Derm I Flashcards
First line tx for venous ulcers? [1]
Compression stockings
NB: CI in arterial ulcers as makes them worse
A mother brings her 17-week-old daughter to the GP. She reports that she has a circular red lesion on her back that started 2 weeks ago. It has doubled in size since then.
On examination it is 1.5cm in diameter, raised, circular and red. There is no history of trauma.
Given the history and examination findings, what is the most likely diagnosis?
Haemangioma
Which infective organism commonly causes infections in immunocompromised or severely ill patients, as well as those who require lines, catheters or other foreign body adjuncts? [1]
P. aeruginosa is a clinically relevant Gram-negative bacterium that commonly causes infections in immunocompromised or severely ill patients, as well as those who require lines, catheters or other foreign body adjuncts.
Describe the differences in TEN and STSS
- which skin layers are affected in each [3]
- which patient groups are impacted? [1]
- what are presenting features of each? [3]
- what causes each? [2]
Toxic epidermal necrolysis (TEN) is a dermatological emergency that usually occurs in the context of an adverse drug reaction.
- Features include positive Nikolsky sign and systemic upset (fever, pyrexia, tachycardia).
- In contrast to Staphylococcal infection, there is involvement of the epidermis and dermis as well as the involvement of the oral mucosa in TEN.
- TEN is usually seen in adults.
Staphylococcal toxic shock syndrome
- history of shock (pyrexia, hypotension, tachycardia), widespread desquamating rash and multi-organ dysfunction with a source of infection (arm wound) raises suspicion of Staphylococcal toxic shock syndrome (STSS).
What is the Dx criteria for STSS? [5]
Diagnostic criteria for STSS:
* Fever >38.9
* Rash with diffuse macular erythroderma
* Desquamation 1-2 weeks after rash onset
* Hypotension SBP < 90
* Multiorgan involvement - GI (vomiting and diarrhoea), creatine kinase >2 times upper limit, renal impairment, hepatitis, thrombocytopaenia and neurologic deficit.
How do you differentiate lentigo maligna and solar lentigo? [2]
Solar lentigo - Usually well circumscribed and can appear in clusters in sun-exposed areas, such as the face or the back of the hands/forearm
Lentigo Maligna - Slow growing, often large, Irregular borders, variable pigmentation
