Derm skills Flashcards
Weak topical steroid
Hydrocortisone
Moderately potent topical steroid
Eumovate (clobetasone butyrate)
Potent topical steroid
Betnovate (betamethasone)
Very potent topical steroid
Dermovate (clobetasol propionate)
Ointment vs cream
Ointment - most suitable for dry, non-hairy skin
Reduced excipients -> reduced risk of irritation
Side effects of topical steroids
Contact dermatitis - esp to excipients
Skin thinning/bruising/stretch marks (striae)
Telangiectasia
Hypertrichosis (increased hair thickness/length)
Periorificial dermatitis (Esp in children)
steroid rosacea
Very uncommon except w/ inappropriate use
Side effects of systemic steroids
Diabetes
Osteoporosis
Hypertension
Cushing’s
cataract
infection
Fitzpatrick skin types
I - never tans, always burns
II - sometimes tans, often burns
III - sometimes burns, always tans
IV - always tans, never burns
Key elements of HOPC in derm
Distribution - esp mucosa/genitalia and nails/scalp
Symptoms - esp pain/itch, discharge, bleeding
Evolution - change in size/appearance, intermittent or continuous
Triggers/relieving factors
Associated symptom systems to ask about
Eyes
Bowels
Joints
Systemic - fever/malaise/weight loss
PMHx to ask about in derm
Atopy
Skin conditions, cancer
Systemic inflamm - e.g. rheum, IBD
Sunburn (esp blistering as child)
New drugs
Social history in derm
Occupation, hobbies, travel
Pets
Tanning beds
Relation of lesions to work
Recent travel, illness, contact
Risk factors malignancy
Sun exposure/tanning beds
Family Hx
Skin type: burn or tan
immunosuppression
Prev cancer/FHx
Risk factors psoriasis
Meds - esp beta blockers, diuretic
Smoking
Stress
FHx
System for describing individual lesions
Site/size/shape
Colour
Associated 2ry change - tenderness/temp
Margin
Distribution if rash/multiple lesion
Blanching vs non-blanching rash
Blanching = erythema - due to vasodilation, inflamm
Non-blanching = petechiae, purpura - due to blood leaking out of vessels
Describing flat changes in skin colour
Macule if small (0.5-1cm)
Patch if large
Describing raised, fluid-filled lesions
Vesciles if small and clear
Bullae if large and clear
Pustules if small and pus-filled
Abscess if large and pus-filled
Describing solid elevations
Papules if small and domed
Nodule if large and domed
Wheal if small anf flat, may be surrounded by erythematous flare, compressible, transient
Plaque if large and flat
Describing skin loss
Erosion - partial epidermal loss
Ulcer - complete epidermal loss
Fissure - linear crack
Atrophy - epidermal thinning
Describing secondary skin lesions
Scale: White flaking - indicates epidermal pathology
Crust - dried pus, sebum, blood; often coloured
Callus - hyperplastic epidermis, areas of friction
Lichenification - epidermal thickening with exaggerated skin markings (e.g. following repeated scratching)
Describing vascular skin lesions
-
Blanching:
- Telangiectasia: Easily visible blood vessels
- Erythema: Local vasodilation
-
Non-blanching:
- Petechiae: Pinhead sized
- Purpura: Approx 2mm, due to blood leakage
- Ecchymosis: A bruise, large purpura
What is a milium
Small white cyst containing keratin
What is a comedone?
Plug in sebaceous follicle containing alterd sebum, bacteria and cellular debris
