Dermatology Flashcards
Describe the presentation of Atopic Eczema
Usually develops in childhood and resolves during adulthood Itchy erythematous dry scaly patches normally on flexor aspects (but can be on face and extensor aspects in infants
Give 3 other dermatological features of atopic eczema
Excoriation Lichenification Nail pitting
Name two conservative managements of Eczema
Avoid triggers (such as wool/synthetic fibres and extremes of temperature) Frequent emollients
Give 3 pharmacological managements for Eczema
Topical Therapies - topical steroids (for flares) or topical immunomodulators (tacrolimus) Oral therapies - antihistamines Immunosupressants for severe non responsive cases
State three secondary viral infectons of Eczema
Molluscum Contagiosum Viral Warts Eczema Herpeticum
What is Bullous Pemphigoid?
Immunobullous blistering (subepidermal) condition usually affecting the elderly
How will Bullous Pemphigoid present?
Tense fluid filled blisters on an erythematous base, often itchy Normally affects trunk or limbs
How do you manage Bullous Pemphigoid?
Topical steroids for local disease Oral therapies for widespread (steroids, tetracycline)
What is Pemphigus Vulgaris?
Immunobullous blistering (intraepidermal) condition usually affecting the middle aged
How will Pemphigus Vulgaris present?
Flaccid and easily ruptured blisters, often painful and affecting mucosal areas
How would you manage Pemphigus Vulgaris?
High dose steroids Immunosupressants
How does Senile Purpura present?
Elderly population with sun damaged skin Extensor surfaces of hands and forearms
Describe the presentation of a Venous Ulcer (including common sites)
Large shallow and irregular usually in malleolar area Exudative and granulating base Pain on standing
How would you manage a Venous Ulcer?
Compression bandaging
Describe the presentation of an Arterial Ulcer (including common sites)
Small and sharply defined with a deep necrotic base Abent peripheral pulses, shiny skin and loss of hair Pain at night/elevation of leg
How would you manage an Arterial Ulcer?
Vascular Reconstruction
What is ABPI? What do values indicate?
Ankle Brachial Pressure Index, compares peripheral blood flow Normal is 1-1.4 If less than 0.8 it is suggestive of arterial insufficiency
Describe the presentation of a Neuropathic Ulcer (including common sites)
Often painless, variable in size and shape Granulating base Often in pressure sites (heels, soles, toes) Can be Neuroischaemic
How would you manage a Neuropathic Ulcer?
Wound debridement Regular repositioning Good nutrition Appropriate footwear
What is a Dermatofibroma?
Benign mass, often mistaken for a more serious pathology, following on from insect bites such as mosquitos
State the two layers of the dermis
Papillary Reticular
Describe the relevance of a skin lesion (suspected malignancy) itching and bleeding respectively
Itching - Perineural Invasion Bleeding - Ulcerative component
When would you do a punch lesion of a suspicious lesion?
If it was in a cosmetically sensitive area
Name 5 subtypes of BCC
Nodular Superficial (can appear like dermatitis) Morphoeic Pigmented Basosquamous
Apart from pre-malignant conditions, give three risk factors specific for SCC
Viral Infections Chronic Wounds Psoriasis Treatment
What is Bowen’s Disease?
In- Situ SCC disease (pre-malignant condition) Erythematous plaques and sharp borders
Name four types of SCC
Ulcerative Verrucous Marjdins (arising from chronic wounds) Subungal (underneath nail bed)
What is Gorlin Syndrome?
Autosomal Dominant condition increasing risk of BCCs. Presents as Multiple BCCs
What is Rosacea?
Chronic relapsing disease of facial skin characterised by flushing episodes, persistent erythema, telangiectasia, papules and pustules
What is a common presentation of Rosacea in men?
Rhinophyma - enlarged nose
What is the first line management for Rosacea?
Topical Metronidazole
How does Lichen Planus present?
Affects flexor surfaces of wrists/forearms/legs Intensely itchy 2-5mm red/violet shiny topped pamphlet (Wickham Striae) Mucous Membranes - White raises trabecular lesions
How is Lichen Planus managed?
Topical Steroids if required
