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My notes - med > Derm > Flashcards

Derm Flashcards

1
Q

Lichen Planus

A

P’s: purple, pruritis, papular, polygonal on flexors, palsm, soles, genitals
Wickham’s straie (white lines) on surface
Oral involvement - white lace
New lesions at signs of trauma

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2
Q

Lichen sclerosus

A

itchy white spots on vulva

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3
Q

Lichen planus causes

A

gold
quinine
thiazides

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4
Q

Lichen planus mgmt

A

Potent topical steroid
benzydamine mouthwash/spray
If rly bad - oral steroids or immunosuppression

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5
Q

Pruritus, lethargy, weight gain, dry skin

A

hypothyroidism

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6
Q

Pruritus, weight gain w low appetite, nausea, pale

A

CKD

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7
Q

Pruritus, lethargy, spoon nails(koilonychia), smooth tongue, angular stomatitis, post-crcoid webs

A

Iron def anemia

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8
Q

Hx alcohol, spider nevi, bruising, palmar erythema, gynecomastia, pruritus

A

liver disease

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9
Q

Pruritus after bath, ruddy complexion, gout, peptic ulcer

A

Polycythemia

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10
Q

Lethargy, pallor, weight gain, edema, hypertension, pruritus

A

CKD

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11
Q

Pruritus, LN, night sweats, splenomegaly, hepatomegaly, fatigue

A

Lymphoma

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12
Q

Acne rosacea ft

A 
note/cheecks/forehead
flushing
telangiectasia
later: persistent erythema w papules + pustules
Rhinophyma (red, bulbous bumpy nose)
Blepharitis of eye
Worse w sunlight
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13
Q

Acne rosacea mgmt

A 
topican metronidazole for mild
brimonidine gel for flushing
Abx for more severe - tetracycline
SPF
Laser/plastics
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14
Q

Dermoid cyst

A

embryological remnants, lines w hair and squamous epithelium

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15
Q

Desmoid tumour

A

ligaments & tendons

Fibroblast dense lesions

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16
Q

BCC

A

Sun exposed parts
Slow growing, low mets
Surgical excision, topical chemo + radio
Punch biopsy

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17
Q

SCC

A 
Sun exposure
Can come from solar-keratoses
Can met
Higher risk in immunosupressed
Wide local excision after biopsy
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18
Q

Malig Melanoma

A

Change in: size, shape, colour

Diam >6mm, inflamm, oozing/bleed, altered sensation

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19
Q

Malig melanoma tx

A

Excision biopsy

Then re-excise for margins

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20
Q

Melanoma Breslow scale

A

0-1mm thick - 1cm margin
1-2mm - 1-2cm margin
2-4mm - 2-3cm margin
>4mm thick - 3cm margin

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21
Q

Kaposi sarcoma

A

Tumour f vascular + lymphatic endothelium
Purple cutaneous
Immuno suppression
Males, slow growing

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22
Q

Dermatitis Herpetiformis

A

Chronic itchy clusters of blisters
Linked to celiac
IgA deposition

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23
Q

Dermatofibroma

A

Bening
Firm elevated nodules
History of trauma
Lesions have histiocytes, blood vessels, fibrotic tissue

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24
Q

Pyogenic granuloma

A

Overgrowth of BVs
red nodules
follow trauma
mimic amelanotic melanoma

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25
Q

Acanthosis nigricans

A

Brown/black, poorly defined, velvety hyperpigmentation of skin
Found in folds of skin (neck, axilla, groin, umbilicus)
Insulin resistance usually
Can be a paraneoplastic syndrome

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26
Q

Pityriasis rosea

A

Young adults - self-limiting
Herald patch, then multiple after a few weeks
Erythematous, oval, scaly patches
Goes away 6-12 w

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27
Q

Guttate psoriasis

A

Preceded by strep throat 2-4w

Tear drop scaly papules on limbs + trunk

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28
Q

Guttate psoriasis tx

A

Resolve within 2-3m
Can use topical psoriasis meds
UVB phototherapy

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29
Q

Erythema multiforme

A

target lesions
starts on back of hands/feet then to torso
Upper limbs> LL
Sometimes itchy

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30
Q

Erythema multiforme causes

A 
Virsu: HSV
Idiopathic
Bacterial (strep, myco)
Drugs (penicillin, allopurinol, NSAID, OSC, carbamazepine, sulphonamides)
SLE
Sarcoidosis
Malignancy
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31
Q

Erythema multiforme major

A

assoc w mucosal involvement

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32
Q

Emollients in eczema

A 
2-3 times/d
after shower
Increase up to every hour if v dry
Downward motion
Leave to soak in
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33
Q

Most common malignancy secondary to immunosuppression

A

SCC

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34
Q

SCC

A

indurated (firm)
Nodular, plaque-like
Ulcerate
Inflamed skin around

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35
Q

Actinic keratoses

A

sun exposed sites
scaly surface
no induratuon

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36
Q

Seborrheic keratoses

A

benign pigmented skin lesions, scalp + otistis externa
warty, “stuck-on” look
Malassezia furfur

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37
Q

BCC

A

translucent, shiny nodules
pearly rolled edges
peripheral telangiectasia

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38
Q

SCC RF

A 
sunlight, UVA
actinic keratoses and bowens disease
Immunosuppresion (transplant, HIV)
Smoking
Long standing leg ulcers (Marjolin)
Genetics
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39
Q

SCC tx

A

excsion w 4mm marcin if lesion <20mm

>20mm - 6mm margins

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40
Q

SCC good prognosis

A

Well diferentiated
<20mm diameter
<2mm deep
No assoc disease

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41
Q

SCC bad prognosis

A

Poorly differentiated
>20mm diameter
>4mm deep
Immunosuppressed

42
Q

Shingles RF

A

older
HIV
Immunosuppresion (chemo, steroids)

43
Q

Shingles tx

A

Avoid contaminating
Analgesia
Antivirals if <72

44
Q

Shingles comps

A

Post herpetic neuralgia
Herpes zoster ophthalmicus (ocular devision of trigeminal nerve) - ocular comps
HZ oticus (Ramsay Hunt) - lesions in ear and facial paralysis

45
Q

Keratoacanthoma

A

volcano shaped crater
initially smooth dome papule
Then crater, centrally filled w keratin
**NEED to exclude SCC

46
Q

Dermatophyte nail infx tx

A

oral terbinafine

47
Q

Candida nail infx tx

A

oral itraconazole

mild - topical amorolfine

48
Q

Psoriasis triggers

A

Trauma
Alcohol
Drugs: BB, lithium, antimalarials, NSAIDs, ACEi, infiximab

49
Q

Psoriasis tx

A

topical cortico

vit D analogue

50
Q

Plantar wart

A

firm, hyperkeratotic with black dots

51
Q

Plantar wart tx

A

salicylic acid

52
Q

Actinic keratosis tx

A

Diclofenac
5-FU
Imiquimod

53
Q

Actinic keratosis

A

hyprkeratotic

sun exposire places

54
Q

Lice tx

A

malathion

55
Q

Seborrheic derm assoc cond

A

HIV

Parkinsons

56
Q

Seborrheic derm tx

A

Ketoconazole

Topical cortico, selenium sulphide

57
Q

Acanthosis nigricans causes

A 
T2DM
GI cancer
Obesity
PCOS
Acromegaly
Cushing's disease
Hypothyroid
Familial
Prader-Willi
Drugs (COCP, Nicotinic acid)
58
Q

Hidradenitis suppurativa

A

chronic, painful inflam skin disorder
Nodules, pustules, sinus tracts, scars in intertriginous areas (axilla, groin, anogenital area, between digits)
RF: obesity, smoking, fhx, PCOS

59
Q

Hidradenitis suppurativa tx

A 
Good hygiene + loose clothes
Quit smoke
Weight loss
Steroids acutely or flucloxacillin
I&D
LT: topical clindamycin, oral lin or rifampicin
60
Q

Vitiligo

A

well demarcated patches of depigmented skin
Peripheries more affected
trauma can precipitate new lesions

61
Q

Vitiligo assoc w

A 
T1 DM
Addisons
Autoimmune thyroid
Pernicious anemia
Alopecia
62
Q

Venous ulcer location

A

above medial malleolus

63
Q

Venous ulcer mgmt

A

Compression bandage

Oral pentoxyfylline - a periph vasodilator

64
Q

Dermatitis herpetiformis

A

Itchy

vesicular lesions on extensors (elbow, knee, butt)

65
Q

Dermatitis herpetiformis tx

A

gluten free diet

dapsone

66
Q

Vitiligo mgmt

A

sunblock
make up
steorids
tacrolimus and phototherapy

67
Q

Acne tx

A 
Single topical (retinoid, benz per)
Topical combo (abx, benzper, retinoid)
Oral: tetracycline, erythromycin (in preg), minocycline (careful) x 3mo + topical benper or retinoid
COCP (dianette)
Oral isotretinoin
68
Q

Keloid scars most common @

A 
sternum
shoulder
neck
face
extensor surfaces
trunk
69
Q

Eczema herpeticum

A

cluster of itchy painful blisters on face/neck
Progresses rapidly
Usually from HSV1/2

70
Q

Eczema herpeticum tx

A

IV acyclovir

71
Q

Type 6 skin

A

black skin, afro Caribbean, never tans/burns

72
Q

Type 5 skin

A

sunburn and tanning after extreme exposure - brown skin/indian

73
Q

Type 4 skin

A

always tans, rarely burns (olive skin

74
Q

Type 3 skin

A

always tans, sometimes buns dark hair, brown eyes)

75
Q

Type 2 skin

A

usually tans, always burns

76
Q

Type 1 skin

A

never tans, always burns (red hai, freckles, blue eyes)

77
Q

Plaque psoriasis mgmt

A

emollients
Potent cortico steroid AM and vit D analogue PM - 4w tx
If not better after 8w, use topical vit D BD
If not better 8-12w: potent corticosteroid BD x 4w OR coal tar prep OD/BD
Short acting dithranol

78
Q

Plaque psoriasis secondary care mgmt

A 
Phototherapy
Systemic therapy
- MTX
- Ciclosporin
- Systemic retinoids
- Infliximad
- Ustekinumab
79
Q

Scalp psoriasis mgmt

A

potent topical steroid OD x 4w

80
Q

Vit D analogues

A

Calcipotriol
Calcitriol
Decrease cell division/epidermal proliferation
Can be used long term

81
Q

Dithranol

A

placque psoriasis
- inhibit DNA synthesis
wash off after 30m
Can burn and stain

82
Q

Spider nevi

A

press down and they fill from centre

Assoc w liver failure, preg, COCP

83
Q

Telangiectasia

A

press down and they fill from edges

84
Q

Oral leukoplakia

A 
premalignant
White, hard spots in mouth
Common i smokers
Dx of exclusion
Can't be rubbed off
85
Q

Psoriasis comps

A 
arthroptathy
metabolic syndrome
CVD
VTE
psych disress
86
Q

Irritant contact derm

A

non-allergic
weak acids or alkalis
Hands, erythema

87
Q

Allergic contact derm

A

T3 hypersensitivity
Head after dying
Acute weeping eczema
needs potent steroids

88
Q

Hereditary hemorrhagic telangiectasia

A

autosomal doninant

multiple telangiectasia on skin + mucous membranes

89
Q

Hereditary hemorrhagic telangiectasia criteria

A 
2 = possible, 3 = definite
epistaxis (recurrent)
telangiectasia (lips/oral/finger/ nose)
Visceral lesions/AVM (GI, pulm, hepatic, cerebral, spinal)
Fam Hx - first degree
90
Q

Cherry hemangioma

A

Benign
Abnormal prolif of caps
Common w advancing age
Erythematous, papular, 1-3mm, non blanching, not on mucous

91
Q

What can cause pellagra

A

Isoniazid

92
Q

Pellagra

A 
Vit B3 deficiency
Diarrhea
Dermatitis
Dementia
Death
93
Q

Bullous vs vulgaris pemphigoid

A

Mucosal involvement: pemphigus vulgaris

94
Q

Bullous pemphigoid ft

A 
elderly
itchy, tense blisters @ flexures
head without scarring
no ucosal involvement
IgG and C3
95
Q

Bullous pemphigoid tx

A

oral corticosteroids

96
Q

Molluscum contagiosum

A

Pinkish/pearly white papules w umbilication
up to 5mm
Clusters anywhere on body (spares palms and soles)
Spontaneous resolution 18mo
Contagious

97
Q

Nodular melanoma

A

Sun exposed areas
Middle aged
red or black lump
oozes or bleeds

98
Q

Superficial spreading melanoma

A

Arms/legs/back/chest
Young people
Growing mole w usual ft

99
Q

Lentigo melanoma

A

Chonically sun exposed
older ppl
growing mole with usual ft

100
Q

Acral lentiginous menaloma

A

nails, palms, soles
African/Asian
Subungal pigmentation or on palms or feet

My notes - med (14 decks)

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