DERM TABLE Flashcards
What is Acne Vulgaris?
A skin condition characterized by the blockage of the pilosebaceous unit (PSU) leading to comedones, inflammation, and pustules.
Acne Vulgaris is the most common form of acne.
What components make up the pilosebaceous unit (PSU)?
Hair follicle and sebaceous gland.
Sebaceous glands produce sebum, which lubricates hair and skin.
What causes the formation of comedones in acne?
Clogging of hair follicles with sebum and dead skin cells.
Comedones are a primary feature of acne.
What are the two types of comedones?
- Open (blackhead) - clogged pore remains open
- Closed (whitehead) - clogged pore covered by skin
Blackheads appear black due to oxidation of debris inside.
What is a papule?
A small raised solid lesion less than 1 cm in size.
Papules can be a result of inflamed comedones.
What is a pustule?
A small pus-filled lesion less than 1 cm in size.
Pustules are typically superficial in nature.
What are the treatment options for mild to moderate acne?
- Benzoyl peroxide (BPO)
- Clindamycin
- Erythromycin
- Trimethoprim (in pregnant/breastfeeding)
- Retinoids (Adapalene/Tretinoin)
- COCP for women as alternative to antibiotics
Combination creams like DUAC (BPO and clindamycin) can also be used.
What is Isotretinoin used for?
Treatment for severe acne, including nodules, cysts, and scarring.
Isotretinoin requires monitoring due to potential side effects.
What is acne fulminans?
A severe form of acne characterized by sudden eruptions and systemic illness, treated with oral steroids and low-dose isotretinoin.
Acne fulminans is rare and requires immediate medical attention.
What are the side effects of Isotretinoin?
- Dry skin, mouth, eyes, lips
- Low mood
- Hair thinning
- Intracranial hypertension
- Nose bleeds
- Photosensitivity
- Teratogenic effects
Women must avoid pregnancy while on Isotretinoin due to its teratogenic effects.
What is Acne Rosacea?
A skin condition characterized by facial flushing, redness, and visible blood vessels, primarily affecting women aged 30-60 with fair skin.
Triggers include sun exposure, stress, and certain foods.
What is vitiligo?
An autoimmune condition resulting in the loss of melanocytes, leading to white patches on the skin.
It often affects the peripheries and can be associated with other autoimmune diseases.
What characterizes psoriasis?
A chronic autoimmune inflammatory disorder with abnormal T-cell activity leading to scaly red patches.
Psoriasis is exacerbated by stress and certain infections.
What is the Koebner phenomenon?
The appearance of new skin lesions on previously healthy skin following injury.
It is associated with conditions like psoriasis and vitiligo.
What is dermatitis herpetiformis?
An autoimmune condition linked to gluten sensitivity, characterized by intense itching and blistering rash.
It typically resolves with a gluten-free diet.
What is the primary treatment for bullous pemphigoid?
Systemic oral steroids until no new lesions develop for a year.
Topical steroids may be used at onset.
What is the difference between bullous pemphigoid and bullous pemphigus vulgaris?
Bullous pemphigoid has tense blisters and spares mucous membranes, while bullous pemphigus vulgaris has flaccid, fragile blisters and may involve mucous membranes.
Nikolsky’s sign is positive in pemphigus vulgaris.
What is erythema nodosum?
A hypersensitivity reaction causing tender, erythematous nodules on the shins.
It is often idiopathic or associated with conditions like sarcoidosis and IBD.
What is atopic dermatitis?
A chronic inflammatory skin disorder characterized by itching, erythema, and dryness.
It often presents in childhood and is associated with asthma and allergic conditions.
What is the first line treatment for mild eczema?
Liberal emollient usage and mild corticosteroids (e.g., hydrocortisone).
Emollients should always accompany corticosteroids.
What is contact dermatitis?
Inflammation of the skin due to contact with irritants or allergens.
It can be classified as allergic or irritant contact dermatitis.
What triggers urticaria?
IgE response to allergens such as food, medication, or insect stings.
Urticaria presents as raised itchy welts that can appear and disappear quickly.
What is Steven Johnson syndrome?
A rare, life-threatening hypersensitivity reaction characterized by severe skin and mucous membrane blistering.
It is often triggered by medications and can present with flu-like symptoms initially.
What medication is often used for trigeminal neuralgia?
Carbamazepine
What are common triggers for certain skin reactions?
Medication, viruses, bacterial infections
What symptoms can appear within a week of medication intake?
Flu-like symptoms
What are the initial symptoms of a flu-like prodrome?
Sore throat, cold, fever
What type of skin changes follow the initial flu-like symptoms?
Erythematous macules/skin changes
What kind of skin rash can develop from these symptoms?
Red or purple skin rash that develops into blisters
What is a positive Nikolsky sign?
Peeling of skin when touched
What are painful ulcers in mucosal areas indicative of?
Mucosal ulceration in at least 2 areas (mouth, conjunctiva, urethra, pharynx)
What does a skin biopsy show in severe skin reactions?
Necrotic keratinocytes and sparse lymphocyte infiltrate
What percentage of body surface involvement is considered significant in these conditions?
10% of body surface
What is a major complication of these skin reactions?
Dehydration
What treatments may be used for severe skin reactions?
IV Fluid, electrolyte management, IV steroid, IVIG
Name a group of drugs that can cause severe skin reactions.
*Sulfonamides
*Beta-lactams (penicillins and cephalosporins)
*Antiepileptics (e.g., phenytoin, carbamazepine)
*Allopurinol
*NSAIDs
*Rifampin
*Bactrim (sulfamethoxazole/trimethoprim)
What is toxic epidermal necrolysis?
A life-threatening skin disorder most commonly due to drug reactions
What characterizes the severe reaction in toxic epidermal necrolysis?
Life-threatening widespread immune response with massive skin and mucosal sloughing
What is the Nikolsky sign related to in toxic epidermal necrolysis?
Epidermis separates with mild lateral pressure
What is Staphylococcal Scalded Skin Syndrome (SSSS)?
A reaction to toxins from staphylococcal infection
What do exfoliative toxins target in SSSS?
Desmoglein 1, a protein that helps skin cells stick together
What is the common age group affected by SSSS?
Primarily newborns, infants, and immunocompromised individuals
What is the appearance of lesions in SSSS?
Initial bullous lesions followed by widespread desquamation
What is the treatment for SSSS?
IV antibiotics (flucloxacillin), fluids, wound care
What is scarlet fever caused by?
Streptococcus (GAS) group A beta-hemolytic strep pyogenes
What are the initial symptoms of scarlet fever?
Fever, malaise, sore throat
What distinctive feature appears in scarlet fever?
Strawberry tongue
What type of rash is associated with scarlet fever?
Sandpaper rash
What antibiotic is commonly prescribed for scarlet fever?
Penicillin V for 10 days
What serious complications can arise from scarlet fever?
*Abscess formation (quinsy)
*Acute rheumatic fever
*Post-streptococcal glomerulonephritis
*Toxic shock syndrome (TSS)
What causes toxic shock syndrome?
Superantigen causes intense T-cell stimulation
What are the symptoms of toxic shock syndrome?
*Diffuse maculopapular rash
*Fever
*Mucosal changes
*Profuse diarrhea
What is the main treatment for toxic shock syndrome?
IV antibiotics and fluid resuscitation
What is impetigo?
Infectious superficial infection of the epidermis
What bacteria commonly cause impetigo?
*Staphylococcus aureus
*Streptococcus pyogenes
What is a characteristic feature of impetigo lesions?
Golden crusted skin lesions
What is the treatment for localized non-bullous impetigo?
Hydrogen peroxide 1% cream
What is cellulitis?
Bacterial infection affecting the dermis and subcutaneous tissue
What are common symptoms of cellulitis?
*Erythema
*Swelling
*Pain
*Heat
What is the main cause of cellulitis?
Streptococcus pyogenes or Staphylococcus aureus
What is erythema migrans associated with?
Lyme disease
What is the characteristic rash of Lyme disease?
Bulls-eye rash with a central clearing
What is Erythema multiforme?
An immune-mediated skin reaction
What triggers Erythema multiforme?
Most commonly caused by Herpes simplex virus (HSV) or EBV
What do the lesions of Erythema multiforme look like?
Target-like lesions on peripheries that can blister
What is Molluscum contagiosum?
Viral skin infection caused by molluscum contagiosum virus
What is the characteristic appearance of molluscum contagiosum lesions?
Small, raised, round lesions with a dimpled center
What is the primary treatment for troublesome molluscum contagiosum?
Topical treatments or cryotherapy
What virus causes viral warts?
Human papilloma virus (HPV)
What is a characteristic feature of warts?
Rough surface
What is the treatment for warts?
Cryotherapy or topical treatments (salicylic acid, podophyllotoxin)
What disease is measles caused by?
Paramyxovirus
What are the initial symptoms of measles?
High fever, coryzal symptoms, conjunctivitis
What is a characteristic rash of measles?
Maculopapular rash
What are Koplik spots?
Small grey discolorations of mucosal membranes in measles
What is the main treatment for measles?
Supportive care and vitamin A administration for children under 2
What virus causes chickenpox?
Varicella zoster virus
What is the characteristic progression of chickenpox lesions?
Starts as raised, red, itchy spots, progresses to fluid-filled blisters
What is the treatment for chickenpox?
Symptomatic treatment, keep fingernails short, and cooling measures
What triggers shingles?
Reactivation of the varicella zoster virus
What is the typical presentation of shingles?
Erythematous papules along one or more dermatomes
What is scabies caused by?
Sarcoptes scabiei mites
What is a classic symptom of scabies?
Itching worse at night
Where do scabies rashes typically occur?
Inter-web spaces, flexures of wrist, abdomen, and groin
What are common areas affected by itching in scabies?
Inter-web spaces, flexures of wrist, axilla, abdomen, and groin
Itching is often worse at night.
What are the characteristics of burrows in scabies?
Small brown lines
Burrows are indicative of scabies infestation.
Describe the typical rash associated with scabies.
Itchy rash that is usually popular or vesicular
Vesicles are small fluid-filled blisters less than 1cm.
What is the recommended treatment for scabies?
Permethrin 5% cream and oral Ivermectin
Permethrin should be applied from head to toe for 8-12 hours.
What is hand, foot, and mouth disease primarily caused by?
Coxsackievirus A16 and Enterovirus 71
This disease primarily affects children.
How does hand, foot, and mouth disease spread?
Direct contact with secretions, coughing, sneezing, contaminated surfaces
What are the symptoms of hand, foot, and mouth disease?
Red rash on hands, feet, buttocks, mouth sores, fever, malaise
Mouth sores can cause painful ulcerations.
What is Erythema infectiosum also known as?
Fifth disease
It presents with a ‘slapped cheek appearance’.
What characterizes Hidradenitis suppurativa?
Painful/intermittent lumps in axilla
It is associated with T2DM, obesity, and inflammatory conditions.
What are Seborrheic keratosis lesions like?
Benign skin growths that are often warty and vary in color
Common in individuals over 50.
What is actinic keratosis?
A pre-malignant skin condition that can lead to squamous cell carcinoma
It presents as dry/scaly patches of skin damaged by the sun.
What are the risks associated with actinic keratosis?
Fair skin (type 1 or 2) and a history of sunburn
What is the appearance of squamous cell carcinoma?
Keratinized, scaly, crusted, irregular nodules
It may present with a cauliflower-like appearance.
What is the most common malignant tumor in older adults?
Basal cell carcinoma
It originates from basal keratinocytes.
What are the ABCD criteria for malignant melanoma?
Asymmetry, Border irregularity, Color variation, Diameter > 6mm
Elevation or evolution of a skin lesion is also a criterion.
What is Pityriasis versicolor caused by?
Malassezia yeast overgrowth
It is common in warm climates and during summer months.
What are the characteristics of vitiligo?
Autoimmune, slower onset, symmetrical, non-scaling, asymptomatic
Lesions are well-defined and have clear borders.
What is the definition of a macule?
Small flat circumscribed area – altered color
What is a vesicle?
Small fluid-filled cavity less than 1cm
What does an abscess represent?
Large pus-filled cavity that needs incision and drainage
What is the appropriate investigation for a suspected fungal infection?
Skin scrapings, nail clippings, hair samples
Fungal cultures may also be conducted.
What does the acronym MC&S stand for?
Microscopy, Culture, and Sensitivities
