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Dermatology Flashcards

learn those skin

1
Q

What is this?

A

Herpes zoster/ Shingles

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2
Q

What is this?

A

Atheles foot, tinea pedis

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3
Q

What could this be?

A

basal cell carcinoma

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4
Q

What is this called? This is a type of ____.

A

Pyogenic granuloma

Nodule: Solid raised lesion >5mm in diameter with a deeper component

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5
Q

What is this called? This is a type of ____.

A

pompholyx from eczema of the palms and feet

Vesicle: Raised clear fluid filled lesion <5mm in diameter e.g.

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6
Q

What kind of lesion is this?

A

macule

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7
Q

what kind of lesion is this?

A

Patch: Larger flat area of altered colour or texture >10mm e.g. Port wine stain (naevus flammeus

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8
Q

what kind of lesion is this?

A

Plaque

Plaque: Palpable raised scaling lesion
>5mm in diameter e.g. psoriasis

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9
Q

what kind of lesion is this?

A

papule

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10
Q

what kind of lesion is this?

A

bulla
Raised clear fluid filled lesion >5mm in diameter e.g. blister

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11
Q

What is a naevus and an example?

A

Naevus: Localised malformation of tissue structures e.g. mole

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12
Q

What is this? what type of lesion?

A

mole. naevus.

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13
Q

What is a comedone and an example?

A

Comedone: A plug in a sebaceous follicle containing altered sebum, bacteria and cellular debris e.g. acne

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14
Q

What is this? What type?

A

acne. comedone.

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15
Q

blackheads are a type of ___ lesion and they are (open/closed)

A

comedone, open

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16
Q

WHiteheads are a type of ___ lesion and they are (open/closed)

A

comedone, closed

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17
Q

This is an example of _____.

A

Pustule: Pus-containing lesion <5mm in diameter e.g. Mod-severe acne

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18
Q

A absecess is a localised accumulation of ____ in ________ tissues. an example is?

A

Localised accumulation of pus in dermis or SC tissues e.g. Periungal abscess in acute paronychia

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19
Q

Describe this

A

Acne:
Open and closed Heads.
Open- Blackheads
Closed- Whiteheads

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20
Q

Describe this

A

Infected eczema of the back of the knees/ atopic dermatitis
Shiny and red (wet/moist)
Crust formation
Erythematous
Papular

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21
Q

Describe and what could this be?

A

Malignant melanoma.
Asymmetrical, irregular border, colour variance

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22
Q

What are the red flags of benign skin lesions?

A

Sudden change in size
Irregularity, itching or bleeding
Sudden appearance of new lesions

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23
Q

Describe.
Management?

A

Sebacesous cyst

Skin coloured nodule with central punctum, regular border, symmetrical, mobile, overlying telangiectasia.

Commonly found on:
Neck
Face
Trunk

Treatment:
No intervention necessary
Excision- Whole cyst wall must be excised

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24
Q

Describe.
Management?

A

Large, dome-shaped, subcutaneous lesion, soft to medium consistency, regular surface and border. No surface changes.

What is it?
Benign, slow-growing subcutaneous tumours made of adipose cells
Usually asymptomatic

Management:
If dx uncertain do US +/- biopsy
No intervention necessary
Can be surgically excised

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25
Q

Describe what you see

A

Seborrhoeic keratosis:

Usually appears as a brown, black or light tan growth on the face, chest shoulders and back.
The growth has a waxy, scaly slightly elevated appearance

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26
Q

SCAM is used when describing skin lesions. What does it stand for?

A

Describe (SCAM)
Site and number of the lesions
Size (the widest diameter) and Shape
Colour
Associated secondary change and Area (Distribution)
Morphology and Margin

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27
Q

When describing pigmented lesions, ABCDE is recommended. What does it stand for?

A

Asymmetry
Border: irregular
Colour: Variegation (2 or more colours within the lesion)
Diameter: >6mm
Evolving: change in size/colour/bleeding

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28
Q

Describe. What is it?

A

Seborrhoeic keratosis
Darkly pigmented papule (or plaque)
Irregular, hard surface - Rough dry crumbling
‘stuck on’ appearance
No malignant potential
Can become irritated

Treatment:
None
Surgical excision
Cryotherapy (freezing or near freezing temperatures to destroy the tissue)

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29
Q

Describe what you see. What are these?

A

Skin tags

Multiple, flesh coloured or brown polypoid lesions attached by a stalk. Soft. Mobile.

Commonly found on:
Neck
Groin
Body folds

Management:
No treatment necessary
Can be removed by excision, cryotherapy, diathermy

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30
Q

What is this?

A

Sebaceous cyst

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31
Q

What are the 2 pre-malignant skin conditions?

A

Actinic keratosis
Bowen’s disease (SCC in situ)

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32
Q

Describe. What might it be?

A

Erythematous, scaly rough patches, somewhat papular.
+/- Adherent yellow crusts
Actinic keratosis

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33
Q

Actinic keratosis has a risk of progressing to ______

A

Squamous cell carcinoma

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34
Q

What might this be?

A

Actinic keratosis

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35
Q

What might this be?

A

Actinic keratosis

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36
Q

Pharmacological management options for actinic keratosis?

A

Topical 5-fluorouracil (OD x 4/52)
3% diclofenac gel (BD x 2-3/12)

5-Fck You & Die

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37
Q

surgical management options for actinic keatosis

A

Cryotherapy
Curettage and cautery

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38
Q

Describe what you see. What might it be?

A

Irregular scaly patch,
with irregular surface and scattered papules.
Pink/red surface.

Bowen’s disease (SCC in situ)

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39
Q

What is Bowen’s disease?

A

Intradermal SCC i.e. SCC in-situ

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40
Q

treatment options for bowen’s disease?

A

Cryotherapy
Superficial skin surgery
Photodynamic therapy

medical: Topical Treatment- 5-Fluorouracil/Imiquimod

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41
Q

Describe this. What might it be?

A

Irregular scaly patch, with irregular surface and scattered papules.
May also present as plaques.
Pink/red surface.
Mildly ulcerated
Can bleed
Can progress to SCC (3-5%)
Assd w/ sun damage, immunosuppression

Bowen’s disease

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42
Q

Uses of Imiquimod?

A

Uses: Genital warts, Superficial BCC, Actinic keratosis

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43
Q

Aldara 5% is brand name of ______

A

Imiquimod’s brand name is Aldara 5%

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44
Q

Actinic Keratosis VS Bowen’s Disease? Think SCAM

A
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45
Q

3 malignant skin lesions

A

Malignant melanoma
Basal cell carcinoma (BCC)
Squamous cell carcinoma (SCC)

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46
Q

malignant melanoma accounts for ___% of skin cancers
and ___% of skin cancer deaths

A

1% of skin cancers

Accounts for 80% of skin cancer deaths

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47
Q

Describe features of a malignant melanoma lesion with ABCDE

A

Asymmetry
Border: irregular
Colour: Variegation Two or more colours within the lesion
Diameter: >6mm
Evolving: change in size/colour/bleeding

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48
Q

Ugly duckling sign is a feature of _____

A

Malignant melanoma

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49
Q

Risk factors of malignant melanoma?

A

UV exposure
History of frequent or severe sunburn in childhood
Skin type I (always burns, never tans)
Increasing age
Male
Immunosuppression
Previous history of skin cancer
Genetic predisposition

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50
Q

Manaegment of malignant melanoma?

A

Surgical excision - definitive treatment (plastic surgery team)
+/- Radiotherapy
Chemotherapy for metastatic disease (oncology team)

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51
Q

melanoma in situ is confined to ______ but is considered _____ melanoma when cells grow past it.

A

basement membrane
invasive melanoma

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52
Q

what is this?

A

melanoma in situ

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53
Q

what is this?

A

melanoma in situ

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54
Q

Picture shows a (superficial/nodular) type of melanoma.

A

Superficial spreading (50-75%)

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55
Q

(Superficial spreading/ nodular) melanoma is common on the lower limbs in young and middle aged adults

A

superficial spreading melanoma Common on the lower limbs in young and middle aged adults.
Related to intermittent high intensity UV exposure

56
Q

Picture shows a (superficial/nodular) type of melanoma.

A

Nodular melanoma:
Common on the trunk in young and middle aged adults.
Related to intermittent high intensity UV exposure

57
Q

(Superficial spreading/ nodular) melanoma is common on the trunks in young and middle aged adults

A

nodular

58
Q

what is this?

A

lentigo maligna (5-15%) melanoma:
Common on the face in elderly population.
Related to long term cumulative UV exposure.

59
Q

What is this?

A

Acral lentiginous melanoma:
Common on palms, soles and nail beds in elderly population.
No clear relation with UV exposure

60
Q

What is this?

A

Squamous cell carcinoma:
Nodule, irregular, with central ulceration. Crusty, scaly.

61
Q

Describe

A

Squamous cell carcinoma:
Hyperkeratotic skin coloured to erythematous papule/nodule/plaque.
Scaling, ulceration, crusting

62
Q

Treatment for SCC?

A

Depends on site, size, location and number of SCCs
Surgical excision
Radiotherapy

63
Q

____ is the 2nd most common skin cancer

A

SCC

64
Q

SCC on a chronic wound/ scar is called ____

A

Marjolin’s ulcer

65
Q

4 types of BCC?

A

Nodular, Superficial, Pigmented, Morphoeic

66
Q

treatment for BCC?

A

Surgical excision
Radiotherapy
Topical therapies- 5-fluorouracil/Imiquimod 5% cream
Cryotherapy

5-fluorouracil: Anti metabolite chemotherapy
Imiquimod 5% cream: Immune response modifier

67
Q

What is this?

A

atopic dermatitis/ eczema

Presents as itchy erythematous dry scaly patches, with associated papules and/or vesicles

68
Q

Dermatitis is asociated with family/personal history of ____

A

Associations:
Personal/Family history of Asthma
Allergic rhinitis
Atopy

69
Q

What is this?

A

atopic dermatitis/ Eczema

Presents as itchy erythematous dry scaly patches, with associated papules and/or vesicles

70
Q

Management of atopic eczema?

A

Management
Emollients!!! (moisturiser)
Topical steroids for flare ups
Topical immunomodulators can be used as steroid sparing agents e.g. Tacrolimus
Phototherapy and immunosuppressants for severe non responsive cases

71
Q

areas affected in eczema

A

Areas affected
Infants: Face and extensor aspects of limbs
Children and adults: Flexor aspects

72
Q

What is this?

A

irritant dermatitis

73
Q

What is this?

A

allergic dermatitis

74
Q

Describe the lesion. What is this?

A

proximal to the medial malleolus
Hyper-pigmented, thickened, scaling skin
champange bottle appearence

This is a Venous eczema

75
Q

Treatment for this condition?

A

Treatment for venous eczema:
Leg elevation
Support stockings (after excluding PAD)
Weight reduction
Emollients
Topical steroids (hydrocortisone to eumovate to betnovate)

76
Q

Describe the picture. What might it be? Give other DDx.

A

Seborrhoeic dermatitis
White yellowish scale on erythematous patches/plaques
Chronic, superficial inflammation affecting hairy regions
Associated with contact dermatitis to Malassezia yeast

DDx:
Atopic eczema
Psoriasis

77
Q

WHat is this? Treatment?

A

Seborrhoeic dermatitis on eyebrows and face

Treatment:
Ketoconazole shampoo +/- cream
Topical keratolytics and steroids

78
Q

What is this?

A

Psoriasis. Sharply demarcated pruritic, erythematous plaques with overlying silvery scale

79
Q

Psoriasis is an independent risk factor for ___

A

CVD

80
Q

Precipitating factors of psoriasis?

A

Trauma
Infection
Drugs
Stress
Alcohol

81
Q
A

plaque psoriasis

82
Q
A

Guttate psoriasis
Multiple drop like lesions that is usually preceded by a streptococcal sore throat/ tonsillitis

83
Q

WHat is this? Management?

A

Well outlined scaly plaques with thickened scales
Scalp psoriasis

Management:
T gel shampoo
Steroid scalp lotion and vitamin D analogue

If still problematic then:
Massage cocois oil into scalp and leave overnight followed by vitamin D/steroid scalp lotion

84
Q

Treatment for localised and mild psoriasis?

A

Emollients to reduce scales

+ Topical therapies such as Vitamin D analogues, Corticosteroids, Coal tar, Dithranol

85
Q

What does Dithranol do?

A

Anthralin- Inhbits keratinocyte hyperproliferation

86
Q

Treatment for extensive psoriasis

A

referral to dermatology for phototherapy

87
Q

Treatment for Extensive severe psoriasis or psoriasis with systemic involvement?

A

Oral therapies e.g. methotrexate
Biologics e.g TNF-alpha inhibitors

88
Q

What is this called? In which disease do you find it?

A

Oncycholysis- Separation of the distal end of the nail plate from the nail bed

Psoriasis nail involvement

89
Q

What might this be? what cause it?

A

Acne

Contributing factors:
Increased sebum production
Abnormal follicular keratinization
Bacterial colonization (propionbacteruim acnes)
Inflammation

90
Q

Acne is defined as inflammation disease of the ______

A

An inflammatory disease of the pilosebaceous follicle

91
Q

what parts of the body does acne commonly affect?

A

Face
Chest
Upper back

92
Q

Mild acne is defined as <_____(number) lesions. They are mainly _____(type of lesion), consisting of _____ which are blackheads, ____ which are white heads

A

< 30 LESIONS
Mainly comedones = plug in sebaceous follicle containing sebum, bacteria, cellular debris
Open (blackheads)
Closed (whiteheads)
May have a few inflammatory papules and pustules

93
Q

Moderate acne is defined as ____(number) of lesion,
______(type of lesion) with several inflammatory papules and pustules, a few nodules

A

30-125 LESIONS
Comedones with several inflammatory papules and pustules, a few nodules

94
Q

Severe acne is defined as >___(number) lesions. It involves ____ unlike mild and moderate

A

> 125 LESIONS
Comedones, several inflammatory papules and pustules, multiple nodules,

  • Involves SCARRING
95
Q

1st line Treatment for mild comedonal acne

A

Topical retinoid (e.g. Adapalene)

96
Q

Acne treatment with oral ABX is reviewed every ___ weeks

A

12 weeks

97
Q

For ACNE, _____ might be used ONLY if all other rx failed for severe acne in AFAB (assigned female at birth) patients, due to risk of thrombosis

A

Co-cyprindiol

98
Q

For ACNE, Patients are referred to dermatology if treatment fails after ___ months

A

6 months OR 6/12

99
Q

Treatment for mild to moderate acne papules and pustules.

A
100
Q

Treatment for Moderate to severe acne when OR when previous rx failed

A
101
Q

For moderate to severe acne treatment, if patient if pregnant or < 12 years old, which ABX is/are recommended?

A

If pregnant, <12 yo: erythromycin or trimethoprim

102
Q

complications of acne

A

Post inflammatory hyperpigmentation
Scarring
Deformity
Psychological and social effects

103
Q

What is this? Describe.

A

Rosacea
Erythema, flushing and papules

104
Q

What is this?

A

Rhinophyma

105
Q

____ is chronic inflammation of facial dermatosis

A

Rosacea

106
Q

Rosacea is common in ____ years old

A

Common in 30-50 yo

107
Q

Triggers of Rosacea

A

Sun exposure/heat
Stress, exercise
Alcohol

108
Q

Treatment for Rosacea

A

Topical antibiotics e.g. metronidazole gel
Oral antibiotics e.g. tetracycline

109
Q

For Rosacea, refer to dermatology if ….

A

Refer to dermatology if complications e.g. Rhinophyma or failure to respond

110
Q

What is this? What is it caused by?

A

Impetigo

Usual pathogens:
Staph aureus
Strep pyogenes

111
Q

Treatment for this condition

A

Treatmen for impetigo:
Topical antibiotics e.g. fusidic acid
Oral antibiotics e.g flucloxacillin

112
Q

What is this? DDx?

A

Cellulitis

Redness, swelling, warmth, tenderness +/- pyrexia
Border ill-defined

DDx DVT

113
Q

____ is the infection of deep subcutaneous tissues

A

Cellulitis

114
Q

Treatment for cellulitis

A

Treatment:
Abx e.g. Flucloxacillin
If leg – rest and elevation

115
Q

Cellulitis increases risk of developing…

A

Abscess
Sepsis
Recurrence
Lymphoedema

116
Q

What is this? Aetiology?

A

Chicken pox/ varicella,
Herpes Varicella zoster virus

117
Q

____ presents as grouped vesicles on erythematous base.

A

chicken pox/ varicella

Highly contagious airborne disease
Rash (very itchy!) + fever
Macular  papular  vesicular (on erythematous base)
Lesions dry and crust

118
Q

Treatment for this condition?

A

Symptomatic management e.g.paracetamol, calamine lotion

119
Q

Shingles AKA ____ is caused by reactivation of ____.

A

Herpes zoster, or shingles, is a painful blisteringrashcaused by reactivation of the herpes varicella-zoster virus.

120
Q

(shingles/chicken pox) is itchy but (shingles/chicken pox) is painful

A

Chicken pox is itchy
Shingles is painful

121
Q

Herpes zoster is _____(symmetrical/asymmetrical) and ____(unilateral/bilateral), in ______ distribution

A

Asymmetrical, unilateral
Dermatomal distribution

122
Q

Treatment?

A
  1. Oral antivirals e.g. acyclovir/valciclovir
    HSE antimicrobial guidelines specify that it may be commenced within 72 hours of rash onset, if patient >50 years old
  2. Analgesia
123
Q

What is this? Describe.

A

Ringworm/ Tinea corporis

Itchy circular/annular lesions with a clearly defined raised and scaly edge

Contagious

124
Q

What is this? Describe.

A

Tinea cruris
(groin)

clearly defined raised skin, scaling lesions

Pruritic

125
Q

What is this? treatment?

A

Tinea Pedis

Mild
Topical antifungal creams e.g. Miconazole
+/- topical corticosteroid if inflamed

Widespread/Severe
Oral antifungals e.g. Terbinafine

126
Q

What might this be? DDx?

A

Tinea uinguium
Ddx: Psoriasis

127
Q

Management for this?

A

Advised to confirm diagnosis by sending nail clippings to microbiology lab

use topical first
if severe (more than 1-2 digits)/ no response to topical rx, try oral antifungals.

However, Get baseline LFT as hepatotoxicity. WARN PATIENTS.

Oral anti-fungals 6-12 weeks if finger nails, 3-6 months if toes

128
Q

What could this be?

A

Oral Candida

Ddx: leukoplakia

129
Q

What could this be?

A

Urticaria/ Hives, sudden onset very itchy

130
Q

What is this?

A

AngioOedema

131
Q

Management?

A

Can be an emergency and can be life threatening – may accompany ANAPHYLAXIS

Treatment:
ABCDE
Call for help
Medications- Adrenaline, Hydrocortisone, Antihistamine
High flow oxygen
Monitor- Pulse oximetry, ECG, BP

132
Q

Sx of anaphylaxis

A

Bronchospasm
Facial and laryngeal oedema
Hypotension

133
Q

Angioedema and anaphylaxis can lead to:

A

Asphyxia
Cardiac arrest
Death

134
Q

Fever, neck stiffness, photophobia… Non-blanching petechial or purpuric rash…what are we concerned about?

A

Meningitis/ Meningcoccal disease

135
Q

Management of meningcoccal disease?

A

Management:
Call for help and phone an ambulance
ABCDE approach
IV access, IVFs and high flow oxygen (100%)
Benzypenicillin IM/IV (cefotaxime can also be given instead)

GP (21 decks)

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