Dermatology Flashcards
What is Nikolsky’s sign?
The appearance of blisters and erosions when the skin is rubbed gently
What are the common drug causes of SJS?
penicillin
sulphonamides
lamotrigine, carbamazepine, phenytoin
allopurinol
NSAIDs
oral contraceptive pill
What is the first-line management of TEM?
Supportive care - ICU
IV Immunoglobulin
What is the first-line management for pyoderma gangrenosum?
Oral prednisolone
What is a Salmon Patch?
A vascular birthmark - a flat vascular lesion typically affecting the nape of the neck.
Which drugs can exacerbate plaque psoriasis?
Beta-blockers, lithium, antimalarials, NSAIDs and ACE inhibitors
What is the most common effect of isoretinoin?
Dry skin
What is the first-line management for Pityriasis versicolor?
Topical ketoconazole
What is the characteristic presentation of Pityriasis versicolor?
Hypo or hyperpigmented scaly macules and patches on the trunk and proximal extremities.
What is the first-line management for non-bullous impetigo?
Hydrogen peroxide cream 1%
What topical ABx cream is indicated in bullous impetigo?
Topical fusidic acid/topical mupirocin
How long should children be excluded from school for with diagnosed impetigo?
Until all lesions are crusted and healed OR 48 hours after commencing ABx management.
What is onycholysis?
Separation of the nail from the nail bed.
What is the first-line management of Scabies?
Permethrin 5% (All household and close physical contacts should be treated at the same tmie)
What is the first common symptom for rosacea?
Flushing
What is the management of moderate-to-severe rosacea (with papules or pustules)?
Combination of topical ivermectin and oral doxycycline
What is the first-line management of rosacea with predominant erythema/flushing?
Topical brimonidine gel
What is the NICE recommended first-line management for plaque psorasis?
8 weeks (Maximum) or vitamin D analogue and a potent corticosteroid
(Apply separately, one in the morning and the other in the evening).
What virus is responsible for molluscum contagiosum?
Poxviridae
What is the characteristic skin presentation of molluscum contagiosum?
Characteristic pinkish or pearly white papules with a central umbilication - up to 5mm in diameter.
What is the first-line management for facial hirsutism?
Elfornithine (Topical)
What is milia?
Small, benign, keratin-filled cysts that typically appear around the face
Most common in newborns.
What is the first line management for Shingles?
Antivirals within 72 hours of presentation
Paracetamol and NSAIDs
What type of rash is associated with guttae psoarsis?
Tear drop papules
What is bullous phemigoid?
Autoimmune condition causing subepidermal blistering of the skin
- No mucosal involvement
itchy tense blisters typically around the flexures
What is a Strawberry naevus?
A capillary haemangioma rapidly develops in the first month of life.
Appear as erythematous raised and multilobed tumours.
Common sites include the face, scalp and back
What are the most common causes of erythema nodosum?
NO – idiopathic
D – drugs (penicillin sulphonamides)
O – oral contraceptive/pregnancy
S – sarcoidosis/TB
U – ulcerative colitis/Crohn’s disease/Behçet’s disease
M – microbiology (streptococcus, mycoplasma, EBV and more)
What specific patch is associated with pityriasis rosea?
Herald patch
What causes tinea veriscolor?
Malassezia furfur
Circular oval areas of hair loss with an autoimmune aetiology
Diagnosis?
Alopecia areata
What is the first line medical management for alopecia areata?
Potent topical corticosteroid (e.g., betamethasone valerate 0.1%, or clobetasol propionate 0.05%) for 3 months.
Papules, pustules and scarring is associated with what severity of acne?
Severe acne
Non-inflamed (Open and closed comedones) is associated with what type of acne vulgaris?
Mild
What term describes severe acne found in men characterised by extensive inflammatory papules and suppurative nodules?
Conglobate acne
What is the first line of maangement for mild-to-moderate acne?
12-week course of: Fixed combination of topical adapalene + topical benzoyl peroxide
OR
* Fixed combination of topical tretinoin + topical clindamycin.
OR
* Fixed combination of topical benzoyl peroxide + topical clindamycin.
What is the first-line therapy for moderate to severe acne?
- A fixed combination of topical adapalene + topical benzoyl peroxide OD in the evening (together with either oral lymecycline 408 mg or oral doxycycline 100 mg).
- Topical tretinoin with topical clindamycin
If first-line management of acne fails, what is next line?
Following a 12 week course, consider stopping if completely cleared or continue for another 12-week (alternative course)
What is the referral dermatology criteria for mild-to-moderate acne management?
Following 2 failed 12-week courses
What is the recommended drug for the management of severe acne?
isotretinoin
Which oral antibiotics is recommended for acne?
oral lymecycline 408 mg or oral doxycycline
What is the maximum duration for the use of topical antibiotics?
2 x 12 week courses
What is the most common cause of boils?
Staph aureus
An infection of the hair follicle with purulent extension into the subcutaneous tissue is the definition of what?
Boils
What is a carbuncle?
Occurs when several adjacent boils join beneath the skin – inflammatory mass that drains pus through many follicular orifices.
What are the common sites of boils?
Boils occur in hair-bearing sites e.g., face, neck, axilla or buttocks.
A firm, tender erythematous nodule that is boggy and associated with hair follicles is what?
Boils
A yellow-grey irregular crater that is slow healing and dome-shaped is what?
carbuncle
What is the first line management for large/fluctuant boils?
Urgent incision
What is the first-line management for boils?
Moist heat three times a day - and apply sterile dressing once pus is drained
What disorder is characterised as facial flushing, persistent erythema and telangiectasia?
Rosacea
Which drugs worsen rosacea?
Calcium-channel blockers
What is the first line management for persistent erythema in rosacea?
Topical brimonidine 0.5% gel (topical alpha-adrenergic agonist)
- Reduces erythema within 30 minutes (reaching peak action at 3-6 hours).
What is the management of mild to moderate rosacea?
Topical ivermectin (an anthelmintic and insecticidal) OD for 8-12 weeks.
What is the management of moderate-to-severe papules and pustules in rosacea?
Combination of ivermectin AND oral doxycycline 40 mg OD for 8-12 weeks.
a. Alternatives: Oxytetracycline 500 mg BDS, or tetracycline, or erythromycin.
What is the aetiology of urticaria?
Mast-cell mediated release of histamine (type 1 hypersensitivity)
How is severity of urticaria assessed?
Urticaria Activity Score7
What is the first line management of urticaria?
Non-sedating antihistamine (e.g., cetirizine, fexofenadine, or loratadine) for up to 6 weeks.
Which drug is associated with necrotising fasciitis?
SGLT-2 inhibitors
Which score is used to determine the diagnosis of necrotising fasciitis?
LRINEC score
What is the first line management of necrotising fasciitis?
Emergent radical debridement and broad-spectrum anbiotics
What are the physical findings observed in necrotising fasciitis?
Crepitus and subcutaneous emphysema
Which premalignant condition is associated with chronic UV sun exposure?
Actinic keratoses
What is the diagnosis of an irregular red scaly papule/plaque on sun-exposed regions?
Actinic keratoses
What is the first line medical management for actinic keratoses?
Fluorouracil cream
Which cancer is associated with pearly nodules + telangiectasia?
Basal cell carcinoma
What is the management of basal cell carcinoma?
Routine dermatology referral for surgical removal
What is the most common form of skin cancer?
Basal cell carcinoma
An ill-defined keratotic or warty inflamed papules that ulcerate easily describes which type of cancer?
Squamous cell carcinoma
Tumour diameter by >x cm increases the risk of SCC?
> 2 cm
What is the surgical excision dimensions for lesions <20 cm squamous cell carcinoma in diameter?
4 mm margins
What are the surgical excision margins for >20 cm squamous cell carcinoma?
6 mm
What is the definitive surgical management for squamous cell carcinoma?
Mohs micrographic surgery for high-risk patients
