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Dermatology Flashcards

1
Q

What is eczema

A

Chronic atopic condition

Inflammation in skin

Tends to run in families

Usually presents in infancy

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2
Q

How might a patient with eczema present

A

Dry, red, itchy, sore patches of skin

On flexor surfaces, face, and neck

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3
Q

What is the maintenance management for eczema

A

Emollients (artificial barrier over skin)

Soap substitutes

Avoid environmental triggers

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4
Q

What is the management for eczema flares

A

Thicker emollients

Topical steroids

Antibiotics (rarely needed)

Zinc impregnated bandages

Phototherapy

Systemic immunosuppressants (corticosteroids, methotrexate)

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5
Q

What is eczema herpecticum

A

Viral infection of skin

Due to: herpes simplex, varicella zoster

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6
Q

How might a patient with eczema herpecticum present

A

Widespread, painful, vesicular rash

Fever

Lethargy

Irritability

Reduced oral intake

Lymphadenopathy

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7
Q

What are the investigations for eczema herpecticum

A

Viral swab of vesicles

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8
Q

What is the management for eczema herpecticum

A

Aciclovir (IV in severe cases)

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9
Q

What are the complications of eczema herpecticum

A

Can be life threatening if not treated properly

Can get bacterial superinfection

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10
Q

What is psoriasis

A

Chronic autoimmune condition

Recurrent psoriatic skin lesions

Skin dry, flaky, scaly, slightly erythematous

Raised and rough plaques

Over extensor surfaces

Due to rapid generation of new skin cells

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11
Q

What are the types of psoriasis

A

Plaque (most common form)

Guttate (mostly in children, triggered by strep throat infection)

Pustular (can be systemically unwell, medical emergency)

Erythrodermic (skin can come away in large patches, medical emergency)

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12
Q

How might a patient with psoriasis present

A

Auspitz sign: small points of bleeding when plaques scraped off

Koebner phenomenon: psoriatic lesions to areas of skin affected by trauma

Residual pigmentation (after lesions resolve)

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13
Q

What is the management for psoriasis

A

Topical steroids

Topical vitamin D analogues

Topical dithranol

Phototherapy

Systemic treatment (methotrexate, cyclosporin)

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14
Q

What are the complications of psoriasis

A

Nail psoriasis (pitting, thickening, discolouration, ridging, separation from bed)

Psoriatic arthritis

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15
Q

What is acne vulgaris

A

During puberty and adolescence

Chronic inflammation of pilosebaceous units under skin

Due to: increased production of sebum, trapping of keratin, blockage of pilosebaceous unit

Exacerbated by androgenic hormones

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16
Q

How might a patient with acne vulgaris present

A

Macules (flat marks on skin)

Papules (small lumps on skin)

Pustules (small lumps containing yellow pus)

Comedones (blocked pilosebaceous units)

Black heads (open comedones with black pigmentation)

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17
Q

What is the management for acne vulgaris

A

Topical benzoyl peroxide (reduced inflammation, unblocks skin)

Topical retinoids (slow production of sebum, highly teratogenic)

Topical/oral antibiotics

COCP

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18
Q

What is first disease

A

Measles

Highly contagious

Symptoms 10-12 days after exposure

Presentation: fever, coryza, conjunctivitis, koplik spots (grey white spots on buccal mucosa)

Rash starts on face, spreads to rest of the body

Self resolves in 7-10 days

Notifiable disease

Complications: pneumonia, diarrhoea, dehydration, encephalitis, meningitis, hearing loss, death

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19
Q

What is 2nd disease

A

Scarlet fever

Due to group A strep

Pink, blotchy, macular rash

Rough ‘sandpaper’ skin

Starts on trunk, spreads outwards

Presentation: fever, lethargy, flushed face, sore throat, strawberry tongue, cervical lymphadenopathy

Antibiotics (penicillin V)

Notifiable disease

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20
Q

What is 3rd disease

A

Rubella

2 week incubation

Erythematous, macular rash

Starts on face, spreads to body

Presentation: mild fever, joint pains, sore throat, lymphadenopathy

Notifiable disease

Should stay off school for 5 days from rash starting, and away from pregnant women

Complications: thrombocytopenia, encephalitis, congenital rubella syndrome (deafness, blindness, congenital heart disease)

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21
Q

What is 4th disease

A

Duke’s disease

Non-specific viral rash

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22
Q

What is 5th disease

A

Slapped cheek syndrome

Parvovirus B19 infection

Affects trunk and limbs

Self resolves in 1-2 weeks

Complications: aplastic anaemia, encephalitis, meningitis, pregnancy complications, hepatitis, myocarditis, nephritis

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23
Q

What is 6th disease

A

Roseola infantum

Due to herpesvirus 6

1-2 week incubation

High fever for 3-5 days, disappears suddenly

Coryzal symptoms

Rash 1-2 days after fever

Rash on arms, legs, face, trunk (not itchy)

Fully recover in a week

Complications: febrile convulsions

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24
Q

What is erythema multiforme

A

Erythematous rash due to hypersensitivity reaction

Mostly due to viruses or medications

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25
How might a patient with erythema multiforme present
Widespread, itchy, erythematous rash Characteristic target lesions Can cause stomatitis Mild fever Muscle and joint pains Headache Flu-like symptoms
26
What is the management for erythema multiforme
Resolves spontaneously in 1-4 weeks If severe: IV fluids, analgesia, steroids
27
What is urticaria
Aka hives Small, itchy lumps on skin Can be associated with angioedema and flushed skin Due to release of histamines by mast cells Can be acute or chronic
28
What are the causes of urticaria
Food allergies Medication allergies Animal allergies Contact with chemicals Viral infections Insect bites
29
What is the management for urticaria
Antihistamines (fexofenadine) Oral steroids
30
What are chicken pox
Due to varicella zoster virus Generalised vesicular rash Highly contagious Incubation 10-21 days Stop being contagious when lesions have crusted over
31
How might a patient with chicken pox present
Widespread, erythematous, raised, vesicular blistering lesions Starts on trunk or face, then spreads Fever Itching Generalised fatigue and malaise
32
What is the management for chicken pox
Usually mild and self limiting Aciclovir (immunocompromised, adults, neonates) Calamine lotion/antihistamines for itching Children should stay off school and away from pregnant women
33
What are the complications of chicken pox
Bacterial superinfection Dehydration Conjunctival lesions Pneumonia Encephalitis Shingles Ramsay Hunt syndrome
34
What is hand, foot and mouth disease
Due to coxsackie A virus 3-5 day incubation
35
How might a patient with hand, foot and mouth disease present
Viral upper respiratory tract infections After 1-2 days, small mouth ulcers Blistering red spots across body Spots most noticeable on hands, feet and mouth Can be itchy
36
What is the management for hand, foot and mouth disease
No treatment Resolves in 10 days Supportive management
37
What are the complications of hand, foot and mouth disease
Dehydration Bacterial superinfection Encephalitis
38
What is molluscum contagiosum
Due to poxvirus Direct contact spread
39
How might a patient with molluscum contagiosum present
Rash Small, flush-coloured papules Have central dimpling Appear in crops
40
What is the management for molluscum contagiosum
Spontaneously resolves (can take 18 months for papules to disappear) Antibiotics if have bacterial superinfection Surgical removal of papules
41
How might a patient with pityriasis rosea present
Characteristic herald patch rash Faint red, scaly, oval lesions Usually on torso Follow lines of ribs General flu-like symptoms
42
What is the management for pityriasis rosea
Usually resolves in 3 months Not contagious (can carry on with normal activity)
43
What is seborrhoeic dermatitis
Inflammatory skin condition affecting sebaceous glands Can cause cradle cap Due to malassezia yeast
44
What is infantile seborrhoeic dermatitis
Cradle cap Crusty, flaking skin Usually resolves by 4 months Management: baby oil, white petroleum jelly, anti-fungal creams
45
What is seborrhoeic dermatitis of the scalp
Get dandruff Management: ketoconazole shampoo, topical steroids
46
What is ringworm
Fungal infection of skin Aka tinea
47
How might a patient with ringworm present
Itchy, erythematous, scally, demarcated rash Ring shaped area, spreads outwards
48
What is the management for ringworm
Antifungal creams/shampoos Oral antifungals Advice: wear loose clothing, keep area clean and dry, avoid sharing towels, avoid scratching and spreading to other areas
49
What is nappy rash
Contact dermatitis in nappy area Due to: friction between skin and nappy, contact with urine and faeces Most common at 9-12 months
50
What are the risk factors for nappy rash
Delayed nappy changing Irritant soaps Vigorous cleaning Certain types of nappies (poorly absorb) Diarrhoea Oral antibiotics Pre-term babies
51
What is the management for nappy rash
Switch to highly absorbent nappies Change nappies asap Water or gentle products for cleaning Make sure area dry before putting nappy on Maximise time not wearing a nappy
52
What are the complications of nappy rash
Candida infection Cellulitis Erosion or ulceration of skin
53
What are scabies
Mites that burrow under skin Cause skin infection and intense itching Up to 8 weeks before rash appears
54
How might a patient with scabies present
Itchy, small red spots Possible track marks (usually between fingers)
55
What is the management for scabies
Permethrin cream (cover whole body, leave for 8-12 hours then wash off, repeat after 1 week)
56
What is the management for headlice
Dimeticone 4% lotion: leave on for 8 hours, wash off, repeat in 1 week Fine comb (systemically comb lice out)
57
What are the differentials for a non-blanching rash
Meningococcal septicaemia Henoch-Schonlein purpura Idiopathic thrombocytopenic purpura Acute leukaemia Haemolytic uraemic syndrome Viral illness
58
What are the investigations for non-blanching rashes
Bloods Blood cultures Lumbar puncture Blood pressure Urine dip
59
What is erythema nodosum
Red lumps on shins Due to inflammation of subcutaneous fat A hypersensitivity reaction Causes: streptococcal throat infection, gastroenteritis, mycoplasma pneumonia, TB, pregnancy, medications (COCP, NSAIDs), inflammatory bowel disease, sarcoidosis, lymphoma, leukaemia
60
What are the investigations for erythema nodosum
Bloods Throat swab Chest X-ray Stool microscopy and culture Faecal calprotectin
61
What is the management for erythema nodosum
Rest and fluids Consider steroids Most resolve in 6 weeks
62
What is impetigo
Superficial bacterial skin infection Usually due to staph aureus Get a 'golden crust' appearance Contagious (keep off school) Non-bullous: around nose and mouth, treat with topical fusidic acid, antiseptic cream, oral flucloxacillin Bullous: in < 2s, fever and generally unwell, treat with flucloxacillin
63
What are the complications of impetigo
Cellulitis Sepsis Scarring Post-streptococcal glomerulonephritis Staph scalded skin syndrome Scarlet fever
64
What is staphylococcal scalded skin syndrome
Staph aureus that produces epidermolytic toxins (protease enzymes) Usually in < 5s
65
How might a patient with staphylococcal scalded skin syndrome present
Generalised patches of erythema on skin Skin becomes thin and wrinkled Formation of bullae (burst and leave sores, erythematous skin below) Nikolsky sign: gently rubbing skin causes it to peel away
66
What is the management for staphylococcal scalded skin syndrome
IV antibiotics
67
What is Steven-Johnson syndrome
Disproportionate immune response causes epidermal necrosis Blistering and shedding of top layer of skin
68
What are the causes of Steven-Johnson syndrome
Medications: anti-epileptics, antibiotics, allopurinol, NSAIDs Infections: herpes, mycoplasma pneumoniae, cytomegalovirus, HIV
69
How might a patient with Steven-Johnson syndrome present
Fever, cough, sore throat, sore mouth, sore eyes, itchy skin Purple/red rash spreading across skin Skin starts to blister Skin breaks away and leaves raw tissue underneath
70
What is the management for Steven-Johnson syndrome
Supportive care Steroids Immunoglobulins Immunosuppressants
71
What are the complications of Steven-Johnson syndrome
Secondary infection Permanent skin damage Visual compromise

Paeds (17 decks)

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