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Finals revision > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Define and name 3 features of hyperlipidemia

A

Xanthelsama

Xanthoma - Yellow flat plaques of lipid-containing macrophages on the body

Corneal arcus - Lipid deposition around the corneal margin

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2
Q

What is Basal cell carcinoma and what are the types

A

Slow-growing invasive malignant tumor of epidermal keratinocytes - common at head and neck

Nodular

Rarely metastases

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3
Q

Name 5 RF for BCC

A

UV exposure
sunbeds
Hx of sunburn
Skin injury - burns and scarring
Increased age
FHx
Immunosuppression

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4
Q

How do you describe a BCC

A

Round
Rolled edges
Raised
Telangiectasia
Central depression
Non-tender
Spontaneous bleeding
Shiny - pearly

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5
Q

How do you describe a skin lesion

A

SCAM

S
- Size
- Shape
- Site

Colour

Associations

M
- Margins
- morphology

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6
Q

How is a BCC managed

A

Cryotherapy
Surgical excision and histology
Radiotherapy

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7
Q

What is a SCC

A

First growing invasive tumor of epidermal keratinocytes

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8
Q

RF for SCC

A

Bowens disease
Actinic keratosis
Immunosuppresion
Skin scarring / burns
Radiation
UV exposure
Elderly
Fair skin
Smoking

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9
Q

What is Bowens disease

A

Precancerous SCC in-situ

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10
Q

What are the features of SCC and how is it managed

A

Rapidly expanding nodule
Ulceration
Areas of bleeding

High risk of mets
- sentinel biopsy
- CT scan

Management
- surgery
- Radiotherapy

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11
Q

What is malignant melanoma

A

Invasive malignant tumour of epidermal melanocytes

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12
Q

What are the types of melanoma

A

Superficial spreading

Nodular - easily bleeds
most aggressive

Lentigo - older / sun exposure

Acral lentiginous - Black

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13
Q

What is impetigo and name 2 common organisms

A

Superficial skin infection

Staph aureus
Strep pyogenes

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14
Q

How does impetigo present

A

pruritus
golden crusted lesions

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15
Q

Management of impetigo

A

Limited + Non bullous - Hydrogen peroxide / fusidic acid

bullous / extensive - flucloxacillin

48hr after starting Abx / until all lesions crusted over

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16
Q

What is urticaria and what causes it

A

Small itchy lumps associated with erythematous rash - can be localised or widespread
swelling of epidermis and dermis
Due to mast cell activation and histamine release

allergens - food / animals
contact with chemicals
medications
insect bites

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17
Q

Management of urticaria

A

Nonsedating - Loratidine / Cetirizine

severe flare - oral steroids

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18
Q

What is angio-oedema

A

Swelling of SC and submucosal tissue
Painful
No pruritus

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19
Q

Name 3 drugs that can cause SJS

A

Penicillin
Lamotrigine
Carbamazepine
Pheytoin
Allopurinol

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20
Q

What is shingles

A

Acute dermatomal painful blistering rash

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21
Q

Name 3 RF for a pressure sore

A

Incontinence
reduced mobility
Malnourished

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22
Q

What is cellulitis and name 2 causative organisms

A

bacterial infection affecting dermis and SC tissue

Strep pyogenes
Staph aureus

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23
Q

Clinical features of cellulitis

A

erythema
swelling
fever
blisters / bullae
malaise
nausea
pain
breach of skin barrier

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24
Q

What is erisypalis

A

Acute superficial cellulitis involving upper dermis
Strep pyogenes

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25
Q

clinicla features of erisypilis

A

boarders sharply defined
red
painful
swollen

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26
Q

RF for cellulitis and erysipelas

A

DM
Immunosuppression
Venous insufficiency
Obesity
Ulcers
Pressure sore
Trauma
Lymphoedema

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27
Q

Management of scabies

A

Topical Permethrin

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28
Q

Management of head lice

A

4% dimeticone lotion

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29
Q

Outline a venous ulcers

A

caused by venous insufficiency

Ulcer is gaiter region - medial mallelous
Large
Shallow
Granulated base
Irregular - sloping borders
pain less than arterial
pain relieved by elevation

chronic venous changes
Varicose eczema
Lipodermatosclerosis
Haemosiderin deposition
Thrombophlebitis

30
Q

Outline an arterial ulcer

A

affect toes / dorsum of foot - pressure points

smaller than venous
deep
well defined boarders
punched out apperance
less likely to bleed
painful
pain worse on elevation

Assosciated with PAD
- Absent pulses
- pallor
- Intermitent claudication

31
Q

what is a leg ulcer

A

wound or break in the skin that doe snot heal or heals slowly due to underlying pathology

32
Q

Investigations for leg ulcers

A

ABPI
Arterial <0.9

Bloods - assess for infection and co-morbidities
FBC
CRP
HbA1c

Charcoal swabs

33
Q

Management of venous ulcers

A

compression bandaging

34
Q

Management of arteril ulcers

A

reduce modifiable RF
treat HTN
Prescribe statin
Prescribe antilpatlet

35
Q

Causes of leukonychia

A

Hypoalbuminemia
Fungal nail infections
Lymphoma

36
Q

causes of clubbing

A

CHD
CF
IBD
IPF
Lung cancer
Bronchiectasis
IE
Cirrhosis

37
Q

causes of onycholysis

A

trauma
psoriasis
fungal

38
Q

What is Acne

A

Chronic inflammation of pilosebaceous unit

39
Q

Describe the pathophysiology of acne

A

Increased sebum production, trapping of keratin and blockage of the pilosebaceous unit

Leads to swelling and inflammation in the unit

blocked unit = comedomes

40
Q

Clinicla features of acne

A

Non inflammatory lesions
- comedomes

inflammatory lesions
- papules
- pustules

41
Q

Outline the management of acne

A

Education and patient information

1st line:
Topical retinoid
+/- Benzoyl peroxide
+/- Topical antibiotic

+ Antibiotic - Lymecycline

Isotretinoin

42
Q

What is the definition of atopic dermatitis / eczema

A

Chronic inflammatory skin disorder due to defects in normal continuity of skin barrier leading to inflammation

43
Q

What is dermatitis hepatiformis

A

AI blistering rash
itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

44
Q

What is erythema nodosum and give 4 causes

A

Inflammation of SC fat - tender nodular lesions over shins

NO - idiopathic
D - Drugs (Penicllins)
OCP
Sarcoidosis / TB
UC / Crohns
Micro - Strep pyogenes

45
Q

Outline the pathophysiology of eczema

A

Defects in skin barrier due to damaged filaggrin provide entry point for irritants, microbes and allergens that create an immune response –> Inflammation

46
Q

Describe the atopic triad

A

Allergic rhinitis
Asthma
Eczema

47
Q

Describe the clinical features of eczema

A

dry skin
flares:
erythrematous
poorly demarcated
itchy patches
Lichenification
scaly
excoration marks

infants - face / trunk / extensor
adults - flexures

48
Q

Outline the management of eczema

A

Avoid irritants / scratching / bathing in hot water / using soaps that remove natural oils

M - Emollients QDS (E45 / Diprobase cream)

Flares
- thicker emollients (Hydromol ointment )
- Steroid creams

Specialist
- topical tacrolimus
- phototherapy
- immunosuppresants - oral steroids / MXT

49
Q

Name 2 organism that cause eczema herpeticum

A

HSV - 1
VZV

50
Q

Clinical features of eczema herpeticum

A

Widespread painful vesicualr rash with systemic sx
- fever
- lethargy
- irritability

51
Q

Investigation and management for eczema herpeticum

A

Virla swabs

Aciclovir

52
Q

Name 4 RF for cellulitis

A

Obesity
Lymphoedema
Led ulcer
Wound
Immunocompromised

53
Q

What is contact dermatitis

A

Inflammatory skin disorder triggered following exposure to irritant or allergen

54
Q

Describe the 2 forms of contact dermatitis

A

Irritant - non allergic
- pain and burning sensation
- dry erythematous rash

Allergic - Type 4 hypersensitivity reaction
can extend beyond site of contact

55
Q

What is seborrhoeic dermaitis

A

chronic dermatitis due to inflammatory reaction related to proliferation of normal skin inhabitant - fungus called malasseiza furfur

affects sebum richa reas:
scalp
periorbital
auricular
nasolabial folds

56
Q

What is psoriasis

A

chronic autoimmune iflammation due to hyperproliferation of keratinocytes and inflammatory cell infiltration
characterised by well-demarcated erythematous scaly plaques

57
Q

outline the classification of psoariasis

A

plaque - symmetrical plaques on extensor surfaces / back / scalp

flexural

guttate - small tear dropped shaped plaques on trunk following streptococcal infection

pustualr - palmes and soles

58
Q

clinical features of plaque psoriasis

A

itchy
well-demarcated
red elevated lesions
silver scale appearance
symmetrical distribution

59
Q

RF for psoariasis trigger

A

skin trauma
strep infection
drugs - b blocker / lithium / NSAIDs
withdrawl of steroids
alcohol
smoking
cold weather
stress

60
Q

Outline the management of psoriasis

A

Education - avoid triggers
Emollients

Flare
- Steroids OD + Topical Vit D analogue OD (reduces keratinocyte proliferation)

  • Vit D analogue BD
  • Potent corticosteroid BD

Phototherapy

systemic treatment
- MXT
- Ciclosporin

Biologics
- Infliximab

61
Q

Give 3 A/E of MXT

A

Pneumonitis
Hepatotoxicity
Myelosuppresion

62
Q

give 3 common cuases of ithching with a rash

A

Utricaria
atopic eczema
psoriasis
scabies

63
Q

give 3 common causes of itching with no rash

A

renal failure
jaundice
lymphoma
polycythaemia rubra vera

64
Q

What is the difference between bacteriostatic and bacteriocidal

A

Bactericidal antibiotics kill the bacteria and bacteriostatic antibiotics suppress the growth of bacteria

65
Q

What is the kobner phenomena

A

Skin lesions develop at site of injury

66
Q

Name 4 types of psoriasis

A

Flexural
Guttate
Plaque
Pustular

67
Q

Name 2 skin conditions associated with the kobner phenomenon

A

Psoriasis
Lichen planus
Vitiligo

68
Q

4 factors to address in management of a pressure sore

A

Nutrition
Analgesia
Antibiotics
Regular dressing
Pressure relieving mattress
Tissue viability referral
Patient positioning
Need for debriedment

69
Q

Outline a pressure score grading

A

1 - non blanching erythema

2 - partial thickness loss

3 - full thickness loss

4 - extensive destruction with muscle / bone involvement

70
Q

4 features of lichen sclerosis

A

Ithcy
dyspareunia
pain on urination

71
Q

3 differentials for lichen sclerosis

A

SCC
VIN
Lichen planus
vitiligo

72
Q

Management of lichen sclerosis

A

topical steroids
avoid soaps / irritants
emollients - relive dryness

Finals revision (17 decks)

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