Dermatology Flashcards

1
Q

Classic presentation of dermatitis herpetiformis

A

itchy papules and vesicles on extensor surfaces

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2
Q

diagnosis of dermatitis herpetiformis

A

immunoflorescence shows IgA deposits in the upper dermis

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3
Q

Management of dermatitis herpetiformis

A

gluten free diet

dapsone

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4
Q

acne rosacea treatment

A

mild/moderate - topical metronidazole

severe/resistant - oral tetracycline

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5
Q

features of acne rosacea:

where it affects, type of lesions

A

cheek face and forehead
initially flushing , telangectesia are common,
later develops into persistent erythema with papules and pustules
can lead to rhinophyma, and my have blepharitis

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6
Q

causes of erythema multiforme

A
  • viruses: HSV (in 50% of cases), Orf (parapox virus)
  • idiopathic
  • bacteria: Mycoplasma, Streptococcus
  • drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, OCP, nevirapine
  • connective tissue disease e.g. SLE
  • sarcoidosis
  • malignancy
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7
Q

features of erythema multiforme

A

target lesions
usually start on backs of hands/feet then spread to torso
more commonly upper limbs than lower limbs
mild pruritis

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8
Q

Definition of onycholysis

A

separation of the nail plate from the nail bed

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9
Q

Causes of onycholysis

A
trauma
infection esp fungal
skin disease eg psoriasis, dermatitis
impaired circulation eg Raynauds
hypo/hyper-thyroidism
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10
Q

define keyloid scar

A

tumour-like growth originating from connective tissue of a scar and extend beyond the border of the original wound

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11
Q

Risk factors for a keyloid scar

A

young
afrocarribean
common sites (most common first): sternum, shoulder, neck, face, extensor surfaces, trunk

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12
Q

Vitiligo:

  • aeteology
  • age of onset
  • features
A

autoimmune loss of melanocytes –> hypopigmentation
1% of population, starts in 20-30s
well demarcated patches of depigmented skin, usually peripheries, trauma may precipitate new lesions (Koebner phenomenon)

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13
Q

Vitiligo associated conditions

A
T1DM
Addisons disease,
Autoimmune thyroid disorders,
Pernicious anaemia,
Alopecia areata
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14
Q

Management of vitiligo

A

sun block

topical steriods if applied early

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15
Q

Main complication of PUVA therapy for psoriasis

A

SCC

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16
Q

features of pyoderma gangrenosum

A

small papule ->deep red necrotic ulcer with violaceous border (gun metal grey)
typically on lower legs
may have systemic upset (fever, myalgia)

17
Q

causes of pyoderma gangrenosum

A
idiopathic
IBD 
RA, SLE
myeloproliferative disorders
lymphoma, myeloid leukaemias
monoclonal gammopathy (IgA)
primary biliary cirrhosis (DR3)
18
Q

Mx of pyoderma gangrenosum

A

oral steroids +/- other immunosuppressants (eg infliximab)

19
Q

Acanthosis nigricans disease associations

A
endo: diabetes mellitus, Cushing's disease, hypothyroid, acromegaly
UC
gastric cancers
PCOS
obesity
Prader-Willi syn
drugs: OCP, nicotinic acid
20
Q

features and pathology of lichen sclerosus

A

inflammation of epidermis of genitals leads to atrophy and formation of itchy white plaques.
More common in elderly females

21
Q

Mx of lichen sclerosus

A

biopsy to exclude other conditions (increased risk of vulval cancer)
topical steroids and emollients

22
Q

features of lichen planus

A

purple papules that are pruritic
white cracks over the top (Wickham’s striae)
oral involvement common.

23
Q

features of toxic epidermal necrolysis?

commonly due to

A

scalded appearance with friable epidermis
systemic upset - pyrexia, tachycardia
most commonly due to a drug reaction (penicillin, phenytoin, allopurinol, carbamazepine)

24
Q

common drug precipitants of TEN?

A

phenytoin,
allopurinol
penicillins
carbamazepine

25
causes of scarring alopecia
trauma, burns, radiotherapy lichen planus discoid lupus tinea capitis (if a kerion develops)
26
causes of non-scarring alopecia
male pattern baldness drugs: cytotoxic, carbimazole, heparin, OCP, colchicine nutritional:iron and zinc def autoimmune: alopecia areata telogen effluvium (hair loss following stressful time) trichotillomania (pulling hair out)
27
classical features of pretibial myxoedema
symmetrical erythematous shin lesions with shiny orange peel skin seen in Graves disease
28
classical features of Necrobiosis lipoidica diabeticorum
shiny, painless areas of yellow/red skin typically on the shin of diabetics often associated with telangiectasia
29
Exacerbating factors for psoriasis
withdrawal of steroids trauma alcohol beta blockers, lithium, NSAIDS, ACEi, antimalarials
30
Features of bullous pemphigoid
Itchy tense blisters, typically around flexures Blisters heal without scarring Rarely involves mucous membranes (NB differentiating feature with pemphigus)
31
Ix and Mx of bullous pemphigoid
Skin biopsy - IgG and C3 deposits at dermoepidermal junction | Oral corticosteroids
32
What are myxoid cysts and where are they usually found? | Associations?
Benign ganglion cysts on the dorsum of a distal phalanx Usually have OA in surrounding joint In middle aged females
33
Complications of psoriasis
``` Psoriatic arthritis Superimposed bacterial infection Metabolic syndrome Cardiovascular disease VTE ```
34
Pathology of bullous pemphigoid
Autoantibodies against hemidesmosomal proteins BP180 and BP230
35
Features of drug hypersensitivity syndrome | Mx
3-6 weeks after starting anticonvulsants or antimicrobials fever, facial oedema, papulopustular rash, lymphadenopathy or hepatitis associated eosinophilia Rx with oral steroids
36
Association of necrolytic migratory erythema
glucagonoma