Dermatology Flashcards
What is the most accuarate way to meaasure the extent of burns? (not rule of nines)
Lund and Browder chart
What are the 4 major types of burn?
- Superficial epidermal
- Partial thickness (superF dermal)
- Partial thickness (deep dermal)
- Full thickness
Describe a superficial epidermal burn
- Red
- Painful
- Dry
- No blisters
Describe a partial thickness (superficial dermal) burn
- Pale pink
- Painful
- Blistered
- Slow cap refill
Describe a partial thickness (deep dermal) burn
- Typically white, may have pathces of non-blanching erythema
- Reduced sensation
- Painful to deep pressure
Describe a full thickness burn
- White (waxy)/brown leathery
- Black
- No blisters
- No pain
What are the indocations that a burn should be referred to secondary care?
- All deep dermal and full-thickness burns
- Superficial dermal >3% (>2% in kids)
- Sup Derm of face, hands, feet, flexure and circumferntial
- Inhalation, chemical, electrical
- Non-accidental
What burns are escharotomies indicated in?
- Circumferential full-thickness burns of torso or limbs
Management of superficial epidermal burn
Symptomatic relief
- Analgesia
- Emollients
Management of superficial dermal burns
- Cleanse wound
- Leave blister intact
- Non-adherent dressing
- Avoid topical creams
When should intubation be considered in burns?
- Deep burns to face or neck
- Blisters or oedema of oropharynx
- Stridor
When are IV fluids required in a burn injury and how is it calculated?
- Gretaer than 10% in kids, 15% in adults
- TBSA x weight x 4 (24hrs)
How much / what solution is given after 24 hrs in fluid resus in burns?
- Colloid infusion at 0.5 x TBSA x BW
- Crystalloid 1.5 x TBSA x BW
- Antioxidants added
What do keratinocytes and dermal fibroblasts interact with to cause acanthosis nigricans?
Insulin-like growth factor receptor-1 (IGFR1)
What is acne fulminans and how is it managed?
Very severe acne associated with severe upset (fever)
- Admission and oral steroids
How can erysipelas be differentiated from cellulitis?
- Erysipelas: Raised well defined border (Strep A), upper dermis
- Cellulitis: Ill-defined, deep dermis and subcut infection
Petechial rash in a kid what do you do?
Admit
1st line treatment for lichen sclerosis?
- Topical clobetasol propionate (topical tacrolimus next line with specialist)
Treatement of eczema herpeticum?
IV aciclovir
When can a child return to daycare folowing impetigo?
48 hrs after starting treatment
What are common complications of seborrhoeic dermatitis?
Otitis externa and blepharitis
What is the 1st and 2nd line treatment for acne vulgaris?
- Benzoyl peroxide (or topical retinoid or both)
- Tetracycline (max 3 months)
What may occur as a complication of long-term antibiotic use as a result of acne?
Gram-negative folliculitis
What can be given for gram-ve folliculitis?
High-dose oral trimethoprim
What are the 4 main subtypes of melanoma?
- Superficial spreading (most common)
- Nodular
- Lentigo aligna
- Acral lentiginous (least common)
Where can acral lentiginous be found? What sign can they have?
Subungual pigmentation (Hutchison’s sign)
- Palms or feet
How can Nodular and lentigo maligna be differentiated?
- Nodular: middle-aged, red or black lump that bleeds or oozes
- Lentigo maligna: Older people, growing mole
What rash in pregnancy is associated with blistering, occurs in 2nd or 3rd trimester and rarely seen in the 1st pregnancy?
Pemphigoid gestationalis
