin manifestation

A
  • erythrema nodosum

- pyoderma gangrenosum

97
Q

chromosome affected in Neurofibromatosis T1

A

17

98
Q

CHR affected in neurofibramotosis T2

A
  • 22
99
Q

sx NF1

A
  • lisch hamartomas; eye nodules
  • phaeochromocytomas
  • cafe au lait spots
  • peripheral neurofibromas
  • freckles in axilla and groin
  • scolioiss
100
Q

sx NF2

A
  • Schwannomas esp IC and bilateral vestibular

- acoustic neruomas

101
Q

cause of neurofibromatosis

A
  • uncoontrolled proliferation of neural crest cells
102
Q

sx tuberous sclerosis

A
  • ash leaf spots
  • retinal hamartomas
  • seizures
  • Intellectual disability
  • developmental delay
  • shagreen patches/ peau de orange
103
Q

commonest cause of erythema multiforme

A

HSV

104
Q

types of pyoderma gangrenosum

A
  • classical in immunosupressed. legs and trunk. can be explosive onset and rapid spread with pain and illness. or indolent and slow spread from one area to another
  • peristomal; around stoma
  • vegetative - single well healing in healthy patients. good response to topicals . head an neck common
  • bullous; in haem disease.
  • pustular - IBD
  • genital
105
Q

define papule

A

palpable noduel <0.5cm

106
Q

define nodule

A

papule >0.5cm

107
Q

what causes bullous pemphigoid

A
  • autoantobodies between dermis and epidermis - IGG
108
Q

Rx for bullous pemphigoid

A
  • steroids topical

- then oral

109
Q

sx bullous pemphogoid

A
  • blistering skin. tense; fluid filled on an erythematous base
  • itchy
  • trunk and limbs, not often mucosal
110
Q

sx pemphigus

A
  • burning and pain
  • mouth often involved
  • flaccid and easy rupture unlike pemphigoid
  • face, torso, flexors
111
Q

what does nikolskyys sign indicate

A
  • pemphigus; applying pressure with finger to bulla causes displacement
112
Q

how to diagnose pemphigus

A

skin biopsy - loss of interccellular connections between cells and epidermis
- IgG on immunoflurosecence - autoabs

113
Q

how to diagnose pemphogoid

A

skin microscopy = itnact subepidermal blisters

114
Q

rx pemphigus

A
  • emergenct
  • immunosupress - prednisolone and azathioprine. give pred till reduced blisters
  • oral lesions - steroid mouthwash
115
Q

dermatitis herpetiformis rx

A
  • dapsone. but check g6pd
116
Q

polymorphous light eruption typically effects whom

A
  • young women in sprign after light exposure
117
Q

rx polymorphous light eruption

A
  • steroids

- severe - UVB phototherapy

118
Q

triggers of porphyria cuntanea tarda

A
  • high oestrogen
  • high iron
  • low ascorbic acid
  • hep c
  • alcohol
  • HIV
119
Q

signs of cutanea tarda

A
  • vesicles/bullae in sun exposed sites, hyperpigmentation
120
Q

ix results in cuanea tarda

A
  • high LFT
  • High ferritis
  • high plasma
    • high faecal and urinary prophyrins
121
Q

rx cutaenea tarda

A
  • sun avoid
  • avoid precipitants
  • regular venesection till ferritin normal;
  • chloroquine
  • ascobic acid
122
Q

rx venous ulcer

A
  • compression bandaging if no arterial insufficiency
123
Q

why should you XR a neuropathic ulcer

A
  • to check for osteomyelitis
124
Q

rx SCC on skin

A

<20mm diameter = surgical excision with 4mm margins

> 20mm = 6mm margins

high risk = mohs

F year medicine facts (19 decks)

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