Derm bits and pieces Flashcards
Which features are NOT found in acne rosacea?
Comedones
What are the features of acne rosacea?
Blushing and flushing (this condition is proangiogenic)
Enlarged sebacous glands and soft tissue
Papules
Pustules
What can trigger acne rosacea?
Prolonged use of steroids
What is the first line treatment for acne rosacea?
Topical metronidazole
How can the blushing aspect of acne rosacea be managed?
Cosmetic concealers, vascular laser surgery
What is the second line treatment for acne rosacea?
Topical metronidazole plus oral tetracycline
What are the complications of acne rosacea?
Blepharitis and keratitis - ocular involvement
Why are creams are more likely than ointments to cause contact sensitisation?
Because they contain preservatives
What type of inheritance pattern does neurofibromatosis have?
autosomal dominant
What type of inheritance pattern does tuberous sclerosis have?
autosomal dominant
What is the aetiology of pemphigus vulgaris?
RARE autoimmune condition
Usually presents in mid-adult life
What is the aetiology of bullous pemphigoid?
Commoner than pemphigus vulgaris
Usually people >60yrs old get it
In pemphigus vulgaris which structure do auto antibodies target?
Desmosomal proteins
In BULLOUS pemphioig which structure do auto antibodies target?
Hemidesmosomal proteins
What are the clinical features of pemphigus vulgaris?
- INTRAEPIDERMAL blisters that are FRAGILE, FLACCID and non itchy
- Blisters will rupture easily and leave weeping erosions
- Oral ulcers (mucosal involvement)
What are the clinical features of bullous pemphigoid?
- LARGE, TENSE bullae (blisters)
- can be very itchy
- Inflamed and itchy underlying skin (resembles urticaria in early disease)
What is the main histological feature of pemphigus vulgaris?
Loss of keratocyte adhesion, sometimes seperation of the stratum corneum from the rest of the epidermis.
What are the histological features of bullous pemphigoid?
Sub-epidermal split through the basement membrane
IgG and complement deposition at the dermo-epidermal junction
How are blistering disorders managed?
Steroids usually, but steroid-sparing immunosuppressive agents such as azathioprine are used in severe cases.
Where are venous ulcers usually found?
Medial or lateral malleoulus
Where are arterial ulcers usually found?
On the foot or mid shin
What does breslow thickness mean?
depth from the GRANULAR LAYER of the epidermis to the deepest melanoma cell. Used as a measure of prognosis for nodular and superficial malignant melanoma.
Which skin cancer is most deadly?
Malignant melanoma, then squamous cell carcinoma then basal cell carcinoma.
Which skin cancer is most common?
Basal cell carcinoma
Which skin cancer grows slowly?
Basal cell carcinoma
Which skin cancers grow fast?
Squamous cell carcinoma and Malignant melanoma
What are the two conditions that SCC can arise from?
Bowen’s disease
SOLAR/actinic keratoses
Where does SCC commonly arise?
On the helix of the ear
What are the features of dermatofibroma?
Pink beige firm nodules, surrounded by a ring of hyperpigmentation.
how does solar/actinic keratoses present
rough scaly patches on sun exposed areeas
What are the features of dermatitis herpetiformis?
- Papules and vesicles
- itchy
- IgA deposits
- associated with coeliac disease
