Dermatology Flashcards

1
Q

What are features of rosacea?

A

Photosensitive rash on cheeks/nose
Papules/pustules
Telangiectasia
Rhinophymia

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2
Q

What is mild rosacea and how is it managed?

A

Erythema/flushing only - no pustules or papules

Mangement - topical brimonidine and lifestyle changes

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3
Q

What is moderate rosacea and how is it managed?

A

Mild papules and pustules
Topical metronidazole
Topical azelaic acid

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4
Q

What is severe rosacea and how is it managed?

A

Extensive papule and pustules

Oral abx e.g. oral oxytetracycline

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5
Q

How are telangiectasia in rosacea managed?

A

laser therapy

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6
Q

What are medications which exacerbate psoriasis?

A
BLANQET
Beta blockers
Lithium
Anti-malarials
NSAIDs
Quinolones
E
T
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7
Q

How is eczema herpeticum treated?

A

Needs admission for IV Aciclovir

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8
Q

Which infections are associated with erythema multiforme?

A

HSV

Mycoplasma pneumoniae

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9
Q

Which rash presents with a herald patch and then a fir tree rash?

A

Pityriasis rosea

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10
Q

Which rash presents with a tear drop rash?

A

Guttate psoriasis

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11
Q

How is actinic keratosis treated?

A

5-fluorouracil cream
topical imiquimod

sun avoidance/suncream

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12
Q

What margins are needed for excisional biopsy for SCC?

A

Less than 20mm = 4mm margins

More than 20mm = 6mm margins

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13
Q

Major criteria for melanoma?

A

Change in size
Change in shape
Change in colour

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14
Q

Minor criteria for melanoma?

A

Diameter > 7mm
Inflammation
Oozing/bleeding
Altered sensation

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15
Q

What is lichen planus (what signs do you see) and how is it managed?

A

Skin disorder
Purple, pruritic, papular, polygonal
Koebner phenomenon - new lesions at site of trauma
Wickham’s striae - white line pattern

Management = topical corticosteroids

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16
Q

What drugs can cause SJS/TEN?

A

Never Press Skin As It Can Peel (Nikolsy’s Sign)

NSAIDs
Phenytoin
Sulphonamides
Allopurinol/Anti-epileptics - Lamotrigine/Carbamazepine/Phenyton
IV Ig
COCP
Penicillins
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17
Q

SJS vs TEN?

A

SJS = Maculopapular rash + target lesions with systemic features e.g. fever, arthralgia

TEN = Very high fever, widespread tender erythema and widespread mucosal involvement
Leads to full thickness necrosis

TEN = Nikolsy’s sign (skin peels with pressure)

18
Q

What is Bowen’s disease? How does it present and how is it managed?

A

Precancerous lesion which can become SCC
Red scaly patches in sun exposed areas
5-fluorouracil cream

19
Q

Which type of melanoma can affect areas not exposed to the sun?

A

Acral lentiginous melanoma

20
Q

Which rash is associated with coeliac disease and how is it managed?

A

Dermatitis herpetiformis

Dapsone

21
Q

How to tell the difference between the different types of burns?

A

Superficial –> blanching erythema
Superficial dermal –> blisters
Deep dermal –> white; and patches of non-blanching erythema
Full thickness –> painless

22
Q

What skin cancer is most common in patients with a renal transplant?

A

Squamous cell carcinoma

23
Q

What are risk factors for SCC?

A
  • excessive exposure to sunlight / psoralen UVA therapy
  • actinic keratoses and Bowen’s disease
  • immunosuppression e.g. following renal transplant, HIV
  • smoking
  • long-standing leg ulcers (Marjolin’s ulcer)
  • genetic conditions e.g. xeroderma pigmentosum, oculocutaneous albinism
24
Q

What is a keratocanthoma?

A

Benign epithelial tumour
Slow growing but can look similar to a SCC
Urgent excision needed due to difficulty excluding SCC

25
What medications can cause erythema nodosum?
Penicillins Sulphonamides COCP
26
In which conditions is the Koebner phenomenon seen in?
* psoriasis * vitiligo * warts * lichen planus * lichen sclerosus * molluscum contagiosum
27
What are causes of spider naevi?
Liver disease Pregnancy COCP
28
Rosacea vs. malar rash in SLE?
SLE – spares nose
29
Spider naevi vs. telangiectasia?
Spider naevi fill from the centre | Telangiectasia fill from the edge
30
What is Athlete's foot and how does it present? How is it managed?
``` Tina infection (tinea pedis) Scaling/flaking/itchy between toes ``` Topical ketoconazole
31
How is a fungal nail infection treated?
If singular nail can use Amorolfine nail lacquer | Otherwise - oral terbinafine
32
Which melanoma is most common?
Superficial spreading
33
Which melanoma is most aggressive and most likely to bleed/ooze?
Nodular
34
What are risk factors for squamous cell carcinoma?
Actinic keratosis Bowen’s disease Immunosuppressed Smoking
35
When should you admit someone with cellulitis?
``` If they are: Under 1 year Frail Significant systemic upset - tachycardia/tachypnoea/hypotension Sepsis Necrotising fasciitis Immunocompromised Facial cellulitis ```
36
How is severe cellulitis treated?
Co-amox
37
What is pyoderma gangreosum? What is it associated with? How is it. managed?
``` Rapidly enlarging painful ulcer IND RA SLE Myeloproliferative disorders ``` management = oral steroids
38
How is erythema nodosum treated?
Self-limiting | Can give NSAIDs
39
What are non dermatological causes of pruritus?
``` Liver disease Iron deficiency anaemia Chronic kidney disease Polycythaemia Lymphoma ```
40
What is the stepwise management of psoriasis in primary care?
1) topical potent corticosteroid + vitamin D analogue (both once daily) 2) vitamin D analogue twice a day 3) topical potent corticosteroid twice a day or coal tar preparation twice a day