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Year 3 GP Block Aashi Jade Pam > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How does cellulitis present?

A 
On lower limb usually 
Swelling/tumor 
Erythematous/rubor 
Warm to touch/calor 
Pain in legs/dolor

Pt may be systemically unwell too - fever, malaise, rigors, previous abrasion to leg (so bacteria can enter).

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2
Q

How is cellulitis managed in primary care?

A

1) Abx - flucloxacillin 500-1000mg qds for 5-7 days
If penicillin allergy = clarithromycin 500mg bds 5-7 days or doxycycline 200mg for one day, then 100mg od for 5-7 days

2) Analgesia - ibuprofen or paracetamol for pain and fever.
3) Drink adequate fluids
4) Manage RF for cellulitis - e.g. breaks in the skin, skin blistering, venous ulcers

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3
Q

Ddx of unilateral redness and/or swelling of limb ?

A 
Cellulitis 
DVT 
Septic arthritis 
Acute gout 
Ruptured Baker's cyst
Thrombophlebitis 
Cutaneous abscess 
Erysipelas (like cellulitis but with raised, well demarcated borders).

see CKS NICE cellulitis for more.

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4
Q

RF for cellulitis ?

A 
Break in skin 
Immunosuppressed 
Obese 
Pregnant 
Skin conditions 
Previous cellulitis 
Venous insufficiency
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5
Q

Complications of untreated cellulitis?

A 
Necrotising fasciitis 
Sepsis 
Osteomyelitis 
Lymphagitis 
Endocarditis 
Meningitis 
Gas gangrene
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6
Q

How does impetigo present?

A 
In children 
Thin blisters, fluid filled
Red sores 
Blisters may have ruptured at presentation - get yellow/golden crust.
Itchy, painful
Common on face - on philtrum
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7
Q

How is impetigo managed?

A

Localised - give topical creams = hydrogen peroxide, fusidic acid cream

Short course abx - flucloxacillin/clarithromycin

Hygiene measures for the whole family

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8
Q

RF for impetigo

A

Young age
Breaks in skin
Close contact - schools
Poor hygiene

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9
Q

Complications of impetigo

A

Misdiagnosed = cellulitis

Contagious - remain home until lesions clear

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10
Q

Presentation of chicken pox.

A

Children
Red papule become fluid filled vesicles and rupture
Fever
Malaise

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11
Q

Management of chicken pox?

A

Not attend school until papule scab over.

Fluid, rest. Symptomatic treatment.

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12
Q

RF for getting chicken pox?

A

Infants,
Immunocompromised - HIV, chemo puts, transplant pts.
Pregnant women

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13
Q

Name of virus causing chicken pox?

A

Varicella-zoster virus

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14
Q

Complications of chicken pox?

A 
Shingles - vesicular rash 
Encephalitis 
Sepsis 
Dehydration 
Bacterial infections of skin 
Pneumonia
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15
Q

Presentation of eczema?

A

Itchy, erythematous, scaly dry patches of skin.
On face, extensors and flexors.
Can be vesicular and weepy
Excoriation
Lichenification
Pt has Hx of atopy - eczema + asthma + hay fever

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16
Q

Management of eczema?

A

Avoid triggers
Emollients - oliatum, epaderm, dermal 500 lotion.
Bath wash and bandages

Topical steroids for flare ups - hydrocortisone 0.1-2.5%.

Antihistamines - fexofenadine

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17
Q

RF for eczema?

A

Hx of atopy, FH of atopy, skin irritants, temperature extremes

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18
Q

Complications of eczema

A

Secondary bacterial or viral skin infection

Psycho-social-emotional impacts

19
Q

How does acne vulgarise present ?

A

Teenager
Comedones which are open or closed
Inflamed papules, pustules, nodules or cysts.

Present on face, chest, upper back.

Present with scarring

20
Q

Managing acne vulgaris?

A

Advice - avoid over cleansing, use non-alkaline cleansing product.

Pharmacological - 12wk topical treatment e.g. topical adapalene (mild/mod) or azelaic acid with oral abx e.g. doxy (for mod/severe)

Woman who can’t take abx? Give cocp

Psych management

Refer to dermatologist

21
Q

RF for acne vulgaris?

A 
Age 
Hormonal changes 
FH 
Oily substances 
Friction/pressure on skin
22
Q

Complications of acne?

A

Scarring

MH complications

23
Q

Presentation of allergic contact dermatitis?

A

Contact wth something on skin - this is where rash appears.

Can present days after.
Red, itchy, swollen, blistered OR dry and bumpy.
Can move from fingers to eyelids due to touching.

Similar presentation to eczema

24
Q

Management of allergic contact dermatitis?

A 
Recognise triggers 
Emollients 
Topical steroids 
Oral abx for any secondary infections 
Tacrolimus ointment 
Azathioprine
25
Q

RF for allergic contact dermatitis?

A

Age, occupation, hx of contact dermatitis

26
Q

Complication of allergic contact dermatitis?

A

Can become generalised - erythroderma

27
Q

How does urticaria present ?

A

Swelling/tumor in superficial dermis
Red or white in colour
Itchy wheals, elevated.
Local or generalised

28
Q

Management of urticaria?

A

Avoid triggers
Symptom diary
Non-sedating antihistamine
Oral corticosteroid if symptoms need treatment = prednisolone 40mg/7days.

29
Q

RF for urticaria?

A 
Food allergies 
Drugs 
Cold exposure or hot shower 
Stress 
Environment
30
Q

Complications of urticaria?

A

Anaphylaxis / Swelling in the throat
Angiodema
MH complications

31
Q

RF for skin cancer?

A

Age, female, sun damage, sunburn, inheritance, ionising radiation, fair skin

32
Q

How does basal cell carcinoma present?

A

Slow growing nodular lesion with necrotic/ulcerated centre.
Can see:
Blood vessels on surface
Shiny/pinky/pearly white
Translucent, and waxy texture.
May be red and scaly. May also be black or brown in a patch.
May bleed or become crusty.

33
Q

How is basal cell carcinoma managed?

A

Needs prompt treatment
Surgical excision
Radiotherapy if surgery is not an option.
Topical treatment if risk is low.

34
Q

Complication of skin carcinoma?

A

Local tissue invasion and destruction. Mets.

35
Q

How does squamous cell cancer present?

A

Firm pink lump with a rough or crusted surface
Spiky horn which sticks up from surface.
Tender when touched.
Bleeds easily
Ulcers.

36
Q

How is squamous cell carcinoma managed?

A

Prompt treatment
Surgical excision
Radiotherapy if surgery is not an option.

37
Q

Mental health impact of skin disorders?

A

Depression, anxiety, low mood, low self esteem eczema - self harm, stress, need for CBT, feel trapped

38
Q

Social aspect of skin disorders?

A 
Stigmatisation 
Discrimination 
Isolation 
Lack of acceptance 
Embarrassment
39
Q

What parts of the sociological theory on chronic illness relates to skin disorders?

A

Illness work

Identity work

40
Q

How should you describe pigmented lesions?

A

The ABCDE rule for suspicious pigmented lesions
A, asymmetry

B for irregular border

C for colour variation

D for diameter greater than 6mm

E for evolution.

41
Q

What are some risk factors for Melanoma? MMRISK mnemonic

A

M – moles – atypical >5;

M – moles- multiple > 50;

R – red hair;

I – inability to tan;

S – sunburn;

K – kindred ( family Hx)

42
Q

What are signs of a squamous cell carcinoma? (capsule)

A

a firm, red nodule; a flat sore with a scanty crust; fast-growing.

43
Q

What is there a small risk actinic keratosis might transform into if untreated?

A

squamous cell carcinoma
keep under surveillance

Alerting signs to development of SCC include lesions that persist in spite of treatment, are hyperkeratotic or become nodular.

Year 3 GP Block Aashi Jade Pam (14 decks)

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