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Year 4 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is acne rosacea

A

Flushing of the forehead, nose, cheeks and chin

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2
Q

Onset of Acne Rosacea

A

30 to 60

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3
Q

What gender is more affected in acne rosacea

A

Female

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4
Q

In what skin type is acne rosacea more common in

A

Pale

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5
Q

Three characteristics of the rash seen in Acne Rosacea

A

Papules and Pustules
Central face affected
Telangiectasia

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6
Q

What is Telangiectasia

A

Dilated, superficial and small blood vessels

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7
Q

What can exacerbate Acne Rosacea

A

Sun exposure
Hot Weather
Warm Baths
Stress
Spicy Foods

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8
Q

General protective measures for acne rosacea

A

Sunscreen (factor 30 or higher)

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9
Q

What antibiotic is commonly given for Acne Rosacea

A

Metronidazole (topical)

or Topical Azelaic Acid

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10
Q

What therapy is given for acne rosacea

A

Laser Therapy

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11
Q

What is the complication of acne rosacea

A

Skin thickening (Rhinophyma)

Blepharitis, Conjunctivitis or Keratitis

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12
Q

Black heads vs white heads

A

Blackheads are open comedones vs closed seen in white heads

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13
Q

Papule vs a pustule

A

Papule is solid and raised < 0.5 cm in diameter

Pustule is puss filled and raised < 0.5cm in diameter

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14
Q

When should someone with acne be referred to dermatology

A

Acne has not resolved after two completed courses of treatment

Acne has scarring

Severe psychological distress

Pigment changes

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15
Q

First Line management of acne

A

Topical retinoid with or without Benzoly peroxide or topical antibiotic OR Azelaic acid

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16
Q

Second line management for Acne Vulagaris

A

Oral antibiotic OR Spironolactone

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17
Q

Third line management of acne

A

Oral retinoid

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18
Q

When should people with acne on treatment be reviewed

A

12 weeks after starting

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19
Q

How old do people need to be in order for isotertinoin (oral) to be considered

A

Over 12 years

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20
Q

If someone on oral isotretinoin has an acute flare, what should be prescribed

A

Oral Prednisolone

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21
Q

What therapy is useful in treating acne scars

A

Photodynamic therapy

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22
Q

If acne responds adequately to a course of treatment, what should be don next

A

Repeat 12 week treatment

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23
Q

What maintenance treatment is recommended following Oral Isotretinoin treatment

A

Adapalene and Benzoyl Peroxide

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24
Q

When should a person with acne scarring be referred to dermatology

A

After 1 year

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25
Q

How is infantile acne treated

A

Topical antiseptics and antibiotics

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26
Q

When are tetracyclines (Doxycyclines and Lymecyclines) contraindicated

A

Pregnancy or Breastfeeding

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27
Q

Side Effects of oral isotretinoin

A

Headaches
Dry mucous membranes
Hair loss

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28
Q

What is Acitinic Keratosis

A

Literally means THICKENED SCALY GROWTH caused by sunlight (actinic)

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29
Q

Describe the appearance of actinic keratosis

A

Sandpaper like rash when exposed to UV light

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30
Q

What can Actinic Keratoses progress to

A

Most common lesions to progress to Invasive squamous cell carcinoma

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31
Q

Risk Factors for actinic Keratosis

A

Fair skinned people in areas with long term sun exposure

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32
Q

Name a virus that can c cause Actinic Keratosis

A

HPVs

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33
Q

Histological presentation of AKs (to differentiate from SCC)

A

Atypical keratinocytes in basal layer that can spread all the way to the cornfield layers of the skin

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34
Q

IN what gender is Actinic Keratosis commonly seen in

A

Men

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35
Q

In what country is Actinic Keratosis more prevalent in

A

Australia

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36
Q

When should skin lesions be referred for two week cancer pathways

A
  1. Recent growth/inflammation
  2. Nodular lesion
  3. Bleeding
  4. Lesions on the lip
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37
Q

When should skin lesions be referred routinely

A
  1. Diagnostic uncertainty
  2. Immunosupressed people
  3. Young patients with AK
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38
Q

What topical agent is typically given to treat AK

A

5-Fluorouracil or Imiquimod

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39
Q

What is Alopecia Areata

A

Well defined patches loss from autoimmune disease (resolves on own)

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40
Q

What is Telogen effluvium

A

Diffuse hair loss after stress

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41
Q

What is Androgenic alopecia

A

Male pattern balding

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42
Q

What is Scarring Alopecia

A

Hair follicles are destroyed and skin becomes scarred

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43
Q

Name two types of scarring alopecia

A

Folliculitis Decalvans

Lichen Planopilaris

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44
Q

What causes Folliculitis Declvans

A

Staph Aureas infection - must be treated with antibiotics

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45
Q

What is Lichen Planopilaris

A

Lichen Plans that causes hair loss

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46
Q

Five symptoms of Atopic Dermatitis

A

Flexures affected
Dry Skin
History of asthma or rhinitis
<2 years old

OR Cheeks/extensors in children < 18 months

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47
Q

What is Erythroderma

A

EMEGRENCY, in people with dermatitis. Causes widespread erythema of 90% of the skin.

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48
Q

Name three effects of topical corticosteroid use

A

Skin Thinning
Striae
Telangiectasia

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49
Q

How often does a basal Cell Carcinoma metastasise

A

Rarely

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50
Q

Do BCCs cause pain or bleeding?

A

No

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51
Q

Describe the rate of growth of a BCC

A

Slow growing

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52
Q

What is the appearance of BCCs

A

Small, skin coloured or pink nodules with central depression and telangiectasia

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53
Q

What is a rodent ulcer

A

In BCCs, older lesions become necrotic in the middle

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54
Q

What causes BCCs

A

UV light, so typically seen in head and neck

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55
Q

What is the most common subtype of BCCs

A

NOdular

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56
Q

What skin types are predisposed to BCCs

A

Type I or II skin

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57
Q

What surgical intervention is used for BCC management

A

4mm margin excision

Curretage and Cautery

Photodynamic Therapy

Cryotherapy

5-Fluorouracil

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58
Q

What antibiotic is given for Cellulitis

A

Flucloxacillin or Clairirthymycin

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59
Q

What can relieve swelling seen in cellulitis

A

Elevating the leg

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60
Q

What is distinctive about the spread of cellulitis

A

Has poorly demarcated margins

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61
Q

What species causes cellulitis

A

Streptococcus or Staph

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62
Q

Name four distinct features of TS

A
  1. Angiofibromas
  2. Ungal fibromas
  3. Shagreen patches (sacrum)
  4. Ashleaf macules
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63
Q

What condition is associated with TS

A

Epilepsy, LF and Autism

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64
Q

Signs of Prophyria Cutanea Tarda

A

Photosensitivity in the dorsum of the hands

Causes blister and bullae formation

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65
Q

How is Porphyria cutanea tarda diagnosed

A

Skin Biopsy or Urinary porphyrin excretion

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66
Q

What antibodies are seen in CREST syndrome (systemic Sclerosis)

A

Anti-topoisomerase 1 (Scl-70) + RNA polymerase

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67
Q

What is the most common skin condition seen in Lupus

A

Discoid, erythematous plaques (not the butterfly rash)

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68
Q

What causes a dermatofibroma

A

Truma

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69
Q

Describe the appearance of a dermatofibroma

A

Benign nodule from fibroblasts

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70
Q

Name two autoimmune conditions that increase the occurance of a dermatofibroma

A

HIV
SLE

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71
Q

Name four skin features of dermatomyositis

A
  1. Heliotrope rash (purple eyelids)
  2. Gottron’s papules (red ppaules on the back of the finger joints)
  3. Shawl rash (erythema on the back of the shoulders and upper back)
  4. Nailfold erythema
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72
Q

What is the diagnostic inv estigation for dermatomyositis

A

Muscle Biopsy

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73
Q

Name two autoantibodies seen in dermatomyositis

A

Anti-MI2 and Anti-Jo

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74
Q

Management of Dermatomyositis

A

Oral Corticosteroids

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75
Q

What is a morbiliform eruption

A

Generalised maculopapular rash (type 4)

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76
Q

Name four drug types that cause Morbiliform Eruptions

A

Amoxicillin (after EBV)
Beta-lactams
Sulfonamides
Allopurinol

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77
Q

What are fixed drug eruptions

A

Circular, erythematous patches that come up at the same location each time

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78
Q

Name three drugs that can cause a fixed drug eruption

A

Paracetamol
Sulfonamides
Tetracyclines

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79
Q

What drug is commonly used to treat Leprosy

A

Dapsone + Rifampicin + Clofazimine

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80
Q

What drug is given to treat Dermatitis Herpetiformis

A

Dapsone

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81
Q

What species causes leprosy

A

Myocobacterium Leprae

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82
Q

What are the causes of erythema nodosum

A

NODOSUM:

NO cause
Drugs: Sulfonamides, Dapsone
OCP
Sarcoidosis
UC/Crohn’s
Micro: TB, Strep, Toxoplasmosis

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83
Q

What is Erythroderma

A

Widespread erythema affectinfg 90% of the skin surface

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84
Q

What can cause erythema nodosum

A

Dermatitis
Psoriasis
Pityriasis rubra pilaris

Drug allergies,
Sezary Syndrome

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85
Q

Why is Erythroderma a medical emergency

A

Heat and fluid loss

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86
Q

Management of Erythroderma

A

Conservative management

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87
Q

What species commonly causes folliculitis

A

Staph Aureus

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88
Q

What causes eosinophilic folliculitis

A

HIV, immunosupression

89
Q

Treatment of eosinophilic folliculitis

A

HAART
Topical Corticosteroids

90
Q

What virus types cause genital warts

91
Q

What is Koebner phenomenon

A

Formation of new skin lesions at sites of skin injury

92
Q

What condition is Koebner Phenomenon seen in

93
Q

What factors may exacerbate psoriasis

A

Trauma
Alcohol
Beta blockers

94
Q

Where are keloid scars most common

95
Q

When should people with burns be referred to dermatology

A

All deep dermal and full-thickness burns
Superficial burns >3% in adults or >2% in children
Superficial burns on the face, hand, feet, perineum
Inhalation injury
Chemical or electrical burns

96
Q

What is the first line treatment of dermatophyte nail infections

A

Oral terbinafine

97
Q

What is Acanthosis Nigricans appearance

A

Brown velvet patches in the axilla, neck and groin

98
Q

What is Bowen’s disease a precursor to

A

Squamous cell carcinoma

99
Q

What sport may cause erectile dysfunction

100
Q

Name five features of erectile dysfunction

A

How confident you can keep and sustain an erection
Hard enough to penetrate your partner
How often you can keep your erection after sex
How hard is it to keep your erection to finish
How satisfactory is sex

101
Q

What are the risk factors for sexual dysfunction

A

Blood flow (hyperlipidaemia)
Nerve damage (parkinson’s, stroke)
Diabetes
Hormonal (head injuries)
Spinal injury
Medictaions
Alcohol
Cycling

102
Q

What is the firts line treatment for ED

A

Phosphodiesterase inhibitors

103
Q

What is the second line treatment for ED

A

Alprostadil (intrautheral)

104
Q

What is the triad of symptosm seen in granulomatosis with polyangitis

A

Upper Respiratory tract involvement: sinusitis, epixstasis, saddle-nose deformity

Lower resp involvement: Coughs, haemoptysis, pleuritis

Haematuria

105
Q

X-Ray findings in granulomatosis with polyangitis

A

Bilateral nodular and cavity infiltrates on Chest X Ray

106
Q

6 Features of Lichen Planus

A

6Ps:
Purple
Pruritic
Polygonal (many sides)
Planar (flat topped)
Papular

107
Q

Symptoms of oral lichen planus

A

Burning on eating

108
Q

What causes burning on eating in lichen planus

A

Mucosal ulceration

109
Q

What medications cna cause a lichenoid eruption

A

Beta blockers
Thiazides
Gold
Antimalarials
Penicillamine
ACE-i

110
Q

What is the first line treatment of Lyme Disease

A

Doxycycline

111
Q

What is the ABCDE assessment for malignant melanoma

A

Assymmetry
Border irregularity
Colour variation
Diameter > 6mm
Evolves over time

112
Q

What is a breslow thcikness scale

A

MEasures the depth of a tumour

113
Q

At what breslow thickness should a sentinel node biopsy be taken

114
Q

What is eryhtrasma

A

Scaly, pink brown rash over the groin or axillae

115
Q

What causes erythrasma

A

Cornybacterium Minutissimum

116
Q

What does wood\s light reveal about erythrasma

A

Coral-red flouorescence

117
Q

Management of Erythrasma

A

Topical miconazole + erythromycin

118
Q

What can trigger pityriasis rosea

A

Upper Respiratory Tract Infection

119
Q

What is a kerion

A

Fungal abscess

120
Q

What is calcipotriol

A

Vitamine D analogue

121
Q

What is Pompholyx Eczema

A

Intensely pruritic rash on the palms and soles

122
Q

What cuases dermatitis herpetiformis

A

Formation of IgA Antibodies

123
Q

What triggers the formatin of a pyogenic granuloma

A

Sites of trauma

124
Q

Describe the appearance of seborrhoeic keratosis

A

Well demarcated brown lesion

125
Q

What defines a malignant melanoma

A

Changes in colour

126
Q

What is the treatment of choice for facial hirsutism

A

Topical eflornithine

127
Q

What is the first line management of toxic epidermal necrolysis

A

IV ivIG

Second line: Plasmapheresis

128
Q

Name drugs that commonly cause toxic epidermal necrolysis

A

Phenytoin
Sulphonamides
Allopurinol
Penicillins
Carbamazepine
NSAIDs

129
Q

What species causes Seborrhoeic dermatitis

A

Malassezia furfur

130
Q

Where are phemphigoid gestationis lesions found

A

Peri-umbilical

131
Q

First line management of pemphigoid gestationis

A

Oral corticosteroids

132
Q

CHaracteristics of pemphigoid gestationis

A

Blistering pruritic lesions

133
Q

At what stage of preganncy are pemphigoid gestationis found

A

Second or third trimester

134
Q

First line management of hyperhidrosis (sweaty hands)

A

Aluminium Chloride

135
Q

At ehat size should a suspected lipoma be USS

136
Q

How can spider naevi be differentiated from telangiectasia

A

Pressing on them and watching them fill.

Spider Naevi: From the centre

Telangiectasia: From the edge

137
Q

How should erythema nodosum be best managed

A

Routine follow-up (just surveillance)

138
Q

What is used to manage pityriasis versicolor

A

Ketoconazole shampoo

139
Q

What drugs may trigger plaque psoriasis

A

Beta blockers
Lithium
Antimalarials
NSAIDs
ACEi

140
Q

What does a keratocanthoma look like

A

Initially smooth dome-shaped papule

141
Q

How does the appearance of a keratocanthoma change over time

A

Volcano rapidly grows to become a crater filled with keratin

142
Q

How long does it take for a keratocanthoma to resolve

A

Within 3 months

143
Q

Management of a keratocanthoma

A

Refer to dermatology to excise to exclude SCC

144
Q

What is the most effective treatment for acne rosacea

A

Laser Therapy

145
Q

Name wo conditions related to polycythaemia

A

GOUT

Peptic Ulcer Disease

146
Q

What is pompholyx Eczema

A

Vesicular palmar eczema

147
Q

What can precipitate pompholyx eczema

A

Humidity (sweating) + high temperatures.

148
Q

Where is discoid eczema commonly found

149
Q

What is stasis dermatitis

A

Varciose eczema

150
Q

Where do venous ulcers typically occur

A

Medial malleolus

151
Q

Scalded Skin Syndrome vs Toxic Epidermal Necrolysis

A

No Mucous Membrane involvement vs Mucous membrane involvement

152
Q

What is Ecthyma

A

Chronic, well-demarcated ulcers with necrotic crusts

153
Q

What people are affected by Ecthyma

154
Q

Management of Ecthyma

A

Phenoxymethylpenecillin 500mg four times daily

155
Q

Where is Erythrasma typically seen

A

Groins or armpits

156
Q

Management of Erythrasma

A

Oral Erythromycin

157
Q

What is the most common rash associated with TB

A

Erythema Nodosum

158
Q

Management of HSV infections

A

500mg twice daily oral aciclovir for 5 days

159
Q

How long are antivirals given for in shingles

160
Q

Managment of Pityriasis Versicolor

A

Topical or oral itraconazole

161
Q

What species causes seborrhoeic Eczema

A

Malassezia

162
Q

What is Asteatotic Eczema

A

Eczema during the wintertime

163
Q

Signs of psoriasis on the nails

A

Onycholysis (nail lifting)

164
Q

Steven Johnson vs Toxic Epidermal Necrolysis

A

<10% surface area vs >30%

165
Q

In what thyroid condition is finger clubbing commonly seen in

A

Graves’ disease

166
Q

What condition is porphyria cutaenea tarda associated with

A

HCV infections

167
Q

What triggers porphyria cutanea tarda

A

UV exposure

168
Q

Management of prophyria cutanea tarda

A

Venesection to reduce iron overload

169
Q

Skin manifesations in sarcoidosis

A

Hypopigmentation

170
Q

Signs of TS

A

Subungal fibromas
Poliosis
Shagreen patches
Cafe au lait spots
Ash-leaf depigmentation

171
Q

IN what people are phemigus vulgaris common in

A

Ashkanazi Jews

172
Q

What autoantibodies are involved in Phemigus Vulgaris

173
Q

What are pyogenic granuloma’s

A

Red vascular nodules following trauma

174
Q

What factor increases the number of cherry angiomas

175
Q

What does brown’s disease typically look similar to

A

Psoriasis (but in older men)

176
Q

Management of a keratocanthoma

A

Excision and biopsy as they look similar to SCC

177
Q

What is lentigo Maligna

A

Slow growing pigmentation on elderly people’s faces

178
Q

Appearance of a BCC

A

Typically an enlarging, shiny NODULE on the head and neck area

Bleeds easily on touching + telangiectasia

Raised appearance

179
Q

Management of SCC

A

5mm margin surgical excision

180
Q

What is the most aggressive type of malignant melanoma

A

Nodular malignant melanoma

181
Q

What is the ABCDE criteria

A

Assymmetry
Border irregularity
Colour variation
Diameter (>6mm)
Elevation

182
Q

What two drugs cause erythema nod-sum

A

Sulphonamides
COCP

183
Q

What is the first line management of psoriasis affecting the extensors

A

Potent topical corticosteroid PLUS Vit D preparation

184
Q

What is the maximum lengh a potent corticosteroid can be prescribed

185
Q

First line management of flexural psoriasis

A

A mild topical corticosteroid ALONE

186
Q

Management of a chronci plaque psoriasis flare after 8 weeks of potent corticosteroid

A

A topical Vit D preparation alone

187
Q

What TB drug can cause pellagra

188
Q

What causes erysipelas

A

Strep Pyogenes

189
Q

Management of refractory shingles

A

Prednisolone

190
Q

What idiopathic rash can be seen in pregnancy

A

Erythema Nodosum

191
Q

Describe a first degree burn

A

Red and painful - superficial epidermal

192
Q

Describe a second degree burn

A

Pale pink, painful and blistered - superficial derma (partial thickness)

193
Q

Whatdegree burn is a deep dermal burn

A

Also second degree

194
Q

Appearance of a deep dermal burn

A

Typically white and non-blanching

195
Q

Describe a full thickness burn

A

White/brown/black in colour

196
Q

Management of a superficial epidermal (first degree) burn

A

EMollients and analgesia

197
Q

Management of a superficial dermal burn (second degree)

A

Cleanse wound, leave blister intact

198
Q

Management of deep dermal and full-thickness burns

A

Refer to secondary

199
Q

When should superficial dermal burns be referred tos econdary care

A

When they are more than 3%

200
Q

How many doses of permethrin should be given for scabies

A

Two - one week apart

201
Q

Second line medical management of acne rosacea

A

Tetracyclines

202
Q

Where do acral lentiginous melanomas arise

A

Areas NOT exposed to the sun

203
Q

What skin condition has a stuck on brown patch appearance

A

Seborrhoeic keratoses

204
Q

When is early intubation considered in burn patients

A

When tehre are deep burns to the face or neck or signs of respiratory distress

205
Q

What joints are typically affected in psoriatic arthritis

206
Q

What skin cancer is most common among those immunocompromised

207
Q

Management of mild eczema

A

Emolient

Consider hydrocortisone 1%

208
Q

Management of Eczema Herpeticum

A

Admit to hospital urgently

209
Q

Management of Moderate Eczema

A

Emolient + Betametasone

210
Q

Management of Severe Eczema

A

Clobetasone or Oral steroid

211
Q

Management of skin infection from eczema

A

Flucloxacillin

212
Q

Most common type of melanoma

A

Superificial spreading melanoma (NOT NODULAR - ignore!!)

213
Q

In what patients are lentigo maligna melanomas found

A

Older patients

214
Q

Where are acral lentiginous melanomas found

A

NON UV EXPOSED parts of the body like the soles of the feet

215
Q

When do lab results not need to be done for Lyme Disease

A

If an Erythema migrant rash is present

Offer antibiotics straight away

216
Q

Name two tests that are done to check for Lyme Disease

A

ELISA test 4-6 weeks

THEN

Immunoblot test

217
Q

What type of microbe cause Lyme Disease

A

Spirochetes

218
Q

When should people be urgently referred for acne

A

People with acne fulminant or congoblata

Diagnostic uncertainty

Year 4 (16 decks)

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