Dermatology 👨🏼⚕️ Flashcards
what is psoriatic arthritis
inflammatory arthritis affecting joints and connective tissue and is associated with psoriasis of skin or nails
“pencil in cup” radiological feature
mx of psoriatic arthritis
NSAIDs and DMARDs
1st and 2nd line systemic treatment for psoriasis
1st - methotrexate
2nd - ciclosporin
what nail deformities are associated with psoriasis
nail pitting
leukonychia
onycholysis
are systemic retinoids teratogenic? Should they be prescribed in pregnancy or during breastfeeding
yes they are teratogenic so NO should not be prescribed
features of acne rosacea
common
chronic
facial flushing covering usually cheeks, nose, chin and forehead
usually presents in ages 30-60 and females
how does acne rosacea present
red rash consisting of papule and pistules on an erythematous background
what exacerbates rosacea
facial flushing causing factors like eating spicy foods, hot weather, sun exposure, stress etc
mx of rosacea
general therapies like sunscreen, camouflage cream
topical treatments like azelaic acid, brimonidine and ivermectin
topical antibiotics like metronidazole
urticaria
hives
what is psoriasis
chronic autoimmune disease characterised by well-demarcated, erythematous, scaly plaques
Cutaneous clinical features of chronic plaque psoriasis
Itchy, well-demarcated circular-to-oval bright red/pink elevated lesions (plaques) with overlying white or silvery scale, distributed symmetrically over extensor body surfaces and the scalp.
1st line topical treatment for psoriasis
All patients should use an emollient to reduce scale and itch
1st: potent topical corticosteroid OD (eg Betnovate) + topical vitamin D OD (eg Dovonex) applied at different times
characteristic features of basal cell carcinoma
round and nodular
skin coloured with a pearly rolled edge
telangicestoma
located on sun exposed areas - head and neck
mx of basal cell carcinoma
Management of a BCC depends on its size, location, type and local guidelines - but the majority are managed surgically
what is tinea
athletes foot
how is Lyme disease spread
tick bites
causes of erythema nodosum
NODOSUM
NO cause
Drugs
OCP
Sarcoidosis
Ulcerative colitis/Crohns
Micro: tuberculosis, streptococcus, toxoplasmosis
presentation of erythema nodosum
tender raised red nodules that usually affect the shin
presentation of BCC
small, skin-coloured or pink nodule with a central depression
they often have a pearly rolled edge and surface telangiectasia
often located on sun-exposed areas
difference between actinic keratosis and seborrheic keratosis
AK is lighter in colour and has a silvery appearance
SK has a more greasy appearance ranging in colour from tan/brown to black
presentation of seborrhoeic dermatitis
classically appears as ill-defined, greasy, flaky scales on an erythematous background
affects in particular the nasolabial folds, scalp and posterior auricular skin
can present with dandruff
triggers/risk factors for psoriasis
skin trauma
infection
drugs - BALI, Beta-blockers, Antimalarials, lithium, Indomethacin
withdrawal of steroids
stress
alcohol+smoking
cold/dry weather
presentation of pyoderma gangrenosum
painful ulcers develop most commonly on the legs
associated with IBD
A 55-year-old woman with a background of ulcerative colitis attends a gastroenterology follow-up appointment. On examination, there is a 2x3cm ulcer on the left shin which is malodorous with a purulent base and an irregular, erythematous border
treatment of pyoderma gangrenosum
small ulcers - topical corticosteroids
large ulcers or if pt is systemically unwell - oral corticosteroids
severe cases may require surgical management
what is contact dermatitis
type of eczema following exposure to a causative agent
two types: irritant and allergic
presentation of contact dermatitis
o/e a dry erythematous rash with blistering and fissuring of the skin is seen
management of contact dermatitis
involves emollient creams and topical corticosteroids
how does cellulitis present
commonly occurs on the shins
usually unilateral
erythema
swelling
systemic upset
management of cellulitis
oral or admit for iv abx depending on certain factors
for cellulitis who gets admitted for IV abx
severe or rapidly deteriorating cellulitis
under 1 y/o or frail
immunocompromised
significant lymphedema
facial or periorbital cellulitis
hemodynamically unstable
management of scabies
topical 5% permethrin
presentation of scabies
intensely itchy pruritic rash commonly seen in the interweb spaces, flexures of the wrist, axillae, abdomen and groin
management of shingles
oral antiviral - valaciclovir - if eye involvement or immunocompromised
IV antiviral if severe
presentation of shingles
tingling feeling in a dermatomal distribution
progresses to erythematous papules which develop into fluid-filled vesicles which then crust over
What is the condition?
Characterised by 6 P’s
Purple
Pruritic
Polygonal
Planar
Papules or
Plaques
Usually found on flexor aspects of wrist and ankles
Lichen planus
Autoimmune disease where there are well defined patches of hair loss
Alopecia areata
Commonest causes of eyrthroderma (widespread erythema with hypothermia and systemic symptoms)
Dermatitis
Psoriasis
ABCDE assessment of malignant melanoma
Asymmetry
Birder irregularity
Colour variation
Diameter > 6mm
Evolves over time
Most common type of malignant melanoma
Superficial spreading melanoma
If a melanoma lesion was located on the soles, palms or nail bed what type is it likely to be
Acral lentiginous melanoma
Describe the features of superficial spreads melanoma
Initially resembles a freckle or mole but grows slowly into an asymmetrical patch
Commonly on lower limbs
Mostly in young or middle aged adults
Management of lichen planus
Potent topical steroids
Oral lichen planus features
Characterised by mucosal ulceration and Wickham’s striae that cannot be wiped off unlike oral Candida
