Dermatology Flashcards
Define eczema
A chronic atopic condition caused by defects in the normal continuity of the skin barrier leading to inflammation - dry red itchy sore patches typically on flezors
Management of eczema
Maintenance - emollient, soap substitutes
Flares - thicker emollients, topical steorids, manage complication
Define eczema herpeticum
Viral skin infection caused by herpes simplex or vaicella zoster. Usually occurs in those who already have a skin condition
Presentation of eczema herpeticum
Suffers with eczema
Develops widespread painful vesicular rash
Systemic symptoms
Fever
Lethargy
Irritability
Reduced oral intake
Lymphadenopathy
Management of oczema herpeticum
Viral swabs
Aciclovir
Define psoriasis
Chronic auto immune condition that causes recurrent of psoriatic skin lesions
Describe psoriasis lesions
Dry
Flaky
Scaly
Faintly erythematoud
Raised
Rough plaques
Commonly over extensors
Caused by rapid generation of skin cells
Presentation of psoriasis
Often triggered by throat infection - guttate psoriasis
Auspitz sign - small point of bleeding when plaques scraped off
Koebner phenomenon - development of psoriatic lesion to areas of skin affected by trauma
Residual pigmentation - of skin after lesions resolve
Management of psoriasis
Topical steroids
Topical vit D
Topical dithranol
Topical tacrolimus
Phototherapy
Associations with psoriasis
Nail psoritatis - pitting, thickening, discolouration, ridging onycholysis
Psoriatic arthritis
Psychosocial
Obesity, hyperlipidaemia, HTN TIIDM
Define acne vulgaria
Extremely common condition affecting people during puberty and adolescence - blockage of pores leads to swelling and inflammation
Presentation of acne
Red inflamed sore spots on skin - typically face, upper chest and back
Macules
Papules
Pustules
Comedomes
Blackheads
Ice pick scars
Hypertrophic scars
Rolling scars
Define macules
Flat marks on the skin
Define papules
Small lumps on the skin
Defin pustules
Small lumps containing yellow pus
Define comedomes
Skin colours papules representing blocked pilosebaceous units
Define ice pick scars
Small indentations that remain after acne lesions heal
Define hypertrophic scars
Small lumps in the skin that remain after acne lesions heal
Define rolling scars
Irregular wave like irregularities of the skin that remain after acne lesions heal
Define measles
Viral xanthem caused by measles virus - highly contagious, respiratory droplet
10-12 day incubation
Presentation of measles
Fever
Coryza
Conjunctivitis
Koplik spots - greyish white spots on buccal mucosa
Rash
Management of measles
Self resolving - week after symptoms apear - isolate until 4 days post symptoms resolving.
Notifiable disease
Manage complication
Complications of measles
Pneumonia
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss
Death
Rash in measles
Starts on face - typically behind ears
Spreads to rest of body
Erythematous
Macular rash - flat lesions
Koplik spots - greyish white spots in buccal mucosa
Define scarlet fever
Viral exantem caused by group A strep - contagious, isolate from school until 24 hours after starting antibiotics
Presentation of scarlet fever
Fever
Lethargy
Flushed face
Sore throat
Strawberry tongue
Cervical lymphadenopathy
Notifiable disease
Management of scarlet fever
Antibiotics - phenoxymethylpenicillin for 10 days
Rash in scarlet fever
Whide spread erythematous rash
Red pin
Blotchy
Macular rash
Rough sandpaper skin
Starts on trunk and spreads outwards
Strawberry tongue
Define rubella
Viral xanthem caused by rubella virus - highly contagious, respiratory droplet - incubation 2 weeks.
Presentation of rubella
Rash
Fever
Joint pain
Sore throat
Enlarged lymph nodes - behind ears and neck
Management of rubella
Self limiting
Supportive management
Notifiable
Avoid pregnancy
Isolate from school until 5 days post rash appearing
Rash in rubella
Like measles but milder
Erythematous macular rash
Starts on face and spreads
Classically lasts 3 days
Define Dukes disease
Non specific viral rash - does not really exist
Define slapped cheek syndrome
Viral xanthem caused by parvovirus B19
Presentation of slapped cheek syndrome
Non specific viral symptoms
Fever
Coryza
Muscle aches
Lethargy
Rash appears 2-5 days later
Complications of slapped cheek syndrome
Aplastic anaemia
Encephalitis or meningitis
Pregnancy complication
Rarely hepatitis, myocarditis or nephritis
Management of slapped cheek syndrome
Self limiting - 1-2 wees
Supportive management
Infectious until rash is formed.
Rash in slapped cheek syndrome
Rapidly speads
Diffue bright red rash on both sheeks
Few days later
Reticular - net like
Mildly erythematous
Spreads to trunk and limbs
Raised and itchy
Define roseola infantum
Viral exanthem caused by human herpesvirus 6
1-2 week incubation
Presentation of roseola infantum
Rapid onset high fever - 1-2 weeks post infection
Lasts 3-5 days and disappears
May be viral symptoms
When fever settles rash appears
Management of roseola infantum
Full recovery within a week
Often well enough to attend nursery
Complication of roseola infantum
Febrile convulsion - very high fever
Rash in roseola infantum
Mild erythematous
Macular rash
Arms legs trunk and face
Not itchy
Define erythema multiforme
An erythematous rash causd by hypersensitivity reaction - commonly viral infection and mredication
Presentation of erythema multiforme
Widespread
Itchy
Erythematous rash
Target lesions - red ring withing learger red rings
Presents abruptly over a few days
Associated with other systemic feature
Fever
Muscle and joint chaes
Headaches
General flu like illness
Management of erythema multiforme
Mange causes
Often self resolving - 1-4 weeks
Define urticaria
Hives - Small itchy lumps that appear on the skin, caused y the released of histamine
Causes of urticaria
Allergies to food
Contact with chemicals
Medications
Viral infections
Insect bites
Dermatographism
Management of urticaria
Antihistamines
Fexofenadine
Oral steroids - severs
Define chicken pox
Viral infection caused by highly contagious varicella zoster virus. s
Presentation of chicken pox
Widespread
Erythematous
Raised
Vesicular
Blistering
Starts on trunk or face spreads outwards
Contagious until lesions scab over
Fever
Itch
General malaise
Complications of chicken pox
Bacterial superinfection
Dehydration
Conjunctival lesions
Pneumonia
Encephalitis
Shingles
Ramsay Hunt syndrome
Management of chicken pox
Self terminating
Management of chicken pox
Self terminating
Aciclovir
Manage complications
Calamine lotion and antihistamine
Define hand foot and mouth disease
Viral infection caused by coxsackie A virus- incubation of 3-5 days
Presentation of hand foot and mouth
URTI symptoms
Small mouth ulcers appear 1-2 days later.
Blistering red spots acrodd body - hands feet and mouth
Painful mouth ulcers
Itchy
Management of hand foot and mouth disease
Highly contagious - avoid sharing towels
Self resolving
Supportive management
Complications of hand foot and mouth
Dehydration
Bacterial super infection
Encephalitis
Define molluscum contagiosum
Viral skin infection caused by molluscum contagiosum virus - poxvirus
Spread through direct contact - sharing towels or sheets
Presentation of molluscum contagiosum
Small
Flesh coloured
Papules
with central dimple
Appear in crops of multiple lesions
Management of molluscum contagiosum
Limited changes necessary
Avoid scratching
Fully resolve - may take up to 18 months
Define pityriasis rosea
Generalised self limiting rash that has unknown cause
Presentation of pityriasis rosea
Prodromal flu-like symptoms
Rash starts - herald patch - faint red or pink scaly oval shaped lesion 2cm or more usually somewhere on torso, appears 2 days prior to rest of the rash
Develop more lesions like this that can be arranged in christmas tree fashion
Management of pityriasis rosea
Resolves without treatment
within 3 months
Not contagious
Antihistamines for itch
Define seborrheic dermatitis
Inflammatory skin condition affecting the sebaceous glands
Management of seborrheic dermatitis
Infants - baby oil, petroleum jelly
Dandruff - ketoconaxole shampoo
Face and body - clotrimazol, miconazole
Define ring worm
Fungal infection of the skin - named according to area affected
Presentation of ringworm
Itchy
Erythematous
Scaly
Well demarcated rash
One or several rings
Spreading outwards
More prominent edge
Presentation of tinea capitis
Ring worm on scalp
Well demarcated hair loss
Itching
Dryness
Erythema
Presentation of tinea pedia
Athletes foot
Red white
Flaky
cracked
Itchy patches
Split
Bleeding
Management of ringworm
Clinical diagnosis - samples for microscopy and culture
Anti fungal creams - clotrimazole
Antifungal shampoo - ketoconazole
Oral antifungal - fluconazole, itraconazole
Education/lifestyle management
Define nappy rash
Contact dermatitis in the nappy area - caused by friction between skin and nappy and contact with urine and faeces indide dirty nappy. Can lead to fungal or bacterial infection
Risk factors for nappy rash
Delayed changing
Irritant soap products and vigorous cleaning
Certain types of nappies
Diarrhoea
Oral antibiotics
Preterm infants
Presentation of nappy rash
Sore
Red
Inflammation
Individual patches
Spares skin creases
Papules
Management of nappy rash
Lifestyle measures
Treat infection
Will resolve with good nappy hygiene
Define scabies
Tiny mtes called sarcoptes scabiei that burrow under the skin causing infection and intesnse itching
Lay eggs in the skin
Presentation of scabies
Incredibly itchy small red spots possibly with track marks
Classicaly in finger webs
Management of scabies
Permethrin cream - applied to whole body
Oral ivermectin
Wash all clothes, bedclothes towels on very hot wash
Define head lice
Pediculus humanus capitis parasite which causes infestations of the scalp - in school aged children
Nits
Management of head lice
Dimeticone - applied to heair and left to dry
Fine combs
Define erythema nodosum
Condition where red lumps appear across the patients shins - inflammation of subcut fat and
Associations with erythema nodosum
Hypersensitivity reaction
Strep throat
Gastroenteritis
Mycoplasma
TB
Pregnancy
Meds
IBD
Sarcoidosis
Lymphoma
Define impetigo
Superficial bacterial skin infection caused by staph aureus
Main tyoes of impetigo
Bullous
Non bullous
Define Non bullous impetigo
Occurs around nose or mouth
Exudate form golden crust
Define bullous impetigo
More systemic infection - lesions are widespread - staphylococcus scalded skin syndrome
Management of impetigo
Topical fusidic acid
Oral flucloxacillin
Define scalded skin syndrome
Wide spread ataph aureus infection
Presentation of scalded skin syndrome
Generalised patches of erythema on skin
Fluid filled bullae - burns
Skin flakes away
Systemic upset
Management of scalded skin syndrome
IV antibiotics
Define Stevens-Johnson syndrome
Spectrum of pathology where disproportional immune response causes epidermal necrosis resulting in blistering and shedding of the top layer of skin - SJS -> toxic epidermal necrolysis
Causes of stevens-Johnson syndrome
Medications
Anti-epileptic
Antibiotics
Allopurinal
NSAIDs
Infection
Herpes simplex
Mycoplasma pneumonia
Cytomegalovirus
HIV
Presentation of stevens johnsosn syndrome
Non specific symptoms - fever, cough sore throat mouth itchy skin
Develop purple reddish rash
Spreads across skin
Starts to blister
Skin breaks away and sheds - raw tissue underneath
Eyes become inflamed and ulcerated
Management of SJS
Emergency
Supportive care
Steroids
Imunoglobulins
Immunosuppressants
