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Mod B > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Management of psoriasis

A
  • Regular emollients
  • Potent steroids (e.g. betamethasone) in the morning, and Vit D analogue (calcitriol) in the evening (can be increased to 2x)
  • Coal tar
  • Phototherapy
  • Systemics - ciclosporin, methotrexate
  • Biologics - anti-TNF
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2
Q

Guttate psoriasis

A

More common in kids and teens. Triggered by strep sore throat.

Presentation:

  • Tear drop papules on trunk

Management:

  • Self-resolving over 2-3 months
  • ?Antibitoics to eradicate strep
  • Topical agents like psoriasis - emollients, steroids, vit D
  • Phototherapy
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3
Q

Pityriasis rosea

A

Young people. HHV-7 likely cause.

Presentation:

  • Recent viral infection
  • Herald patch appears, usually on trunk
  • Erythematous, oval, scaly patches appear

Management:

  • Self-limiting - disappears after 2/3 months
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4
Q

What drugs can exacerbate psoriasis?

A

NSAIDs, beta blockers, ACE inhibitors, lithium, anti-malarials

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5
Q

Management of acne

A

1 - Topicals - benzyl peroxide, retinoids, antibiotics
2 - Oral antibiotics (tetracylines or eythromycin) for 3 months max
3 - Combined pill

4 - Refer to derm for orał isotretinoin

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6
Q

Causes of erythema multiforme

A

Infection - HSV, strep
Drugs - antibiotics, C/oCP, NSAIDs, allopurinol
Autoimmune - SLE, sarcoidosis
Malignancy

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7
Q

Seborrhoeic dermatitis

A

Caused by a fungus. Linked to HIV and Parkinson’s.

Presentation:

  • Dandruff, dry lesions in scalp, ears, around eyes, nose

Management:

  • Topical antifungals - ketonconazole shampoo
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8
Q

Impetigo

A

Caused by staph aureus. Often secondary to eczema

Presentation:

  • Golden, crusted lesions around mouth

Management:

  • Topical hydrogen peroxide 1%
  • Topical fusidic acid
  • If more unwell - oral flucloxallin or erythromycin
  • Exclude from school until crusted over or until 48hrs after treatment started
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9
Q

Pityriasis versicolor

A

Fungal infection

Presentation:

  • Hypo pigment or pink or brown lesions on trunk
  • Mild itching

Management:

  • Ketoconazole shampoo
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10
Q

Lichen sclerosus

A

Inflammatory conditions. More common in women

Presentation:

  • White patches on genitalia
  • Itchy
  • Can lead to fusion of the labia

Management:

  • Topical emollients and steroids
  • If resistant - refer - topical tacrolimus can be given
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11
Q

Pyogenic granuloma

A

Red nodules that appear at sites of trauma

ManagementL

  • Sometimes appear in pregnancy and will go
  • Others may need removed by curettage and cauterisation, cryotherapy, excision
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12
Q

Lichen planus

A

Presentation:

  • Itchy, red/purple lesions
  • On flexor surfaces
  • Can have a white lace pattern over surface
  • Mucosal involvement

Management:

  • Topical steroids e.g. clobetasone
  • Oral steroids, immunosuppressants if severe
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13
Q

Order of topical steroids by potency

A

Most potent - Clobetasol propionate
- Betamethasone
Least - hydrocortisone

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14
Q

Eczema herpeticum

A

Caused by HSV 1,2 often in those with eczema. Derm emergency

Presentation:

  • Monomorphic punched-out lesions

Management:

  • IV aciclovir
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15
Q

Bullous pemphigoid

A

Autoimmune disease, causing blistering of the skin. Would only consider as a differential in the elderly.

Presentation:

  • History of itching, then sudden eruption of blisters
  • No mucosal involvement

Management:

  • Refer to derm
  • Oral corticosteroids
  • Plus topical corticosteroids
  • May give long term doxycycline for antiinflammatory properties
  • Blisters can heal without scarring
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16
Q

Pemphigous vulgaris

A

Autoimmune disease, causing blistering. Liked bullous pemphigoid but has mucosal involvement. More common in Ashkenazi Jews

Presentation:

  • Mucosal ulceration
  • Skin blistering - painful

Management:

  • Refer to derm
  • Oral steroids
  • Immunosuppressants
17
Q

Pyoderma gangrenosum

A

Rare, caused by neutrophil infiltration.

Caused by:

  • Idiopathic (50%)
  • IBD
  • SLE, RA
  • Haem malignancies

Presentation:

  • Sudden red blister/pustule
  • Often lower limb
  • Develops into a purple painful ulcer
  • May have systemic symptoms

Management:

  • Oral steroids
  • Immunosuppression or biologics if steroids don’t work
18
Q

Rosacea

A

Presentation:

  • Flushing initially
  • Then persistent erythema, papules and pustules
  • Can have blepharitis
  • Can have rhinophyma
  • Worse in sunlight

Management:

  • Mild - topical metronidazole
  • Severe - oral antibiotics - e.g. oxytetracycline
  • High SPF
  • Laser therapy for prominent telangiectasia
19
Q

Types of non-scarring alopecia

A

Telogen effluvium:

  • After trauma, thinning of whole hair - spontaneous regrowth after 3-6months

Chronic telogen effuvium

  • Shortening of hair cycle so increased shedding but no actual baldness
  • Doesn’t progress to alopecia

Alopecia areata

  • Random round smooth bald patch
  • For 50%, hair will regrow in 1 yr

Treatment - topical steroids, minoxidil, phototherapy

20
Q

Toxic epidermal necrolysis

A

Life threatening drug reaction - derm emergency

Presentation:

  • Systemically unwell
  • Positive Nikolsky sign
  • Can also affect eyes

Management:

  • Stop drug!
  • Supportive care - ITU, fluid, electrolytes , monitor for sepsis, thermoregulation
  • Iv immunoglobulins
  • Plasmapheresis
21
Q

Difference between TEN and SJS

A

SJS is less than 10% of body surface
TEN is more than 30%

22
Q

DRESS

A

Drug reaction with eosinophilia and systemic symptoms

Presentation:

  • Morbilliform eruption - non specific maculopapular rash
  • More gradual than TEN or SJS

Management:

  • Topical steroids and oral steroids
  • May need supportive care
23
Q

First aid for burns

A
  • AE (would need to intubate if deep burns to face/neck)
  • Cool water for 10-30 mins
  • Cover with layered cling film
24
Q

Depths of burns - presentation and management for each

A
  • Superficial epidermal - red - emollients and analgesia
  • Partial thickness (superficial dermal) - pink and blistered - clean, dress, avoid cream, review in 24 hours
  • Partial thickness (deep dermal) - white, reduced sensation, non blanching due to vessel damage - refer to secondary care
  • Full thickness - no pain - refer to secondary care
25
Q

Drugs to watch out for for TEN/SJS/DRESS

A

Antibiotics, anti epileptics, antigouts

26
Q

When would you refer superficial dermal burns to secondary care?

A
  • If covers more than 3% of body
  • If involves face, hands, feet, perineum, genital, flexures
  • NAI, electrical, chemical burns

Mod B (5 decks)

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