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
2
Q
Lichen sclerosus
A
itchy white spots on vulva
3
Q
Lichen planus causes
A
gold
quinine
thiazides
4
Q
Lichen planus mgmt
A
Potent topical steroid
benzydamine mouthwash/spray
If rly bad - oral steroids or immunosuppression
5
Q
Pruritus, lethargy, weight gain, dry skin
A
hypothyroidism
6
Q
Pruritus, weight gain w low appetite, nausea, pale
A
CKD
7
Q
Pruritus, lethargy, spoon nails(koilonychia), smooth tongue, angular stomatitis, post-crcoid webs
A
Iron def anemia
8
Q
Hx alcohol, spider nevi, bruising, palmar erythema, gynecomastia, pruritus
A
liver disease
9
Q
Pruritus after bath, ruddy complexion, gout, peptic ulcer
A
Polycythemia
10
Q
Lethargy, pallor, weight gain, edema, hypertension, pruritus
A
CKD
11
Q
Pruritus, LN, night sweats, splenomegaly, hepatomegaly, fatigue
A
Lymphoma
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
13
Q
Acne rosacea mgmt
A
topican metronidazole for mild brimonidine gel for flushing Abx for more severe - tetracycline SPF Laser/plastics
14
Q
Dermoid cyst
A
embryological remnants, lines w hair and squamous epithelium
15
Q
Desmoid tumour
A
ligaments & tendons
Fibroblast dense lesions
16
Q
BCC
A
Sun exposed parts
Slow growing, low mets
Surgical excision, topical chemo + radio
Punch biopsy
17
Q
SCC
A
Sun exposure Can come from solar-keratoses Can met Higher risk in immunosupressed Wide local excision after biopsy
18
Q
Malig Melanoma
A
Change in: size, shape, colour
Diam >6mm, inflamm, oozing/bleed, altered sensation
19
Q
Malig melanoma tx
A
Excision biopsy
Then re-excise for margins
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
21
Q
Kaposi sarcoma
A
Tumour f vascular + lymphatic endothelium
Purple cutaneous
Immuno suppression
Males, slow growing
22
Q
Dermatitis Herpetiformis
A
Chronic itchy clusters of blisters
Linked to celiac
IgA deposition
23
Q
Dermatofibroma
A
Bening
Firm elevated nodules
History of trauma
Lesions have histiocytes, blood vessels, fibrotic tissue
24
Q
Pyogenic granuloma
A
Overgrowth of BVs
red nodules
follow trauma
mimic amelanotic melanoma
25
Acanthosis nigricans
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
26
Pityriasis rosea
Young adults - self-limiting
Herald patch, then multiple after a few weeks
Erythematous, oval, scaly patches
Goes away 6-12 w
27
Guttate psoriasis
Preceded by strep throat 2-4w
| Tear drop scaly papules on limbs + trunk
28
Guttate psoriasis tx
Resolve within 2-3m
Can use topical psoriasis meds
UVB phototherapy
29
Erythema multiforme
target lesions
starts on back of hands/feet then to torso
Upper limbs> LL
Sometimes itchy
30
Erythema multiforme causes
```
Virsu: HSV
Idiopathic
Bacterial (strep, myco)
Drugs (penicillin, allopurinol, NSAID, OSC, carbamazepine, sulphonamides)
SLE
Sarcoidosis
Malignancy
```
31
Erythema multiforme major
assoc w mucosal involvement
32
Emollients in eczema
```
2-3 times/d
after shower
Increase up to every hour if v dry
Downward motion
Leave to soak in
```
33
Most common malignancy secondary to immunosuppression
SCC
34
SCC
indurated (firm)
Nodular, plaque-like
Ulcerate
Inflamed skin around
35
Actinic keratoses
sun exposed sites
scaly surface
no induratuon
36
Seborrheic keratoses
benign pigmented skin lesions, scalp + otistis externa
warty, "stuck-on" look
Malassezia furfur
37
BCC
translucent, shiny nodules
pearly rolled edges
peripheral telangiectasia
38
SCC RF
```
sunlight, UVA
actinic keratoses and bowens disease
Immunosuppresion (transplant, HIV)
Smoking
Long standing leg ulcers (Marjolin)
Genetics
```
39
SCC tx
excsion w 4mm marcin if lesion <20mm
| >20mm - 6mm margins
40
SCC good prognosis
Well diferentiated
<20mm diameter
<2mm deep
No assoc disease
41
SCC bad prognosis
Poorly differentiated
>20mm diameter
>4mm deep
Immunosuppressed
42
Shingles RF
older
HIV
Immunosuppresion (chemo, steroids)
43
Shingles tx
Avoid contaminating
Analgesia
Antivirals if <72
44
Shingles comps
Post herpetic neuralgia
Herpes zoster ophthalmicus (ocular devision of trigeminal nerve) - ocular comps
HZ oticus (Ramsay Hunt) - lesions in ear and facial paralysis
45
Keratoacanthoma
volcano shaped crater
initially smooth dome papule
Then crater, centrally filled w keratin
**NEED to exclude SCC
46
Dermatophyte nail infx tx
oral terbinafine
47
Candida nail infx tx
oral itraconazole
| mild - topical amorolfine
48
Psoriasis triggers
Trauma
Alcohol
Drugs: BB, lithium, antimalarials, NSAIDs, ACEi, infiximab
49
Psoriasis tx
topical cortico
| vit D analogue
50
Plantar wart
firm, hyperkeratotic with black dots
51
Plantar wart tx
salicylic acid
52
Actinic keratosis tx
Diclofenac
5-FU
Imiquimod
53
Actinic keratosis
hyprkeratotic
| sun exposire places
54
Lice tx
malathion
55
Seborrheic derm assoc cond
HIV
| Parkinsons
56
Seborrheic derm tx
Ketoconazole
| Topical cortico, selenium sulphide
57
Acanthosis nigricans causes
```
T2DM
GI cancer
Obesity
PCOS
Acromegaly
Cushing's disease
Hypothyroid
Familial
Prader-Willi
Drugs (COCP, Nicotinic acid)
```
58
Hidradenitis suppurativa
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
Hidradenitis suppurativa tx
```
Good hygiene + loose clothes
Quit smoke
Weight loss
Steroids acutely or flucloxacillin
I&D
LT: topical clindamycin, oral lin or rifampicin
```
60
Vitiligo
well demarcated patches of depigmented skin
Peripheries more affected
trauma can precipitate new lesions
61
Vitiligo assoc w
```
T1 DM
Addisons
Autoimmune thyroid
Pernicious anemia
Alopecia
```
62
Venous ulcer location
above medial malleolus
63
Venous ulcer mgmt
Compression bandage
| Oral pentoxyfylline - a periph vasodilator
64
Dermatitis herpetiformis
Itchy
| vesicular lesions on extensors (elbow, knee, butt)
65
Dermatitis herpetiformis tx
gluten free diet
| dapsone
66
Vitiligo mgmt
sunblock
make up
steorids
tacrolimus and phototherapy
67
Acne tx
```
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
Keloid scars most common @
```
sternum
shoulder
neck
face
extensor surfaces
trunk
```
69
Eczema herpeticum
cluster of itchy painful blisters on face/neck
Progresses rapidly
Usually from HSV1/2
70
Eczema herpeticum tx
IV acyclovir
71
Type 6 skin
black skin, afro Caribbean, never tans/burns
72
Type 5 skin
sunburn and tanning after extreme exposure - brown skin/indian
73
Type 4 skin
always tans, rarely burns (olive skin
74
Type 3 skin
always tans, sometimes buns dark hair, brown eyes)
75
Type 2 skin
usually tans, always burns
76
Type 1 skin
never tans, always burns (red hai, freckles, blue eyes)
77
Plaque psoriasis mgmt
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
Plaque psoriasis secondary care mgmt
```
Phototherapy
Systemic therapy
- MTX
- Ciclosporin
- Systemic retinoids
- Infliximad
- Ustekinumab
```
79
Scalp psoriasis mgmt
potent topical steroid OD x 4w
80
Vit D analogues
Calcipotriol
Calcitriol
Decrease cell division/epidermal proliferation
Can be used long term
81
Dithranol
placque psoriasis
- inhibit DNA synthesis
wash off after 30m
Can burn and stain
82
Spider nevi
press down and they fill from centre
| Assoc w liver failure, preg, COCP
83
Telangiectasia
press down and they fill from edges
84
Oral leukoplakia
```
premalignant
White, hard spots in mouth
Common i smokers
Dx of exclusion
Can't be rubbed off
```
85
Psoriasis comps
```
arthroptathy
metabolic syndrome
CVD
VTE
psych disress
```
86
Irritant contact derm
non-allergic
weak acids or alkalis
Hands, erythema
87
Allergic contact derm
T3 hypersensitivity
Head after dying
Acute weeping eczema
needs potent steroids
88
Hereditary hemorrhagic telangiectasia
autosomal doninant
| multiple telangiectasia on skin + mucous membranes
89
Hereditary hemorrhagic telangiectasia criteria
```
2 = possible, 3 = definite
epistaxis (recurrent)
telangiectasia (lips/oral/finger/ nose)
Visceral lesions/AVM (GI, pulm, hepatic, cerebral, spinal)
Fam Hx - first degree
```
90
Cherry hemangioma
Benign
Abnormal prolif of caps
Common w advancing age
Erythematous, papular, 1-3mm, non blanching, not on mucous
91
What can cause pellagra
Isoniazid
92
Pellagra
```
Vit B3 deficiency
Diarrhea
Dermatitis
Dementia
Death
```
93
Bullous vs vulgaris pemphigoid
Mucosal involvement: pemphigus vulgaris
94
Bullous pemphigoid ft
```
elderly
itchy, tense blisters @ flexures
head without scarring
no ucosal involvement
IgG and C3
```
95
Bullous pemphigoid tx
oral corticosteroids
96
Molluscum contagiosum
Pinkish/pearly white papules w umbilication
up to 5mm
Clusters anywhere on body (spares palms and soles)
Spontaneous resolution 18mo
Contagious
97
Nodular melanoma
Sun exposed areas
Middle aged
red or black lump
oozes or bleeds
98
Superficial spreading melanoma
Arms/legs/back/chest
Young people
Growing mole w usual ft
99
Lentigo melanoma
Chonically sun exposed
older ppl
growing mole with usual ft
100
Acral lentiginous menaloma
nails, palms, soles
African/Asian
Subungal pigmentation or on palms or feet
