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Y3 GP > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is paryonchia?

A

Paronychia is an infection of the proximal and lateral fingernails and toenails folds, including the tissue that borders the root and sides of the nail.

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2
Q

Describe the rash seen in Measles

A

Discrete maculopapular rash becoming blotchy & confluent

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3
Q

What are Koplik spots?

A

Koplik spots are highly characteristic of the prodromal phase of measles and can often be identified before the onset of the rash.

White spots on the inside of the cheeks

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4
Q

What is the distribution of the rash seen in Measles?

A

Starts on the face and behind the ears-before spreading to the rest of the body.

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5
Q

What mnemonic can you use to describe lesions in dermatology?

A

Asymmetry
Border
Colour
Diameter
Evolution

Pink
Ugly duckling
Nails

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6
Q

What oral medication can you give for fungal nail infections but what do you have to be mindful of?

A

Oral Terbinafine

Takes 2-4 weeks to work

Have to be mindful of liver function

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7
Q

What is the difference between a furuncle and a carbuncle?

A

A furuncle is a localized infection of a hair follicle

A carbuncle is a more extensive skin infection, involving a cluster of interconnected furuncles

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8
Q

What are the features of lichen sclerosus?

A

white patches that may scar
itch is prominent
may result in pain during intercourse or urination

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9
Q

How does Terbinafine work?

A

It gets involved into the new nail.
Terbinafine works by inhibiting the enzyme squalene epoxidase, thereby disrupting the synthesis of ergosterol, a key component of fungal cell membranes, leading to fungal cell death.

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10
Q

What do you have to be sure of before you treat Lichen Sclerosus?

A

You treat it with steroids

You have to make sure it is not thrush as this will make it worse

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11
Q

What is involved in a pruritus screen?

A

FBC, Us&Es, LFTs, CRP and TFTs.

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12
Q

What is the first line medication for Scabies?

A

Permethrin

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13
Q

When can a child go back to school if they have chicken pox?

A

Once the last lesion has crusted over

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14
Q

What is a Herald patch?

A

Seen in Pityriasis Rosacea. The herald patch is a single patch that appears before the generalised rash of pityriasis rosea. It is a slightly raised, oval, salmon-pink or red plaque 2–5 cm in diameter, with a peripheral scale trailing just inside the edge of the lesion, like a collaret.

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15
Q

What is the medication used that treats psoriasis, is a concentrated form of vitamin D?

A

Dovonex

Inhibits cell proliferation, anti-inflammatory effects and immune modulation.

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16
Q

List steroid medications in increasing strengths.

A

Hydrocortisone
Eumovate (clobetasone)
Betnovate (betamethasone)
Dermovate (clobetasol)

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17
Q

What is Tinea?

A

Tinea is a term used to describe various fungal infections of the skin, hair, and nails caused by dermatophyte fungi.

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18
Q

How does a patient with urticaria commonly present?

A

Raised, itchy welts or hives on the skin.
These wheals are often red or pink and vary in size.

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19
Q

What key aspects of the history must not be overlooked when assessing a patient with urticaria?

A

If there are any systemic symptoms- respiratory
Any triggers- medications, infections, insect bites.
Are the hives associated with any foods? Have any new foods been added to the diet?

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20
Q

What is the correct terminology to describe a typical urticarial rash?

A

Wheals/Hives

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21
Q

What is the management of urticaria?

A

Management

Non-sedating antihistamines (e.g. loratadine or cetirizine) are first-line
NICE Clinical Knowledge Summaries suggest continuing these for up to 6 weeks following an episode of acute urticaria CKS

A sedating antihistamine (e.g. chlorphenamine) may be considered for night-time use (in addition to day-time non-sedating antihistamine) for troublesome sleep symptoms CKS

Prednisolone is used for severe or resistant episodes

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22
Q

How do you manage pityriasis rosea?

A

It is a self-limiting disease, an important goal of treatment is to control pruritus.

Topical steroid creams/ointments and oral antihistamines may reduce the itch.

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23
Q

What is the first line treatment for mild-moderate acne

A

12 week course of either:

  • Topical adapalene with topical benzoyl peroxide
  • Topical tretinoin with topical clindamycin
  • Topical benzoyl peroxide with topical clindamycin
24
Q

What is the treatment for moderate-severe acne?

A

12 week course of one of:
- First 2 options for mild to moderate acne
- Topical adapalene with topical benzoyl peroxide with oral lymecycline/oral doxycycline
- Topical azelaic acid twice daily, with oral lymecycline/oral doxycycline
- Trimethoprim/oral macrolide for those who can’t tolerate
- COCP (Dianette/Yasmin)

25
Q

What is acne fulminans?

A

Acne fulminans is a rare and very severe form of acne conglobata associated with systemic symptoms

26
Q

What is guttate psoriasis?

A

Guttate psoriasis is a type of psoriasis characterized by the sudden onset of small, red, scaly papules or plaques that resemble water droplets on the skin.

27
Q

What is Dovonex?

A

Dovonex, also known as calcipotriene, is a synthetic vitamin D analogue that helps treat psoriasis by slowing down the excessive growth of skin cells and reducing inflammation in affected areas when applied topically. It works by binding to vitamin D receptors on keratinocytes, regulating cell differentiation and proliferation, thereby normalizing the skin’s growth cycle and improving psoriatic lesions.

28
Q

What are some risk factors for squamous cell carcinoma?

A

Tanning beds
HIV
Smoking
Genetic conditions (xeroderma pigmentosum)

29
Q

What are the features of squamous cell carcinoma?

A
  • Typically present on sun exposed sights- head, neck, dorsum
  • Rapidly expanding painless, ulcerated nodules
  • May have a cauliflower appearance
  • There may be areas of bleeding
30
Q

What margins are used for low risk and high risk excisions for squamous cell carcinoma?

A

4mm for low risk
6mm for high risk

31
Q

What are some options apart from surgical excision for squamous cell carcinoma?

A
  • Mohs
  • Radiotherapy
  • Cryotherapy
  • Plastic surgery
  • Lifestyle advice
32
Q

What follow up should you arrange for squamous cell carcinoma?

A
  • Cancer 2 week wait pathway
  • Psychosocial support
  • Follow up after specialist referral complete
33
Q

What safety netting should you arrange for a squamous cell carcinoma?

A

If the patient notices that the lesion is increasing in size rapidly and invading surrounding tissues

If the patient notices any new swelling or lumps in the in their neck

34
Q

What are the risks associated with psoriasis?

A

Cardiovascular disease
VTE

35
Q

When would you see systemic side-effects of topical corticosteroids?

A

When they are used on large areas >10% of the body surface area

36
Q

How long should you wait before starting another course of topical corticosteroids?

A

4 weeks

37
Q

What are some examples of vitamin D analogues?

A

Calcipotriol
Calcitriol

They work by decreasing cell division and differentiation for epidermal proliferation

38
Q

What is the first line for chronic plaque psoriasis?

A

A potent corticosteroid applied once daily plus vitamin D analogue applied once daily

39
Q

What is a macule?

A

A flat, circumscribed area of skin discoloration

40
Q

What is a papule?

A

A circumscribed elevation of the skin <0.5cm in diameter

41
Q

What is a nodule?

A

A circumscribed visible or palpable lump >0.5cm in diameter

42
Q

What is a plaque?

A

A circumscribed, disc-shaped, elevated area of skin:

‘Small’ <2cm in diameter
‘Large’ >2cm in diameter

43
Q

What is a vesicle?

A

A small visible collection of fluid <0.5cm in diameter

44
Q

What is a bulla?

A

A large visible collection of fluid >0.5cm

45
Q

What is a pustule?

A

A visible accumulation of pus

46
Q

What is an ulcer?

A

A loss of epidermis (often with loss of underlying dermis and subcutis as well)

47
Q

Weal

A

A circumscribed, elevated area of cutaneous oedema

48
Q

What should you ask in a dermatological history?

A

Past history
- Diabetes and TB
- Past skin problems
- Significant allergies or intolerances

Family history
- Some disorders are infectious; others have strong genetic backgrounds

Occupation and hobbies

Therapy
- Topical remedies and any cosmetic creams

49
Q

What must you assess in a dermatological assessment?

A
  1. Site
  2. Characteristics of the lesions
    Type
    Size
    Shape
    Outline and border
    The colour
    Surface features
    Texture- superficial/deep?
  3. Secondary sites
  4. Special techniques
50
Q

What is the difference between verrucas, common warts, calluses and filiform warts?

A

This picture shows common warts – these appear as papules with a rough and hyperkeratotic surface. They are often found on backs of fingers, toes and around the nails.

Molluscum Contagiosum is a viral skin infection of childhood that causes localised clusters of small round epidermal papules called mollusca.. The papules range in size from 1 to 6 mm and may be white, pink or brown. They often have a waxy, shiny look with a small central pit.

Verrucas are hard raised warts with rough surface, which appear on feet.

Calluses are common skin lesions of hard thickened skin. They are painless.

Filiform warts are long and slender. They are commonly found on the face, neck and the armpits.

51
Q

How should you apply salicylic acid to the common wart?

A
  1. Rub off any dead tissue from the top of the wart
  2. Soak the wart in water for 5-10 minutes before applying the salicylic acid
  3. Needs to be applied every day- some cases may need to be continued for up to three months
52
Q

What are the options of treating warts?

A

Salicylic acid and cryotherapy (liquid nitrogen)

Cryotherapy is not an appropriate treatment for young children as it is painful

53
Q

How are seborrhoeic warts normally removed?

A

As they do not usually cause any problems, they are usually advised to be left alone, and excision biopsies should be reserved for cases of diagnostic uncertainty or when they do cause problems such as itching and/or interference with clothing or jewellery.

Removal is usually via two ways – through use of curettage or by liquid nitrogen therapy.

Seborrhoeic warts are relatively easy to remove.

54
Q

What are risk factors for developing acne?

A
  • Family history
  • Topical skin products that can be occlusive/ makeup, shaving products
  • Medications- steroids, anti-epileptics
  • PCOS/steroids/testosterone
55
Q

What are the options for treating mosaic warts?

A
  • Topical salicyclic acid
  • Intralesional bleomycin injections

Y3 GP (13 decks)

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