Derm2 Flashcards
Name 3 examples of emollients
White soft paraffin and liquid paraffin
Aqueous cream
Emulsifying ointment
How much topical steroid do you use?
A finger tip unit (length of finger) for the area of 2 hands
30g tube is enough to cover whole body once
5 local SE to topical steroid cream
Skin atrophy Striae Telangiectasia May mask/exacerbate skin infections Acne
Name 7 systemic SE to steroids
Cushing's Immunosuppression Hypertension Diabetes Osteoporosis Cataracts Steroid induced psychosis
Name 2 sedating and 2 non sedating antihistamines
Sedating (chlorpromazine, hydroxyzine) Non sedating (cetirizine, loratidine)
Unwanted effects of older antihistamines
Sedation
Anticholinergic (dry mouth, urinary retention)
Name 2 topical antibiotics
Fusidic acid
Mupirocin (bactroban)
Name 2 antiseptics
Chlorhexidine
Povidone-iodine
Name an oral retinoid
isotretinoin
What are retinoids used for?
Acne
Psoriasis
Disorders of keratinisation
SE of retinoids
Teratogenicity
Dry skin, eyes
Disordered liver function
Lipid profile
Give 2 tips for topical steroids
Only for short term use (up to 2 weeks)
Only use 1% hydrocortisone for face
Where are skin scrapes taken from?
Scaly lesions (suspected fungal infection) Burrows in scabies)
How do you do an ABPI?
BP at dorsalis pedis/posterior tibial
BP at brachial artery
Ratio, normally >0.8
What do you never prescribe in psoriasis?
Oral steroids
Beta blockers
What is scleroderma?
Fibrotic change Probably autoimmune Can affects joints (contractures) Decreased blood supply-> ulcers Can lead to systemic sclerosis
8 causes of ulcers
Venous Arterial Vasculitis Neuropathic Infectious (TB, protazoa, herpes) SCC Drug induced (nicorandil, methotrexate)
Steps towards skin cancer
Acitinic keratoses
Bowen’s
SCC
What does Bowen’s look like?
Can look like patches of psoriasis Inflammatory base Disordered structure Keratinisation Fairly well defined border Tiny regular clods of blood vessels
Treatment of rosacea
Topical ivamectin/metronidazole
Oral antibiotics
What is an epidermoid cyst?
Normal epidermis contained under skin
Produces skin
Can get infected and cause an abscess
What is Breslow thickness?
> 1mm thickness of melanoma is likely to have spread
Other factors: mitotic rate, poorly differentiated
Describe the progress of a mole
If acquired, it progresses from a junctional nevus (most common in children) to a compound nevus and eventually to an intradermal nevus
What are the 6Ps of lichen planus?
Pruritic, purple, polygonal, planar papules and plaques
Difference between varicella zoster and herpes zoster?
Varicella: chickenpox
Herpes: shingles
What is erysipelas?
What is cellulitis?
Erysipelas involves the superficial dermis
and epidermis, often resulting in superficial
blistering. Lymphangitis is common.
Cellulitis involves the deep dermis and
subcutaneous tissue.
Function of langerhan cells
Antigen presenting cells
What cells are involved in wound healing?
Neutrophils and macrophages phagocytose cellular debris and invading bacteria
Fibroblasts form granulation tissue
Epidermal cells proliferate and migrate (re-epithelialisation)
Difference between Steven Johnson and TEN
SJ is mucosal, infection or drug induced
TEN is skin and mucosa, systemic toxicity, full thickness epidermal necrosis
How can you tell it’s erysipelas?
Inflammation
Fever, malaise, rigors
Well-defined red raised border
Which antibiotics are used to treat Staph Scalded Skin Syndrome?
Fusidic acid
Best lactamase resistance penicillin
Erythromycin
Cephalosporin
Define tinea unguium
fungal tinea infection of the nail
Yellow, crumbly, thickened
Define pityriasis versicolor
Scaly fungal pale brown patches that fail to tan
usually asymptomatic
What is imiquimod cream used for?
Anogenital ulcers
Actinic Keratosis
Bowen’s
BCC
3 types of melanoma and associations
Nodular (young and middle aged, intermittent high intensity Uv exposure) Lentigo maligna (elderly, face, cumulative UV) Acral (dark skinned, palms soles and nail beds, elderly)
Genetic defect for eczema?
Fillagrin protein function
Skin barrier defect
Name a topical immuno modulator
Tacrolimus
Name the bacteria that causes acne
Proprionibacterium acnes
Name 7 most common causes of blisters
Impetigo Herpes (zoster/simplex) Pompholyx eczema Contact dermatitis Burns Insect bites
what features are associated with venous ulcers?
warm skin, normal pulses
leg oedema
haemosiderin deposits
lipodermatosclerosis
