Dermatology Flashcards
What is acne rosacea
Flushing of the forehead, nose, cheeks and chin
Onset of Acne Rosacea
30 to 60
What gender is more affected in acne rosacea
Female
In what skin type is acne rosacea more common in
Pale
Three characteristics of the rash seen in Acne Rosacea
Papules and Pustules
Central face affected
Telangiectasia
What is Telangiectasia
Dilated, superficial and small blood vessels
What can exacerbate Acne Rosacea
Sun exposure
Hot Weather
Warm Baths
Stress
Spicy Foods
General protective measures for acne rosacea
Sunscreen (factor 30 or higher)
What antibiotic is commonly given for Acne Rosacea
Metronidazole (topical)
or Topical Azelaic Acid
What therapy is given for acne rosacea
Laser Therapy
What is the complication of acne rosacea
Skin thickening (Rhinophyma)
Blepharitis, Conjunctivitis or Keratitis
Black heads vs white heads
Blackheads are open comedones vs closed seen in white heads
Papule vs a pustule
Papule is solid and raised < 0.5 cm in diameter
Pustule is puss filled and raised < 0.5cm in diameter
When should someone with acne be referred to dermatology
Acne has not resolved after two completed courses of treatment
Acne has scarring
Severe psychological distress
Pigment changes
First Line management of acne
Topical retinoid with or without Benzoly peroxide or topical antibiotic OR Azelaic acid
Second line management for Acne Vulagaris
Oral antibiotic OR Spironolactone
Third line management of acne
Oral retinoid
When should people with acne on treatment be reviewed
12 weeks after starting
How old do people need to be in order for isotertinoin (oral) to be considered
Over 12 years
If someone on oral isotretinoin has an acute flare, what should be prescribed
Oral Prednisolone
What therapy is useful in treating acne scars
Photodynamic therapy
If acne responds adequately to a course of treatment, what should be don next
Repeat 12 week treatment
What maintenance treatment is recommended following Oral Isotretinoin treatment
Adapalene and Benzoyl Peroxide
When should a person with acne scarring be referred to dermatology
After 1 year
How is infantile acne treated
Topical antiseptics and antibiotics
When are tetracyclines (Doxycyclines and Lymecyclines) contraindicated
Pregnancy or Breastfeeding
Side Effects of oral isotretinoin
Headaches
Dry mucous membranes
Hair loss
What is Acitinic Keratosis
Literally means THICKENED SCALY GROWTH caused by sunlight (actinic)
Describe the appearance of actinic keratosis
Sandpaper like rash when exposed to UV light
What can Actinic Keratoses progress to
Most common lesions to progress to Invasive squamous cell carcinoma
Risk Factors for actinic Keratosis
Fair skinned people in areas with long term sun exposure
Name a virus that can c cause Actinic Keratosis
HPVs
Histological presentation of AKs (to differentiate from SCC)
Atypical keratinocytes in basal layer that can spread all the way to the cornfield layers of the skin
IN what gender is Actinic Keratosis commonly seen in
Men
In what country is Actinic Keratosis more prevalent in
Australia
When should skin lesions be referred for two week cancer pathways
- Recent growth/inflammation
- Nodular lesion
- Bleeding
- Lesions on the lip
When should skin lesions be referred routinely
- Diagnostic uncertainty
- Immunosupressed people
- Young patients with AK
What topical agent is typically given to treat AK
5-Fluorouracil or Imiquimod
What is Alopecia Areata
Well defined patches loss from autoimmune disease (resolves on own)
What is Telogen effluvium
Diffuse hair loss after stress
What is Androgenic alopecia
Male pattern balding
What is Scarring Alopecia
Hair follicles are destroyed and skin becomes scarred
Name two types of scarring alopecia
Folliculitis Decalvans
Lichen Planopilaris
What causes Folliculitis Declvans
Staph Aureas infection - must be treated with antibiotics
What is Lichen Planopilaris
Lichen Plans that causes hair loss
Five symptoms of Atopic Dermatitis
Flexures affected
Dry Skin
History of asthma or rhinitis
<2 years old
OR Cheeks/extensors in children < 18 months
What is Erythroderma
EMEGRENCY, in people with dermatitis. Causes widespread erythema of 90% of the skin.
Name three effects of topical corticosteroid use
Skin Thinning
Striae
Telangiectasia
How often does a basal Cell Carcinoma metastasise
Rarely
Do BCCs cause pain or bleeding?
No
Describe the rate of growth of a BCC
Slow growing
What is the appearance of BCCs
Small, skin coloured or pink nodules with central depression and telangiectasia
What is a rodent ulcer
In BCCs, older lesions become necrotic in the middle
What causes BCCs
UV light, so typically seen in head and neck
What is the most common subtype of BCCs
NOdular
What skin types are predisposed to BCCs
Type I or II skin
What surgical intervention is used for BCC management
4mm margin excision
Curretage and Cautery
Photodynamic Therapy
Cryotherapy
5-Fluorouracil
What antibiotic is given for Cellulitis
Flucloxacillin or Clairirthymycin
What can relieve swelling seen in cellulitis
Elevating the leg
What is distinctive about the spread of cellulitis
Has poorly demarcated margins
What species causes cellulitis
Streptococcus or Staph
Name four distinct features of TS
- Angiofibromas
- Ungal fibromas
- Shagreen patches (sacrum)
- Ashleaf macules
What condition is associated with TS
Epilepsy, LF and Autism
Signs of Prophyria Cutanea Tarda
Photosensitivity in the dorsum of the hands
Causes blister and bullae formation
How is Porphyria cutanea tarda diagnosed
Skin Biopsy or Urinary porphyrin excretion
What antibodies are seen in CREST syndrome (systemic Sclerosis)
Anti-topoisomerase 1 (Scl-70) + RNA polymerase
What is the most common skin condition seen in Lupus
Discoid, erythematous plaques (not the butterfly rash)
What causes a dermatofibroma
Truma
Describe the appearance of a dermatofibroma
Benign nodule from fibroblasts
Name two autoimmune conditions that increase the occurance of a dermatofibroma
HIV
SLE
Name four skin features of dermatomyositis
- Heliotrope rash (purple eyelids)
- Gottron’s papules (red ppaules on the back of the finger joints)
- Shawl rash (erythema on the back of the shoulders and upper back)
- Nailfold erythema
What is the diagnostic inv estigation for dermatomyositis
Muscle Biopsy
Name two autoantibodies seen in dermatomyositis
Anti-MI2 and Anti-Jo
Management of Dermatomyositis
Oral Corticosteroids
What is a morbiliform eruption
Generalised maculopapular rash (type 4)
Name four drug types that cause Morbiliform Eruptions
Amoxicillin (after EBV)
Beta-lactams
Sulfonamides
Allopurinol
What are fixed drug eruptions
Circular, erythematous patches that come up at the same location each time
Name three drugs that can cause a fixed drug eruption
Paracetamol
Sulfonamides
Tetracyclines
What drug is commonly used to treat Leprosy
Dapsone + Rifampicin + Clofazimine
What drug is given to treat Dermatitis Herpetiformis
Dapsone
What species causes leprosy
Myocobacterium Leprae
What are the causes of erythema nodosum
NODOSUM:
NO cause
Drugs: Sulfonamides, Dapsone
OCP
Sarcoidosis
UC/Crohn’s
Micro: TB, Strep, Toxoplasmosis
What is Erythroderma
Widespread erythema affectinfg 90% of the skin surface
What can cause erythema nodosum
Dermatitis
Psoriasis
Pityriasis rubra pilaris
Drug allergies,
Sezary Syndrome
Why is Erythroderma a medical emergency
Heat and fluid loss
Management of Erythroderma
Conservative management
What species commonly causes folliculitis
Staph Aureus