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Primary Care Block Year 3 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are the 4 layers of skin?

A

Epidermis
Basement membrane
Dermis
Subcutaneous tissue

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2
Q

What is a pneumonic to help guide a dermatology consultation?

A

SCAM

S- Site, ditribution
C - Colour
A - Associated changes e.g surface feautures
M - Morphology of individual lesions

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3
Q

What does ABCD stand for in dermatology to describe pigmented lesions?

A

A - Assymetry
B - Border
C - Colour
D - Diameter

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4
Q

What does a generalised distribution mean?

A

It all over the body

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5
Q

What describes a rash confined to areas with joints that flex e.g elbow crease

A

Flexural

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6
Q

What distribution describes a rash confined to areas that extend e.g elbow

A

Extensor

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7
Q

What word describes when areas affected by the rash are only ones that see sunlight?

A

Photosensitive distrubution

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8
Q

What word decribes when lesions are separated from one another?

A

Discrete ( configuration)

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9
Q

What word describes when lesions overlap each other?

A

Confluent

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10
Q

What a linear configuration of a lesion indicate?

A

Koebner’s Phenomenon

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11
Q

What is Koebner’s Phenomenon?

A

Presence of inflammatory skin disease in response to trauma ( e.g scratching ) - usually psoriasis , lichen planus and vitiligo

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12
Q

What rash typically gives target shaped lesions?

A

Erythema Multiforme

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13
Q

What can cause Erythema Multiforme?

A

Herpes Simplex Virus
Mycoplasma Pneumoniae infection

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14
Q

What word describes when a skin change is red and blanching?

A

Erythematous

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15
Q

What word describes when a lesion is red/purple and non-blanching?

A

Purpuric

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16
Q

What is a purpuric rash?

A

Its when red blood cells have leaked out or extravasated to the skin

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17
Q

What word describes brown/ black pigmentation?

A

Pigmented or Hyperpigmented

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18
Q

What word describes loss of colour from skin?

A

Hypopigmentation

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19
Q

What word describes total loss of colour from the skin? What condition is this specific for?

A

Depigmentation , usually Vitiligo

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20
Q

What word describes a build up of keratin on the skin?

A

Scale

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21
Q

What word describes dried exudate on the skin?

A

Crust

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22
Q

What word describes the appearance of erosions from scratching ?

A

Excoriation, implies rash is pruritic

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23
Q

What word describes partial or full thickness loss of skin?

A

Erosion = partial
Ulceration = full

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24
Q

What is a macule?

A

Flat lesion of altered colour that is <1cm

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25
Q

What is a patch?

A

A large flat area of altered colour >1cm

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26
Q

What is a Papule?

A

An elevated palpable lesion <1cm

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27
Q

What is a Nodule?

A

An elevated palpable lesion > 1cm

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28
Q

What is a cyst?

A

A papule or nodule that contains fluid so is fluctuant

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29
Q

What is a Plaque?

A

An elevated thickened lesion >1cm

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30
Q

What is a vesicle?

A

A fluid filled blister >1cm

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31
Q

What is a bulla

A

A fluid filled blister >1cm

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32
Q

What is a pustule?

A

A circumscribed lesion containing pus

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33
Q

What is a wheal?

A

A transient elevation of the skin due to dermal oedema , indicates urticaria/ urticaria like condition

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34
Q

What is a Comedone?

A

Acne

Open - whiteheads
Closed - blackheads

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35
Q

What is hair loss called?

A

Alopecia

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36
Q

How can alopecia be described?

A

Patchy or Diffuse

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37
Q

What is excess hair growth called?

A

Hypertrichosis

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38
Q

What is excess hair growth in a masculine distribution called?

A

Hirsuitism

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39
Q

What is Koilonychia?

A

Spoon-shaped nails

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40
Q

What is Onycholysis ?

A

Splitting of the nail plate from the nail bed?

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41
Q

What word describes when lesion is affecting the distal extremities ( ears, fingers, toes, penis, nipples etc )

A

Acral

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42
Q

What word describes when lesions are confined to one or more segments of skin innervated by a single spinal nerve?

A

Dermatomal

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43
Q

What word describes when lesion is round?

A

Nummular

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44
Q

What word describes when lesion is ring-shaped?

A

Annular

45
Q

What describes a lesion which has concentric rings?

A

A target lesions

46
Q

What is the first line treatment for Acne Vulgaris?

A

Fixed combination of topical Adapalene and Benzyol Peroxide ( Epiduo )
12 week course of Oral doxycyline

47
Q

What is the management for severe Acne Vulgaris that does not respond to initial treatment?

A

Dermatology referral

48
Q

What is the presentation of Seborrhoeic dematitis?

A

An itchy rash that affects the gland-rich lesions of the face , scalp and trunk.
Its erythematous, yellow and scaly

49
Q

What is the most common side effect of Isotretinoin?

A

Dry skin - reduces sebum production to reduce comedome formation in Severe Acne

50
Q

How does Lichen Planus present?

A

Itchy rash which is purple, raised and has fine white lines on the surface
They also have Wickham Striae on the oral mucosa

51
Q

What is the treatment for Lichen Planus?

A

Topical steroids

52
Q

What is the treatment for athlete’s foot?

A

Topical Miconazole

53
Q

What can topical corticosteroids cause on patients with darker skin?

A

Patchy depigmentation

54
Q

What is Dermatitis Herpetiformis caused by? How does it present?

A

Coeliac Disease

Itchy, vesicular lesions on extensor surfaces

55
Q

What is the first line treatment for Psoriasis?

A

Topical corticosteroid

56
Q

What are the types of skin cancer?

A

Melanoma
Squamous Cell Carcinoma
Basal Cell Carcinoma

57
Q

How does a Melanoma present?

A

A new mole or change in appearance of an existing mole ( Irregular shape, multiple colours, can be itchy, can bleed)
History of sun exposure / tanning beds
More common in Fitzpatrick Type 1 skin types

58
Q

What is the treatment for Melanoma?

A

Surgical Excision

59
Q

How does Basal Cell Carcinoma present?

A

Occurs mostly on the face, head, neck and hands
Appears as a flat, firm, pale area that is small, raised, pink or rer, translucent, shiny and waxy
They can look like ope sores and they may ooze, crust, itch and bleed

60
Q

What are some risk factors for Basal Cell Carcinoma?

A

Sun exposure
Radiation therapy
Fitzpatrick Type 1 Skin
Older
Immune-suppressing drugs
Family History

61
Q

How does a Squamous Cell Carcinoma appear?

A

Scaly red patches, open sores, rough, thickened or wart-like skin
Or raised growths with a central depression

62
Q

What are some risk factors for Squamous Cell Carcinoma?

A

Sun exposure
Fitzpatrick Type 1 Skin
Tanning beds
Weakened Immune system

63
Q

What is the treatment for Basal Cell Carcinoma?

A

Surgical Excision

64
Q

What is the treatment for Basal Cell Carcinoma?

A

Surgical excision
Cryotherapy
Radiotherapy

65
Q

Contact Dermatitis is what type of sensitivity reaction?

A

Type IV Hypersensitivity

66
Q

What is the first line treatment for Rosacea?

A

Topical ivermectin + oral doxycycline

67
Q

What is Eczema Herpiticum?

A

When an area of eczema is infected by Herpes SImplex Virus. Presents with rash on torso and face and flu-like symptoms

68
Q

What is the treatment for a dermatophyte nail infection?

A

Oral terbinafine

69
Q

Which gastro condition is Dermatitis Herpetiformis associated with?

A

Coeliac Disease

70
Q

What is Pityriasis Versicolor?

A

A common superficial fungal infection. Presents with hyperpigmented scaly macules and patches on trunk and proximal extremities

71
Q

What is the treatment for pityriasis versicolor?

A

Ketoconazole shampoo ( anti-fungal shampoo)

72
Q

An adult with erythematous target lesions on the hands which later spread to the torso following a herpes simplex infection

What is the likely diagnosis?

A

Erythema Multiforme

73
Q

What is the treatment for seborrhoeic dermatitis?

A

Topical Ketoconazole

74
Q

What is Psoriasis commonly worsened by?

A

Alcohol
ACE inhibitors
Lithium
NSAIDs
B-Blockers
Chloroquine

75
Q

A middle-aged woman develops painful, erythematous, nodular lesions over both shins

What is the likely diagnosis?

A

Erythema nodosum

76
Q

Purple, pruritic, polygonal plaques in a question is most likely to indicate?

A

Lichen Planus

77
Q

An obese man with type 2 diabetes mellitus develops brown, velvety plaques on his neck and axillae

What is the likely diagnosis?

A

Acanthosis Nigricans

78
Q

What is the treatment of choice for rosacea with predominant erythema/flushing?

A

Topical Brimonidine

79
Q

What is the treatment for severe Acne Vulgaris?

A

Oral Isotretinoin ( Roaccutane )

80
Q

What are side effects of Isotretinoin?

A

Dry mouth, skin, lips
Rashes
Mild pruritus
Arthralgia
Photosensitivity
Epistaxis
Hair thinning
Depression

81
Q

An elderly women develops itchy, tense blisters around the flexures. There is no mucosal involvement s a stereotypical history of?

A

Bullous pemphigoid

82
Q

A young adult notices hypopigmented patches on her trunk after coming getting a suntan. The patches are mildly pruritic with some scale is a stereotypical history of?

A

Pityriasis Versicolor

83
Q

A man presents with a raised, red, spherical lesion on his neck. It initially was a red spot but rapidly grew over 4 weeks is a stereotypical history of?

A

Pyogenic Granuloma

84
Q

An elderly woman develops a reticulated, hyperpigmented rash after using a hot water bottle excessively is a stereotypical history of?

A

Erythema ab igne

85
Q

On examination, the child is alert and interactive but appears pale. Multiple discrete purple blotches around both ankles extending up his shins, which are non-blanching. The boy is afebrile and all other observations are within normal limits for his age.

What is the most appropriate next step in management?

A

Children with new-onset purpura should be referred immediately for investigations to exclude ALL and meningococcal disease

86
Q

Where are Keloid scars most commonly formed?

A

Sternum

87
Q

What is Livedo Reticularis?

A

A purplish, lace-patterned discolouration of the skin

88
Q

What is Livedo Reticularis caused by?

A

Idiopathic (most common)
Polyarteritis nodosa
SLE
Cryoglobulinemia
Antiphospholipid syndrome
Ehlers-Danlos Syndrome
Homocystinuria

89
Q

How does IgA Vasculitis ( Henoch-Schonlein Purpura) present?

A

Small cell vasculitis
Purpura on lower limbs
Abdominal pain
Arthritis

Often triggered by a viral URTI

90
Q

What investigations will you do for IgA Vasculitis?

A

Urine dipstick ( nephritic or nephrotic syndrome)
BP
ESR/CRP
Immunoglobulin ( Raised IgA)
Skin/Renal biopsy

91
Q

What type of hypersensitivity reaction is Contact Dermatitis?

A

Type IV - mediated by T lymphocytes

92
Q

What are red flags for Eczema Herpeticum?

A

Red itchy, painful blisters over previous areas of eczema

Urgent hospital admission is recquired

93
Q

What tests are indicated for contact dermatitis?

A

Patch test of substance for 48 hours

94
Q

What are some triggers for Psoriasis?

A

sunburn
trauma
HIV
stress
streptococcal infection
medications ( B-Blockers, ACEi, Lithium, NSAIDs)

95
Q

What is the treatment for Scabies?

A

Topical permethrin 5% + treat household members

96
Q

What is the most important prognostic factor for Malignant Melanoma?

A

Depth

97
Q

What is the A to E of irregular skin lesions?

A

A = asymmetry (one half of the spot is unlike the other half)
B = border (the spot has an irregular or poorly defined border)
C = colour (the spot has 2 or more colours that vary from one area to the next)
D = diameter (the diameter of the spot is equal to or more than 7mm)
E = evolution (the spot is changing over time).

98
Q

What is the pathophysiology of a venous ulcer?

A

Oedema in the subcutaneous tissue with poor lymphatic and capillary drainage, leading to inadequate nutrients and oxygen reaching the skin. This causes skin to die and ulcers to arise

99
Q

What is the treatment of shingles?

A

Oral antiviral ( V alaciclovir)

100
Q

What is the treatment for Basal Cell Carcinoma?

A

Mohs micrographic surgery

Removal under a microscope for cosmetic purposes

101
Q

What is the organism responsible for Scabies?

A

Sarcoptes Scabiei

102
Q

What type of biopsy should be done for a suspected malignant melanoma?

A

Excisional - whole lesion should be removed , 1cm margin for every 1mm of depth

103
Q

What is the first line treatment for Psoriasis?

A

Potent topical steroid e.g 0.1% Betamethasone
Vitamin D Cream

104
Q

What is Bowen’s Disease?

A

A pre-cancerous skin disease for SCC

105
Q

What is the cause of Atopic Dermatitis?

A

A defect in the skin barrier

106
Q

Which rash is associated with HSV?

A

Erythema Multiforme

107
Q

What is the treatment for Cradle Cap / infant Seborrheic Dermatitis?

A

Topical emollient

108
Q

What is the treatment for adult Seborrheic Dermatitis?

A

2% Ketoconazole Shampoo

Primary Care Block Year 3 (5 decks)

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