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Dermatology Flashcards

1
Q

In eczema, there is abnormal epithelial barrier function in the skin. This causes the entrance for what?

A

Irritants, microbes, allergens

Stimulates immune response

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2
Q

What the signs of eczema?

A

Dry, red, itchy patches on flexor surfaces
Excoriations
Lichenification
Hypopigmentation

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3
Q

Management of eczema is formed of maintenance and management of flares. How would you maintain eczema?

A

Emollients - creates artificial barrier to compensate for defective barrier

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4
Q

How would you treat flare ups of eczema?

A

Topical steroids
Antibiotics
Oral steroids

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5
Q

How would you treat severe eczema?

A

Zinc bandages
Topical tacrolimus
Phototherapy
Immunosuppressants e.g. methotrexate

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6
Q

The general rule is to use the weakest steroid for the shortest period required to get the skin under control. What are the side effects of steroid use?

A

Thinning of skin, making it more susceptible to flares

Telangiectasia

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7
Q

What lifestyle changes can be done for a patient with eczema?

A

Avoid hot baths
Avoid scratching
Avoid stress
Avoid triggering detergents and soaps

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8
Q

What are the environmental triggers of psorasis?

A 
Group strep A infection
Lithium 
UV light
Stress
High alcohol
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9
Q

What are the signs of psoriasis?

A

Salmon pink silvery scales on extensor surfaces
Red non scaly plaques on flexor surfaces
Raindrop: eruption of small circular plaques on trunk
Pyrexia
Nail pitting
Oncholysis

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10
Q

State the types of psoriasis.

A

Plaque
Guttate: triggered by infection
Pustular
Erythrodermic

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11
Q

How would you manage psoriasis?

A 
Topical steroids
Topical vitamin D analogues
Topical tacrolimus
Phototherapy
Dovobet 
Methotrexate
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12
Q

What are the complications of psoriasis?

A

Psoriatic arthritis
Anxiety and depression
Increased risk of CV disease

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13
Q

Cellulitis is an acute bacterial infection of the dermis. Which organisms most commonly cause cellulitis?

A

Strep.pyogenes
Staph aureus
MRSA

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14
Q

What are the risk factors for developing cellulitis?

A 
Leg oedema
Ulcers
Immunosuppression
Fungal infection
Eczema 
Obesity
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15
Q

What the signs of cellulitis?

A 
Acute onset 
Hot, red, swollen tender skin
Unilateral
Fever
Malaise
Commonly lower limb
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16
Q

What are the differential diagnoses of cellulitis?

A

DVT
Septic arthritis
Gout

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17
Q

What investigations would you do if you suspected cellulitis?

A

Bloods: raised WCC, ESR/CRP

Blood cultures

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18
Q

How would you manage cellulitis?

A

Antibiotics e.g. flucloxacilin

Analgesia

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19
Q

What are the complications of cellulitis?

A

Necrotising fascilitis
Myositis
Abscess
Septicaemia

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20
Q

Outline the pathophysiology of acne vulgaris/

A

Increased sebum –> Trapping of keratin —> Blockage of pilosebaceous unit —> Swelling and inflammation, exacerbated by propionibacterium —> Comedones and papules

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21
Q

What are the signs of acne?

A 
Papules
Pustules
Comedones
Blackheads 
Ice pick scars
Hypertrophic scars
Rolling scars
Hyperpigmentation
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22
Q

How would you manage mild acne?

A

Topical retinoid
Topical antibiotic
Benzoyl peroxide
Oral contraceptive

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23
Q

How would you manage moderate acne?

A

Oral antibiotics

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24
Q

How would you manage severe acne?

A

Oral retinoids

25
What are the side effects of isotretinoin?
``` Dry skin and lips Photosensitivity Suicidal ideation Stevens-Johnson syndrome Teratogenic effects ```
26
Urticaria is caused by the release of histamine. Where is histamine secreted from?
Mast cells
27
What are the causes of acute urticaria?
Allergies Medications Viral infections Insect bits
28
What are the causes of chronic urticaria?
Autoimmune condition e.g. SLE Sunlight Exercise Stress
29
How would you manage urticaria?
Antihistamines Oral steroids Montelukast Omalizumab
30
Molluscum contagiosum is a viral skin infection caused by the molluscum contagiosum virus. What type of virus is this?
Poxvirus
31
How does molluscum contagiosum present?
Small flesh coloured papules with a central dimple, appears in crops
32
How would you manage molluscum contagiosum?
No treatment normally required Avoid sharing towels Immunocompromised patients: topical benzoyl peroxide, cryotherapy
33
Impetigo is a superficial bacterial skin infection, usually caused by which organism?
Staph. aureus
34
What are the signs of non-bullous impetigo?
Lesions around nose and mouth | Golden crust exudate
35
How would you manage non-bullous impetigo?
Topical fusidic acid Antiseptic cream Oral flucloxacillin
36
What are the signs of bullous impetigo?
``` Fluid filled vesicles on skin Golden crust exudate Fever Malaise Scalded skin syndrome ```
37
How would you manage bullous impetigo?
Flucloxacillin
38
What are the complications of impetigo?
Cellulitis Sepsis Scarring Scarlet fever
39
Scabies are tiny mites called Sarcoptes scabiei that burrow under the skin causing infection and intense itching. What are the signs of scabies?
Itchy small red spots Track marks Rash between finger webs
40
How would you manage scabies?
Permethrin cream Oral ivermectin Treat whole household Crotamiton cream for itching
41
What type of scabies is found in immunocompromised patients?
Crusted scabies - These patient may have over a million mites in their skin. They are extremely contagious. Rather than individual spots and burrows, they have patches of red skin that turn into scaly plaques
42
Headlice presents with an itchy scalp and visible lice. How would you manage head lice?
Dimeticone 4% lotion | Fine combs
43
Which virus causes shingles?
Varicella zoster (HSV3)
44
Who can develop shingles?
Anyone who has previously been infected with chickenpox
45
What are the trigger factors for reactivation of varicella?
Pressure on nerve roots Radiotherapy at level of nerve root Spinal surgery Infection
46
What are the signs of shingles?
``` Dermatomal distribution of blisters Unilateral Never crosses midline Localised pain Enlarged lymph nodes Nerve pain ```
47
What are the complications of shingles?
Facial nerve palsy Encephalitis Post herpetic neuralgia
48
How would you manage shingles?
Aciclovir | Analgesia
49
How would you manage post herpetic neuralgia?
Topical capsaicin Amitriptyline Gabapentin Botulinum toxin
50
Rosacea is a chronic rash involving the central face, what are the signs of this?
``` Erythema Papules Pustules Telangiectasia Frequent blushing or flushing Sensitive skin prone to burning and stinging Conjunctivitis Rhinophyma ```
51
How would you manage rosacea?
``` Avoid oil based creams and makeup Sunscreen Doxycycline Metronidazole cream Ivermectin cram ```
52
State the types of ringworm.
Tinea capitis - scalp Tinea pedis - athletes foot Tinea corporis - body Onychomycosis - nail
53
What are the signs of ringworm?
``` Itchy rash Erythema Well demarcated scales Hair loss Flaky skin Discoloured and deformed nails ```
54
How would you manage ringworm?
Creams: clotrimazole Anti fungal shampoo Oral antifungals e.g. fluconazole Topical steroid
55
Which sensory nerve ganglia do cold sores arise from?
Trigeminal nerve ganglion
56
Which sensory nerve ganglia does genital herpes arise from?
Sacral nerve ganglia
57
What are the signs of herpes simplex?
``` Blistering lesions Neuropathic pain Flu like prodrome Dysuria Inguinal lymphadenopathy ```
58
How would you treat herpes?
Aciclovir Topical lidocaine Analgesia

3a (13 decks)

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