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
Q

features of TEN?

A
  • widespread skin and mucosal necrosis

- pt is septic, looks toxic

26
Q

main cause of TEN?

A

drug-induced

27
Q

key causes of death in TEN?

A
  • sepsis
  • electrolyte imbalance
  • muiltisystem organ failure
28
Q

describe the causative organism in acute meningococcaemia

A
  • neisseria meningitides

- G-ve diplococcus

29
Q

describe the skin changes seen in meningococcal meningitis

A
  • non-blanching purpuric rash
  • on trunk and limbs
  • may be preceded by blanching maculopapular rash
30
Q

what could the rash in meningococcal meningitis progress to? (end-stage disease)

A
  • ecchymoses
  • haemorrhagic bullae
  • tissue necrosis
31
Q

management of acute meningococcaemia?

A
  • benzylpenicillin

- close contacts: prophylactic rifampicin within 14d

32
Q

complications of acute meningococcaemia?

A
  • septic shock
  • DIC
  • multi-organ failure
  • death
33
Q

describe erythroderma

A

exfoliative dermatitis involving >90% of total skin!

34
Q

causes of erythroderma?

A
  • prev skin disease
  • lymphoma
  • drugs
  • idiopathic
35
Q

which pre-existing skin diseases could lead to erythroderma?

A
  • eczema

- psoriasis

36
Q

drug causes of erythroderma?

A
  • sulphonylureas
  • gold
  • penicillin
  • allopurinol
37
Q

management of erythroderma?

A
  • treat underlying cause
  • emollients, wet-wraps (keep skin moist)
  • TOP steroids
38
Q

complications of erythroderma?

A
  • secondary infection
  • fluid loss, electrolyte imbalance
  • capillary leak syndrome (fatal)
39
Q

prognosis of erythroderma?

A

20-40% mortality rate

40
Q

which condition is eczema herpeticum a serious complication of?

A

atopic eczema

41
Q

cause of eczema herpeticum?

A

HSV infection

42
Q

presentation of eczema herpeticum?

A
  • crusted papules
  • blisters
  • erosions
  • extensive coverage
  • systemically unwell (fever, malaise)
43
Q

complications of eczema herpeticum?

A
  • herpes hepatitis
  • herpes encephalitis
  • DIC
  • death (rare)
44
Q

causes / RFs of necrotising fasciitis?

A
  • group A haemolytic strep
  • abdo surgery
  • DM
  • malignancy
45
Q

presentation of necrotising fasciitis?

A
  • severe pain
  • erythematous, blistering, necrotic skin
  • systemically unwell (high HR, fever)
  • crepitus
46
Q

what causes crepitus in necrotising fasciitis?

A

subcutaneous emphysema

47
Q

what might be seen on X-ray in necrotising fasciitis?

A

soft tissue gas

48
Q

management of necrotising fasciitis?

A
  • urgent surgical debridement

- IV ABx

49
Q

prognosis in necrotising fasciitis?

A

mortality is as high as 76% !!