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dermatology Flashcards

1
Q

what is a Pyogenic Granuloma? how does it present?
What are the triggers for it ?
where does it mainly occur?
what important differential needs to be excluded ?

A

It is a benign rapidly growing tumour of capillaries that presents as a discrete lump with a red or dark appearance that grows rapidly upto 1-2 cm in size.
Triggers:
Follows trauma
pregnancy
hormonal contraception
infection
occurs on fingers/ upper chest/ back / neck/ head
Nodular melanoma needs to be excluded

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2
Q

what are the areas commonly affected by acne rosacea ? how does it present

A

typically affects nose, cheeks and forehead
first symptom : flushing
telangiectasia : common
develops into erythema with papules and pustules

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3
Q

how would you manage acne Vulgaris that has not responded to topical and oral therapies

A

refer to dermatology for prescription of Isotretinoin

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4
Q

what is an alternative to tetracyclines that can be used in pregnant women for the management of acne vulgaris

A

erythromycin

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5
Q

how does idiopathic livedo reticularis present

A

purple, lace patterned discolouration of the skin and worsening of the symptoms in the cold.

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6
Q

how does miliaria present

A

rash characterised by small, raised spots that are often red on white skin and colourless on brown and black skin

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7
Q

what is the first line management of scalp psoriasis

A

topical corticosteroid

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8
Q

what is the Koebner phenomenon ? What conditions does it appear in?

A

skin lesions that appear at the site of injury
psoriasis, vitiligo, warts, lichen planus, lichen sclerosus, molluscum contagiosum

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9
Q

what is guttate psoriasis

A

psoriatic condition clasically occuring after infections such as strep throat

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10
Q

how soon after an strep infection does guttate psoriasis present

A

2-4 weeks after infection

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11
Q

how does a venous ulcer present ?

A

aching lower limb
ulceration in the ‘‘gaiter region’’
night cramps or cramps that occur after sitting or active standing
symptom relief from leg elevation
skin discolouration

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12
Q

how do you investigate a venous ulcer ?what value indicates arterial disease ?

A

ABPI ( Value < 0.9 indicates arterial disease)

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13
Q

what is the management of venous ulcer

A

compression bandage

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14
Q

what is the difference between bullous pemphigoid and pemphigus

A

Both are auto-immune blistering disorders affecting the elderly.
a Pemphigus presents with blisters and erosions involving the mucous membranes whereas a pemphigoid does not involve the mucosa

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15
Q

which parts does rosacea affect

A

nose cheeks and forehead

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16
Q

give 3 features of rosacea

A

flushing, Erythema, telangiectasia

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17
Q

how is pityriasis versicolor managed

A

Ketoconazole shampoo

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18
Q

give 4 features of pityriasis versicolor

A

affects trunk
hypo-pigmented, pink or brown patches
more prominent after a suntan
scale
pruritis

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19
Q

first line management of scabies

A

Permethin

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20
Q

what is Nikolsky sign ? In which condition is it present ?

A

Blisters and Erosions that appear when the skin is rubbed gently . Seen in Stevens Johnson syndrome, toxic epidermal necrolysis

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21
Q

what is the classical sign seen in Erythema multiforme

A

Target sign

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22
Q

what is Erythema Multiforme triggered by

A

Infection

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23
Q

What is Actinic Keratosis

A

It is a common Pre-malignant condition that develops as a consequence of chronic sun exposure.

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24
Q

where does actinic keratosis commonly occur and how does it present ?

A

Small crusty or scaly lesions on sun exposed areas like the temple of head

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25
Q

what are the management options for actinic keratosis

A

prevention : Sun cream
Florouracil : 2-3 week course
topical diclofenac / topical imiquimod

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26
Q

whats a condition that features hair loss after pregnancy

A

Alopecia areata

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27
Q

give 3 features of pyoderma gangrenosum

A

Initially a small red papule
followed by deep, red, necrotic ulcer with a violaceous border
idiopathic in 50% of cases and can be seen in IBD, Connective tissue disorders and Myeloproliferative disorders

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28
Q

A man presents with a growing round raised flesh colored lesion with central depression and Telangiectasia . What is the diagnosis ?

A

BCC

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29
Q

which condition presents with the formation of corkscrew shaped collateral vessels distally- What is the strongest association for this condition

A

Buerger’s disease
smoking

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30
Q

what is the treatment of -
mild/moderate acne Rosacea
severe/ resistance Rosacea

A

mild : Topical Ivermectin
Severe/ resistant : combination of topical Ivermectin and oral doxycycline

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31
Q

which is the single most important prognostic factor in malignant melanoma ?

A

Invasion of the tumour

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32
Q

2 key features of Toxic epidermal necrolysis

A

systemically unwell ( pyrexia, tachycardia)
Positive Nikolsky’s sign : epidermis separates with mild lateral pressure

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33
Q

name 2 complications of toxic epidermal necrolysis

A

Volume loss
Electrolyte derangement

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34
Q

name 6medication triggers of TEN

A

PSA PCN
Phenytoin
Sulphonamides
Allopurinol
Penicillins
Carbamazepine
NSAIDs

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35
Q

Under what circumstances would you refer a patient with molluscum contagiosum

A

HIV +ve with extensive lesions

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36
Q

what is the name of the rash caused by TB

A

Erythema nodosum

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37
Q

which malignancy is most commonly associated with acanthosis nigricans

A

Gastrointestinal adenocarcinoma

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38
Q

first line treatment for non bullous impetigo

A

Hydrogen peroxide 1% cream

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39
Q

do you need a break when prescribing topical steroids in patients with psoriasis ?

A

yes, 4 week break in between courses

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40
Q

what is the antibiotic of choice for acne in pregnancy? Can it be used alone

A

Oral erythromycin, to be used with Benzoyl peroxide. do not use Abx alone as it can lead to antibiotic resistance.

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41
Q

which medications should not be used in combination in the management of acne vulgaris

A

Topical and oral antibiotics

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42
Q

what is an alternative to oral antibiotics in the management of acne in women

A

COCP

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43
Q

_____________ is a contraindication to topical and oral retinoid treatment

A

pregnancy

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44
Q

what is the first line management of mild-moderate acne

A

12 week course of topical combination therapy such as :

  1. topical adapalene with topical benzoyl peroxide
  2. Topical tretinoin with topical clindamycin
  3. topical benzoyl peroxide with topical clindamycin
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45
Q

which malignancy are patients who have undergone renal transplant most at risk of developing

A

skin cancer ( Squamous cell carcinoma)

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46
Q

What is the first line medical manegement of actinic keratosis

A

Florouracil cream ( 2-3 week course)

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47
Q

what are Curling’s ulcers ? How do they present ?

A

Gastric ulcers that develop in response to severe physiological stress such as burns. presents as haematemesis

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48
Q

give 3 characteristic features of acne vulgaris

A

Open and closed comedones
Pustules
Nodules

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49
Q

Name 5 nail changes that may be present in psoriasis

A

Pitting
Onycholysis
Subungal Hyperkeratosis
loss of the nail
dactylitis and enthesitis

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50
Q

name 5 nail changes that maybe seen in psoriasis

A

Pitting
Onycholysis ( seperation of nail from nail bed)
subungual hyperkeratosis
loss of the nail
dactylitis and enthesitis

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51
Q

what is the first line management of Bowens disease

A

5- Fluorouracil

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52
Q

where is venous ulceration most commonly seen

A

above the medial malleolus

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53
Q

what medications exacerbate psoriasis

A

MALIN B
( anti) Malarials
ACEi
Lithium
Infliximab
NSAID’s
Beta blockers

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54
Q

what is the nature of inheritance of hereditary haemorrhagic telangiectasia ? describe it.

A

autosomal dominant. Characterised by telangiectasia over the skin and mucous membranes as well as features like epistaxis, visceral lesions and a family history

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55
Q

what are the 4 diagnostic criteria used to diagnose HHT

A
  • Epistaxis : Spontaneous, recurrent nosebleeds
    Telangiectasias : multiple at different sites ( Lips, oral cavity, fingers, nose)
    visceral lesions ( AVM’s)
    Fhx : 1st degree relative
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56
Q

how would you differentiate pyogenic granuloma from amelanotic melanoma

A

pyogenic granuloma has a history of trauma

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57
Q

how do you investigate contact dermatitis

A

Patch testing

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58
Q

how long does it take for the pityriasis rosea rash to resolve

A

6-12 weeks

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59
Q

classical sign of pityriasis rosea

A

herald sign

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60
Q

Wikham striae are present in which condition

A

lichen planus

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61
Q

which gi condition is pyoderma gangrenosum associated with

A

IBD

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62
Q

which condition is high voltage burns associated with ?

A

Rhabdomyolysis

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63
Q

what are the 2 types of Comedones

A

top closed–> whitehead
top open –> blackhead

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64
Q

when follicles burst releasing irritants, the following types of inflammatory lesions are formed

A

nodules and cyst

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65
Q

what are the 2 types of scars that can be formed due to excessive inflammatory response in acne vulgaris

A

ice pick scars
hypertrophic scars

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66
Q

what is acne fulminans

A

severe acne associated with systemic upset ( fever)

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67
Q

what is a consequence of long term antibiotic use in acne. how do you treat this

A

gram negative folliculitis. treat with high dose oral trimethoprim

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68
Q

________ is a contraindication to topical and oral retinoid treatment

A

Pregnancy

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69
Q

To reduce the risk of antibiotic resistance developing the following should not be used to treat acne:

A

-monotherapy with a topical antibiotic
-monotherapy with an oral antibiotic
-a combination of a topical antibiotic and an oral antibiotic

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70
Q

what is the management of mild to moderate acne that has not responded to 2 completed courses of treatment

A

consider referral

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71
Q

what is the first line management of plaque psoriasis ?

A

potent corticosteroid such as betamethasone applied once daily plus vitamin D analogue applied OD

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72
Q

what are dermoid cysts and what can they be lined by

A

embryological remnants and may be lined by hair and squamous epithelium

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73
Q

what are the 4 p’s of lichen planus

A

purple
pruritic
papular
polygonal

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74
Q

how do you manage dermatophyte nail infections

A

oral terbinafine

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75
Q

which medications can cause depigmentation in patients with darker skin

A

topical corticosteroids such as clobetasone

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76
Q

what is the management of mild to moderate acne rosacea with pustules and papules ?

A

Topical ivermectin

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77
Q

what is the management of moderate to severe papules and pustules

A

combination of topical ivermectin and oral Doxycycine

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77
Q

how is erythema and flushing managed in acne rosacea ?

A

Topical brimonidine gel

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77
Q

which condition presents with orange peel shins

A

graves disease

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78
Q

How many weeks should be given between courses of topical corticosteroids

A

4 week break

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79
Q

what is the first line management of chronic plaque psoriasis ? How long is the treatment continued ?

A

potent corticosteroid applied once daily plus vitamin D Analogue applied once daily - for up to 4 weeks

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80
Q

what is the first line management of urticaria

A

non sedating anti histamines such as certizine

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81
Q

what is used for severe / resistant cases of urticaria

A

Prednisolone

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82
Q

what is used in the long term management of chronic plaque psoriasis

A

vitamin D Analogues such as calcipotriol, calcitriol

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83
Q

which medications exacerbate psoriasis

A

beta blocker
lithium
anti malarial
NSAIDs
ACEi
Infliximab

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84
Q

which malignancy are patients who undergo renal transplant at risk of

A

squamous cell carcinoma of the skin

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85
Q

what test is most appropriate for diagnosing contact dermatititis ?

A

Skin patch testing

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86
Q

what type of hypersensitivity reaction is allergic contact dermatitis?

A

Type 4

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87
Q
A
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88
Q

which factors may exacerbate psoriasis

A

trauma
alcohol
drugs
withdrawal of systemic steroids

89
Q

what are school exclusion rules for impetigo?

A

exclude child from school until the lesions are crusted over and healed / 48 hours after commencing antibiotic treatment

90
Q

what medications can be used in severe impetigo?

A

Oral flucloxacillin
oral erythromycin if penicillin allergic

91
Q

where does erythema nodosum most commonly occur?

A

shins

92
Q

what is the main cause of actinic keratosis

A

chronic sun exposure

93
Q

what factors can worsen acne rosacea ?

A

alcohol
sunlight

94
Q

give 2 precipitating factors of pompolyx

A

humidity ( sweating)
high temperatures

95
Q

how does pompholyx present?

A

small blisters on palms and soles
pruritis - intensely itchy/ burning sensation

96
Q

how do cherry hemangiomas present ?

A

small bright red raised bumps usually found on the skin of adults over 30 years

97
Q

how does pemphigoid gestationis present ? At what stage of pregnancy do they present? what is the management ?

A

pruritic blistering lesions in periumbilical region later spreading to trunk, back , buttocks and arms.
2nd/3rd trimester
oral corticosteroids

98
Q

how do you distinguish polymorphic eruption of pregnancy from pemphigoid gestationis?

A

polymorphic eruption of pregnancy : no blistering
pemphigoid gestationis : blistering

99
Q

what is the commonest skin disorder of pregnancy

A

atopic eruption of pregnancy

100
Q

give 3 skin disorders associated with pregnancy

A

atopic eruption of pregnancy
polymorphic eruption of pregnancy
Pemphigoid gestationis

101
Q

how does atopic eruption of pregnancy present ?

A

itchy erythematous papules on face, neck , chest and extensor surfaces of the limbs

102
Q

urticaria not being managed with cetirizine?

A

add 5 day course of oral prednisolone

103
Q

what type of medication is used for urticaria ? give an example.

A

non sedating anti-histamine such as loratadine

104
Q

what is the antihistamine of choice for chronic urticaria?

A

Fexofenadine

105
Q

when should early intubation be considered in the management of burns

A

deep burns to the face or neck, blisters or oedema of the oropharynx, stridor etc.

106
Q

what is the most common cause of erythema multiforme?

A

herpes simplex virus

107
Q

which drugs can precipitate erythema multiforme?

A

Penicillin
Sulphonamides
Carbamezapine
allopurinol
NSAID’s
oral contraceptive pill
nevirapine

108
Q

what is erythrasma? what is it caused by ? what is the first and second line management ?

A

asymptomatic, flat, slightly scaly pink or brown rash generally found in groin or axillae.

caused by an overgrowth of diptheroid cornyebacterium mutissimum.

1st line : topical miconazole
2nd line: oral erythromycin

109
Q

which is the most aggressive kind of melanoma

A

Nodular melanoma

110
Q

which is the most common subtype of melanoma

A

superficial spreading

111
Q

what virus is molluscum contagiosum caused by?

A

Poxvirus

112
Q

what are 2 complications of seborrhoeic dermatitis?

A

Otitis externa
Blepharitis

113
Q

give a list of causes of erythema nodosum

A

NODOSUM

NO cause ( Idiopathic)
Drugs ( sulphonamides)
Oral contraceptive pill
Sarcoidosis
UC , Crohns
Microorganisms : TB, Streptococcus, toxoplasmosis

114
Q

give a short history on how pityriasis rosea may present ?

A

acute, self limiting rash caused by HHV-7 , some may give a history of a viral infection followed by a herald patch and erythematous, oval scaly patches. generally self limiting.

115
Q

what are keloid scars ?

A

tumour like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound

116
Q

what ethnicity are keloid scars more common in?

A

dark skin

117
Q

what is the management of keloid

A

early - intralesional steroids
late-excision

118
Q

what is a differential of keratoacanthoma

A

squamous cell carcinoma

119
Q

what are the features of keratoacanthoma?

A

looks like volcano or crater
smooth dome shaped papule that grows to become a crater centrally filled with keratin.

120
Q

what are the characteristic features of granulomatosis with polyangiitis

A

haemoptysis
sinusitis
nasal discharge
malaise
joint pain
vasculitic rash

121
Q

2 key features of eosinophilic granulomatosis with polyangiitis

A

asthma and eosinophilia

122
Q

what are the characteristic features of polyarteritis nodusa

A

non specific features
history of hepatitis b

123
Q

which skin types are squamous cell carcinomas most common in

A

Fitzpatrick skin types 5,6

124
Q

what is the key feature of a dermatofibroma?

A

it is an asymptomatic papule that dimples when squeezed

125
Q

A GP needs to prescribe medication for severe acne ? what is an appropriate treatment regime ?

A

Topical retinoid + Topical benzoyl peroxide + oral doxycycline

126
Q

what are the 2 key clinical features of dermatomyositis

A

muscle weakness
skin manifestations

127
Q

give 5 skin manifestations of dermatomyositis

A

heliotrope rash - lilac discolouration around eyes
Gottron’s papules - purple nodules on knuckles
Shawl rash / sign - fixed erythematous rash on torso
V sign - photosensitive rash on chest
nailfold erythema

128
Q

what is the diagnostic investigation for dermatomyositis

A

muscle biopsy

129
Q

what antibodies and markers may be present in dermatomyositis ?

A

Anti-Mi2
Anti-Jo1
Anti SRP
CK, ALT, AST, LDH

130
Q

give 2 ways dermatomyositis is managed ?

A

oral steroids
malignancy screening

131
Q

give 5 side effects of ciclosporin

A

hypertrophy of gums
hypertrichosis
hypertension
hyperkalaemia
hyperglycaemia

132
Q

give 2 medications used in the systemic management of chronic plaque psoriasis

A

methotrexate
cyclosporin

133
Q

give 5 cutaneous manifestations of SLE

A

Malar rash - butterfly rash
Discoid Lupus Erythematous
photosensitivity
alopecia
ulcers and vasculitis

134
Q

what is the first and second line management of cellulitis and the management if patient is pregnant

A

1st line Flucloxacillin
2nd line Doxycycline / Clarithromycin
pregnancy Erythromycin

135
Q

what is erythroderma? what are its triggers? how would you investigate and manage it.

A

dermatological emergency with widespread erythema affecting > 90% of skin surface.

signs and symptoms include skin redness and systemic symptoms.

triggers include
dermatitis
psoriasis
drug allergies

investigation and management includes fluid replacement and emollients alongside treatment of underlying cause.

136
Q

what other manifestations can be present in acne rosacea apart from skin manifestations?

A

ocular features such as blepharitis and conjunctivitis
rhinophyma - swelling of nose

137
Q

what is auspitz sign

A

pinpoint bleeding on removal of a layer of scale seen in chronic plaque psoriasis

138
Q

what are some causes of acanthosis nigricans

A

T2DM
Gi cancer
PCOS
Obesity
endocrine disorders like acromegaly, Cushing’s, Hypothyroidism

139
Q

what is tinea? what is it characteristically known as ? how is it managed?

A

Superficial fungal infection caused by dermatophytes. It is commonly known as ringworm due to its characteristic ring shaped rash.

managed with topical antifungals such as clotrimazole and ketoconazole.

140
Q

give the treatment summary for eczema

A
  1. Mild : emollients + mild topical corticosteroid ( such as hydrocortisone 1%)
  2. Moderate eczema : emollients + moderate topical steroid ( Clobetasone butyrate 0.5% ( Eumovate)) for 5 days + hydrocortisone for face
    severe eczema : emollients + strong topical steroid ( Betamethasone valerate 0.1% ( Betnovate) ( Eumovate for face)
141
Q

what is CREST syndrome ? What is it also known as ? What antibodies are present ?

A

Calcinosis
Raynauds
oEsophageal dysmotility
Sclerodacyly
Telangiectasia

Also known as systemic sclerosis

ANA +ve
Anti centromeric antibodies

142
Q

what medications trigger Stevens Johnsons syndrome

A

sulfonamides
beta lactams - penicillins and cephalosporins
antiepileptics
allopurinol
NSAIDs

143
Q

what are the classical features of SJS

A

symptoms of a URTI
mucosal ulceration and erythematous macules

144
Q

what are the warning signs of malingnant melanoma

A

Asymmetry
Borders ( irregular)
Colour variegation
Diameter > 6 mm
Elevation

145
Q

how much of the skin surface is affected in Erythroderma ?

A

Erythema of > 90% of the skin

146
Q

which cancer can actinic keratosis precede ?

A

Squamous cell carcinoma

147
Q

what pathogen causes scabies

A

sarcoptes scabiei

148
Q

give the clinical manifestations of lichen planus

A

purple
pruritic
papular
polygonal
planar

149
Q

how would you distinguish between plaque psoriasis and atopic eczema

A

atopic eczema presents with an erythematous pruritic dry rash whereas plaque psoriasis presents with silver scale plaques

150
Q

What bacteria is folliculitis caused by ? how does it present

A

staphylococcus aureus
pustules and papules

151
Q

in which patients does eosinophilic folliculitis occur

A

immunosuppressed patients - hiv

152
Q

how does a pyogenic granuloma present ? where does it most commonly occur ?

A

single, shiny red nodule described as raspberry like
generally located on fingers and hands

153
Q

give 4 causes of pyogenic granuloma

A

minor trauma ( pin prick)
infection ( Staph. Aureus)
pregnancy
medications like oral retinoids

154
Q

which disorders need to be screened for before commencing isotretinoin

A

mental health disorders

155
Q

what is erythema ab igne

A

chronic skin condition caused by prolonged exposure to infrared radiations - often with a history of prolonged hot water bottle use.

156
Q

what is erythema toxicum

A

common rash seen in newborn infants on face, chest, arms and legs presenting in the first few days after birth

157
Q

what is erythema migrans

A

underlying lyme disease
bulls eye appearance

158
Q

how do you manage staphylococcus skin scalded syndrome ?

A

IV flucloxacillin

159
Q

how is pyoderma gangenosum managed

A

high dose oral corticosteroids / other immunosuppressives
would care

160
Q

what type of reaction is allergic contact dermatitis

A

delayed type 4 hypersensitivity reaction mediated by t lymphocytes

161
Q

what is the nature of inheritance of tuberous sclerosis

A

autosomal dominant

162
Q

what are some key manifestations of tuberous sclerosis

A

angiofibromas : dome shaped papules in butterfly distribution
ashleaf macules : hypopigmented skin
shagreen patch: leathery plaque on sacrum
ungal fibromas : fleshy tumours that grow from the nail folds
cafe au lait spots : hyperpigmented macules on the body

163
Q

how is lichen planus with oral involvement managed

A

potent topical steroids and benzydamine mouthwash

164
Q

what is a classical feature of pemphigus vulgaris

A

involvement of the oral mucosa

165
Q

distinguish between pemphigus vulgaris and bullous pemphigoid

A

bullous pemphigoid

negative nikolsky’s sign
mucous membrane spared
itchy rash with tense blisters

pemphigus vulgaris

+ve nikolsky’s sign
mucous membrane may be involved
thin walled blisters causing erosions

both treated with topical potent steroids

166
Q

what is the name of the term used to predict recurrence of a melanoma

A

Breslow thickness - measures the depth of the melanoma from the top of the granular layer of the epidermis to the deepest cancerous cell

167
Q

which condition causes a scarring alopecia

A

folliculitis decalvans

168
Q

what type of an appearance does have an arterial ulcer have

A

punched out appearance

169
Q

how long does it take for molluscum contagiosum to clear up spontaneously

A

18 months

170
Q

which medication is used to manage symptoms of dermatitis herpetiformis

A

dapsone

171
Q

which part of the body is spared by folliculitis

A

hands

172
Q

smoking - rf for bcc or scc

A

scc

173
Q

how is shingles managed in immunocompromised patient

A

valaciclovir

174
Q

what is the management of pyoderma gangrenosum

A

Oral steroids such as oral prednisolone

175
Q

which conditions are associated with seborrheic dermatitis

A

HIV
Parkinson’s

176
Q

what is the management of genital warts ?

A

Podophyllotoxin

177
Q

what are features of arterial ulcers ?

A

'’punched out appearance’’
faint dorsalis pedis pulse
history of HTN - other features of PAD
distally occurring
Small and deep

178
Q

what are features of venous ulcers ?

A

gaiter region
large and shallow
bleeding / oozing
other features of chronic venous insufficiency

179
Q

investigation and diagnosis for arterial and venous ulcers

A

ABPI
<0.9 arterial disease

180
Q

what is the management for arterial and venous ulcers ?

A

lifestyle factors
compression stockings

181
Q

what is periorificial dermatitis

A

clustered erythematous papules and papulopustules in the perinasal , periocular region

182
Q

management of perioroficial dermatitis

A

topical or oral abx

183
Q

which complications are persons with psoriatic arthritis at higher risk of

A

cardiovascular disease

184
Q

salmon patch

A

pink coloured vascular skin lesion that blanches on pressure

185
Q

port wine stain

A

unilateral, deep red or purple that darken and become raised over time

186
Q

sebaceous cysts

A

located in the scalp, contains central punctum

187
Q

most common side effect of isotretinoin

A

dry skin

188
Q

important side effect of ketoconazole

A

gynaecomastia

189
Q

sign of acute deterioration in erythroderma

A

sob

190
Q

what is pellagra caused by ? how does it present?

A

nicotinic acid deficiency
Presents with - dermatitis, diarrhoea, dementia due to isoniazid therapy

191
Q

how to differentiate hypertrophic and keloid scars

A

hypertrophic = do not extend past margins of damaged skin
keloids = extend past margins of damaged skin

192
Q

what is a dermatofibroma

A

common fibrous skin lesions often after a precipitating injury . common areas include arms and legs
solitary firm papule or nodule typically on a limb

193
Q

keratoacanthoma

A

characteristic cap made of keratin scale and debris

194
Q

what is alopecia areata

A

auto-immune condition causing localised well demarcated patches with small broken exclamation hair marks at the edge

195
Q

pathophysiology of dermatitis herpetiformis

A

formation of IgA antibodies

196
Q

Keloid scars are most common on the

A

sternum

197
Q

what are the types of burns

A

superficial epidermal ( first degree) : red and painful, dry and no blisters
partial thickness - superficial - blistered and pink
partial thickness - deep dermal - white with areas of non blanching erythema with reduced sensation
full thickness - white and leathery, no blisters and no pain

198
Q

how to assess the extent of burns

A

Wallace’s rule of nines
Lund and Browder - most accurate = palmar surface is equal to approx 1% of body surface

199
Q

first aid management of burns

A

ABC
heat - remove source, irrigate within 20 mins for 10-30 mins and wrap using clingfilm
electrical - switch off source and remove person from the source
chemical - brush any powder off then irrigate with water

200
Q

when do you refer burns to secondary care

A

all deep dermal and full thickness burns
face , feet, genitalia involved
inhalation injury, electrical or chemical
superficial burns that involve < 3% TBSA in adults or > 2% TBSA in children

201
Q

Initial management of burns

A

superficial epidermal: symptomatic relief - analgesia, emollients etc
superficial dermal: cleanse wound, leave blister intact, non-adherent dressing, avoid topical creams, review in 24 hours

202
Q

wallaces rule of nines

A

head + neck = 9%
each arm = 9%
each anterior part of leg = 9%
each posterior part of the leg = 9%
anterior chest = 9%
posterior chest = 9%
posterior abdomen = 9%

203
Q

what are the features of lipomas

A

smooth, mobile painless mass

204
Q

what features are suggestive of liposarcomas

A

size > 5 cm
increasing size
pain
deep anatomical location

205
Q

at what size is a suspected lipoma imaged

A

> 5 cm due to suspicion of liposarcomas

206
Q

management of tinea pedis

A

topical miconazole

207
Q

causes of hirsutism

A

Cushing’s syndrome
congenital adrenal hyperplasia
androgen therapy
obesity: thought to be due to insulin resistance
adrenal tumour
androgen secreting ovarian tumour
drugs: phenytoin, corticosteroids

208
Q

which medications are associated with the development of spider naevi

A

COCP

209
Q

zinc deficiency

A

hypogonadotrophic hypogonadism
perianal dermatitis

210
Q

management of prominent telangiectasia in acne rosacea

A

laser therapy

211
Q

The Koebner phenomenon describes skin lesions that appear at the site of injury. It is seen in:

A

psoriasis
vitiligo
warts
lichen planus
lichen sclerosis
molluscum contagiosum

212
Q

management of vitiligo

A

sunblock
topical corticosteroids
topical tacrolimus and phototherapy

213
Q

management of tinea

A

topical antifungal such as terbinafine

214
Q

management of hirsutism in pcos

A

eflornithine

215
Q

types of contact dermatitis

A

irritant contact dermatitis - non-allergic reaction ,erythema and crusting

allergic contact dermatitis - type 4 hypersensivity, eczema

216
Q

curlings ulcer

A

stress ulcers occuring in the duodenum of burns patients and more common in children

217
Q

what type of reaction is scabies

A

delayed type 4 hypersensitivity reaction

218
Q

dermoid cysts

A

embryological remnants that may be lined by hair and squamous epithelium , dumbell shaped

219
Q

desmoid tumours

A

develop in ligaments and tendon, aggressive and should be managed like sarcomas

220
Q

management of squamous cell carcinomas

A

surgical excision with 4 mm margins if lesion < 20 mm
if tumour > 20 mm, then margins should be 6 mm
Mohs micrographic surgery in high risk / cosmetically important sites

221
Q

athletes foot mx if imidazole fails

A

oral terbinafine

222
Q
A

SBA passmed Flashcards (30 decks)

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