Dermatological cases Flashcards
History of eczema
History of atopy (asthma, eczema, hay fever) - commonly presents in young children.
Could possibly be caused by a food allergy
Key presenting features of eczema
Generalised, symmetrical rash consisting of erythematous, scaly, ill-defined patches, erosions.
Treatment of eczema
Education - national eczema society
Avoidance of exacerbating factors
Generous use of non-perfumed emollient (500g/week)
Topical steroids / calcineurin inhibitors
Phototherapy
Systemic therapies
History of psoriasis
Something to do with immune cells and can run in families.
Can get worse because of “triggers” such as skin injury, throat infection or certain medication
Key presenting features of of psoriasis
Well demarcated, erythematous scales. Typically on extensors.
Treatment of psoriasis
Emollients Steroids Vitamin D analogues Phototherapy Systemic treatment
History of acne
Typically teenagers or young adults (11-30)
Runs in families
Key presenting features of acne
Spots on face and maybe back or neck.
Blackheads, whiteheads, papule, pustules, nodules, cysts
Treatment of acne
Self care - wash but not too much, emollients and remove makeup
Lotions and creams for spots in pharmacy
Antibiotics
Roacutaine
What is urticaria?
Erythematous, pruritic ‘swellings’ (wheals).
Transient (<24hours) +/- angiodema
Caused by mast cell degranulation and histamine release leading to increased capillary permeability and leakage of fluid into surrounding tissue.
What is Molluscum contagiosum?
Pox virus infection 2-6 week incubation period More common in atopic and immunocompromised patients. Most self resolve in 6-9 months. No treatment required
What is tinea (fungal) infection?
Dermatophyte fungi infection cause a tinea infection
Presentation and course depends on site and strain of fungus involved.
Skin scraping, nail clipping or plucked hair for microscopic examination of fungi.
Cultures should be carried out in microbiology lab.
Treatment can be topical or systemic.
What is drug exanthema?
Often appears after a latent period required for induction.
Cell mediated immune reaction.
Most common reaction is macular-papular (morbilliform) rash.
Culprit drug avoidance is important.
What is shingles?
Rash with burning sensation.
Herper virus - viracella-zoster - dermatomal.
Attack usually result of reactivation of virus which has remained dormant in a sensory root ganglion side an earlier episode of chicken pox.
Elderly and immunocompromised are at higher risk.
Duration is around 2-3 weeks.
Treat with systemic acyclovir within two days of episode and analgesics.
What are the complications of shingles?
Secondary bacterial infection, paralysis (if motor nerve involvement), corneal ulcers and scarring if ophthalmic division of trigeminal nerve involved, neuralgic pain.
