Dermatology Flashcards
Steven Johnson syndrome drugs
Never press skin as it can peel
NSAIDs
Phenytoin
Sulphonamides
Allopurinol
IVIG
Carbmazepine
Penicillin
Lamotrigine
Allergy tests and their uses
Skin prick- food allergens
RAST- IgE- food and inhaled- use if skin prick CI- on AH or anaphylaxis or extensive eczema
Skin patch- contact dermatitis
Tx of Bowen’s disease/actinic keratoses
5-fluorouracil cream
Tx of SJS
Stop factor
IVIG - 1st, 2nd IS
Cause of seb dermatitis
Malassezia Furfur
More common in PD
Tx of seb dermatitis
Scalp- zinc
Face/body- topical ketoconazole
Golden crusty appearance dx
Impetigo
Tx of impetigo
Localised non bulls- Hydrogen peroxide
Widespread non- oral fluclox
Bullous systemic- oral fluclox
School exclusion- 48hrs after tx or crusted
Tx of acne
Mild- topical retinoid
Moderate- Oral lymecycline or COCP + BPO
Derm referal- oral isoretanoin
SE of isoretanoin
Dryness, teratogenic, photosensitivity, low mood
acne roseacea sx
Flushing, nose cheeks forehead - realted to alcohol consumption
Persistent pustopapular erythema
Middle Aged
Tx of acne rosacea
Topical ivermectin/metronidazole - mild/mod
Prominently flushing- bromonidine gel
Severe- oral tetracycline and topical ivermectin- if rhinophyllia or severe papule/pustules
Pityriasis versicolour organism
Malassezia furfur
Pityriasis versicolour sx and tx
Hypopigmented patches, after suntan
Happens in warm climates
Itchy
Topical ketoconazole
Vitiligo mx
AI screen
Sunbloc, topical CS
Psoriasis tx
4 week-topical CS potent in morn
and Vit D analogue at night
If flexor- such as axilla- mild topical CS only
Face- potent CS
Aim fro 4 weeks between CS tx
2nd- if no improvement in 8 weeks - BD Vit D and CS
Tx of eczema
Low dose- hydrocortisone
Clobetasone
Betamethasone, fluticortisone
Clobetasol
Infective- oral fluclox
Eczema herp- oral acyclovir
Tx of scabies
Permethrin
All close contacts
2 doses- 1 week apart
Tx of head lice
Malathion
Tx of keloid
Intralesional steroids
White plaques on vulva
Lichen sclerosis
Spider nevi vs telangiectasia
Press down on them watch fill
Nevi fill from the centre, telangiectasia fill from edge
What can actinic keratosis turn into
Squamous cell
Raised pink papule with central dimple
Molloscum contagiosum
Irregular lesion on palms or feet
Acral lentiginous melanoma
Hyperpigmentation and hyperkeratosis around axilla
Acanthosis nigricans
Tx of ulcer with hyperpigmentation
Venous- compression bandages
Lesion grown from previous injury- single nodule
Dermatofibroma
Reassure
Purple, polygonal, pleuritic papule and plaques with white lace in flexors tx
Lichen planus
Topical potent steroids
Complications of seborrhoea dermatitis
Otitis media and blepharitis
Itchy red patches of skin in face
Seb dermatitis
Mottled erythema with net like pattern
Erythema ab igne
Where exposed to heat
Pyogenic granuloma features
Past trauma
Rapid progressing
Bleed or ulcerate
Can remove
Dermatophyte nail infection tx
Oral terbinafine
monomorphic, punched-out lesions
Eczema herpecticum
Healthcare workers with no varicella AB
Should be vaccinated
When to refer with acne roseca
If red inflamed eyes and eyelids
Erythematous circular patch with raised edge and central hypo pigmentation tx
Tinea corpis
Oral fluconazole
Rule of % surface area of burn
Rule of 9s
9- chest, abdo face, anterior leg, head and neck
4.5- anterior arm
Tx of hyerhidrosis
Aluminium chloride
Which drug can exacerbate psoriatic plaques
BLAN
Beta blockers
Lithium
Alcohol
NSAIDs
Scaly tear drop papular rash 2 weeks after URTI
Guttate psoriasis
Pruitic papulovesicular elbow/knee/buttocks rash
Dermatitis herpetiformis
Types of skin lesion
Macule- flat, <1cm
Plaque- >1cm palpable, elevated
Papule- elevated, solid, <1cm
Nodule- elevated, solid, >1cm
Vesicle- elevated fluid <1cm
Pustule- >1cm
Tx of guttate psoriasis
Reassurance and topical tx if symptomatic lesions
Topical steroids SE
Skin depigmentation
When to give IV fluids in burns
When >15% of second or third in adult
Tx of lichen sclerosis
Topical steroids
If IC or previous transplant and lesion what should you do
Urgent referral to term
Singel plaque with scale, then generalised rash with patches and plaques, follows a viral infection
Pityriasis rosea
Herediatoary haemorrhagic telangiectasia sx
Epistaxis
Haemoptysis and dyspnoea
Telang- lips
Buegers disease features and angiogram
Corkscrew collaterals
Absent pulses
Shingles tx
Antiviral <72 hrs
Organism of erysipelas
Strep pyogenies
Meds causing spider nevi
COCP
Haematemesis after severe burns
Curlings ulcer- due to volume depletion causing ischaemia in gastric mucosa
Pearly, flesh-coloured papule, rolled edges with telangiectasia may ulcerate
BCC
Target lesions
Erythema multiforme
Dermoid vs sebaceous cyst
Demoid- many hairs, skin cells, teeth ect
Seb- 1 hair punctin, filled with pus
Oedema after burns reason
Hypoalbuminaemia
If have severe burns what should you consider doing
Early intubation
Cause of pellagra
Isoniazid
Nikolsky sign
Blisters and erosions appear when the skin is rubbed gently
Causes of hirsutism
PCOS- most common
Cushing
CAH
Androgen therapy
Obesity
Parkland formula
% bunt x weight x 4= total fluid
Half delivered in first 8 hours
Features of Bowen disease
May progress to squamous cell
persistent reddish-brown patch or plaque of dry, scaly skin
Tx of erythema nodosum
Nothing
Features of shingles
Burning pain
Macular rash
Vesicular
Rapid growth, red, dome, central defect containing keratinous material
Keratoacanthoma
Light that causes squamous cell cancer
UVA
Cancer most likely developed with immune suppression
SCC
Types of contact dermatitis
Irritant- usually acids/alkalis
Allergic-hair dyes, weeping eczema- type 4
Vasculitic rash
Purpura- flat red blotches looking like bruises
and blistering
Pustules and nodules in nack and axilla, swollen, yellow discharge
Hirdradenitis suppurativa
Hari loss, broken exclamation mark hairs
Alopecia areata
Mx of SJS/TEN
ICU
Main use o antiviral in older people
Reduce incidence of post herpetic neuralgia
Pompholyx eczema
High humidity
Vesicle eruptions
Palms
Lentigo maligns features
Chronic sun exposed areas- face
Older people
Slow
Atheltes foot tx
Topical anti fungal 4 weeks
If not working- oral anti fungal
When is breslow depth a poor prognosis
> 4mm- 5year survival 50%
Most aggressive melanoma
Nodular
Tingling when eating apples, kiwis ect
Oral allergy syndrome
Vitiligo vs versicoloured
Vitiligo affects peripheries and is more confluent
Pityriasis rosea tx
Self limiting
Tx of tinea
Topical antifungal
Oral antifungal when severe or if capitus
Aktinic keratoses and Immunosuppressed
2ww Derm referral
Bullous pemphigoid vs pemphigus vulgaris
Mucosal- vulgaris
Non- pemphigoid
When should superficial burns be referred to secondary care
> 3% body surface area
Malignancy causing acanthuses nigricans
gastric adenocarcinoma
Causes of erythema multiforme
Same as SJS but no pheytoin
Plus COCP
What is erythroderma
> 95% skin is involved in a rash
Solitary firm nodule that dimples on pinching
Dermatofibroma
Urticaria management
Non sedating AH
Oral pred- severe or resistant
What tool most accurately measures burn area
Lund and Browder chart
Drugs causing erythema nodosum
Penicillins
Sulphalazine
COCP
Tx of keratoancanthoma
Usually regress in 3 months with scar
But can excise out of caution as looks like SCC
Pityriasis versicoloured tx
Topical ketoconazole
Impetigo but HPO didn’t help last time
Give fusidic acid topically
Nail changes with psoriasis
POSH
Pitting
Onchylysis
Subunal hyperkeratosis
Smooth, rubbery, mobile mass
Lipoma
When to US a lipoma
When >5cm
Tx of telang in acne roses
Laser