Dermatology Flashcards
SCC
- irregular, ill-defined red nodule with scale and ulceration
- sun exposed areas
BCC
- small, skin-coloured or pink nodule with a central depression
- pearly rolled edge and surface telangiectasia
Bullous pemphigoid
- elderly women
- itchy, tense, fluid-filled bullae
- no mucosal involvement
pemphigus = superficial blisters, pemphigoid = deep blisters
Erythema multiforme
- annular, concentric ring erythematous skin eruption
- drug related or viral illness.
Discoid eczema/Nummular dermatitis
round circumscribed plaques
Pompholyx eczema
- precipitated by humid, warm conditions and typically affects the palms and soles
- vesicular lesions are also typical for this type of eczema.
Shingles
- Diagnosed clinically
- Dermatomal vesicular rash which is painful, tingly and itchy
- Typical course: prodrome (described above) and then new vesicles continue to form over three to five days and progressively dry and crust over.
Guttate psoriasis
- multiple, small tear-drop shaped scales
- common in AI conditions
Pityriasis rosea
- Hx of viral infection
- preceded by a large herald patch
- many oval red patches across the chest and back.
Tinea corporis
- ring shaped lesion with a central clearing
Pityriasis rosea
- Hx of viral infection
- preceded by a large herald patch- a single, large, discoid (coin-shaped), erythematous patch.
- many oval red patches across the chest and back develop after the herald patch
- self-limiting
Impetigo
- golden crusty lesions and vesicles
- staph aureus
- fever UNCOMMON
- Children should be excluded from school until lesions have crusted or healed, or for 48 hours after starting antibiotics.
Mx- Hydrogen peroxide 1% cream can also be used as first line treatment in localised cases.
Pyogenic Granuloma
- reactive overgrowth of capillary blood vessels
- single, shiny, red nodule of up to 1cm “raspberry-like”.
- benign lesion, discomfort and bleeding
- rapidly growing
- common sites- hands/fingers
- Causes: minor trauma, infection and pregnancy
Erythema nodosum
- painful red, rounded lumps on the shins and around ankles
Lyme Disease
- spread by tick bites
- red swollen area surrounding the bite
- systemic symptoms: fevers, arthralgia and myalgia
Diagnosis: serology
Actinic Keratosis
- pre-cancerous (SCC), crusty, thick area of skin
- commonly on sun exposed areas
- asymptomatic, can be itchy
Lichen planus
Cutaneous lichen planus is characterised by the 6 Ps:
Purple Pruritic (itchy) Polygonal (multiple sides) Planar (flat-topped) Papules/plaques
Treatment of lichen planus and lichenoid eruption are topical corticosteroids. Most lesions will spontaneously resolve after 12 months.
Systemic immunosuppressants can be used for resistant cases
Eczema Herpeticum
- complication of Atopic Eczema
- HSV
- widespread red, monomorphic blisters and erosions
- systemically unwell with fever and malaise
- immediate treatment with antivirals (IV Aciclovir)
Psoriasis
- Mx
All patients should use an emollient to reduce scale and itch
1st: potent topical corticosteroid OD (eg Betnovate) + topical vitamin D OD (eg Dovonex) applied at different times
2nd: stop the topical corticosteroid, apply topical vitamin D twice daily
3rd: stop the topical vitamin D, apply potent topical corticosteroid twice daily
Dithranol + tar are alternatives
Psoriasis
- Systemic treatment
1st: methotrexate
2nd: ciclosporin (1st line if rapid disease control needed/palmoplantar pustulosis/are considering conception)
3rd: acitretin
Topical steroid potencies
Topical corticosteroids are available in 4 different potencies (remembered by the mnemonic “Help Every Budding Dermatologist”)
Mild- Hydrocortisone 0.5%
Moderate- Eumovate (clobetasone butyrate 0.05%)
Potent- Betnovate (betamethasone valerate 0.1%)
Very potent- Dermovate (clobetasol propionate 0.05%)
What bloods do you need to check if pt with acne is on oral retinoid
lipids
