Dermatology Flashcards
What is the first line treatment for psoriasis?
- Emollients
- Potent topical corticosteroid + vitamin D analogue (calcipotriol)-> both OD
What treatments can be used in psoriasis?
- Psoriasis
- Topical corticosteroids
- Topical vitamin D analogues-> calcipotriol
- Coal tar preparations
- Phototherapy
- Oral immunosuppressants
How does guttate psoriasis present?
- Often after an URTI (strep infection)
- Acute onset
- Tear drop shaped scaly rash on back + chest-> itchy but not painful
How does erythema multiforme present?
- Triggered by infections
- Target shape rash
- Back of hands or feet then spread to torso
How does pityriasis rosea present?
- Herald patch-> single ovoidal lesion initially
- Few weeks later-> multiple, erythematous, raised, oval
What causes seborrhoeic dermatitis?
Malassezia furfur-> normal skin inhabitant proliferates + causes inflammatory reaction
How does seborrhoeic dermatitis present?
Eczematous lesions-> scalp, periorbital, auricular, nasolabial
What is the most common type of melanoma?
Superficial spreading
How does superficial spreading melanoma present?
- Growing mole with irregular ABCDE features
- Arms, legs, back, chest
- Young people
How does nodular melanoma present?
- Red/black lump
- Might bleed or ooze
- Sun exposed skin
- Middle aged people
How does lentigo maligna melanoma present?
- Growing mole with irregular ABCDE features
- Chronically sun exposed skin
- Older people
How does acral lentiginous melanoma present?
- Nails, palms or soles
- Subungual pigmentation (Hutchinson’s sign)
- African and Asian people/descent
How is erythema nodosum managed?
- No active treatment
- Arrange routine follow up
What malignancy is often associated with acanthosis migricans?
Gastrointestinal adenocarcinoma
What are the features of lichen planus?
- Itchy papular rash
- Usually on palms, soles, genitalia + flexor surfaces of arms
- Polygonal
- Wickham’s striae-> white lines on surface
- Oral involvement-> white lace on buccal mucosa
- Nails-> thinning of plate, longitudinal ridging
How is lichen planus managed?
- Potent topical steroids
- Oral-> benzydamine mouthwash or spray
- Severe-> oral steroids/immunosuppression
What is pyoderma gangrenosum associated with?
- Idiopathic
- IBD
- RA
- SLE
- Haem disorders-> lymphoma, leukaemias etc
How does pyoderma gangrenosum present?
- Lower limb
- Minor injury-> small pustule/blister-> large ulcer
- Ulcer-> purple, violaceous, deep, necrotis
- Fever + myalgia
How is pyoderma gangrenosum managed?
- Oral steroids
- Ciclosporin + infliximab
- Surgery-> after progression controlled on immunosuppression
How does erythema nodosum present?
- Inflammation of SC fat
- Tender, erythematous, nodular lesions
- Over shins, forearms or thighs
- Resolves in 6 weeks ish
- Heals without scarring
What can cause erythema nodosum?
- Streptococci
- TB
- Sarcoidosis
- IBD
- Behcet’s
- Malignancy
- Lymphoma
- Penicillins
- COCP
- Pregnancy
