Dermatology Flashcards
what is the A-E approach used in dermatology?
A- asymmetrical? B- Borders C- colour D-diameter E- evolving
if a melanoma is suspected what investgiation needs to occur?
2 week wait referral to be biopsied
when would a melanoma be suspected?
irregular looking naevus indistinct borders mild asymmetry irregularity of colour inflammation oozing/crusting change in sensation
what are some risk factors of melanoma?
- FHx of melanoma
- Personal Hx of melanma
- immunosupression
- XS UV light exposure
what is the managment of a melanoma in primary care ?
- biopsy on 2 wk wait referral
- give advice on UV protection
- come back if other moles look simialr/irregular
what is the managemnt of a benign pigmented lesion?
if high degree of confidnece, reaasure patient
provide them with info regarding changes that suggest malignant transformation
what are the features of contact dermatitis?
erythema and vesiculation
- dryness, scaling and bullae
can be itchy in allergic contact dermatitis
how is contact dermititis managed?
- avoid trigger
- no aqueous creams
- topical corticosteroid prescribed
what are teh clinical features of acne vulgaris
- comedones (white or black)
- papules and pustules (superficial raised lesions less than 5mm in diameter)
- nodules or cysts (larger than 5mm in diameter)
- scarring
- pigmentations
- seborrhoea
what is the management of acne vulagris?
- discuss reasons for acne
- OTC treatment options
- topical retinoids and oral tetracyclines
how does psoriasis present?
- widespread monomorphic erythematous plaque
- covered by silvery white scale
0 usually found on scalp, behind ears, trunk, buttocks, periumbilical, extensor surfaces - clear delineation between normal and affected skin
what is the management of psoriasis?
- stop smoking, xs alcohol
- weight loss
- reduce stress
- emollients
- corticosteroids topical
- vitamin D
- possible salycylic acid
- follow up within 4 wks
what is the presentation of a patient with a fungal infection?
single or multiple red or pink, flat or slightly raised annular patches of varying sizes which enlarge outwards
active red, scaly advancing edge and clear central area, larger lesions and coalescence of lesions
rare but could have pustules
most commonyl affects: inguinal folds, proximal medial thighs, perinanl skin, buttock, above waistline, below breasts
what is the manageent of a skin fungal infection?
- wash sheets, loose fitting clothes, good hygeine
- topical antifungal cream (clotrimazole, miconazole, or econazole cream)
- consider topical corticosteroid (hydrocortisone 1%) for 7 days
- if v severe, consider oral antifungals (oral terbinafine)
what is the presentation of a basal cell carcinoma?
- irregular borders, asymmetrical
- dome shaped papule
- prominent telangiectatic surface vessels
- appears on areas exposed to UV
- lesions enlarge with time
what is the referral recommendation for basal cell carcinomas?
- only do 2 wk wait referral if particular concern that a delay may have a significant impact
- basal cell carcinomas are most common type of skin cancer and least deadly
what is the management for a basal cell carcinoma and squmous cell carcinoma?
referral to dermatologist biopsy taken 1. excision surgery 2. cyrotherapy 3. radiotherapy 4. photodynamic therapy 5. Mohs micrographic surgery
what is the referral recommendation for a squamous cell carcinoma?
consider a 2 week wait referral
what is teh presenation of a squamous cell carcinoma?
- firm, smooth or hyperkeratotic papule or plaque, oftne with central ulceration
what is the presenation of eczema?
generalized dryness and itching localised to flexure of limbs
thickened (lichenified) skin resulting from repeated scratching.
poorly demarcated redness to fluid in the skin (vesicles), scaling, or crusting of the skin - in acute ezcema flare
what is the management of eczema?
mild: emollients + mild topical corticosteroid (1% hydrocortisone)
moderate: refer, emollients + potent topical corticosteroid (betamethasone valerate 0.025%), consider antihistamines for 1 month
severE: refer, emollients + potent topical corticosteroid (betamethasone valerate 0.1%, 0.025% for sensitive areas), antihistamines for 1 month
what is the presenation of a patient with urticaria?
3 features:
- A central swelling of variable size (red or white in colour), surrounded by redness (flare).
- itching or burning.
- fleeting, with the skin returning to its normal appearance, usually within 1–24 hours.
> 6 wks = chronic urticaria
managment of a patient iwht urticaria?
manage causes/trigger factors (if mild)
non sedating antihistmaine for 6 wks (if moderate)
topical antipruritic treatment (calamine lotion) to relieve itch
oral corticosteroid -prednisolone 40 mg daily, 7 days (if severe)
what is the presenation of a patient with cellulitis?
acute onset of red, painful, hot, swollen, and tender skin, that spreads rapidly - usually lower limb
Fever, malaise, nausea, shivering, and rigors
diffuse redness or a well-demarcated edge
Blisters and bullae may be seen
