Dermatology Flashcards
What skin condition can be made worse by topical steroids
Perioral dermatitis
What medication exacerbated plaque psoriasis
Beta blockers
also lithium but but bb first
How can you differentiate between spider naevi and telangiectasia
By pressing on them and watching them fill
- Spider naevi fill from the centre
- Telangiectasia fill from the edge
What bacteria contributes towards the development of acne
Propionibacterium
What is alopecia areata and what should you measure?
Autoimmune condition causing localised well-demarcated patches of hair loss with small ‘exclamation mark’ hairs
Screen for other autoimmune diseases
Golden crust
IMPETIGO
Acute onset of tear drop scaly papules on the trunk and limbs
Guttate psoriasis
What infection can precipitate guttae psoriasis or erythema nodosum
Streptococcal throat infection
First line treatment for lichen planus
Potent topical steroids
Flat topped rash on palms, elbow creases and soles of feet
Lichen planus
Treatment for dermatophyte nail infections
Oral terbinafine
Features associated with hereditary haemorrhagic telangiectasia
Pulmonary hepatic cerebral and spinal AVMs
Pathophysiology of pemphigus
Antibodies target the desmosomes that connect the cells
Cause of hirsutism
Cushings syndrome
Treatment of pityriasis versicolor
Ketoconazole shampoo
How many weeks does it take for scabies to stop itching
4 weeks
Subtype of eczema characterised by an intensely pruritic rash on the palms and soles
Pompholyx eczema
Features of rosacea
Nose cheeks and forehead
Flushing erythema telangiectasia –> papules and pustules
Complication of hidradenitis suppurativa
Sinus tracts and fistulas
What is hutchinson’s sign
Pigmentation of nail bed affecting proximal nail fold
Suggests menalona
First line treatment for hyperhidrosis
Topical aluminiumc hloride
What can PUVA progress to
SCC
First line treatment for seborrhoeic dermatitis
Topical ketoconazole
Long-term management of psoriasis
Calcipotriol
2 common complications of seborrhoeic dermatitis
Otitis externa and blepharitis
Management of children with new onset purpura
Refer immediately for investigations to exclude ALL and meningococcal disease
Treatment of psoriasis
Potent corticosteroid applied once daily and vitamin D analogue applied once daily
Aim for a 4 week break in between courses of topical corticosteroids
Treatment of erythema nodosum
Supportive
Features of lichen planus
Purple, pruritic, papular, polygonal rash on flexor surfaces
Wickham’s striae over surface
Oral involvement common
Features of lichen sclerosus
itchy white spots typically seen on the vulva of elderly women
Main clinical feature of polymorphic eruption in pregnancy
Periumbilical sparing
What is hidradenitis suppurativa
a chronic, painful, inflammatory skin disorder is characterized by nodules, pustules, sinus tracts, and scars in intertriginous areas
2 precipitating factors for pompholyx eczema
Humidity (sweating)
High temperatures
Treatment of rosacea
mild/moderate: topical metronidazole
severe/resistant: oral tetracycline e.g. doxycycline
What should you monitor when a patient is admitted for erythroderma
Complications e.g. dehydration and high output heart failure
Sign of herpes simplex
Erythema multiforme
2 types of blisters/bullae
no mucosal involvement (in exams at least*): bullous pemphigoid
mucosal involvement: pemphigus vulgaris
Visible cold sores, punched out lesions, lymphadenopathy, fever and malaise
What is it?
What is the cause?
How is it managed?
Eczema herpeticum
Herpes Simplex Virus (rarely Coxsackievirus)
Antiviral treatment
most effective treatment for prominent telangiectasia in rosacea
Laser therapy
Management of shingles
Treat with antivirals within 72 hours of onset
Infectious until the vesicles have crusted over
Best way to diagnose allergic contact dermatitis
Skin patch test
Molluscum contagiosum
Pink or white papules in the umbilical area with a central dimple
Management of molluscum contagiosum
No treatment
Send to school
What is Acanthosis nigricans
Thickened skin around the axilla and groin area
Golden, crusted skin lesions typically found around the mouth of a child
Impetigo
Superficial epidermal burn
Red and painful
Partial thickness (superficial dermal)
Pale, pink, painful, blistered, blanching erythema
Partial thickness (deep dermal)
White but patches of non-blanching erythema, reduced sensation
Full thickness burn
White/brown/black
No blisters
No pain
Lipoma presentation and management
Mobile, rubbery, non-tender mass
Ultrasound if more than 6cm
Can iron deficiency anaemia cause puritis
Yes
Where are keloid scars most common?
Sternum
Raised well defined rash with sharp borders on the legs of a diabetic
What is it and what is the causative organism
Erysipelas
Strep pyrogens
6 causes of acanthosis nigricans
T2DM PCOS Obesity GI adenocarcinoma / pancreatic cancer Cushings Acromegaly
Acne rosacea vs vulgaris
Vulgaris: comedomes (blackheads)
Rosacea: just red
Trigger for pityriasis rosea
Viral infection
Trigger for acne rosacea
Sun exposure, hot drinks, exercise
Acne management
Single topical therapy (retinoid, benzoyl peroxide)
Topical combination therapy (add an ABx)
Oral ABx (tetracycline, erythromycin in pregnancy) or COCP
Oral isotretinoin
Skin disorder associated with coeliac
Dermatitis herpetiformis
Management of venous ulceration
Compression bandaging
Treatment of impetigo
Topical Hydrogen Peroxide
Topical Fusidic Acid
Oral flucloxacillin
What is pityriasis rosea
Self-limiting rash in young adults that lasts 6-12 weeks
Herald patch followed by smaller lesions elsewhere
Treatment of facial hair in PCOS
Topical eflornithine
Differentiate between pyogenic granuloma and amelanotic melanoma
Granuloma = hx of trauma Melanona = grows slowly under the foot or nail,
Treatment of guttae psoriasis
Reassurance and topical treatment if sx
What do antivirals in shingles aim to reduce?
Post-herpetic neuralgia
3 treatments for athletes foot
topical imidazole, undecenoate, or terbinafine first-line
causative organism for pityriasis versicolor and seborrheic dermatitis
Malassezia furfur
Vasculitis with upper limb claudication and absent pulses
Takaysau’s arteritis
Vasculitis with lower limb claudication and corkscrew shaped vessels in young male smokers
Buergers disease
Vasculitis with headache and blurred vision with pain when combing hair
Giant cell vasculitis
Rapidly worsening painful eczema - what is it and how is it treated?
Eczema herperticum
Admission for IV antivirals
Side effect of topical steroids in patients with darker skin
Patchy depigmentation of skin
Autoimmune blistering skin disorder causing itchy vesicular skin lesions on extensor surfaces
Dermatitis herpetiformis
Newborn with tiny white papules on the nose
Milia
pink-coloured, vascular skin lesion over the nape of a baby’s neck, which blanches on pressure
Salmon patch
darker would be a port wine stain
What is pellagra and what can it be caused by?
Lack of vitamin B3
Dermatitis, Diarrhoea, Dementia
Isoniazid can cause it
Side effect of ketocanazole
Gynecomastia
erythema ab igne rash
overexposure to heat e.g. sitting next to a fire or using a hot water bottle
Presentation of erythema multiforme
Giant non-itchy target lesions with three colours
What is pityriasis versicolor
Patches of skin discolouration on the trunk, flaky and itchy precipitated by hot weather
overgrowth of yeast
Extensive blistering and necrotic skin rash affecting the whole body and mucus membranes
Toxic Epidermal necrolysis
Severe end of the sprctrum of erythema multiforme –> steven johnson syndrome
Causes of Toxic epidermal necrolysis
phenytoin sulphonamides allopurinol penicillins carbamazepine NSAIDs
4 treatments for vitiligo
Sun block
Topical tacrolimus
Phototherapy
Topical corticosteroids
Pyoderma gangrenosum associations, features and treatment
Associated with IBD, RA, myeloproliferative disorders
Deep painful ulcer that grows and looks like a pizza
Treated with steroids
Pearly edge
BCC
Single most important prognostic factor in melanoma
Depth of the lesion
Do healthcare workers need to be vaccinated against varicella zoster
Healthcare workers who aren’t naturally immune to varicella should be vaccinated
Hepatitis vaccinations
Hepatitis A and B
Management of superficial dermal burns covering more than 3% of the body
Refer to secondary care
Pruritic blistering lesions in pregnancy
Pemphigoid gestationis
Investigation for skin ulcers
Ankle-brachial pressure index
Investigation for skin ulcers
Ankle-brachial pressure index
What is the gold standard approach in managing morphoeic BCC
Mohs microgaphic surger
Melanoma in areas not associated with sun exposure (palms and soles)
Acral lentiginous melanoma
Scarring in acne
Referral for oral isotrenitoin
Management of lichen sclerosus
Topical clobetasol propionate
Where do venous ulcers usually occur?
Around the medial malleolus
Rash with pain
Shingles
Dermatofibroma
Solitary firm papule/nodule that dimples on pinching
Common secondary malignancy after renal cell carcinoma
Squamous cell carcinoma of the skin
Treatment of verruca
Salicyclic acid
Treatment of actinic keratosis
Flurouracil cream
Topical Diclofenac
Treatment of headlice
Malathion
treatment of patients with moderate-severe hirsutism
Co-cyprindiol
Complications of toxic epidermal necrolysis
Volume loss and electrolyte derangemetn
What is the koebner phenomenon
Formation of new skin lesions at the site of skin injury
Common in psoriasis
3 associations with ulcerative colitis
large-joint arthritis, sacroilitis and pyoderma gangrenosum
First line for scalp psoriasis
Topical potent corticosteroid e.g. betamethasone
Chondrodermatitis nodularis helicis is usually painful.
Small crusty or scaly lesions on sun-exposed areas
Actinic keratoses
Premalignant
Medication which causes spider naevi
COCP
What skin lesion can TB cause
Erythema nodosum
Lichen
planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common
Treatment of bullous pemphigoif
Oral corticosteroids
What is Wallace’s Rule fo Nine
Each of the following is 9% of the body when calculating surface area % if a burn:
Head + neck, each arm, each anterior part of leg, each posterior part of leg, anterior chest, posterior chest, anterior abdomen, posterior abdomen
Lichen sclerosis in males
uncircumcised man, who has developed a tight white ring around the tip of the foreskin and phimosis
Impetigo back to school
Patients may return to school or work when they are no longer contagious which is when all lesions have crusted over or 48h after treatment starts
Vililigo and alopecia areata association?
Yes
tender, erythematous nodules over her forearms with high calcium
Erythema nodosum - likely sarcoidosis (get a cxr)
Endocrinological cause of acne vulgaris
COCP
Cause of haematemesis in a burn victim
Curlings ulcers
2 features of a sebaceous cyst
Located in the scalp
Associated central punctu,
Complication of electrical burns causing hyperkalaemia and high CK
Rhabdomyolysis
Post burn parasthesia and severe pain in the lower leg
Compartment syndrome
Most invasive melanoma which metastasises early
Nodular
Cause of ringworn
Fungus
Cause of fine layer of soft hair over an adolescent girl
Malnutrition - lanugo hair
Treatment of scabies
Everyone in the family needs two applications of permethrin one week apart
ABx to treat erythrasma
Erythromycin
What dermatitis is parkinsons disease associated with
Seborrhoeic dermatitis
Formula to calculate IV fluid for burns
Parkland formula
What does psoriasis increase the risk of?
CVD
