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Revision all topics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Mechanism of bullous pemphigoid?

A

Antibody against hemidesmosomes

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2
Q

Mechanism of pemphigus vulgaris?

A

Antibody against desmoglein 3

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3
Q

Mechanism of bullous impetigo?

A

Staph aureus toxin cleaves desmoglein 1

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4
Q

Treatment of bullous pemphigoid?

A

Corticosteroids

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5
Q

Treatment of pemphigus vulgaris?

A

Corticosteroids

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6
Q

Difference between SJS and TEN?

A

SJS: <10% body surface area affected
TEN: >30% body surface area affected

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7
Q

What are the 2 types of alopecia and what are their differences?

A

Androgenic alopecia: hypersensitivity to androgens associated with family history

Alopecia areata: autoimmune disease of hair follicles. Has exclamation mark hairs

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8
Q

Features of basal cell carcinoma?

A
  • Slow growing, raised lesion
  • Pearly, flesh-coloured papule with a central crater and telangiectasia
  • Bleeds with minor trauma
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9
Q

Management of a BCC?

A

Wide excision with 4mm margin

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10
Q

What is the most common skin cancer?

A

BCC

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11
Q

What is the second most common skin cancer?

A

SCC

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12
Q

Risk factors of BCC?

A
  • UV exposure
  • Skin types 1&2
  • Age
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13
Q

Risk factors of SCC?

A
  • Excessive exposure to sunlight
  • Actinic keratoses and Bowen’s disease
  • Immunosuppression
  • Smoking
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14
Q

Management of SCC?

A
  • Urgent 2ww referral

- Wide excision. 4mm margin if <20mm diameter, 6mm margin if >20mm diameter

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15
Q

Which is the most reliable prognostic factor of a skin cancer?

A

Depth as measured using the Breslow thickness scale

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16
Q

Risk factors of melanoma?

A
  • Type 1&2 skin
  • Gingers & blondes
  • Family history
  • Atypical melanocytic naevi
  • Giant congenital melanocytic naevi
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17
Q

Most common type of melanoma?

A

Superficial spreading

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18
Q

Which melanoma is seen in chronically sun-exposed elderly people?

A

Lentigo maligna

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19
Q

Which melanoma is seen on the palms/soles, African American/Asian patients?

A

Acral lentiginous

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20
Q

Which melanoma is most aggressive and generally bleeds/oozes?

A

Nodular

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21
Q

Management of melanomas?

A
  • Urgent 2ww referral

- Wide excision with 2mm margin and send for histology

22
Q

Treatment for impetigo? How does this differ if they have extensive disease?

A

Topical hydrogen peroxide

Oral flucloxacillin in extensive disease

23
Q

Treatment of pityriasis versicolour?

A

-Ketoconazole shampoo

24
Q

Management of pityriasis rosea?

A

-No treatment as it is self limiting. Give emollients or mild steroid if there is itchiness

25
Q

Difference between guttate psoriasis and pityriasis rosea?

A

Guttate psoriasis is usually preceded by streptococcal sore throat

26
Q

Which group of patients are particularly susceptible to shingles/herpes zoster infection?

A

HIV positive patients

27
Q

Most common complication of shingles?

A

Post-herpetic neuralgia (severe, persistent pain).

Herpes zoster ophthalmicus

28
Q

Which immune cells mediate the eczema reactions?

A

Th2 immune response - IgE, eosinophils, TNFalpha

29
Q

Treatment of seborrheic eczema?

A

Topical azole anti-fungal creams

30
Q

What investigations should be done in someone with suspected allergic contact eczema?

A

Patch testing

31
Q

What drugs can exacerbate psoriasis?

A
  • Beta blockers
  • Lithium
  • Hydroxychloroquine
  • NSAIDs
  • ACEi
  • Infliximab
32
Q

What features of psoriatic arthropathy are there?

A
  • Pencil in cup appearance on X-ray

- Dactylitis (sausage fingers)

33
Q

Nail changes in psoriasis?

A
  • Pitting
  • Onycholysis
  • Longitudinal ridges
  • Sub-ungual hyperkeratosis
34
Q

1st line treatment for psoriasis?

A
  • Topical Vitamin D analogue (calcitriol) and emollients

- Moderate-potent steroids can be used

35
Q

2nd line treatment for psoriasis?

A

Phototherapy (UVB or PVA). Guttate psoriasis usually treated this way

36
Q

What is used 3rd and 4th line for psoriasis?

A

3rd: systemic therapy with methotrexate if resistant to topical therapy
4th: biologic therapy with infliximab, adalimumab

37
Q

Features of lichen planus?

A
  • Intensely itchy rash of wrists, ankles and lumbar region
  • Shiny, polygonal papules
  • Koebner phenomenon
  • Involvement of mucosal surfaces (buccal, vulva)
38
Q

Treatment of lichen planus?

A

Potent topical steroids

39
Q

Features of lichen sclerosus?

A
  • Intensely sore lesions that are shiny, white, fissured seen in genital regions
  • Can cause atrophy and fusion of vulva, labia
40
Q

What cancer is associated with lichen sclerosus?

A

SCC

41
Q

Treatment of lichen sclerosus?

A

Potent/super potent topical steroids

42
Q

What is the 1st, 2nd, 3rd, 4th line treatment of acne?

A

1st: Topical monotherapy (retinoid, benzoyl peroxide)
2nd: Topical combination therapy (antibiotic, benzoyl peroxide, retinoid)
3rd: Oral antibiotics (doxycycline or erythromycin if pregnant)

4th line: Oral isotreinoin

43
Q

What side effects must be warned before taking isotretinoin?

A
  • Teratogenicity
  • Depression
  • Hair thinning
  • Hyperlipidaemia, hepatotoxicity
  • Dryness
44
Q

What tests must be done before starting isotretinoin?

A
  • Pregnancy test
  • Depression screen
  • Bloods (lipids, LFTs)
45
Q

Treatment for mild rosacea?

A

Topical metronidazole

46
Q

Treatment for moderate-severe rosacea?

A

Oral doxycycline

47
Q

Give examples of: mild, moderate, potent, very potent steroids?

A

Mild: hydrocortisone 0.1-2.5%
Moderate: eumovate
Potent: betnovate
Very potent: dermovate

48
Q

Features of hereditary haemorrhagic telangiectasia?

A
  • Family history
  • Epistaxis
  • Visceral lesions: pulmonary, hepatic, GI, cerebral, spinal AVM
  • Telangiectasia
49
Q

Which malignancy is associated with acanthosis nigricans?

A

Gastric adenocarcinoma

50
Q

Which drugs can cause erythema nodosum?

A
  • COCP
  • Penicillins
  • Sulfasalazine
51
Q

Treatment for erythema nodosum?

A

Self limiting and resolves within 6 weeks

52
Q

First line treatment of impetigo?

A

Topical hydrogen peroxide

Revision all topics (11 decks)

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