Dermatology Flashcards

1
Q

How are mutiple, non-keratinised (genital) warts treated?

A

Topical podophyllum

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2
Q

How are solitary keratinised genital warts treated?

A

Cryotherapy

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3
Q

What is a Marjolin’s ulcer?

A

Squamous cell carcinoma occuring at sites of chronic inflammation or previous injury

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4
Q

First line treatment for impetigo

A

Topical fusidic acid is the first-line treatment for impetigo.

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5
Q

What is impetigo?

A

a superficial skin infection caused by staphylococcus aureus most often diagnosed in children. It is a highly contagious infection and hygiene measures alongside avoidance of other children until 48 hours after the rash has resolved is recommended.
Good crusted plaques under mouth and nose

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6
Q

What is erythema multiform?

A

Rash on upper limbs and trunk is composed of multiple dusky central area, a darker red inflammatory zone surrounded by a pale ring of oedema, and an erythematous halo on the extreme periphery of the skin lesion.

most likely to be caused by mycoplasma pneumoniae

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7
Q

What is cellulitis?

A

Characteristic features of cellulitis include acute onset of diffuse redness, swelling, heat and tenderness, most commonly occurring in one of the lower limbs (bilateral leg cellulitis is rare). Cellulitis develops when micro-organisms gain entry into the dermal and subcutaneous tissues.

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8
Q

How does pyoderma gangrenuosum present

A

The presence of an ulcerated lesion, with a purple base that has developed from a small blister or pustule, is strongly suggestive of PG. PG is commonly associated with inflammatory bowel disease. The association of trauma and then development of an ulcerated area further support a diagnosis of PG.

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9
Q

Treat,ent of low risk superficial BCC?

A

Imiquimod cream (topical treatment)

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10
Q

What type of skin lesion is often referred to as a Rodent ulcer?

A

Basal cell carcinoma

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11
Q

SCC VS BCC

A

BCC most common. Commonly have telangiectasia on them. Several months to years.

Squamous cell carcinomas are the second commonest type of skin cancer and commonly occur on sun-exposed sites such as the face. However, they are usually ulcerated nodules with an indurated margin. They do not commonly have telangiectasia on them. More strongly associated with smoking and immunosupression grows over weeks/months

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12
Q

What is Actinic keratoses?

A

Actinic keratoses are scaly lesions typically found on areas of sun-damaged skin such as the scalp, face and dorsum of the hands
Associated with sun exposure
May be painless or may be itchy

The appearance of actinic keratoses can vary from barely visible to pink or reddish-brown 1-2 centimetre patches. The surrounding skin may have evidence of sun damage. Palpation reveals a rough scaly texture, similar to that of sandpaper. Actinic keratoses are a pre-cancerous lesion which can in some cases transform into squamous cell carcinoma. Elevation, tenderness and bleeding of actinic keratoses are suggestive of malignant transformation.

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13
Q

What is sebhorric keratosis?

A

SK may also be referred to as a basal cell papilloma, brown wart, barnacle, or senile wart. This condition is the most common form of benign, cutaneous tumour that affects the elderly population. Major risk factors for SK development include increasing age (the most important risk factor) and fair skin. The precise pathophysiology underlying SK remains undefined. These lesions may appear anywhere on the body except on the palms and soles.

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14
Q

Clinical features of sebhorric keratosis

A

a raised lesion with a ‘stuck on’ appearance
1mm to several centimetres in diameter
variation in colour (e.g. yellow, light brown, grey, dark brown)
a warty/greasy/waxy appearance and typical dermatoscopy findings (i.e. ‘clods’ of keratin, ridges and furrows creating a cerebriform appearance)

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15
Q

What is Steven Johnson Syndrome

A

Stevens-Johnson syndrome (SJS) – a severe dermatological condition often triggered by medications. It is characterised by extensive skin necrosis and epidermal detachment. Mucous membranes are involved in the majority of cases. Patients typically have a prodrome with fever and influenza-like symptoms followed by dermatological manifestations which can be complicated by dehydration, electrolyte disturbances and hypoalbuminaemia. SJS and toxic epidermal necrolysis (TEN) are considered to be on the same disease spectrum; distinguished mainly by the percentage of body surface affected by blisters and erosions. SJS is the less severe form of the disease, in which 10% of the body surface area is affected, and TEN typically involves >30% of body surface area. Management involves withdrawal of the offending agent, referral to a specialist unit and aggressive fluid resuscitation with electrolyte replacement.

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16
Q

What is bullous impetigo?

A

Bullous impetigo, which is exclusively caused by Staphylococcus aureus, accounts for the remaining 30% of cases and is characterised by the development of vesicles that progress to form large, flaccid bullae, which persist for up to 2-3 days. When these blisters rupture, they leave behind a thin, flat, yellow/brown crust. Bullous impetigo can occur anywhere on the body but is most commonly seen on the flexures, face, trunk and limbs. If large areas of skin are affected, the patient may also present with systemic symptoms.

17
Q

Bullous vs non bullous impetigo

A

Bullous
Less common
Pts systemically unwell
development of vesicles that progress to form large, flaccid bullae, which persist for up to 2-3 days

18
Q

What is a plaque

A

A plaque is an elevated area of skin 1cm or more in diameter. It may be formed by a coalescence of papules or nodules. The surface area is greater than its height. It is a plate-like lesion.

19
Q

Common infective trigger of psoriasis?

A

Streptococcal throat infection

tear dropped shaped lesions

20
Q

What common drug can exacerbate psoriasis?

A

Beta-blockers ie. propanonol

21
Q

What is the length of time between starting beta blockers and

A

Beta-blockers are assoicated with a long period of latencey so the time between starting them and the appearance of psoriasis may be months?

22
Q

Management of acne?

A

No treatment may be acceptable if mild
1. Topical benzoyl peroxide reduces inflammation, helps unblock the skin and is toxic to the P. acnes bacteria
2. Topical retinoids (chemicals related to vitamin A) slow the production of sebum (women of childbearing age need effective contraception)
Topical antibiotics such as clindamycin (prescribed with benzoyl peroxide to reduce bacterial resistance)
Oral antibiotics such as lymecycline
Oral contraceptive pill can help female patients stabilise their hormones and slow the production of sebum

Oral retinoids started by specilists only - note highly tertogenic
Co-cyprindiol (Dianette) is the most effective combined contraceptive pill for acne due to it’s anti-androgen effects. It has a higher risk of thromboembolism, so treatment is usually discontinued once acne is controlled and it is not prescribed long term.

23
Q

What is psoriasis?

A

Psoriasis is a chronic autoimmune condition that causes recurrent symptoms of psoriatic skin lesions. There is a large variation in how severely patients are affected with psoriasis. There appears to be a genetic component but no clear genetic inheritance has been established. Around a third of patients have a first degree relative with psoriasis. The symptoms start in childhood in a third of patients.

Patches of psoriasis are dry, flaky, scaly, faintly erythematous skin lesions that appear in raised and rough plaques, commonly over the extensor surfaces of the elbows and knees and on the scalp.

THESE SKIN CHANGES ARE CAUSED BY RAPID GENERATION OF NEW SKIN CELLS, resulting in an abnormal buildup and thickening of the skin in those areas.