Dermatology Flashcards
Conditions that cause flaccid blisters
bullous pemphigoid (NO mucosal involvement)
pemphigoid vulgaris (mucosal involvement)
Pemphigoid = rigid blisters
Describe the skin condition associated with Grave’s disease
pretibial myxoedema. This condition is characterized by bilateral, symmetrical, non-pitting, scaly thickening of the skin with an orange-peel appearance
most common cancer in transplant patients?
SCC
how to diagnose carcinoid syndrome?
urinary 5-HIAA levels
what is pellagra?
niacin deficiency
3 D’s - dermatitis (rash on neck), diarrhoea and dementia.
consequence of isoniazid therapy (isoniazid inhibits the conversion of tryptophan to niacin) and it is more common in alcoholics.
drug triggers of plaque psoriasis
beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids
which skin condition is associated with coeliac disease and what antibody causes it?
Dermatitis herpetiformis
deposition of IgA in the dermis
Eczema herpeticum
serious condition
IV Aciclovir
gold standard for diagnosing contact dermatitis
skin PATCH test
management of Pyoderma gangrenosum
oral pred
The most common malignancy in the lower lip
SCC
most common type of all skin cancers in the UK
BCC
the single most important prognostic factor for malignant melanoma?
depth of tumour (Breslow’s thickness)
pompholyx eczema
itchy blisters on your hands and feet.
triggers - humidity
also known as dyshidrotic eczema.
what are the 5 layers of epidermis?
Come Lets Get Sun Burnt/Girls
stratum Corneum - shedding
stratum Lucidum - thick skin
stratum Granulosum -
stratum Spinosum - thickest layer, site of keratin production
statum Basale/Germinativum - melanocytes and keratinocytes formed
what is lichen planus?
skin disorder
unknown cause
itchy papules on palms, soles, genitalia
white lines inside mucous membranes (wickhams’ striae)
nail thinning and ridging
management - topical clobetasone butyrate
management of rosacea
erythema and flushing: topical brimonidine gel
mild-to-moderate papules and/or pustules:
topical ivermectin is first-line
alternatives include: topical metronidazole or topical azelaic acid
moderate-to-severe papules and/or pustules:
combination of topical ivermectin + oral doxycycline
where are keloid scars more likely to form?
The sternum, along with other areas such as shoulders, upper arms and earlobes, is particularly prone to keloid formation due to high tension in these areas.
main organism causing Erysipelas
strep pyogenes
Management of Hyperhidrosis
Hyperhidrosis describes the excessive production of sweat.
Management options include
topical aluminium chloride preparations are first-line. Main side effect is skin irritation
iontophoresis: particularly useful for patients with palmar, plantar and axillary hyperhidrosis
botulinum toxin: currently licensed for axillary symptoms
surgery: e.g. Endoscopic transthoracic sympathectomy. Patients should be made aware of the risk of compensatory sweating
itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
dermatitis herpetiformis
IgA autoimmune condition
associated with coeliac disease
Primary herpes simplex infection can cause what rash
Erythema multiforme
first-line treatment for pyoderma gangrenosum
Oral steroids
What is the minimum steroid intake a patient should be taking before they are offered osteoporosis prophylaxis?
Equivalent of prednisolone 7.5 mg or more each day for 3 months
Systemic mastocytosis
Features
Diagnosis
Systemic mastocytosis results from a neoplastic proliferation of mast cells
Features
urticaria pigmentosa - produces a wheal on rubbing (Darier’s sign)
flushing
abdominal pain
monocytosis on the blood film
Diagnosis
raised serum tryptase levels
urinary histamine
bullous pemphigoid Skin biopsy findings
immunofluorescence shows IgG and C3 at the dermoepidermal junction
bullous conditions and their antibodies
hemidesmosomal proteins BP180 and BP230 = Bullous pemphigoid antibodies
Desmoglein-3 i = Pemphigus vulgaris
virus causing pityriasis rosea
Human herpesvirus 6 and 7
varicella-zoster virus (VZV) is known as which herpes virus
Human herpesvirus virus 3 (HHV-3) also commonly known a
Epstein-Barr virus (EBV) is known as which herpes virus
Human herpesvirus virus 4 (HHV-4) also commonly known as Epstein-Barr virus (EBV)
which virus causes oral and/or genital herpes
herpes simplex virus-2 (HSV-2)
which virus causes kaposi sarcoma
Human herpesvirus virus 8 (HHV-8)
features of pityriasis rosea
in the majority of patients there is no prodrome, but a minority may give a history of a recent viral infection
herald patch (usually on trunk)
followed by erythematous, oval, scaly patches which follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a ‘fir-tree’ appearance
features of guttate psoriasis
‘Tear drop’, scaly papules on the trunk and limbs
post strep infection
define Erythroderma
term used when more than 95% of the skin is involved in a rash of any kind.
in Pemphigus vulgaris, antibodies are directed against ?
desmoglein 3, a cadherin-type epithelial cell adhesion molecule.
investigation of choice for avascular necrosis of the hip
MRI
the most common side-effect of isotretinoin
dry skin, eyes and lips/mouth
what must all patients taking isotretinoin for acne be on?
contraception
it is teratogenic
guttate psoriasis management
Most cases resolve spontaneously within 2-3 months
Topical agents as per psoriasis
UVB phototherapy - can speed up clearance
Dermatitis in acral, peri-orificial and perianal distribution
→ zinc deficiency
Which one of the following complications is most associated with psoralen + ultraviolet A light (PUVA) therapy?
SCC
first-line treatment for lichen planus
Potent topical steroids
US finding of the double-contour sign a hyperechoic, irregular band over the superficial margin of the joint cartilage,
The most useful characteristic lesion of gout
Seborrhoeic dermatitis - first-line treatment is
topical ketoconazole
Associated conditions of Seborrhoeic dermatitis
HIV
Parkinson’s disease
infections causing pyoderma gangrenosum
none
Erythema gyratum repens
Lung cancer
Necrolytic migratory erythema
Glucagonoma
mx lichen planus
topical steroids
