Derm Brief Flashcards
Describe impetigo and its common cause.
Impetigo is characterized by honey-crusted lesions on the face of a child. It is commonly caused by Staphylococcus aureus.
What is the treatment of choice for impetigo?
Topical mupirocin, also known as Bactroban, is the drug of choice for treating impetigo. Of systemic feature cephalexin
How long should a child with impetigo be excluded from school after starting antibiotic treatment?
One day after starting antibiotic treatment.
What is the preferred treatment for bullous impetigo?
Hydration and intravenous antibiotics are the preferred treatment for bullous impetigo.
Define cellulitis and its most common cause.
Cellulitis is characterized by a red, hot, and swollen leg with high-grade fever. The most common cause is Streptococcus pyogenes.
What is the treatment of choice for cellulitis?
Intravenous flucloxacillin is the treatment of choice for cellulitis.
Describe the presentation of a hematoma in a patient on warfarin therapy.
A patient on warfarin therapy presenting with a red, hot, and swollen leg likely has a hematoma.
What is the likely diagnosis for a patient with a red, hot, and swollen leg and a past history of DVT or risk factors for DVT?
Deep Vein Thrombosis (DVT) is the likely diagnosis.
Define acne and its common cause.
Acne is a skin condition caused by Propionibacterium acnes.
What is the treatment for mild cases of acne?
Benzoyl peroxide is used to treat mild cases of acne.
What is the treatment for severe cases of acne?
Oral isotretinoin is the treatment for severe cases of acne, but it is contraindicated in pregnancy.
Describe the presentation of Tinea pedis in an athletic patient.
Tinea pedis presents with lesions of bad odor between the toes in athletic patients.
What is the treatment for Tinea pedis?
Antifungal cream or powder, such as miconazole, is used to treat Tinea pedis.
Define Tinea cruris and its common presentation.
Tinea cruris is characterized by a red, scaly lesion in the inguinal region with severe itching.
What are the hypo-pigmented macules seen in Tinea versicolor and its common cause?
Hypo-pigmented macules on the back, neck, and shoulders are characteristic of Tinea versicolor, caused by Malassezia furfur in its mycelial form.
What is the treatment for Tinea versicolor?
Topical selenium sulfide is the treatment for Tinea versicolor.
Describe the presentation of Tinea corporis.
Tinea corporis presents as an itchy lesion with a pale center and red, scaly border.
What is the treatment for Tinea corporis?
Topical azoles are used to treat Tinea corporis.
What is the drug of choice for pediculosis?
Permethrin is the drug of choice for pediculosis.
Describe the presentation of scabies and its characteristic feature.
Scabies presents as an intense itchy patch with linear burrows.
What is the treatment for scabies?
Permethrin is the treatment for scabies, recommended even in children and pregnancy. Patients should be retreated after 1-2 weeks.
What is a common symptom of scabies affecting all family members at night?
Severe itching at night affecting all family members is a common symptom of scabies.
Describe the presentation of HSV on the lips in a child.
HSV (herpes labialis) presents with multiple vesicles on the lips of a child.
What is the presentation of HSV on the genitalia?
HSV (herpes genitalis) presents with multiple painful vesicles on the genitalia.
What is the presentation of HSV on the fingers?
HSV (herpes whitlow) presents with multiple vesicles on an erythematous base on the fingers.
What is the common cause of HSV encephalitis and its typical symptoms?
HSV encephalitis is mainly caused by herpes simplex virus and presents with fever, confusion, and seizures, affecting mainly the temporal lobe.
Describe the treatment for varicella within the first 72 hours of onset. DERM
Acyclovir intravenously
What is the recommended treatment for post-herpetic neuralgia as the first line?
Carbamazepine
How can primary herpes infection be differentiated from recurrent herpes infection?
Through serology
Define the term Ramsay Hunt syndrome.
Varicella infection with facial nerve palsy
What is the first-line treatment for condyloma acuminata?
Podophyllin resins
Describe the appearance of molluscum contagiosum lesions.
Flesh-colored, dome-shaped papules with central umbilication
What is the most common cause of contact dermatitis?
Nickel
How is atopic dermatitis typically treated?
With cortisone cream
What is the recommended treatment for angioedema?
IM adrenaline (1:1000)
What is the hereditary cause of angioedema?
C1 esterase inhibitor deficiency
Describe the appearance of psoriasis lesions.
Yellow scaly lesions that can be easily removed, leaving bleeding spots
Describe the first step in managing a frostbite injury
Rapid rewarming in water at 40-42 degrees Celsius
What is the lesion called in Pityriasis rosea that serves as an initial patch?
Herald patch
What is the treatment for Candida infection in the napkin area of a child with fissures and satellite lesions?
Nystatin mouth wash
Define Telogen effluvium and its association with stress
Hair loss in females under stress; reassure the patient
How is Alopecia areata characterized, and what is the first-line treatment?
Hair loss with exclamation hair mark; local cortisone as first-line treatment
What is the treatment for vitiligo, and what is commonly associated with this condition?
Camouflage with skin-colored material; other autoimmune diseases
What is the recommended treatment for lipoma?
Excision
Describe the treatment for leukoplakia in a smoker that is not removed by scraping
Removal due to the risk of squamous cell carcinoma of the tongue
What is the first most common risk factor for melanoma?
History of atypical nevi
What is the second most common risk factor for melanoma?
Family history
What is the third most common risk factor for melanoma?
Sun exposure
What is the most important prognostic factor for melanoma?
Depth of the lesion
What is the most important advice to decrease the risk of melanoma?
Avoid sun exposure
What is the most important advice for high-risk patients with nevi?
Regular skin exams and photography
Describe the management of a recurrent lesion after excision
Excision again
What is the recommended action if a pathology report shows malignant cells at the margins after excision?
Re-excision with a wider safety margin
Dermatitis in napkin area of child NOT affecting fissures with NO satellite lesion
Napkin dermatitis
What is the treatment for melanoma near the eye?
Refer to a specialist
What is the recommended first step in managing atypical nevi?
Wide excision with a 2-3 cm safety margin
Describe the management of melanoma with enlarged lymph nodes
Excision of both the melanoma and the lymph nodes
What is the recommended action for an old smoker presenting with a white lesion and an ulcer on the tongue?
Suspect tongue cancer (not leukoplakia)
What is the recommended action for an old smoker with bloody stained saliva?
Suspect tongue cancer
What is the most important advice for a high-risk patient with a history of melanoma and a brain mass on CT?
Immediate medical evaluation and management
Describe the next step for a patient presenting with black coloration at the fingers after being in ice 2-3 weeks ago.
Excision (NOT re-warming; it is NOT frostbite lesion)
Do for a dark ulcer on a patient’s face suspected to be Basal Cell Carcinoma (BCC) until proven otherwise.
Shave biopsy (biopsy with 2-3 mm safety margin)
If the clinical examination suggests a superficial BCC or Bowen’s disease, a shave biopsy may be the most appropriate procedure.
https://www.racgp.org.au › may
Skin biopsy in the diagnosis of neoplastic skin disease - RACGP
Define the treatment of choice for Basal Cell Carcinoma (BCC).
Moh’s surgery
The choice of biopsy technique will be determined by the site, size and shape of the lesion. For thin lesions (eg. Bowen disease or superficial BCC), a partial shave biopsy is ideal as it provides a larger surface area of malignant cells (Figure 7–10). Occasionally a small punch biopsy will miss the malignant cells in these lesions (a false negative). For thicker lesions, a punch biopsy is more appropriate so that deeper cells are included in the histology. Punch biopsy tools are very sharp and can penetrate quickly to several millimetres in depth. Be very mindful of this in danger areas such as over the facial nerve or over a major vessel.
How should one proceed if the pathology report after removal of Basal Cell Carcinoma (BCC) indicates malignant cells?
Excision again
Describe the type of carcinoma commonly found in the lower lip.
Squamous Cell Carcinoma (SCC)
Define the type of carcinoma commonly found in the tongue.
Squamous Cell Carcinoma (SCC)
How is carcinoma of the esophagus typically classified?
Squamous Cell Carcinoma (SCC)
Describe the type of carcinoma associated with Marjolin ulcer.
Squamous Cell Carcinoma (SCC)
Do for carcinoma arising from chronic osteomyelitis.
Squamous Cell Carcinoma (SCC)
Define the skin condition characterized by a nodule appearing on the hand or face after a mosquito bite.
Dermatofibroma
Describe the skin condition in a female characterized by face flushing occurring with emotion or hot drinks.
Rosacea
Define the flaky, red, itchy skin condition with yellow scales.
Seborrheic dermatitis
How should you treat severe lesions of a skin condition with anti-fungal in children and consider checking for HIV in adults?
Anti-fungal for children. Check HIV if severe lesions in adults
Describe the appearance of a scaly lesion on an old patient’s face with a stuck-on appearance.
Seborrheic keratosis
Do for a dark or light, pink or red scaly lesion on an old patient, which may indicate Actinic Keratosis.
Removal (risk of malignancy)
Define the dome-shaped, rapid-growing lesion commonly found in older patients.
Keratoacanthoma
How should you treat a small vascular lesion in a pregnant woman or child after trauma?
Surgery (check image of pyogenic granuloma)
Describe the severe, itchy, painful vesicles on top of healed atopic dermatitis.
Eczema herpeticum
Define the treatment for Eczema herpeticum.
Acyclovir
