Dermatology Flashcards
What is eczema herpeticum
Infection of the skin by herpes simplex 1 or 2 in children with atopic eczema - rapidly progressing painful rash
Life threatening - admission to hosp for iV aciclovir
What are the features and management of impetigo
Skin infection - staph aureus/ strep pyogenes
Spread by direct contact with discharges from scabs
Incubation period between 4-10 days
Golden crusted lesions around mouth
Management
Hydrogen peroxide 1% cream - those who are high risk/ systemically unwell
Topical antibiotics- topic fusidic acid
If extensive - oral fluclox
School exclusion- until all lesions are crusted/ healed or 48 hrs after starting abx
What are the features of stephen johnson syndrome?
severe systemic drug reaction that affects skin and mucosa
Causes
Penicillin, suphonamides, lamotrigine, carbamazepine, phenytoin, allopurinol, NSAIDs, OCP
Maculopapular target lesions
Nikolsky sign positive blisters and erosions appear when the skin is rubbed
Hosp admission
What is the treatment for fungal nail infections
Send nail clippings for microscopy
If dermatophyte/ candidia0 give topic amorolfine nail lacquer
If more extensive give oral terbinafine
If more extensive due nto candidia give oral intraconazole
What are the features of dermatitis herpetiformis
Autoimmune blistering skin condition- coeliac association - deposition of IgA on extensor surfaces
What is the management of rosacea
Mainly erythema/ flushing- topical brimonidine gel - alpha 2 agonist to reduce redness
Papules and pustules- mild/ moderate- topical ivermectin , topical metronidazole, topical azelaic acid
Moderate/severe papules and pustulses- combination topical ivermectin and oral doxycycline
Laser therpy if no improvement in telangectasia
What is the difference between steven johnson syndrome and toxic epidermal necrosis
SJS- affects less than 10% skin
TEN- affects more than 30% skin
What is pyoderma gangrenosum
Very painful skin ulceration associated with IBD, rheumatological conditions, PBC, haematological conditions
Affects lower limbs usually, ulcer may become deep and necrotic
Management: Oral steroids first line
Immunosuppressive therapy- ciclosporin/ infliximab
What investigation is done in contact dermatitis
Patch testing
What are the features and management of Guttae psoriasis
More common in children and adolescents
May be following a streptococcal infection
Tear drop papules on trunk and limbs
Most cases resolve in 2-3 months
Topical psoriasis agents if needed - steroids and emollients
What is polymorphic eruption of pregnancy
Periumbilical area is spared
Pruitic condition in last trimester
Emollients, topical steroids, oral steroids
What is the treatment for cellulitis
Investigations - Bloods- FBCm CRP, U&E, wound swab, USS scan
Management
Oral flucloxacillin
If systemically unwell or have co-morbidity- IV abx
What are the features of a squamous cell carcinoma
Irregular, ill defined red nodule with scale and ulceration , can form a horn
On face, scalp, ears hands and shin
Slow growing- over weeks / months- painful and bleed
Bowen’s disease and actinic keratosis cause it
Management: Surgical excision using a 4mm margin or 6mm if high risk
What are the features of melanoma
More common on trunk/ lower limbs
ABCDE assessment
Assymetry, Borders, Colour, Diamete >6mm Evolution over time
Superficial spreading is the most common type
Management
Breslow thickness determined
Excision with a 2mm margin and further excision depending on breslow
Melanoma <1mm- 10mm excision
Melanoma 1-2mm- 10-20mm excision
Melanoma >2mm- 20mm excision
What are the features of bullous pemphigoid
Autoimmune blistering- tense subepidermal blisters
Older people
Treat with potent steroids and docycycline
Systemic steroids until no lesions for 1 yr
