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Finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

functions of the skin

A

STAIN B

Storage 
Thermoregulation 
Aesthetics + communication 
Immunological 
Neurological
Barrier/protection
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2
Q

describe a rash structure

A

distribution - where is it:

  • flexures/ extensors
  • dermatomal
  • intertriginous (folds of skin e.g. under breasts)
  • photodistribution

configuration - grouping of the rash:

  • linear
  • annular (ring shaped)
  • discoid (like a disc)
  • clusters (infections!)

morphology - describe it

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3
Q

describe a skin lesion struction

A 
Asymmetry
Border: irregular/regular 
Colour 
Diameter
Elevation/everything else
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4
Q

Eczema

aka

A

dermatitis

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5
Q

Eczema

acute dermatitis

A

rapidly evolving red rash which may be blistered or swollen

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6
Q

Eczema

chronic

A

longstanding irritable area

often darker, thickened (lichenified) and much scratched

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7
Q

Eczema

sub-acute

A

an inbetween state

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8
Q

Eczema

RFs (4)

A
  • allergic rhinitis
  • asthma
  • age <5yrs
  • FH of eczema
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9
Q

Eczema

where does it present in infants

A

extensors
cheeks
forehead
scalp

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10
Q

Eczema

where does it present in children and adults

A

flexures

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11
Q

Eczema

signs and symptoms

A
  • pruritis
  • xerosis (dry skin)
  • erythematous
  • scaly
  • excoriations
  • lichenification
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12
Q

Eczema

what does crust and weeping suggest

A

infections from staphylococcus

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13
Q

Eczema

what is atopic eczema

A
  • prevalent in children

- FH of dermatitis or asthma

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14
Q

Eczema

what is allergic contact dermatitis

A

skin contact with substances that most ppl don’t react to

  • nickel
  • perfume
  • rubber
  • half dye
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15
Q

Eczema

what is irritant contact dermatitis

A
  • provoked by bodily fluids, water, detergents, solvents/harsh chemicals, friction
  • worse if has atopic eczema
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16
Q

Eczema

what is seborrheic dermatitis

A

irritation from toxic substances produced by Malassezia yeasts that live on the scalp and face

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17
Q

Eczema

what is nummular dermatitis

A

aka discoid

  • may be set off initially by an injury
  • scattered coin-shaped irritable patches
  • persist for a few months
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18
Q

Eczema

what is gravitational dermatitis

A
  • arises on lower legs of elderly

- due to swelling + poorly functioning leg veins

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19
Q

Eczema

what is infective dermatitis

A

provoked by impetigo (bacterial infection) or fungal infection

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20
Q

Eczema

trx for an acute flare

A
  1. emollients TDS

and

  1. topical corticosteroids (intermittent) e.g. hydrocortisone BD
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21
Q

Eczema

trx for chronic

A
  • emollients
  • continuous low-mid potent topical corticosteroid
  • reduce exposure to triggers
  • immunosuppressive agents
  • biologics
  • antihistamines, phototherapy, abx
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22
Q

Psoriasis

what is it

A

chronic autoimmune disease characterised by well demarcated, erythematous scaly plaques

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23
Q

Psoriasis

what are the different types

A
  • chronic plaque
  • flexural
  • guttate
  • pustular
  • generalised/erythrodermic
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24
Q

Psoriasis

describe chronic plaque psoriasis

A

most common

  • symmetrical plaques
  • extensor (knees + elbows), scalp, lower back
  • itchy
  • well dermarcated circular to oval
  • bright pink elevated lesion (plaque) w/ overlying white/silvery scale
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25
Q

Psoriasis

describe flexural (inverse) psoriasis

A
  • smooth, erythematous plaques without scale

- in flexures + skin folds

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26
Q

Psoriasis

describe guttate psoriasis

A
  • multiple, small tear dropped erythematous plaques
  • on trunk
  • after strep infection
  • young adults
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27
Q

Psoriasis

describe pustular psoriasis

A
  • multiple petechiae + pustules

- on palms + soles

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28
Q

Psoriasis

what is generalised/erythrodermic psoriasis

A
  • rare but serious form

- erythroderma + systemic illness

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29
Q

Psoriasis

nail changes (3)

A
  • nailbed pitting
  • onycholysis
  • sublungual hyperkeratosis
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30
Q

Psoriasis

nail changes: what is nailbed pitting

A

superficial depression in nailbed

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31
Q

Psoriasis

nail changes: what is onycholysis

A

seperation of nail plate from nail bed

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32
Q

Psoriasis

nail changes: what is subungual hyperkeratosis

A

thickening of nailbed

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33
Q

Psoriasis

RFs (4)

A
  • FH
  • HIV
  • obesity
  • smoking
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34
Q

Psoriasis

triggers

A
  • skin trauma
  • infection: strep, HIV
  • drugs
  • withdrawal of steroids
  • stress
  • alcohol + smoking
  • cold/dry weather
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35
Q

Psoriasis

what is Koeber phenomenon

A

skin lesions occur at sites of skin injury (inc lichen planus + vitiligo too)

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36
Q

Psoriasis

which drugs can trigger psoriasis

A

BALI

BB
ACEi, anti-malarials (hydroxychloroquine)
Lithium
Indomethacin/NSAIDs

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37
Q

Psoriasis

chronic plaque mnx 1st line

A 
regular emollient 
\+
potent corticosteroid (topical) OD
\+
vit D analogue (topical) OD
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38
Q

Psoriasis

chronic plaque mnx 2nd line

A

vit D analogue BD

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39
Q

Psoriasis

chronic plaque mnx 3rd line

A

potent corticosteroid BD for up to 4w
or
coal tar preparation (OD/BD)

short acting dithranol can also be used

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40
Q

Psoriasis

systemic trx

A

1st: methotrexate
2nd: ciclosporin
3rd: Acitretin

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41
Q

Psoriasis

systemic trx: why monitor LFTs if giving methotrexate

A

hepatotoxicity

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42
Q

Psoriasis

systemic trx: why monitor FBCs if giving methotrexate

A

myelosuppression –> pancytopenia

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43
Q

Psoriasis

systemic trx: when can ciclosporin be used 1st line

A 
if rapid control needed
             or
palmoplantar pustulosis 
             or
considering conception
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44
Q

Psoriasis

systemic trx: what are the SE’s of ciclosporin

A

5 H’s

  • hypertrophy of gums
  • hypertrichosis
  • HTN
  • Hyperkalaemia
  • Hyperglycaemia
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45
Q

Psoriasis

systemic trx: what are the SE’s of Acitretin

A
  • teratogenic
  • hepatotoxicity
  • increased lipids
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46
Q

Psoriasis

1st line phototherapy

A

narrowband UVB

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47
Q

Psoriasis

2nd line phototherapy

A

psoralen + UVA (PUVA)

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48
Q

Psoriasis

SE’s of phototherapy

A
  • skin aging

- squamous cell cancer (not melanoma)

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49
Q

Psoriasis

what biological therapy can be used

A
  • Infliximab
  • Etanercept
  • Adalimumab
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50
Q

Psoriasis

biological therapy: what is associated with Adalimumab

A

reactivation of latent TB

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51
Q

Acne Vulgaris

what is it

A

an inflammatory disease of the pilosebaceous unit

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52
Q

Acne Vulgaris

what is the pilosebaceous unit

A

hair follicles and sebaceous gland

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53
Q

Acne Vulgaris

how do non-inflammatory lesions present as

A

cornedones

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54
Q

Acne Vulgaris

how do less severe inflammatory lesions present as

A

papules

pustules

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55
Q

Acne Vulgaris

how do severe inflammatory lesions present

A

nodules
cyst
scarring

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56
Q

Acne Vulgaris

what is mild acne

A
  • non inflammatory lesions

- w/ sparse inflammatory lesions

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57
Q

Acne Vulgaris

what is moderate acne

A
  • widespread non inflammatory lesions

- w/ numerous papules + pustules

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58
Q

Acne Vulgaris

what is severe acne

A
  • extensive inflammatory lesions

- inc nodules, pitting and scarring

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59
Q

Acne Vulgaris

aetiology

A
  • ↑ sebum production
  • ↑ androgens -> hyperplasia of sebaceous glands
  • hyperactive immune response
  • bacterial colonisation
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60
Q

Acne Vulgaris

complications

A
  • post inflammatory pigmentation
  • scarring
  • deformity
  • psychological + social effects
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61
Q

Acne Vulgaris

1st line (mild) mnx

A

topical benzoyl peroxide

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62
Q

Acne Vulgaris

2nd line (mild) mnx

A

topical abx or topical retinoid

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63
Q

Acne Vulgaris

3rd line (mod) mnx

A
  • PO tetracyclines
    or
  • PO anti-androgens
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64
Q

Acne Vulgaris

3rd line (mod) mnx: name some tetracyclines

A
  • lymecyline
  • oxtetracycline
  • doxycycline
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65
Q

Acne Vulgaris

3rd line (mod) mnx: CI’s of tetracyclines

A

avoid in pregnant/breastfeeding women

avoid if <12 years

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66
Q

Acne Vulgaris

3rd line (mod) mnx: which abx can you used instead of tetracyclines in pregnant/breastfeeding women

A

erythromycin

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67
Q

Acne Vulgaris

3rd line (mod) mnx: what is the max duration of PO abx

A

3m

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68
Q

Acne Vulgaris

3rd line (mod) mnx: SE of long term abx use and what do you give if it occurs

A

gram -ve folliculitis

give high dose PO trimethoprim

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69
Q

Acne Vulgaris

3rd line (mod) mnx: name some PO anti-androgens

A
  • OCP

- spironolactone

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70
Q

Acne Vulgaris

4th line (severe) mnx

A

PO retinoid

e.g. isotretinoin

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71
Q

Acne Vulgaris

4th line (severe) mnx: SEs of PO retinoid

A
  • highly teratogenic
  • hepatitis (moniter LFTs)
  • dry mucous membrane
  • headache
  • hair thinning/loss
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72
Q

Rosacae

features

A
  • 1st sx: flushing
  • then persistent erythema w/ pustules + papules
  • telangiectasia
  • rhinophyma (large, red, bumpy nose)
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73
Q

Rosacae

where does it typically affect

A

nose, cheeks, forehead

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74
Q

Rosacae

how does it involve the eye

A

blepharitis

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75
Q

Rosacae

epidemiology

A

30-60yrs

F>M

common in pale skins

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76
Q

Rosacae

exacerbating factors

A
  • sunlight
  • hot weather
  • warm baths
  • stress
  • spicy foods
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77
Q

Rosacae

mnx (general measures)

A
  • camourflage creams
  • sun protection
  • avoid exacerbating factors
  • emollient as a soap substitute if skin is dry
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78
Q

Rosacae

1st line mnx (mild)

A

topical metronidazole

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79
Q

Rosacae

what classes it as mild

A

limited number of papules and pustules and no plaque

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80
Q

Rosacae

2nd line mnx (for predominant flushing but limited telangectasia)

A

topical Azelaic acid / Brimonidine / Ivermectin

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81
Q

Rosacae

what can be used to manage persistent telangiectasia

A

laser therapy

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82
Q

Rosacae

mnx for severe cases

A

systemic abx: PO tetracyclines e.g. ocytetracycline

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83
Q

Viral Warts

where can they present on the body

A

cutaneous (aka veruca papilloma)

mucosal

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84
Q

Viral Warts

describe a cutaneous wart

A
  • hard keratinous surface

- papillary capillaries (tiny red/black dots visible on wart)

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85
Q

Viral Warts

cause

A
  • infection by HPV

- direct skin to skin contact or autoinoculation

86
Q

Viral Warts

common wart

A

cauliflower like papulae

87
Q

Viral Warts

plantar

A
  • sole

- caused by HPV1, 2

88
Q

Viral Warts

plane

A
  • multiple small flat topped skin coloured papules

- often spread shaving

89
Q

Viral Warts

filiform

A
  • cluster of fine fronds emerging from pedicle base

- face

90
Q

Viral Warts

butcher’s

A

HPV 7 infecting butcher’s hand

91
Q

Viral Warts

epidermodysplasia veruciforms

A
  • rare autosomal recessive
92
Q

Viral Warts

mnx

A
  • topical paints containing salicylic acid or podophyllin
  • cryotherapy
  • electrosurgery (curettage + cautery) for large resistant warts
93
Q

cause of genital warts

A

HPV 6 or 11

spread by skin to skin contact

94
Q

mnx of epidermoid and pilar cysts

A

none - most disappear

if red hot –> infected –> flucloxacillin

95
Q

epidermoid cyst

location

A

face, neck, trunk

96
Q

epidermoid cyst

central punctum?

97
Q

epidermoid cyst

origin

A

epithelium or hair follicle infundibulum

98
Q

epidermoid cyst

cyst wall

A

delicate and prone to rupture

99
Q

epidermoid cyst

histology

A

granular layer

100
Q

epidermoid cyst

which syndrome is it present in

A

Gardner Syndrome

101
Q

pilar cyst

location

A

scalp and scrotum

102
Q

pilar cyst

central punctum?

103
Q

pilar cyst

origin

A

outer root sheath

104
Q

pilar cyst

cyst wall

A

thick + not prone to rupture

105
Q

pilar cyst

histology

A

granular layer is absent

106
Q

pilar cyst

what does it contain

A

keratinous material

107
Q

pilar cyst

inheritance pattent

A

often autosomal dominant

108
Q

Seborrhoeic Keratosis

what is it

A

a harmless warty spot and a common sign of skin ageing

109
Q

Seborrhoeic Keratosis

presentation

A
  • ‘stuck on’ appearance
  • large variation in colour from flesh to light-brown to black
  • fissured keratin surface.
110
Q

Seborrhoeic Keratosis

mnx

A
  • leave alone
  • cryotherapy
  • shave biopsy
  • curettage
111
Q

Dermatofibroma

what is it

A

a common benign fibrous nodule usually found on the skin of the lower legs

occurring at sites of previous trauma (insect bite)

112
Q

Dermatofibroma

size

113
Q

Dermatofibroma

presentation

A
  • tethered to skin surface + mobile over sc tissue
  • sometimes painful, tender, itchy
  • Pinch Sign
  • solitary dermal nodules
114
Q

Dermatofibroma

what is Pinch Sign

A

the overlying skin dimples on pinching the lesion

115
Q

Dermatofibroma

mnx

116
Q

Dermatofibroma

histology

A
  • proliferating fibroblasts

- merging w/ sparsely cellular dermal tissues

117
Q

Shingles

cause

A

reactivation of the varicella zoster virus which an lie dormant in nerve ganglia following primary infection (chickenpox)

118
Q

Shingles

commonly effects who?

A

elderly + young adults

119
Q

Shingles

prodromal period features

A
  • burning pain over affected dermatome

- fever, headache, lethargy

120
Q

Shingles

which is the most commonly affected dermatome

121
Q

Shingles

describe the rash

A

initially erythematous, macular rash over affected dermatome

becomes vesicular

well demarcated by the dermatome

doesn’t cross midline

122
Q

Shingles

whom should pts avoid

A

pregnant women + the immunosuppressed

123
Q

Shingles

when are pts infectious till

A

until the vesicles have crusted over

usually 5-7d following onset

124
Q

Shingles

mnx to reduce risk of spread

A

cover lesions

125
Q

Shingles

mnx: analgesia

A

1st line: NSAIDs + paracetamol

consider amitriptyline

severe + immunocompetent: PO corticosteroids 2w

126
Q

Shingles

mnx

A

antivirals within 72hrs (aciclovir)

unless <50y + mild truncal rash w/ mild pain + no underlying RFs

127
Q

Shingles

what is the most common complication

A

post herpetic neuralgia

128
Q

Shingles

complications other than post herpetic neuralgia

A

herpes zoster opthalmicus

herpes zoster oticus (Ramsay hunt syndrome) - HHV3 infection of the facial nerve

129
Q

Shingles

what is herpes zoster opthalmicus

A

a complication.

shingles affecting the ocular division of the trigeminal nerve

130
Q

Lichen planus

what is it

A

an autoimmune condition that causes localised chronic inflammation

131
Q

Lichen planus

describe the rash

A

itchy, papular rash

polygonal in shape

Wickham’s striae: white lines pattern on the surface

Koebner phenomenon

132
Q

Lichen planus

where is the rash most common

A

on the palms, soles, genitalia and flexor surfaces of the arms

133
Q

Lichen planus

what may be seen in the mouth

A

white-lace pattern on the buccal mucosa

134
Q

Lichen planus

nail features

A

longitudinal ridging (onychorrhexis)

thinning of nail plate

135
Q

Lichen planus

lichenoid drug eruption causes

A
  • gold
  • quinine
  • thiazides
136
Q

Lichen planus

mnx

A
  • potent topical steroids
137
Q

Lichen planus

mnx for oral lichen planus

A

benzydamine mouthwash or spray

138
Q

Actinic Keratoses

what is it

A

a common premalignant skin lesion that develops as a consequence of chronic sun exposure

pre cursors for SCCs

139
Q

Actinic Keratoses

RFs

A
  • type I or II skin
  • hx of sunburn
  • outdoor occupation or hobbies
  • immunosuppression
140
Q

Actinic Keratoses

describe it

A

thickened papules or plaques w/ surrounding erythematous skin + a keratotic, rough warty surface

141
Q

Actinic Keratoses

common location

A
  • temple of head

- back of head

142
Q

Actinic Keratoses

mnx for localised lesions

A

cryotherapy, curettage or surgical excision

143
Q

Actinic Keratoses

mnx for larger lesions

A
  • topical S-Fluorouracil (cytotoxic agent)
  • topical imiquimod (modifies immune response)
  • topical diclofenac (NSAID for mild AK)
144
Q

Bowen’s disease

what is it

A

a type of precancerous dematosis that is a precursor to SCC

more common in older patients

145
Q

Bowen’s disease

features

A
  • irregular, red, scaly plaques
  • often 10-15mm
  • on sun exposed areas: temple, neck, lower limbs
  • slow growing
146
Q

Bowen’s disease

mnx

A
  • top 5-flurouracil
  • top steroids
  • cyro, excision
147
Q

what is the most common form of skin cancer

148
Q

Basal Cell Carcinoma

which type of BCC is most common and name some others

A 
most common: nodular 
superficial 
pigmented
cystic 
keratotic
morphoeic
149
Q

Basal Cell Carcinoma

presentation of a nodular BCC

A
  • Pearly / shiny nodule with a smooth surface
  • small, skin coloured/pink nodule w/ central depression
  • surface telangiectasia
  • head + neck
150
Q

Basal Cell Carcinoma

mnx

A
  • surgical excision w/ 4mm margin
  • curettage + cautery
  • cryo
  • top: imiquimod, fluorouracil
  • radiotherapy
151
Q

Squamous Cell Carcinoma

presentation

A
  • irregular ill-defined red nodule
  • scale + ulceration
  • rapidly growing
152
Q

Squamous Cell Carcinoma

causes

A
  • UV light
  • human wart virus
  • burns
  • genetic

lead to DNA mutations

153
Q

Squamous Cell Carcinoma

what makes it a good prognosis

A
  • well differentiated tumour
  • <20mm in diameter
  • <2mm deep
  • no associated diseases
154
Q

Squamous Cell Carcinoma

what makes a bad prognosis

A
  • poorly differentiated tumours
  • > 20mm in diameter
  • > 4mm deep
  • immunosuppression
155
Q

Squamous Cell Carcinoma

mnx

A
  • lesion <20mm: surgical excision w/ 4mm margin
  • > 20mm: surgical excision w/ 6mm margin
  • Mohs micrographic surgery if in cosmetically important sites
156
Q

Malignant Melanoma

if any lesion has ____, you should refer urgently under 2w wait pathway

A 
Asymmetry
Border irregularity 
Colour variation 
Diameter >6mm
Evolves over time
157
Q

Malignant Melanoma

what are the types

A
  • superficial spreading
  • nodular
  • lentigo maligna
  • acral lentiginous
158
Q

Malignant Melanoma

superficial spreading:
- common?

A

yes 70% of cases

159
Q

Malignant Melanoma

superficial spreading: typically affects?

A
  • young ppl

- arms, legs, back, chest

160
Q

Malignant Melanoma

superficial spreading: appearance

A
  • growing moles

- usually grows horizontally first

161
Q

Malignant Melanoma

dx

A
  • dermatoscope

- excisional biopsy –> histology for dx + establish Breslow thickness

162
Q

Malignant Melanoma

trx

A
  • wider excision margin around lesion
163
Q

Malignant Melanoma

trx for stage III + IV (metastatic)

A
  • adjuvant immunotherapy + chemo
164
Q

Malignant Melanoma

further inx if Breslow Thickness >1mm

A

sentinal node biopsy (to look for metastases + stage the cancer)

165
Q

Scabies

cause

A

by the mite Sarcoptes scabiei

166
Q

Scabies

pathphysiology

A
  • Sarcoptes scabiei burrows into skin
  • lays eggs in the stratum corneum
  • 30d later: delayed type 4 hypersensitivity reaction to mites/eggs
  • intense puritis
167
Q

Scabies

features

A
  • widespread pruritis
  • linear burrows on hands
  • classically worse at night
  • excoriation, infection due to scratching
  • papular vesicular
168
Q

Scabies

1st line trx

A

top permethrin 5%

leave on for 12h before washing off
for 7d

169
Q

Scabies

2nd line trx

A

malathion 0.5%

leave on skin for 24h

170
Q

Scabies

trx for all contacts

A

all should be treated even if asymptomatic

171
Q

Tinea

what is it

A

dermatophyte fungal infections

172
Q

Tinea

what are the types

A
  • tinea capitis (scalp ringworm)
  • tinea corporis (ringworm)
  • tinea pedis (athlete’s foot)
  • tinea incognita
173
Q

Tinea

what is tinea corporis (ringworm)

A

itchy annular lesions with clear, defined, raised, scaly edge

174
Q

Tinea

what is tinea capitis

A

Scalp ringworm: Patches broken hair, scaling and inflammation

175
Q

Tinea

what is tinea pedis

A

athlete’s foot: Moist scaling and fissuring in toewebs

176
Q

Tinea

what is tinea incognita

A

inappropriate treatment of tinea with corticosteroids, causing a different appearance

may occur when rash is wrongly diagnosed as dermatitis initially

177
Q

Tinea

establish dx with?

A

skin scraping, swabs or hair/nail clippings

178
Q

Tinea

mnx

A
  • top antifungal: terbinafine cream, ketoconazole/selenium sulphate shampoo
  • PO antifungal: itraconazole, fluconazole
179
Q

Impetigo

clinical features

A
  • golden crusted lesions around mouth
  • pruritic rash
  • v. contagious
180
Q

Impetigo

common cause

A

staph aureus

strep pyogenes

181
Q

Impetigo

who is it common in

182
Q

Impetigo

mnx for pts NOT systemically unwell/high risk of complications

A

hydrogen peroxide 1% cream

183
Q

Impetigo

mnx

A
  • top fusidic acid
  • intranasal mupirocin
  • PO flucloxacillin
184
Q

Impetigo

what should children do about school

A

exclude from school until lesions are crusted and healed

or 48h after abx trx

185
Q

Cellulitis & Erysipelas

what is the difference

A

cellulitis: acute bac infection of dermis + SC tissue
erysipelas: more superficial infection

186
Q

Cellulitis & Erysipelas

organisms

A

staph aureus, strep pyogenes

187
Q

Cellulitis & Erysipelas

presentation

A
  • warmth, pain, erythema, swelling
  • blisters may form
  • usually lower limb
  • generally unilateral
188
Q

Cellulitis & Erysipelas

inx

A
  • FBC (raised WCC)
  • blood culture
  • purulent focus culture
  • CT/MRI if orbital cellulitis suspected
189
Q

Cellulitis & Erysipelas

mnx

A

flucloxacillin PO

190
Q

Cellulitis & Erysipelas

comlications

A
  • local tissue damage
  • sepsis
  • orbital cellulitis
191
Q

well-defined circular papules on which evolve at different stages to form a ‘target-shaped’ lesion of three concentric rings of different colours. The rash starts on the palms/soles and spread up the limbs to the trunk. what is it

A

erythema multiforme (could be caused by HSV)

192
Q

what is psoriasis relieved by

A

exposure to sun

193
Q

pruritic papulovesicular lesions over the buttocks and extensor surfaces of the arms, legs, and trunk. Diarrhoea for a few months. What could this be

A

dermatitis herpetiformis (assc w/ coeliac disease)

194
Q

mnx of pruritic sx of Dermatitis Herpetiformis

A

Dapsone (an abx)

and a gluten free diet

195
Q

mnx of staph scalded skin syndrome

A

IV vancomycin

196
Q

trx of psoriasis on scalp

A

3% salicylic acid cream in combination with a tar-containing shampoo.

197
Q

Pemphigus vulgaris

what is it

A

an autoimmune disease caused by antibodies directed against desmoglein 3, a cadherin-type epithelial cell adhesion molecule

198
Q

Pemphigus vulgaris

which molecule is affected by the attacking antibodies

A

desmoglein 3

199
Q

Pemphigus vulgaris

which population is commonly affected

A

Ashkenazi Jewish population

200
Q

Pemphigus vulgaris

features

A
  • mucosal ulceration
  • skin blistering
  • flaccid, easily ruptured vesicles and bullae
  • typically painful but not itchy
  • Nikolsky sign positive
201
Q

Pemphigus vulgaris

what will biopsy show

A

acantholysis (loss of coherence between epidermal cells due to the breakdown of intercellular bridges)

202
Q

Pemphigus vulgaris

mnx

A

steroids are first-line

immunosuppressants

203
Q

Bullous pemphigoid

what is it

A

an autoimmune condition causing sub-epidermal blistering of the skin

204
Q

Bullous pemphigoid

which proteins are attacked by antibodies

A

hemidesmosomal proteins BP180 and BP230

205
Q

Bullous pemphigoid

who is it more common in

A

elderly patients

206
Q

Bullous pemphigoid

features

A
  • itchy, tense blisters typically around flexures
  • blisters usually heal without scarring
  • no mucosal involvement (i.e. the mouth is spared)
207
Q

Bullous pemphigoid

what will skin biopsy show

A

immunofluorescence shows IgG and C3 at the dermoepidermal junction

208
Q

Bullous pemphigoid

mnx

A
  • PO corticosteroids

- topical corticosteroids, immunosuppressants and antibiotics are also used

209
Q

Bullous pemphigoid

complications

A
  • Bacterial staph + strep skin infection, and sepsis
  • Viral infection with herpes simplex, varicella or herpes zoster
  • Complications of treatment
210
Q

Bullous pemphigoid

inx

A
  • Direct immunofluorescence staining of a skin biopsy

- bloods: indirect immunofluorescence test for circulating pemphigoid BP180 antibodies

Finals (47 decks)

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