Dermatology Flashcards

1
Q

presentation of acne rosacea?

A
  • 1st symptom is usually flushing
  • affects: nose, cheeks, forehead
  • telangiectasia
  • persistent erythema with pustules and papules
  • rhinophyma of nose
  • worsened by sunlight
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2
Q

how can acne rosacea affect the eyes?

A
  • blepharitis
  • keratitis
  • conjunctivitis
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3
Q

management of acne rosacea?

A
  • topical metronidazole
  • brimonidine gel for flushing
  • PO oxytetracycline if severe
  • laser therapy for severe telangiectasia
  • daily sun cream
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4
Q

what is a keloid scar?

A

abnormal growth of scar tissue at the site of a skin injury

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5
Q

epidemiology of keloid scars?

A
  • 15x more likely in POCs than white people

- typically aged 10-30

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6
Q

how to differentiate between a keloid scar and hypertrophic scar tissue?

A

hypertrophic scars don’t grow beyond boundaries of the original wound and shrink over time

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7
Q

where are keloid scars most likely to be found?

A
  • upper chest

- shoulders

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8
Q

what are the 4 pressure areas of the body?

A
  • sacrum
  • buttocks
  • ankles
  • knees
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9
Q

describe a koebner phenomenon

A

a linear eruption arising at the site of trauma

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10
Q

describe a target lesion. where are these seen?

A
  • concentric rings, like a dart board

- erythema multiforme

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11
Q

describe an annular lesion. where are these seen?

A
  • in a circular shape

- tinea corporis (ringworm)

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12
Q

describe a discoid lesion. where are these seen?

A
  • coin-shaped
  • discoid eczema
  • discoid lupus
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13
Q

is purpura blanching or non-blanching? how can the lesions within this be described?

A
  • non-blanching
  • petechiae = small, pinpoint macules
  • ecchymoses = larger, bruise-like lesions
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14
Q

what should be commented on when palpating a skin lesion?

A
  • surface
  • consistency
  • mobility
  • tenderness
  • temperature
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15
Q

give some examples of dermatological emergencies

A
  • anaphylaxis, angioedema
  • toxic epidermal necrolysis (TEN)
  • stevens-johnson syndrome
  • meningococcaemia
  • erythroderma
  • eczema herpeticum
  • necrotising fasciitis
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16
Q

causes of urticaria / angioedema / anaphylaxis?

A
  • food (esp nuts)
  • drugs
  • insect bites
  • latex
  • viral / parasitic infections
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17
Q

management of urticaria?

A
  • antihistamines if mild
  • corticosteroids if more severe
  • adrenaline if anaphylaxis
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18
Q

complications of anaphylaxis?

A
  • asphyxiation
  • cardiac arrest
  • death
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19
Q

causes of erythema nodosum?

A
  • group A B-haemolytic strep
  • primary TB
  • pregnancy
  • malignancy
  • sarcoidosis
  • IBD
  • chlamydia
  • leprosy
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20
Q

presentation of erythema nodosum?

A
  • tender nodules
  • typically on shins
  • may be confluent
  • leave bruise-like mark when they go, but no scarring
  • last 1-2 wks
21
Q

key risk factor for erythema multiforme?

A

HSV infection

22
Q

risk factors for stevens-johnson syndrome?

A
  • drugs
  • infections
  • combination of both
23
Q

how can stevens-johnson syndrome be differentiated from erythema multiforme?

A

in SJS, there’s more widespread skin involvement

24
Q

classic description of erythema multiforme?

A

target lesions

25
features of TEN?
- widespread skin and mucosal necrosis | - pt is septic, looks toxic
26
main cause of TEN?
drug-induced
27
key causes of death in TEN?
- sepsis - electrolyte imbalance - muiltisystem organ failure
28
describe the causative organism in acute meningococcaemia
- neisseria meningitides | - G-ve diplococcus
29
describe the skin changes seen in meningococcal meningitis
- non-blanching purpuric rash - on trunk and limbs - may be preceded by blanching maculopapular rash
30
what could the rash in meningococcal meningitis progress to? (end-stage disease)
- ecchymoses - haemorrhagic bullae - tissue necrosis
31
management of acute meningococcaemia?
- benzylpenicillin | - close contacts: prophylactic rifampicin within 14d
32
complications of acute meningococcaemia?
- septic shock - DIC - multi-organ failure - death
33
describe erythroderma
exfoliative dermatitis involving >90% of total skin!
34
causes of erythroderma?
- prev skin disease - lymphoma - drugs - idiopathic
35
which pre-existing skin diseases could lead to erythroderma?
- eczema | - psoriasis
36
drug causes of erythroderma?
- sulphonylureas - gold - penicillin - allopurinol
37
management of erythroderma?
- treat underlying cause - emollients, wet-wraps (keep skin moist) - TOP steroids
38
complications of erythroderma?
- secondary infection - fluid loss, electrolyte imbalance - capillary leak syndrome (fatal)
39
prognosis of erythroderma?
20-40% mortality rate
40
which condition is eczema herpeticum a serious complication of?
atopic eczema
41
cause of eczema herpeticum?
HSV infection
42
presentation of eczema herpeticum?
- crusted papules - blisters - erosions - extensive coverage - systemically unwell (fever, malaise)
43
complications of eczema herpeticum?
- herpes hepatitis - herpes encephalitis - DIC - death (rare)
44
causes / RFs of necrotising fasciitis?
- group A haemolytic strep - abdo surgery - DM - malignancy
45
presentation of necrotising fasciitis?
- severe pain - erythematous, blistering, necrotic skin - systemically unwell (high HR, fever) - crepitus
46
what causes crepitus in necrotising fasciitis?
subcutaneous emphysema
47
what might be seen on X-ray in necrotising fasciitis?
soft tissue gas
48
management of necrotising fasciitis?
- urgent surgical debridement | - IV ABx
49
prognosis in necrotising fasciitis?
mortality is as high as 76% !!