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4th year passmed > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the commonest infective agent of onychomycosis (fungal nail)?

A

Trichophyton rubrum

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2
Q

What differentials might you give for fungal nail?

A

Psoriasis
Repeated trauma
Lichen planus
Yellow nail syndrome

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3
Q

What is the management of acne?

A
  1. Single topical therapy (topical retinoids, benzoyl peroxide)
  2. Topical combo therapy (+ antibiotic)
  3. Oral abx e.g. tetracyclines
    a) COCP can be used as an alternative in pregnant women
  4. Oral isotretinoin under specialist supervision
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4
Q

When can patients with impetigo return to work?

A

After being on treatment for 48 hours

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5
Q

What is the management of venous ulceration which maximises the likelihood of healing?

A

Compression bandaging

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6
Q

What is the first line management of hyperhidrosis?

A

Aluminium chloride topical

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7
Q

What are the causes of erythema nodosum?

A 
Infection - strep, TB, brucella
Systemic - Sarcoid, IBD, Behcets
Malignancy
Drugs - Penicillin, sulphonamides, COCP
Pregnancy
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8
Q

What is the main complication of actinic keratoses?

A

SCC

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9
Q

Where would you typically find a pyoderma gangrenosum?

A

Lower limb or peristomal

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10
Q

What ar the causes of pyoderma gangrenosum?

A

Idiopathic
IBD
RA, SLE
Myeloproliferation

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11
Q

What is the management of pyoderma gangrenosum?

A
  1. Oral steroids

2. Immunosuppressive therapy

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12
Q

What is a side effect of topical side steroids particularly seen in darker patients?

A

Patchy depigmentation

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13
Q

What are the different steriod potencies and examples of each?

A

Mild - Hydrocortisone
Moderate - Betamethasone/Clobetasone
Potent - Fluticasone
Very potent - Clobetasol (Dermovate)

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14
Q

What conditions is vitiligo associated with?

A 
T1DM
Addison's 
Autoimmune thyroiditis
Pernicious anaemia
Alopecia areata
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15
Q

What is the management of vitiligo?

A

Sun block

Topical steroids if started early

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16
Q

What are the common and important side effects of isoretinoin?

A

Important - Teratogenicity, low mood

Common - Dry eyes, skin, and lips, raised triglycerides

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17
Q

What are the features of acne rosacea?

A

Affect nose, cheeks, forehead
Begins with flushing
Telangiectasia are common
Persistent erythema with papule form later one
Rhinophyma and blepharitis are later signs

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18
Q

What is the management of acne rosacea?

A

Topical metronidazole or PO if more severe disease

High factor suncream

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19
Q

Which drugs might cause worsening of plaque psoriasis?

A 
Beta blockers
Lithium
Antimalarials
NSAIDs
ACEi
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20
Q

What endocrine condition can cause acne vulgaris?

A

PCOS

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21
Q

What disease is dermatitis herpetiformis associated with?

A

Coeliac disease

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22
Q

How would you differentiate between pemphigus vulgaris and bullous pemphigoid?

A

Bullous pemphigoid is restricted to the skin, whereas phemphigus vulgaris also involves the mucosa

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23
Q

Where does acanthuses nigricans typically occur?

A

Axilla, neck, groin (folds)

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24
Q

What is pityriasis versicolor?

A

A superficial cutaneous fungal infection caused by Malassezia furfur

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25
Q

What are the features of pityriasis versicolor?

A

trunk involvement predominantly with hypo pigmentation, pink our brown patches.
Often scaly

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26
Q

What are the features of keratoacanthomata?

A

Volcano or crater like

Initially a smooth dome shaped papule which rapidly grows into a crater filled with keratin

27
Q

What do ‘exclamation mark’ hairs indicate?

A

Alopecia areata

28
Q

What is it important to screen for in patients with alopecia aerate?

A

Autoimmune disease - thyroiditis, diabetes, pernicious anaemia

29
Q

What is the first line management of sevorrheic dermatitis?

A

Ketoconazole topical

30
Q

When does guttate psoriasis classically present?

A

After a streptococcal or viral URTI

31
Q

What factors might exacerbate acne rosacea?

A

Sunlight

32
Q

Is dermatitis herpetiformis itchy?

A

Yis

33
Q

What is a well recognised side effect of ketoconazole?

A

Gynaecomastia

34
Q

Which malignancy is assocaited with acanthosis nigricans

A

GI Adenocarcinoma

35
Q

What are the risk factors for SCC?

A 
Sunlight
Immunosuppression
SMoking 
Chronic leg ulcers
Actinic keratoses
36
Q

What are the antibodies targeting in pemphigus vulgaris?

A

Desmosomes

37
Q

Where are the lesions in HHT/Osler Weber Rendu?

A

Skin and mucosal membranes

38
Q

What are the diagnostic criteria for HHT?

A

Epistaxes
Telangiectasiae at multiple sites
Visceral lesions e/g/ GI telangiectasia or pulmonary nodules
FHx

39
Q

What topical agent is commonly prescribed on diagnosis of actinic keratoses?

A

5-Fluorouracil cream for 2-3 weeks

40
Q

What are the features of lichen planus?

A

Itchy papular rash on the palms, soles, genitals and flexor surfaces
Polygonal rash
Koebner phenomenon often seen (new lesions at site of trauma)
White lace pattern on buccal mucosa

41
Q

What is the most common cause of hirsutism and what drug is good in this use?

A

PCOS

Dianette - Co-cyprindiol (also a COCP)

42
Q

Peri-orbital and nasolabial scaly rash associated with dandruff =

A

Seborrhoeic dermatitis

43
Q

What are the causes of erythema multiforme?

A

HSV - commonest cause
Idiopathic
Mycoplasma, Strep

Drugs - Penicillin, sulphonamides, carbamazepine, NSAIDs, COCP

CTDs e.g. SLE
Sarcoid
Malignany

44
Q

What is the management of lichen planus?

A

Topical steroids are mainstay

Mayrequire oral steroids/immunosuppression if severe

45
Q

How many skin types are there?

A

6

46
Q

What is pityriasis rosea?

A

An acute self limiting viral rash with a Herald Patch on the trunk followed by erythematous, oval scaly patches which follow the lines of Langer producing a fir tree appearance

47
Q

What is the disease course of pityrisaisis rosea?

A

Rash disappears after 6-12 weeks

48
Q

What are the causes of leukonychia?

A

Hypoalbuminaemia
Fungal disease
Lymphoma

49
Q

What is Nikolsky’s sign?

A

Epidermis separates on mild lateral pressure

50
Q

Which drugs are known to cause TEN?

A 
Phenytoin
Sulphonamides 
Allopurinol
Penicillins
Carbamazepine
51
Q

How would you differentiate telangiectasia from spider naevi?

A

Telangiectasia refill from the edges, spider naevi refill from the centre

52
Q

What is leukoplakia and who is it commonly seen in?

A

White hard spots of the mucous membranes commonly seen in smokers

53
Q

Is leukoplakia serious?

A

Yes - premalignant

54
Q

What are the systemic causes of pruritus?

A 
Liver disease
IDA
Polycythaemia
CKD
Lymphoma 
Thyroid disease
55
Q

What are some non liver related causes of spider naevi?

A

Pregnancy

COCP

56
Q

What are the features of necrobiosis lipodica diabeticorum?

A

Shiny painless areas of yellow-red skin on the shin of diabetics.
Associated with telangiectasia

57
Q

Parkinson’s is associated with which skin disease?

A

Seborrhoeic dermatitis

58
Q

What is the management of chronic plaque psoriasis?

A

Regular emolients
1. Topical corticosteroids and VitD analogue for 4 weeks

  1. If no improvement then up the VitD dose
  2. Offercoal tar preparation
  3. Short acting dithranol
59
Q

What skin disorders are associated with SLE?

A

Photosensitive butterfly rash
Discoid lupus
Alopecia
Livedo reticular (net-like)

60
Q

What type of melanoma commonly affects the nail beds?

A

Acral lentiginous melanoma

61
Q

What is the difference between lichen planus and lichen sclerosis?

A

Planus= purple pruritic papular polygonal rash on flexor surfaces

Sclerosus= itch white spots on old ladies vulvae

62
Q

Where are you most likely to find a keloid scar?

A

Sternum

63
Q

What is the mainstay of treatment for bullous pemphigoid?

A

Oral steroids

4th year passmed (28 decks)

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