Dermatology Flashcards
Exacerbating factors in psoriasis?
Stress, alcohol, smoking, b-blockers
How would you describe the appearance of a psoriatic plaque?
well demarcated scaly patches on extensor surfaces
Where should you look specifically for psoriasis? (4)
Extensors Behind ears Scalp Umbilicus Sites of trauma (Koebner phenomenon)
What are the forms of psoriatic arthritis? (5)
DIPJ involvement (like OA) Large joint mono/oligoarthritis Seronegative arthritis (similar to RA) Sacroilitis (like Ank spOnd) Arthritis mutilans
Life threatening complication of psoriasis?
Erythroderma
Treatment options for psoriasis?
Emollient
Calcipotriol
Coal tar
Phototherapy
Cytotoxics i.e. methotrexate and cyclosporin
Anti-TNF (adilimumab)
How would you describe an eczema rash?
Erythematous and lichenified patches of skin on predominantly flexor aspects. Commonly very itchy.
What investigations would you consider in eczema?
Patch testing for allergies
Treatment options for eczema?
Topical emollients Topical steroids Tacrolimus (topical) Antihistamines for pruritis Systemic therapy with steroids
How would you easily distinguish between arterial and venous leg ulcers?
Arterial are painful, typically extremities and pressure points with signs of PVD.
Venous usually gaiter area of the leg. May be stigmata of chronic venous changes- lipodermatosclerosis, varicose eczema, varicose veins.
What investigations might you consider in a patient with an ulcer?
USS doppler and calculate ABPI.
How would you manage venous vs arterial ulcer?
Venous- compression bandaging and regular input from specialist nurses.
Arterial- revascularisation/amputation/angioplasty.
How would you describe the rash of necrobiosis lipoidica diabeticorum?
Well demarcated plaques with waxy yellow centre and red-brown edges. (90% female)
Where would you look for skin complications of diabetes?
Shins
Feet
Abdomen or thigh (lipoatrophy)
Chest for vitiligo
How would you treat necrobiosis lipodica diabeticorum?
Topical steroid and support bandages (not affected by glycaemia control)
Give 4 causes of erythema nodosum?
Sarcoidosis COCP IBD TB Streptococcal throat infection Pregnancy
Definition of psoriasis?
Epidermal hyper proliferation and accumulation of inflammatory cells.
What is lupus pernio?
Diffuse bluish/brown plaque with central small papules commonly affecting the nose. Associated with sarcoidosis.
Typical triad of HSP?
Purpuric rash of buttocks, thigh and legs
Arthritis
Abdo pain
What precipitates HSP?
Antibiotics
Streptococcal infection
HSV
Parvovirus
Treatment of HSP?
Usually recover without treatment but can use steroids for recovery and painful arthralgia.
Complications of HSP?
IgA nephropathy and HTN
What would you ask in suspected skin cancer? (5)
Rate of growth Recent changes or bleeding Sun exposed area Previous occupation Immunosuppression (previous transplant)
Describe appearance of BCC? b
Usually in sun exposed areas, pearly nodule with rolled edge and superficial telangiectasia.
Rarely metastasises.
