Dermatology Flashcards
List 6 common skin conditions
-eczema
-acne vulgaris
-psoriasis
-urticaria
-infections
-skin cancer
What are the 3 different types of skin cancer?
-Melanoma
-Squamous cell carcinoma
-Basal cell carcinoma
How is atopic eczema/dermatitis diagnosed?
It’s a clinical diagnosis
No investigations needed
Whats the typical patient history for someone with suspected atopic eczema/dermatitis?
-Begins in childhood (can occur later)
-Atopy
-Family history of atopy
What are some clinical features of atopic eczema/dermatitis?
-Pruritus (itchy)
-Typically occurs in skin creases - flexural
-Can occur in response to specific triggers
What’s the treatment for atopic eczema/dermatitis?
-Education and support
-Avoidance of triggers
-Topical:
-emollients
-steroids and/or calcineurin inhibitors
-soap substitutes
-phototherapy
-Systemic therapy
How is Acne Vulgaris diagnosed?
It’s a clinical diagnosis
What’s the typical history for a patient presenting with suspected Acne Vulgaris?
-Adolescents and young adults
-Chronic issue with skin, spots due to blocked hair follicles in skin
Acne vulgaris has a multifactorial cause, list some features.
-Increased sebum production (androgen influence)
-Excessive deposition of keratin in pores
-Overgrowth of Cutibacterium acnes (skin commensal)
-Pro-inflammatory chemicals released in skin
What are the treatment options for Acne Vulgaris?
-Topical
-non-antibiotic
-antibiotic
-Systemic
-Antibiotics
-Oral contraceptive pill
-Isotretinoin (!!! Teratogenic)
How is psoriasis diagnosed?
It’s a clinical diagnosis, using patient symptoms and history.
What’s the typical history of a patient presenting with psoriasis?
-Chronic skin condition
-Often between ages 20-30yrs and 50-60yrs
-Strong genetic predisposition (family history)
-Relapsing and remitting course
-Triggers e.g. ACEi, b-blockers
What’s the cause of psoriasis?
T cell cytokine production is stimulated, causes keratinocyte proliferation
What are the treatment options for psoriasis?
-Topical
-Phototherapy
-Systemic
-Oral and injectable
How is urticaria diagnosed?
Clinical diagnosis, no special tests
Whats the typical history of patient presenting with suspected urticaria?
-Can be acute OR chronic
-Normally a trigger involved such as foods, allergens, medication, viral infections
What’s the pathophysiology of urticaria?
Mast cell degranulation and histamine release -> increased capillary permeability and leakage of fluid into surrounding tissue
What are the treatment options for urticaria?
-General education
-Systemic
-H1 anti-histamine
-H2 anti-histamine
-Other: steroids, ciclosporin, montelukast, omaluzimab
Name 2 viral skin infections
-Molluscum contagiosum
-Shingles
Describe some features of Molluscum contagiosum
-Pox virus
-Common in children - spread via DIRECT contact
-Self limiting (usually)
-Small firm spots, dimple in middle
-Can be itchy
-Appear anywhere
Describe some features of Shingles
-Herpes Zoster virus
-Painful
-Tingling feeling in skin
-Dermatomal pattern
-Vesicles
Give an example of a bacterial skin infection
Impetigo
Describe some features of Impetigo
-Highly contagious
-Common in children
-Staph or Strep cause
-Seen in areas of broken skin
-Treated with topical antibiotics
Give an example of a fungal skin infection
Dermatophytosis (ringworm)
Describe some features of Dermatophytosis
-Superficial fungal infection
-Need keratin to grow
-Spread via direct contact
-Classified by area affected
-Responds well to antifungals
Describe features of Malignant Melanoma
-Cancer from melanocytes
-UV light exposure main cause
-New or change to existing mole
-Most common in areas exposed to sun
-Treated with surgery, may require further treatment with radiotherapy
Describe features of squamous cell carcinoma
-Abnormal and accelerated growth of squamous cells
-Develop in sun exposed areas of skin
-More common in middle aged or older
-Treated with surgery to remove affected area
Explain features of basal cell carcinoma
-Commonest type of skin cancer
-Slow growing, rarely spread
-Older adults
-Caused by DNA mutation in basal cells (commonly due to UV exposure)
-Treated with surgery
What does SCAM stand for in dermatology examinations?
S: site and distribution (rash)
Size and shape (lesion)
C: colour and configuration
A: assoc changes
M: morphology
What is the ABCDE approach for examining pigmented lesions?
A: asymmetry
B: border
C: colour
D: diameter
E: evolution
What are the components of dermatology history taking?
-Presenting complaint
-History of presenting complaint
-PMHx
-FHx
-SHx
-THx
-DHx
-Allergies
-ICE
What do you want to know about the presenting complaint?
-Nature
-Size
-Duration
What do you want to know about the history of the presenting complaint?
-Initial appearance
-Location
-Associated symptoms
-Aggravating and relieving symptoms
-Prev episodes
-Treatments
-Contact history
What do you want to know about their past medical history?
-Systemic disease
-History of atopy
-History of skin cancer
-History of sun burn
What do you want to know about their family history?
-Skin disease
-Atopy
-Autoimmune disease
What do you want to know about patients social history?
-Home situation (pets!!!)
-Smoking
-Drugs and alcohol
-Occupation
-Diet
-Cleaning products
-Travel history
What can you ask about drug history?
-Prescribed any medication?
-Taking any over the counter medication?
-Any allergies to drugs?
