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HYMS FINALS REVISION > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what is BCC a malignancy of?

A

basal epidermal keratinocytes

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2
Q

a pearly, flesh coloured papule with rolled edge
Associated telangiectaisa.
Ulcerated
Bleeds from minor trauma

What is the diagnosis?

A

BCC

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3
Q
  1. what is SCC a malignancy of?
  2. What are its premalignant lesions known as?
  3. What is SCC in situ also known as?
A
  1. epidermal keratinocytes
  2. solar keratosis
  3. bowen’s disease
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4
Q

Ill defined, dome shaped lesion
rapid growing
ulcerated and bleeds easily
multiple associated actinic solar keratoses on surrounding skin.

What is the diagnosis?

A

SCC

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5
Q

What is malignant melanoma a malignancy of?

A

Melanocytes

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6
Q

Mole has grown recently
Borders are now irregular
multiple colours

What is the dx?

A

Malignant Melanoma

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7
Q
  1. What is the most common form of Malignant Melanoma?
  2. What is the most aggressive type of malignant melanoma and why?
  3. What is used to measure depth of spread of melanoma (i.e. T on TNM staging?
A
  1. superficial spreading
  2. nodular - vertical invasion
  3. breslow thickness
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8
Q
  1. Inflammatory lesions of acne vulgaris (3)

2. non-inflammatory lesions of acne vulgaris (2)

A
  1. papules, pustules, macules

2. comedomes, pseudocysts

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9
Q

stepwise management of acne vulgaris (4)

A
  1. single topical therapy - benzyl peroxide or retinoids
  2. combination topical therapy - benzyl peroxide/retinoids + clindamycin
  3. oral antibiotics (tetracyclines or erythromycin if contraindicated)/COCP + topical treatments
  4. oral isotreinoin
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10
Q

elderly patient
itchy, tense blisters, around flexures
mouth is spared

  1. what is the diagnosis
  2. pathophysiology
  3. management
A
  1. bullous pemphygoid
  2. autoimmune
  3. refer to derm; oral corticosteroids
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11
Q
  1. Most common subtype of psoriaisis

2. exacerbating factors (5)

A
  1. plaque psoriasis
  2. trauma
    alcohol
    drugs - beta blockers, lithium, antimalarials, NSAIDS, ACEi
    withdrawal of systemic steroids
    steptococcal infection (gluttate psoriasis)
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12
Q

NAME THE SUBTYPE OF PSORIASIS BASED ON THE FOLLOWING CLINICAL FEATURES

  1. well defined, red, scaly patches affecting extensor surfaces, sacrum and scalp
  2. shiny, smooth, red, well defined patches localised to skin folds and genitals
  3. transient psoriatic rash with multiple teardrop lesions
  4. red, tender, rash followed by the appearance of small pustules, which become bigger. Commonly occurs on palms and soles
A
  1. plaque psoriasis
  2. flexural psoriasis
  3. gluttate psoriasis
  4. pustular psoriasis
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13
Q

Management of Psoriasis

a) general conservative measure
b) stepwise topical mangagement
c) first line systemic therapy and what this can be useful for

A

a) regular emollients to reduce scales and pruritis

b) 1. topical potent corticosteroid + vitamin D analogue OD for up to 4 weeks
2. vitamin D analogue BD for up to 8 weeks
3. potent corticosteroid BD for up to 4 weeks, or coal tar preparation

c) methotrexate - associated joint disease

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14
Q
  1. What other condition is dermatitis herpetiformis associated with and why?
  2. how is it managed?
A
  1. coeliac disease - IgA deposition in dermis leading to inflammatory response
  2. management of coeliac disease
    Dapsone
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15
Q

Itchy, vesicular skin lesions on extensor surfaces
abdominal pain and bloating, weight loss, steatorrhoea

What is the dx?

A

Dermatitis Herpeteformis

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16
Q 
Child with atopic eczema
Rash has come on suddenly
painful
round, punched out lesions
feels unwell

What is the dx?

A

Eczema herpeticum

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17
Q

Management of Eczema Herpeticum

A
  • swab for viral PCR and bacterial cultures (impetigo is a ddx; can be complicated by secondary bacterial infection)
  • consider admission - dermatological emergency
  • acyclovir - oral or consider IV
  • systemic Abx if complicated by secondary bacterial infection
18
Q

rapid eruption of multiple target lesions of varying sizes
flat, or slightly raised
painless
preceding viral infection

what is the diagnosis?

A

Erythema multiforme

19
Q

Causes of Erythema Multiforme:

  1. infection
  2. drugs
  3. systemic diseases
A
  1. herpes simplex, streptococcus, mycoplasma
  2. penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraception
  3. SLE, sarcoidosis
20
Q

tender, erythematous, nodular lesions over the shins
self resolving over 6 weeks, with no scarring

What is the dx?

A

erythema nodosum

21
Q

Causes of Erythema Nodosum

  1. infection
  2. systemic disease
  3. drugs
A
  1. streptococcus, tuberculosis
  2. Sarcoidosis, IBD, malignancy, lymphoma
  3. penicillins, sulfonamides, COCP
    pregnancy
22
Q
  1. tinea infection of the head
  2. tinea infection of the body
  3. tinea infection of the groin
A
  1. tinea capitis
  2. tinea corporis
  3. tinea cruris
23
Q

ring shaped lesion, with scaly edge, and central hypopigmentation
associated itch

what’s the diagnosis?

A

dermatophyte infection (tinea)

24
Q

management of tinea

A

topical antifungals - terbinafine is first line

keep skin clean and dry thoroughly

25
Q
  1. Pathophysiology of Impetigo
  2. ddx
  3. management of impetigo
  4. public health measures
A
  1. S. aureus/S. pyrogenes infection
  2. eczema herpeticum
  3. topical hudrogen peroxide or topical fusidic acid; oral fluclox/erythromycin if extensive disease
  4. children should be excluded from school until all lesions are crusted and healed or 48 hours after commencing abx
26
Q

summer
child with golden crusted lesions around the mouth

what is the dx?

A

Impetigo

27
Q

What is keratoacanthoma?

A

A benign epithelial tumour

28
Q

smooth, dome shaped papule
central crater filled with keratin

what is the dx?

A

Keratoacanthoma

29
Q

hard white spots on oral mucous membranes/tongue
lesions can’t be rubbed off

  1. what is the dx?
  2. what are the concerns with this condition? (2)
A
  1. leukoplakia
  2. premalignant condition - can transform to become SCC (regular follow up required)
    associated with HIV infection
30
Q

itchy, papular rash over flexor surfaces, palms and soles
polygonal lesions with white line pattern on surface

  1. dx?
  2. management?
A
  1. Lichen Planus

2. potent topical steroids

31
Q

white/hypopigmented crinkled or thickened patches of skin that tend to scar.
elderly female, lesion over genitals
very itchy

  1. diagnosis
  2. management
  3. concern?
A
  1. lichen sclerosus
  2. topical steroids and emollients
  3. increased risk of vulval cancer
32
Q

pinkish/pearly white papules with central umbilication <5mm in diameter
clusters of lesions
found on trunk/flexures/anogenital region

  1. dx?
  2. cause/pathophysiology?
  3. management?
A
  1. molloscum contagiosum
  2. viral infection (molloscum contagiosum). spread by close contact
  3. self limiting
    mild topical corticosteroid and emollient if itching is problematic
33
Q

Ashkenazi Jewish patient
widespread, painful blisters and mucosal ulceration
easily ruptured

  1. dx?
  2. aetiopathophysiology?
  3. management?
A
  1. Pemphigus Vulgaris
  2. autoimmune condition - antidesmoglein 3 antibodies
  3. steroids and immunosuppressants
34
Q

19 year old patient
Initial red patch on trunk
now has generalised “fir tree” rash
had a URTI last week

  1. dx?
  2. Ddx?
A
  1. Pitytiasis Rosea

2. gluttate psoriasis

35
Q

Hypopigmented and pink patches affecting the trunk
Itchy
Mild scale
Recently returned from Cyprus

  1. Dx?
  2. underlying aetiology
  3. management
A
  1. tinea/pitytiasis versicolour
  2. superficial fungal infection - Malassezia furfur
  3. topical ketoconazole
36
Q

eczema type rash on hands and feet
blisters which are very itchy
skin is dry and cracked
worsened during heatwave last week

  1. dx?
  2. management?
A
  1. pompholyx

2. cool compresses, emollients, topical steroids

37
Q

really painful ulcer on leg
was initially a small papule, but has rapidly become bigger.
necrotic tissue within lesion
background of Rheumatoid Arthritis

  1. Dx?
  2. management
A
  1. pyoderma gangrenosum

2. oral steroids

38
Q

Flushing of the cheeks and nose
some papules and telangiectasia in same distribution of rash
got worse during holiday abroad

dx?

A

Rosacea

39
Q

Management of roseaca

A

topical metronidazole
topical brimonidine if flushing is predominant
systemic abx if more severe disease

daily application of high factor suncream

40
Q

child who can’t stop itching
excoriations present, predominantly on limbs
linear burrows can be seen on interdigital webs and flexor aspect of wrist

  1. dx?
  2. management?
A
  1. scabies

2. permethrin 5% to patient and all household contacts

41
Q

multiple lesions on both covered and uncovered skin
stuck on lesions, highly variable in colour
brother had similar problem

  1. dx?
  2. management?
A
  1. seborrhoeic keratosis

2. reassurance

42
Q

Differences between seborrhoeic and actinic keratoses?

  1. body distribution?
  2. cancerous potential?
  3. cause
A
  1. seborrhoeic keratoses can be found on covered and uncovered areas of the body, while actinic keratoses are exclusively found on sun exposed areas
  2. actinic keratoses are pre-malignant for SCC. Seborrhoeic keratoses have no malignant potential
  3. Actinic keratoses are associated with chronic sun exposure, while seborrhoeic keratoses are associated with genetics/family hx

HYMS FINALS REVISION (9 decks)

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