Dermatology Flashcards
46 y/o male known chronic plaque psoriasis diagnosis
- usually well controlled with emollients
- has had flare up in last couple weeks
- patches of psoriasis over elbows and knees
what might you give him to control his flare?
- potent topical corticosteroid
AND a
- separate topical vitamin D preparation
32 y/o with known psoriasis.
- usually well controlled
- has had flare up in last couple weeks
- patches of psoriasis in axilla
what would you prescribe to control his flare up?
- mild topical corticosteroid alone
- skin of flexure areas in much thinner and more sensitive to steroids compared to extensor surfaces
potent steroid applications should be limited to how many weeks?
what might be given as next line treatment?
- 8 weeks, with atleast 4 week break
- topical vitamin D analogue twice daily.
children with new purpuric rash should be admitted immediately for investigations as it may be a sign of :
- meningococcal septicaemic
- acute lymphoblastic leukaemia
The following description is indicative of what rash:
- herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with a fine scale confined to the outer aspects of the lesions
- fir tree appearance
Pityriasis rosea
- acute
- self limiting
- usually disappears after 6-12 weeks
how long does pityriasis rosea last?
6 to 12 weeks
patient presenting with
- erythematous rash on nose. forehead, cheeks
- associated with telangiectasis and papules
- flushing symptoms
characteristic of:
acne rosacea
management of acne rosacea?
topical metronidazole may be used for mild symptoms
rhinophyma is a common complication of
acne rosacea
onchomycosis is a …
fungal infection of the nails
65 y/o male
- T2DM
- subungual hyperkatosis of both bit toenails
- yellow discoloration
- onycholysis
- really bothering patient
clippings confirm onychomycosis cause by dermatophytes
first line medication of dermatophyte nail infections?
oral terbinafine
do not need to be treated if it is asymptomatic and the patient is not bothered by the appearance
onychomycosis if a fungal infection of the nails.
may be caused by ? (3)
- dermatophytes (mainly trichophyton rubrum, 90%)
- yeasts (candida)
- non-dermatophyte moulds
generally asymptomatic, flat, slightly scaly, pink or brown rash usually found in the groin or axillae.
erythrasma
- usually treated with oral erythromycin
female patient post birth presents with
- itchy, erythematosus papules on face, neck, chest and extensor surfaces of limbs
most likely to be
atopic eruption of pregnancy
female pregnant patient with:
- pruritic blistering lesions
- often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms
- usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy
indicative of:
pemphigoid gestationis
- usually requires oral corticosteroids
5 3 y/o female
- worsening erythematous rash on nose, forehead and cheeks
- associated with telangiectasia and papules
- aggravated by sun exposure
- NKDA
condition and first line management?
- acne rosacea
- topical metronidazole
what condition is characterised by the following:
- acute eruptions of deep seated vesicles in the palms and fingers
- followed by scaling and fissuring of affected areas
- associated with hot, humid environments
pompholyx eczema
Features
- small blisters on the palms and soles
- pruritic
- —–often intensely itchy
- —–sometimes burning sensation
-once blisters burst skin may become dry and crack
Management: cool compresses, emollients, topical steroids
pink discoloration commonly on nape of neck. flat vascular lesion from birth.
likely to be a :
salmon patch
They are pink and blotchy, and commonly found on the forehead, eyelids and nape of the neck. They usually fade over a few months, though marks on the neck may persist.
62 y/p lesion on RHS of nose.
lesion described to be:
- rolled pearly edges
- with telangiectasia surrounding central crater
likely diangosis?
basal cell carcinoma
- slow growth , local invasion
the intense pruritus associated with scabies is due to a:
delayed type IV hypersensitivity reaction to mites/ eggs which occurs 30 days post infection
blepharitis is
inflammation of the eyelids
72 y/o female
- 4 week hx of sore gritty eyes
- inflamed skin with fine scaling around nasolabial folds and eyelashes
- ear canal is erythematous, obscured by debris
- pmh parkinsons
likely diagnosis?
seborrhoeic dermatitis
- pt has both otitis externa and blepharitis
- more common in parkinson’s disease
what does the koebner phenomenon describe?
- skin lesions that appear at site of injury
- molluscum contagiosum is a common viral lesion which exhibits this phenomenon
Red or black lump, oozes or bleeds, sun-exposed skin
indicative of:
nodular melanoma
how can spider naevia be differentiated from telangiectasia?
- by pressing on them
- spider naevia fill from centre
- telangiectasia fill from edge
symmetrical typical brown, velvety patches which affect the axilla, neck and groin.
known as:
acanthosis nigricans
pt with Parkinson’s presents with
- itchy red rash on neck, behind ears, around nasolabial folds
- similar flare up last winter
likely to be:
seborrhoea dermatitis
- causes eczematous lesions on sebum rich areas
- otitis externa and blepharitis may develop
baby with multiple white tiny papule on nose.
likely diagnosis?
- milia
- common, normal finding on new borns
- usually resolve spontaneously over the course of a few weeks
small, benign, keratin-filled cysts that typically appear around the face. They may appear at any age but are more common in newborns.
indicative of:
milia
condition characterised by
- multiple telangiectasia over the skin and mucous membranes
hereditary haemorrhagic telangiectasia
autosomal dominant
diagnostic criteria:
- epistaxis
- telangiectasis
- visceral lesions: GI t.tasia
- FH
autoimmune condition causing
- sub-epidermal blistering of skin
- itchy, tense blisters typically around flexures
- blisters usually heal without scarring
- no mucosal involvement
bullous pemphigoid
mainstay of treatment
- oral corticosteroids
tumour-like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound
keloid scars
17 y/o female
- very fine layer of soft un-pigmented hair covering entire body
- apart from palmar and plantar surfaces
most likely cause:
- pt has lanugo hair
- malnutrition
- common finding in anorexia nervosa pts
stress ulcers in burns patients are referred to as
curlings ulcers
A 19-year-old student presents with a 1 cm golden, crusted lesion on the border of her left lower lip.
characteristic of:
impetigo
what is impetigo?
- superficial bacterial skin infection
- caused by either staph aureus, or strep progenies
- very contagious
treatment of impetigo?
- hydrogen peroxide 1% cream
- topical antibiotic creams
- topical fusidic acid
white hard spots on mucous membranes of mouth.
more common in smokers.
leukoplakia
- premalignant condition
you should also consider candidiasis and lichen planus esp if the lesions can be rubbed off
17 y/o with pmh of asthma and eczema.
normally fit and well but developed rash on face extending down to torso yday
generally unwell with flu like symptoms
most likely:
eczema herpeticum
- severe primary infection of the skin by herpes simplex virus 1 or 2
itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
autoimmune blistering skin condition associated with coeliac disease
dermatitis herpetiformis
36 y/o
- 4 month hx intermittment bloating and loose stools
- never passed blood
- lost couple kgs in weight
anti TTG positive
likely diagnosis?
coeliacs disease
During NIPE: You notice a flat purple lesion on the babies cheek which has been present since birth. This does not seem to be painful. All other examinations are normal.
likely diagnosis
port wine stain
- capillary malformation seen at birth
- does not require treatment
drugs known to exacerbate psoriasis include:
Lithium
Beta-blockers
NSAIDs
ACEi
TNF-alpha Inhibitors
Anti-malarials
which skin condition is characterised by the following
- caused by overgrowth of malassezia yeast
- common in young people
- causes multiple patches of skin discolouration
- mildly flaky and itchy
- may present after spending time in sunny humid environments
pityriasis versicolor
autoimmune disease caused by antibodies directed against desmoglein 3, a cadherin-type epithelial cell adhesion molecule.
pemphigus vulgaris
Ketoconazole shampoo is used to treat pityriasis versicolor
The raised pearly edges in an ulcerated lesion at a sun exposed site makes what diagnosis likely?
basal cell carcinoma
A 78-year-old man presents with symptoms of headaches and deteriorating vision. He notices that there is marked pain on the right hand side of his face when he combs his hair.
indicative of:
giant cell arteritis
treatment with immunosuppressants should be started promptly.
32 y/o male, smoker
- foot pain during exertion
- foot pulses are absent
- pulses present to level of popliteal
- formation of corkscrew shaped collateral vessels distally
indicative of:
burger’s disease
Pruritus particularly after warm bath
‘Ruddy complexion’
Gout
Peptic ulcer disease
common condition:
polycythaemia
Night sweats
Lymphadenopathy
Splenomegaly, hepatomegaly
Fatigue
condition:
lymphoma
Lethargy & pallor
Oedema & weight gain
Hypertension
condition:
chronic kidney disease
