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RW FY1 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Erythematous, annular patches

“Wood-grain” appearance

Diagnosis? Associated with what malignancy?

A

Erythema gyratum repens

Associated with lung cancer

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2
Q

Pityriasis rosea - caused?

A

HHV-7

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3
Q

Steroid ladder + examples

A
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4
Q

Tx for acne vulgaris

A

(1) Topical retinoid

+/- Topical ABx +/- Oral ABx (doxycycline, erythromycin)

+/- Topical benzoyl peroxide

+/- Topical Azelaic acid

If cycle related –> COCP

If resistant –> Isotretinoin (S/E: Dry skin, eyes, mouth, nosebleeds, suicide)

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5
Q

Middle-aged (30-60 year old)

Triggered by Alcohol and Spicy food

**Flushing**

Papules, Pustules

Telangiectasis

Diagnosis? Treatment?

A

Acne rosacea

(1) Topical metronidazole
(2) Oral tetracycline or erythromycin

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6
Q

Inherited

Skin fragility

Blistering of skin and mucous membranes

Diagnosis? Cause?

A

Epidermolysis bullosa

Mutations in Laminin V

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7
Q

Itchy, deep, tense, bullae

No mucosal involvement

Diagnosis? Ix? Tx?

A

Bullous pemphigoid

Itchy, deep, tense, bullae + No mucosal involvement

IgG and C3 linear deposition at the dermoepidermal junction

Tx: oral corticosteroids

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8
Q

Flaccid bullae

Mucosal involvement

Diagnosis? Ix? Tx?

A

Bullous pemphigus (Pemphigus vulgaris, Pemphigus foliaceus)

Flaccid, superficial bullae + Mucosal involvement

Ix: auto-antibodies against desmoglein –> acantholysis

loss of intercellular connections between keratinocytes

Tx: oral prednioslone

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9
Q

Itchy, dry skin

Vesicles

Punched out ulcerations

Diagnosis? Cause? Treatment?

A

Eczema herpeticum

Caused by HSV 1/2

IV Aciclovir

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10
Q

Tx for treatment resistant hand dermatitis

A

(1) Emollients
(2) Aliretinoin

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11
Q

Types, Pathogenesis and Ix for contact dermatitis

A

Allergic contact dermatitis –> Type IV hypersensitivity reaction (sub-acute onset)

Irritant contact dermatitis –> due to friction or chemical damage (acute onset)

Ix: Patch testing

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12
Q

Itchy, red, scaly lesions

on head, nasolabial folds, scalp

Diagnosis? Cause? Treatment? Complications?

A

Seborrhoeic dermatitis

Caused by Malassezia furfur

If scalp –> Topical shampoo

If face and body –> Topical ketoconazole

Complications: Blepharitis, Otitis externa

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13
Q

Hot climate

Multiple, small, itchy blisters/vesicles

on fingers, palms and soles of feet

Diagnosis? Differential?

A

Pompholyx dermatitis

Difficult to DDx from palmoplantar pustulosis (psoriasis in other areas)

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14
Q

Acute onset

Target lesions

Mucosal involvement

Diagnosis? Cause? Prognosis?

A

Erythema multiforme

EM minor –> no mucosal involvement

EM major –> mucosal involvement

Caused by infections (HSV, Mycoplasma) or drug reactions

Good prognosis as self limiting

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15
Q

Painful, red, subcutaneous nodules on shins

Diagnosis? Cause? Next Ix? Prognosis?

A

Erythema nodosum

Causes

  • Infection
    • Streptococcal throat infection
    • TB
  • IBD
  • Sarcoidosis
  • Hodgkin’s lymphoma
  • Pregnancy

CXR to look for sarcoidosis or TB

Good prognosis as self limiting

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16
Q

Hot water bottle

Ertyematous patch with areas of hyperpigmentation

Diagnosis? Next Ix?

A

Erythema ab igne

Often related to chronic pain ? bone metastases

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17
Q

Erythema marginatum

What does it look like?

Associated with?

A

Rheumatic fever

Erythema marginatum

Causing pink border with fading centre (central clearing)

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18
Q

Expanding patch of erythema

Classical bull’s eye appearance

Diagnosis? Associated with?

A

Erythema chronicum migrans

Lyme disease

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19
Q

Purple, pruritic, papular, polygonal rash

on flexor surfaces

Wickham’s striae (white reticular webs)

Diagnosis? Cause? Tx?

A

Lichen planus

Unknown cause ? autoimmune

Clinical diagnosis

Tx: High dose topical steroids

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20
Q

Elderly woman

Vulval itching

Hypopigmentation

Fragile skin / White parchment paper

Diagnosis? Tx? Complications?

A

Lichen sclerosus

Unknown cause ? autoimmune

Clinical diagnosis

Tx: high-dose topical steroids

Complications: Vulval cancer (5%)

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21
Q

Tx for pressure ulcers

A

Pressure-reducing aids

Repositioning

Hydrocolloid dressings + Hydrogels (moist environment encourages ulcer healing)

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22
Q

Triggers for psoriasis

A
  • Drugs
    • B blockers
    • Lithium
    • Withdrawal or oral steroids
    • Anti-malarials
  • Alcohol
  • Smoking
  • Post-partum
  • Trauma / Kobner phenomenon
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23
Q

Sore throat 2 weeks ago

Acute onset

Red, scaly, tear-drop lesions

Diagnosis?

A

Guttate psoriasis

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24
Q

Recent withdrawal of oral steroids

Erythema with yellow pustules

Systemic symptoms

Diagnosis?

A

Generalised pustular psoriasis

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25
Q

Chronic onset

pustules and erythema on palms and soles

Smoking

Diagnosis?

A

Palmoplantar pustulosis

26
Q

Smooth

Itchy, red skin

Flexural surfaces

No scale

Diagnosis?

A

Flexural psoriasis

27
Q

Features of nail psoriasis

A

Tip: POSH

Pitting of nails

Onchyolysis

Subungual Hyperkeratosis

28
Q

Subtypes of psoriatic arthritis

A
29
Q

Tx for plaque psoriasis

Tx for scalp psoriasis

Tx for flexoral psoriasis

A
30
Q

Gum bleeding

Brusing

Gingival discolouration

Diagnosis? Ix? Tx?

A

Vitamin C deficiency / Scurvy

Ix: serum L-ascorbic acid

Tx: Replace Vitamin C

31
Q

Started a new drug

Acute onset

Skin + mucosal involvement

(Diffuse skin pain)

(Bullae)

Targetoid lesions

Diagnosis? Classification?

A
32
Q

School child

Slapped cheek appearance

(Sparing of nasal ridge)

Lacy reticular erythema

Diagnosis? Cause? Tx?

A

Erythema infectiosum

Parvovirus B19

Tx: supportive

33
Q

Golden crusted lesion

Itchy

Children

Diagnosis? Cause? Tx?

A

Impetigo

Staph aureus or Strep pyogenes

Fusidic acid +/- Flucloaxcillin

34
Q

Umbilicated pearly papule

Henderson-Patterson bodies

Diagnosis? Cause?

A

Molluscum contagiosum

Pox virus

35
Q

Initially scaly, salmon-pinnk patch on the trunk

Now multiple red scaly ovale lesions in a christmas tree distribution

Diagnosis? Cause? Tx?

A

Pityriasis rosea

HHV-7

Tx: none required as self limiting

36
Q

Hypopigmentation on trunk

More noticeable after skin tan

Diagnosis? Cause? Tx?

A

Pityriasis versicolour

Malassezia furfur

(1) Topical ketoconazole shampoo

37
Q

Progression to SCC

A

Actinic keratosis (Precursor lesion to SCC)

–> Bowen’s disease (in situ tumour)

–> Invasive SCC

–> Metastatic SCC

38
Q

Dome shaped papule on sun damaged skin

Keratin filled crater

Little volcano

Diagnosis?

A

Keratoacanthoma

39
Q

Non-healing painless ulcer

Arises from chronic wound / burns

Diagnosis?

A

Marjolin ulcer

40
Q

Tx for Bowen’s disease

A

(1) Topical therapies

  • Topical imiquimod
  • Topical 5-FU

(2) Surgical excision

41
Q

Itchy, erythematous macule with overlying scale / crust

sun-exposed areas

Diagnosis? Tx?

A

Actinic keratosis

  • Topical Fluorouracil (5FU) cream (5%)
  • Topical Imiquimod (5%) cream

Risk of progression Actinic keratotis –> Bowen’s disease –> SCC

42
Q

Itchy, erythematous macule with overlying scale / crust

Biopsy shows dysplasia with intact basement membrane

Diagnosis? Tx?

A

Bowen’s disease (SCC in situ)

  • Topical Fluorouracil (5FU) cream (5%)
  • Topical Imiquimod (5%) cream

Risk of progression to SCC

43
Q

Precursor lesion to melanoma

A
  • Benign naevus
  • Solar lentigo
44
Q

Types of malignant melnoma

A
45
Q

? melanoma

Next Ix?

A

All NEW + irregular black lesions with ABCDE features MUST be excised for biopsy

46
Q

Most important prognostic factor for malignant melanoma

A

Breslow thickness [the single most important prognostic factor]

47
Q

Trauma

Soft, round, mobile, superficial, painless mass

Diagnosis?

A

Lipoma

48
Q

Free-moving, firm skin nodule

Pinch sign (forms a dimple)

Diagnosis?

A

Dermatofibroma

Non-cancerous

49
Q

Stuck on appearance

Warty surface

Multiple

Face, Trunk, Back

Diagnosis?

A

Seborrhoeic keratosis (Barnacle)

50
Q

Velvety, hyperpigmentation of the skin

Neck, Axillae, Groin

+/- Mucosal involvement

A

Acanthosis nigricans

Associated with

  • Insulin resistance
  • Gastric cancer
51
Q

Widespread, thick, dry “fish-scale” skin

Diagnosis? Associated with?

A

Acquired ichthyosis

Associated with Lymphoma

52
Q

Necrolytic migratory erythema

Associated with

A

Glucagonoma

53
Q

Migratory thrombophlebitis

Associated with?

A

Pancreatic cancer

54
Q

Pregnant

Flat, symmetrical, brown patch on cheeks

Diagnosis?

A

Melasma

55
Q

Pregnancy

Itchy, red lesions

On stretch marks

Sparing umbilicus

Diagnosis?

A

Polymorphic eruption of pregnancy (PEP)

56
Q

Pregnancy

Multiple bilsters on abdomen

Diagnosis?

A

Pemphigoid gestationis

(Autoimmune)

57
Q

Osler-Weber-Rendu syndrome

AKA

Cause?

Clinical features?

A

Hereditary haemorrhagic telangiectasia = Osler-Weber-Rendu syndrome

Autosomal dominant

  • Recurrent nosebleeds
  • Telangiectasia
  • GI Telangiectasia
  • Pulmonary AVM
58
Q

Causes of hypopigmentation

Causes of hyperpigmentation

A
59
Q

Tx for facial hirsuitism

A

Topical eflornithine

60
Q

well demarcated patches of hair loss

small, broken, “exclamation mark” hairs

Diagnosis? Cause?

A

Alopecia areata

Autoimmune

61
Q

Tx for Hyperhidrosis

A

(1) Topical aluminium chloride

S/E: Skin irritation

RW FY1 (15 decks)

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