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Medicine finals KTB > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Describe the presentation and causes of erythema multiforme

A

Presentation:
-Symmetricla erythematous lesions of variable morphology eg. target lesions, hives

Caused by drugs/infections:

  • HSV, Mycoplasma pneumonia
  • Sulphonamides, anticonvulsants
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2
Q

Describe the presentation and causes of Stevens-Johnson Syndrome + TEN

A

Presentation:

  • SJS: widespread MP rash <10% of body area, blistering of skin + mucous membranes, and illness
  • TEN: widespread rash >30% of body area, blistering, severe systemic illness

Usually caused by drugs: sulphonamides esp

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3
Q

Describe the presentation and causes of erythema nodosum

A 
Multiple raised, tender, erythematous/purple lesions on the shins 
Causes:
-NO cause/idiopathic
-Drugs: sulphonamides 
-OCP 
-Sarcoidosis
-UC + Crohn's
-Micro eg TB, Brucella
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4
Q

Describe the aetiology + presentation of lichen planus

A 
Aetiology: autoimmune skin condition 
Presents w: 
-Pruritic purple papules + plaques 
-May affect mucous membranes
-Koebner phenomenon: trauma -> lesions 
-Wickham's striae (white lace-like)
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5
Q

Describe the management of lichen planus

A

Topical/systemic steroids

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6
Q

Describe the aetiology and presentation + management of bullous pemphigoid

A

Aetiology: autoimmune- to BM, causing separation from dermis
Presents in elderly:
-Tense blisters that do not slough on erythematous base
Mx: topical steroids (Clobetasone) or systemic

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7
Q

Describe the aetiology, presentation + management of pemphigus vulgaris

A

Aetiology: autoimmune- to desmosomes, causing acantholysis
Presents w:
-Superficial flaccid blisters that rupture (Nikolsky’s sign)
-Mucosal involvement
Management: steroids, immunosuppressants, rituximab

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8
Q

What is erythroderma? What are the causes?

A

Erythroderma is widespread (>90% of skin) reddening of the skin, assoc with exfoliation
Causes:
-Drug reaction
-Inflammatory skin conditions: psoriasis, dermatitis
-Malignancies
-HIV

Appearance: widespread erythema + warmth, scaling, weeping serous fluid

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9
Q

What are some risk factors for pressure sores? Where are they commonly found?

A
  • Immobility
  • Hospitalisation, esp ITU
  • Impaired sensation eg spinal cord injury

Found: sacrum + buttocks, heels, ears (oxygen)

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10
Q

How are pressure sores categorised? What is the management?

A

Based on thickness + tissues involved

1: no skin loss
2: superficial skin loss
3: full thickness skin loss, up to adipose
4: full thickness loss with muscle + fascia visible

Mx

  • Conservative: pressure relief, nutrition, hygiene
  • Medical: antibiotics if infected
  • Surgical: debridement if necrotic
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11
Q

Describe the presentation of urticaria and management

A

Presents w acutely pruritic raised wheals
Management:
-Antihistamines eg. loratidine, cetirizine hydrochloride

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12
Q

Which pathogen causes ringworm? Name the types of ringworm

A

Dermatophytes eg. trichophyton

Tinea capitis, corporis, cruris, pedis etc

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13
Q

Describe the presentation of ringworm + management

A

Itchy, erythematous rash with yellow scale
On body: annular lesions with central clearing

Mx:

  • Scalp: oral terbinafine
  • Body: topical eg. ketoconazole shampoo, terbinafine
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14
Q

What pathogen causes pityriasis veriscolor? Describe the presentation and management

A

Malassezia furfur
Large patches of hypopigmentation (may also be hyper in light skin) + fine scale. Spaghetti + meatballs appearance on microscopy
Mx: ketoconazole shampoo

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15
Q

What pathogen causes molluscum contagiosum? Describe the appearance and management

A

Pox virus
Multiple small, pearly papules with central umbilication
Mx: allow spontaneous resolution w/in 1 year

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16
Q

Describe the presentation of pityriasis rosea

A

Small papules + plaques in symmetrical ‘Christmas tree-like’ distribution, preceded by single larger herald patch

17
Q

Describe the presentation of psoriasis

A
  • Well-demarcated salmon pink plaques with silvery scale
  • Found often on extensor surfaces eg elbows
  • Morphology may be guttate (eg post-strep), plaque, etc
  • Also have lichenification + fissures, Koebner phenomenon, nail changes
18
Q

Describe the management of psoriasis

A

Conservative:

  • Smoking cessation, reduce alcohol, avoid trauma
  • Soap substitutes + emollients
Medical:
-Topical steroids
-> Calcipotriol (Vit D)
-> Calcineurin inhibitors- tacrolimus
\+/- Phototherapy
-> Immunosuppressants- methotrexate
-> Biologics
19
Q

What are some examples of emollients?

A

Dermol, Diprobase

20
Q

What are the different topical steroids? List in order of strength

A

Hydrocortisone 1%
Eumovate aka clobetasone
Betnovate aka betamethasone
Dermovate aka clobetasol

21
Q

Describe the presentation of atopic eczema

A
  • Itchy, dry skin +/- erythema
  • Tends to be flexural surface eg. antecubital fossa, and around eyes
  • Usually in patches, can be discoid
  • > over time lichenification + fissuring
22
Q

Describe the management of atopic eczema

A

Conservative:
-Soap substitutes + daily emollients for everyone

Medical:

  • Topical steroids during flares eg. hydrocortisone 1%
  • Can increase steroid strength, topical calcineurin i
  • > phototherapy
23
Q

Describe the presentation and management of seborrheic dermatitis

A

Non-itchy scaling, typically on scalp (dandruff), eyebrows + nasolabial folds
Mx: topical steroids + antifungals eg. ketoconazole shampoo

24
Q

What are actinic keratoses? Describe the appearance

A

Pre-malignant skin condition (pre-SCC)

Scaly patch on sun-exposed skin

25
Q

What is Bowen’s disease? Describe the appearance

A

Pre-malignant skin condition (SCC in situ)

Red/brown scaly plaques on sun-exposed skin

26
Q

What is the management of actinic keratoses and Bowen’s disease?

A

Mechanical or pharmacological
Mechanical: cautery, cryotherapy
Pharmcological: 5-FU, imiquimod

27
Q

What is seborrheic keratosis? Describe the appearance

A

Benign skin lesion, common in older age

Stuck-on pigmented lesions, often on trunk

28
Q

Describe the appearance of basal cell carcinoma + management

A

Pearly nodule with rolled edge and telangiectasia +/- ulceration
Mx:
-Routine referral to derm
-Excision eg. MOHS

29
Q

Describe the appearance of squamous cell carcinoma + management

A

Ulcerated lesion +/- irregular edge, crusting, surrounding erythema
Keratoacanthoma: subtype. Dome-shaped, with keratin plug

30
Q

Describe the types of malignant melanoma + signs on examination

A 
Superficial spreading, nodular, lentigo, acral lentiginous, amelanotic 
A: asymmetry
B: irregular borders
C: multiple colours
D: diameter >6mm
E: evolution
31
Q

What is the most important prognostic factor in melanomas? Describe the management

A

Breslow’s thickness/depth
Mx:
-Excision +/- lymph node removal +/- chemo

Medicine finals KTB (4 decks)

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