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GP > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Most common cause of recurrent erythema multiforme?

A

HSV

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2
Q

When is chickenpox contagious?

A

2 days prior to rash and until all lesions have crusted over

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3
Q

How long does chickenpox vesicles take to break, and when do crusts fall off?

A

8-12 hours, 7 days

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4
Q

Post-herpes zoster complications?

A

Post-herpetic neuralgia, myelitis, encephalitis

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5
Q

Hutchinson’s sign?

A

Vesicles found on the side/tip of the nose in ophthalmic zoster, marker of serious ocular complications

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6
Q

Lesion of molloscum contagiosium

A

Pearly papule with central umbilication and a core that can be expressed by applying firm pressure to either side of lesion. Can scar (atrophic )

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7
Q

How do children and adolescents get molloscum?

A

Children: from family or with people they swim/bathe with. usually armpits and waist
Adolescents: pubic region as STIs

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8
Q

Treating molloscum

A
  1. Can leave alone (will resolve within 8 months usually)

2. Cryotherapy, curettage, tape occlusion

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9
Q

How can HPV be transmitted (for warts)

A

Contact with infected skin/contaminated surfaces, easier if there are breaks in the skin.

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10
Q

How to treat warts?

A
  1. Usually resolves within 2 years

2. Can also apply topical salicylic acid or cryotherapy

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11
Q

Cause of HFM?

A

Coxsackie virus A16

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12
Q

Where does impetigo spread easily?

A

Warm moist environments with close physical contact and poor hygiene

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13
Q

What is ecthyma?

A

A deeper ulcerated and scarring infection of the dermis from impetigo

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14
Q

How to control spread of impetigo?

A

Cover affected areas and keep affected children away from school
Use separate bath towels and launder in hot water daily
Treat crusted areas with moist compresses for 10 minutes 3 times daily, then remove residual crusts

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15
Q

What is cellulitis?

A

A bacterial infection of the dermis and subcutaneous tissues characterised by pain, redness and oedema

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16
Q

What is erysipelas?

A

A superficial form of cellulitis, predominantly involving the dermis. Has well-defined edges and may be raised.

17
Q

Treatment of acne

A

Education: not due to diet or hygiene, explain actual cause, don’t pick and squeeze, don’t over wash, don’t use too much make up (water based), remove makeup before sleep
Mild acne: benzoyl peroxide + topical retinoid (adapalene 0.1% at night), review in 6 weeks or try topical clindamycin + benzoyl
Moderate: oral antibiotic (MUST be with benzoyl peroxide)
- doxycycline/minocycline/erythromycin
- hormonal: COCP (only improve after 3 months), cytoproterone acetate, spironolactone
Severe: oral isotretinoin (need referral) cause risk of mucosal dryness, bleeding, pancytopenia, depression

18
Q

Pityriasis rosea features

A

Herald oval/round patch (1-2 weeks) which is salmon-pink/copper-coloured
Then generalized coin-shaped patches with scaly margins following Christmas tree pattern on back, t-shirt pattern on front
Itchy

19
Q

Management of pityriasis rosea

A

Bathe and shower using neutral soap
Soothing bath oil
For itch, apply mild topical CS or calamine lotion with 1% phenol in aqueous cream
Severe itch use potent topical CS
UV therapy - sunlight/UV 3x a week with care

20
Q

Treatment for psoriasis

A

Avoid known ppt factors: infection, trauma, emotional stress, beta blockers, lithium, NSAIDS, COCP, sunburn
Healthy lifestyle
Avoid irritants, soap substitute
Moisturizers!
Potent topical steroids
- short term for up to 6 weeks, intermittent use for flares
Topical calcipotriol (Vit D analogue) which takes 6 weeks to take effect or combination product for longer term use
Coal tar 1% emulsion/gel
phototherapy if extensive disease
systemic: oral methotrexate, oral acitrecin, oral cyclosporine

21
Q

Psoriatic arthritis imp features

A

DIP arthritis
Dactylitis (sausage digits)
Joint stiffness

22
Q

Urticaria management

A

Avoid triggers
Oral antihistamine
Consider H2 antagonist
Systemic corticosteroid (avoid if possible)
Severe urticaria with hypotension and anaphylaxis: IV Adrenaline
Topical soothing prep like phenol in calamine or menthol cream
Bath with bath oil

23
Q

Rosacea mild management

A

Mild:

  • Metronidazole 0.75% BD
  • Azelaic acid 15% gel OD
  • 6-12 weeks for max response, if unsuccessful add/replace with oral therapy
24
Q

Rosacea mod/severe

A

Doxycycline 50-100mg daily for 8-10 weeks
If inadequate after 4 weeks, minocycline
Erythromycin 250-500mg BD off pregnant woman
Laser therapy/isotretinoin

25
Q

Management of SCC

A

Early excision of tumors <1cm with 3-5mm margin to deep fat level
Refer for specialized surgery and/or radiotherapy if large, difficult site or lymphadenopathy
SCC of ear and lip do WLE
Must do surgery if central nose/helix
Radiotherapy is optional in a biopsy-proven tumor when surgery not feasible

26
Q

BCC management

A

Simple elliptical excision (3-4 mm margin) is best
If not, do biopsy before other management
Can do radiotherapy especially in frail people
Mohs micrographic surgery: for large, recurrent, in site where tissue needs to be preserved
Photodynamic therapy; >90% response for nodule and superficial
Cryo for well-defined, histologically confirmed superficial tumor away from head and neck
Imiquimod is option for proven BCC

27
Q

Management of melanoma

A

WLE with SLNB and regional LN dissection
Skin flaps/graft
Chemo/radio

28
Q

What is tinea on the body and limbs, hands and scalp called

A

Corporis

Manuum

Capitis

29
Q

3 manifestations of tinea pedis

A

Dry scaly eruption of feet, might be interdigital
Interdigital maceration usually between 4th/5th toes, athlete’s foot
Vesicular or blistering

30
Q

How to diagnose tinea

A

Microscopy and culture of surface scraping

31
Q

Treatment of tinea

A

Topical: if localized, terbinafine
Oral: if extensive or hair-bearing, so griseofulvin/terbinafine. for nail tinea too.

32
Q

Treatment of MRSA

A

Mild-moderate: clindamycin or trimethoprim/sulfamethoxazole

Severe in hospital: vancomycin

GP (20 decks)

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