Dermatology Flashcards
What are the 5 layers of the epidermis from outermost to innermost
Stratum corneum, lucidum, granulosum, spinosum, germinativum
Which layer of the epidermis gives rise to keratinocytes and contains melanocytes
Stratum germinativum
How many naevi equate to increased risk of developing melanoma
> 50 naevi 2mm or more in diameter
What is the most important factor in determining prognosis of a patient with melanoma
Invasion depth of the tumour (Breslow score)
What is the 5 year survival in patients with >4mm depth of melanoma
50%
Where is venous ulceration most typically seen
Above medial malleolus
What is the most important test to investigate non-healing ulcers
ABPI
What is the treatment of venous ulcer
Compression multi-layer bandaging
Which cancers are associated with acanthosis nigricans
GI, gastric cancer
Which cancers are associated with dermatomyositis
Lung and ovarian cancer
Which cancers are associated with erythema gyratum repens
Solid organ malignancies - Lung and breast cancer
Which cancer is associated with erythroderma
Lymphoma
Which skin condition is associated with glucagonoma
Necrolytic migratory erythema
Which skin condition is associated with myeloproliferative disorders
Pyoderma gangrenosum
What is Sweet’s syndrome (Acute febrile neutrophilic dermatosis) associated with
Haematological malignancy e.g. myelodysplasia, AML
Which skin condition is oesophageal cancer associated with
Tylosis
Which condition is associated with migratory thrombophlebitis
Pancreatic cancer
What are the 4 common causes of shin lesions
Erythema nodosum, pyoderma gangrenosum, pretibial myxoedema, necrobiosis lipoidica diabeticorum
Which infections can present with erythema nodosum
Strep, TB, histoplasmosis, brucellosis, campylobacter
Which ulceration skin condition can PSC and PBC be associated with
Pyoderma gangrenosum
Which conditions are associated with increased risk of seborrhoeic dermatitis
HIV, Parkinson’s
Which skin condition is seen in young adults and presents with a herald patch on the trunk followed by a fir tree appearance
Pityriasis rosacea
What is first line treatment of impetigo
Topical fusidic acid
Which skin condition presents with telangiectasia after sitting in front of a fire for prolonged periods
Erythema ab igne
What is the first line management of actinic keratosis
Fluorouracil cream for 2-3 weeks (can give steroid after to reduce inflammation)
Which skin condition is associated with IgA in the dermis and anti-gliadin antibodies
Dermatitis Herpetiformis
What skin condition arises from a scar typically in young black males
Keloid scar
Which two conditions are most associated with vitiligo
Pernicious anaemia, T1DM
Which drugs cause hirsutism/hypertrichosis
Phenytoin, minoxidil, cyclosporin, diazoxide
Which conditions cause hypertrichosis
Congenital, PCT, anorexia nervosa
Which interleukin is increased in eczema
IL4
What is the treatment of eczema herpeticum
IV aciclovir
Which skin condition presents with target lesions on upper limbs
Erythema multiforme
What causes 50% of erythema multiforme
HSV
Which drugs cause erythema multiforme
Penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, COCP
Which condition is characterised by a positive Nikolsky’s sign
Toxic Epidermal Necrolysis
What is the treatment of toxic epidermal necrolysis
ITU, volume expansion, IV IG
Which systemic condition is granuloma annulare associated with
Diabetes
What is the most common skin presentation in TB
Lupus vulgaris (50%)
Which deficiency causes ingesting soil/clay
Zinc deficiency
What oral treatment is safe for acne in pregnancy
Oral erythromycin
Which immune cells are involved in psoriasis
Th1 cells
What is the first line treatment of psoriasis
Topical steroid + topical calcipotriol
Which cancer does PUVA increase the risk of developing
Squamous cell carcinoma
Which skin condition appears 2-4 weeks after strep infection in children and resolves spontaneously
Guttate psoriasis
What investigation is used to diagnose PCT
Increased urinary uroporphyrinogen
What is the treatment of PCT
Chloroquine, venesection
Which skin condition causes blisters with mucosal involvement due to antibodies against desmoglein 3
Pemphigus vulgaris
Which skin condition causes sub-epidermal blistering with IgG and C3 in dermoepidermal space
Bullies pemphigoid
Which skin condition presents with flushing and abdominal pain and increased urinary histamine
Systemic mastocytosis
Which skin disorders are photosensitive
Discoid lupus, PCT, SLE, pellagra, herpes labialis, xeroderma pigmentosum
What skin presentation is associated with mcCune-Albright syndrome
Cafe-au-lait spots
Which type of leprosy presents with extensive skin involvement and symmetrical nerve involvement
Lepromatous leprosy (multibacillary) - low degree of cell-mediated immunity
Which type of leprosy presents with minimal skin involvement and asymmetric nerve involvement
Tuberculoid leprosy (paucibacillary) - high degree of cell-mediated immunity
What is the treatment of leprosy
Rifampicin + dapsone + clofazimine
Which drugs can trigger psoriasis
Beta blockers, lithium, antimalarials, NSAIDs, ACEis, infliximab
What is the most common skin malignancy secondary to immunosuppression
Squamous cell carcinoma
Which condition causes a photosensitive rash and blistering on dorsal aspect of hands due to hepatocyte damage
Porphyria cutanea tarda
Which acne drug can cause irreversible skin pigmentation
Minocycline
What is the treatment of alopecia areata
Topical corticosteroids or watchful waiting
Which areas of the skin does dermatitis herpetiformis tend to affect
Elbows, knees, buttocks
Which HHV is thought to play a role in pityriasis rosea
HHV-6, HHV-7
What is the most aggressive form of melanoma
Nodular melanoma
What is the most common form of melanoma
Superficial spreading melanoma
Which type of melanoma looks like a suspicious freckle on the face or scalp after chronic sun exposure
Lentigo maligna
What is the first line treatment of pityriasis vesicular
Topical antifungal - ketoconazole shampoo
Which skin condition has a pruritic rash on flexor surfaces and mucosal involvement
Lichen planus
What is the treatment of lichen planus
Potent topical steroids, benzydamine mouthwash
Which biological therapies can be used for psoriasis management in secondary care
Anti-TNF drugs: Infliximab, etanercept, adalimumab
What are the causes of livedo reticularis
Antiphospholipid syndrome, SLE, PAN, cryoglobulinaemia, EDS, homocystinuria, idiopathic
What kind of hair loss does discoid lupus cause
Scarring alopecia
What is the management of pyoderma gangrenosum
Oral steroids
What is the most potent topical steroid
Dermovate - clobetasol propionate 0.05%
Which skin condition causes abdominal pain and monocytosis on blood film
Systemic mastocytosis
What is the treatment of immune related adverse effects to checkpoint inhibitors in melanoma
Corticosteroids
When can a patient be fast track discharged 2 hours after symptom resolution in anaphylaxis
Good response to single dose of adrenaline and given epipen
When does a patient need to be kept for 6 hours before discharge after anaphylaxis
2 doses of IM adrenaline needed, or biphasic reaction in the past
When does a patient have to be kept in minimum 12 hours after symptom resolution in anaphylaxis
Severe reaction requiring >2 doses adrenaline, severe asthma, possibility of ongoing reaction, presents late at night
What percentage of anaphylactic reactions are biphasic
20%
Which condition presents with tear drop papules on the trunk and limbs
Guttate psoriasis
What can be used to accelerate treatment in guttate psoriasis
UVB phototherapy
What is the treatment of unstable, progressive vitiligo
Oral betamethasone pulse therapy with narrow band UVB
Which type of dermatitis occurs in dry areas of the world with diamond-shaped plates of skin
Asteatotic eczema
What is the investigation for pemphigus vulgaris
Direct immunofluorescence of skin
What is first line treatment of dermatitis herpetiformis
Dapsone
Which cutaneous form of sarcoidosis presents with violaceous nodules over the nose, cheeks and ears
Lupus pernio
