Dermatology Flashcards
Recent virla illness
Started as herald patch on trunk then went to red and scaly in the fir tree appearance
Pityriasis Rosea
(HHV-7)
Self limiting 6-12 weeks
Flushing, redness and pustules/papules with some telangiectasis
Dx and Mx
Rosacea
erythema/flushing - top brimonidine gel
Mild-mod papules/pustules - top ivermectin
mod-severe papules/pustules - top ivermectin + po doxy
2-4 weeks after a strep sore throat, tear drop rash - dx
Guttate psoriasis
Tender, red, nodular lesions mostly on shins.
Erythema nodosum
Inflamm subcut fat
Usually resolves <6wks
Causes - TB, sarcoidosis, IBD, drugs, pregnancy…
Ix for this rash = Serum ACE, sputum culture, CXR
1.small red papule
2. Deep red necrotic ulcers
Dx and Mx
PMH IBD
Pyoderma gangrenosum
May be seen in IBD, CT disorders, myeloproliferative disorders
Steroids (Po prednis)
Mx seborrheic dermatitis
- Head and hsoulders (zinc pyrithione) and Tar
2.Ketoconazole
Pinkish or pearly white papules with central umbilication in clusters.
Dx and Mx
molluscum contagiosum
Self-lim, <18m, contagious so dont share towels etc. No exclusion
(Cryotherapy, squeezing but not recommended usually…)
Tx impetigo localised vs non localised disease
Localised, limited - hydrogen peroxide 1% cream and if unsuccessful then topical fusidic acid or mupirocin
Extensive disease - fluclox (or erythromycin)
Off school till >48hrs after Abx or lesions crusted
Itchy, papular rash, polygonal with white lines on pattern.
Dx and mx
Causes - gold, quinine, thiazides
Potent topical steroids (clobetasone butyrate)
If oral - benzydamine mouthwash or spray
Extensive - oral steroids/immunsup
Small crusty or scaly lesions.
Dx and Mx
Actinic Keratosis
Fluorouracil cream 2-3 week course. (+steroid for inflam form this).
Top diclofenac for mild/ topical imiquimoid/cryotherapy..
Red scaly patches, slow growing
Dx and mx
Bowens disease
Precursor to SCC
Topical 5-fluorouracil (+ topical steroids to control inflammation form this), cryotherapy, excision.
Sun exposed areas, rapidly expanding painless ulcerate nodules, may have cauliflower appearance.
SCC
Pearly, flesh coloured with telangiectasia. May later ulcerate -> central crater.
bcc
Widespread Pruitis, linear Burrows side fingers, interdigital webs + flexor aspects wrists.
dx/Mx
scabies
1.permethrin (8-12hrs)
2.Malathion (24hrs)
Dry on skin, wash off and repeat at 7 days
Itching persists up to 4-6 weeks.
Treat whole house
Prodromal burning pain
Red, macular rash - dermatomal, becomes vesicular
DX/MX
Infectious till crusted vesicle
Paracetamol/NSAIDs and if not responding then amitriptyline considered
PO corticosteroids if immunocompetent <2wks and not responding.
Antivirals <72hours for all
Itchy rash Often first appear in abdominal striae
Spares the periumbilical region
Prgenant
Dx/Mx
Pruritic condition ass with last trimester
Mx depends on severity
Mx fungal nail infection and the most common organism
Most commonly trichophyton rubrum
Limited involvement - topical amorolfine nail lacquer 6+m
Extensive involvement from dermaophyte infection - PO Terbinafine
Extensive due to Candida - PO Itraconazole
Acne Vulgaris Mx
Single topical therapy - retinoids/benzoyl peroxide
Topical combo therapy - retinoids/benzoyl peroxide/ Abx 3m (tetracyclines unles spreg/BF/<12)
COCP - Dianette (3m only as increased risk VTE)
PO Isotretinoin with dermatology
Mx Hidradenitis suppurativa
chronic inflammatory skin disorder - inflammatory nodules, pustules, sinus tracts, boils… Axilla is most common site. Acute flares can be treated with steroids or fluclox. Long term with topical clindamycine or oral lymecycline/clindamycin/rifampicin Abx.
Mx Psoriasis on body
Potent corticosteroid OD + Vitamin D analogue OD (applied separate) up to 4 weeks
If no improvement after 8 weeks then Vitamin D analogue BD
If no improvement 8-12 weeks then either: Potent corticosteroid BD p to 4 weeks or coal tar prep OD/BD
SHort acting dithranol also
Secondar care - phototherapy, systemic therapy
Mx scalp psoriasis
topical corticosteroids OD 4 weeks
Cream for facial hirsutism
Eflornithine cream
Burns IV fluid formula
TBSA% X weight kg x 4
This is half fluid administered in first 8 hours
Venous vs arterial ulcer
venous - Malleolar area, large and shallow, warm skin, normal pulses, ABPI normal (0.8-1). Compression bandage
Arterial -
punched out, cold skin, weak/absent pulses, loss hair, ABPI <0.8.
