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Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Five layers of the epidermis

A

Stratum corneum, lucidum, granulosum, spinosum, basale

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2
Q

Dermatofibroma

A

Benign tumour - fibroblast proliferation

No treatment required

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3
Q

Skin tags

A

Small pedunculated (stalked) papule

Mx: snip excision, cryosurgery

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4
Q

Seborrheic Keratosis

A

Waxy papule - proliferation of keratinocytes and melanocytes

Mx: not required

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5
Q

Actinic (solar) keratoses

A

Erythematous papule with scaly keratonised surface

Pre-cancerous –> SCC

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6
Q

What are ephelides

A

Freckles

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7
Q

What is a vesicle?

A

Elevated fluid filled lesion

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8
Q

Lipoma

A

Soft mobile tumours - adipocytes with fibrous cap

Mx: reassurance, excision

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9
Q

Xanthoma

A

Hyperlipidaemia in macrophages of the skin

Ix: biopsy, fasting lipid panel

Mx: conservative, exicision

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10
Q

Acne Vulgaris Pathophysiology

A
  1. Hyperkeratinisation at follicle opening
  2. Blocks sebum –> microcomedomes
  3. Androgens promote excess sebum production
  4. C. acnes bacteria metabolize sebum
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11
Q

Management acne

A

Mild: topical benzoyl peroxide, salicylic acid

Clindamycin, retinoids

Moderate: doxycycline, spirinolactone, estrogen/progesterone

Severe: Isotretinoin (Accutane)

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12
Q

Perioral dermatitis

A

Discrete papules around the mouth

Can be caused by steroid use

Mx: avoid steroids, metronidazole gel, tetracycline

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13
Q

Rosacea

A

Chronic inflammatory erythema - relapsing, remitting

Exacerbated: temperature, wind, sun, stress, alcohol, spices

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14
Q

Scabies treatment

A

TOP permethrin

if topical treatment fails, PO ivermectin

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15
Q

Keloid management

A
  1. Intralesional steroid injection
  2. Silicone gel sheets
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16
Q

Atopic Dermatitis Features (5)

A
  1. Pruritus
  2. Inflammation
  3. Lichenification
  4. Excoriation
  5. Hyperlinearity of the palms
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17
Q

Management of atopic dermatitis

A
  1. Emollient creams
  2. TOP corticosteroid
  3. TOP calcineurin inhibitor (tacrolimus)
  4. Biologics
  5. TOP PDE-4 inhibitor - Eucrisa
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18
Q

Dyshidrotic eczema

A

Papulovesicular rash affecting palms and soles of the feet

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19
Q

Seborrheic dermatitis

A

Erythema, yellow scaling, papules and plaques

Mx: ketoconazole (Nizoral) cream/ shampoo

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20
Q

Lichen Planus

A

Inflammation of skin and/ or mucous membranes

Pruritic papules
Can have white-grey lines - Wickham’s striae

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21
Q

Lichen Planus Management

A

Steroids - TOP or intralesional
PO prednisolone

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22
Q

Pityriasis Rosea

A

Red, oval plaques/ patches
Management: conservative, steroid if itchy

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23
Q

Pityriasis Rosea associated viruses

A

HHV-6/7

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24
Q

Plaque Psoriasis

A

Erythematous plaques with silvery white scales

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25
Q

Psoriasis Severity BSA

A

Mild <3% Body Surface Area
Moderate 3-10%
Severe >10%

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26
Q

Treatment mild plaque psoriasis

A

Management:
Steroids +/- calcipotriol
Retinol +/- top steroid
Emollient
Phototherapy

27
Q

Treatment moderate plaque psoriasis

A
  1. Phototherapy
  2. Methotrexate/ biologics
  3. Ciclosporin
  4. Acitretin (retinoid)
28
Q

Guttate Psoriasis

A

Scattered small pink papules

29
Q

Erythrodermic psoriasis management

A

Medical emergency
IVF, treat underlying aggravating cause
Ciclosporin, acitretin, biologics, methotrexate

30
Q

Bullous Pemphigoid

A

Chronic autoimmune bullae
Subepidermal

Mx: prednisone
TOP potent steroid
(clobetasol)
Immunosuppressants

31
Q

Pemphigoid Vulgaris

A

Intraepidermal blisters, autoimmune

Can affect mucous membranes

Mx: same as bullous pemphigoid

32
Q

Dermatitis Herpetiformis

A

Inflammatory immunobullous manifestation of coeliac disease

Ix: skin biopsy, immunofluorescence - IgA deposits

Mx: Dapsone, GF diet

33
Q

Steven Johnson Syndrome/ Toxic Epidermal Necrolysis Features

A
  1. Prodromal illness with fever and malaise
  2. Red macular rash, blisters, targetoid lesions
  3. Nikolsky’s sign
  4. Associated AKI/ ATN, cytopenia, tracheal erosion
34
Q

SJS/ TEN Management

A
  1. Discontinue drug
  2. Admit ITU/ burn unit
  3. IVF, supportive care
  4. IVIg, ciclosporin, etanercept (anti-TNF)
35
Q

Neurofibromatosis I
Features (7)

A

2 or more of:
1. >5 café au lait spots
2. axilla/inguinal freckles
3. iris hamartoma
4.optic gliomas
5.neurofibromas
6. bony lesions
7. FHx in first degree relative

36
Q

Cancer associated with neurofibromatosis I?

A

Astrocytoma

37
Q

Impetigo

A

Honey-crusted lesions

S.aureus or Group A Strep

Mx: TOP antibiotic - mupirocin or fusidic acid

38
Q

Cellulitis

A

Unilateral inflammed erythematous rash

Tx: Cloxacillin first line

39
Q

Cutaneous anthrax

A

Bacillus anthracis infection

Ix: gram stain MC&S, PCR, full thickness punch biopsy

Mx: PO ciprofloxacin

40
Q

Tinea capitus

A

Mx: terbinafine

41
Q

Herpes Simplex Virus

A

Grouped vesicles
Associated with: dendritic corneal ulcer, EM, Ramsay Hunt syndrome

Mx:

42
Q

HSV -1

A

Cold sores
Tx: TOP or PO acyclovir

43
Q

HSV - 2

A

STIs
Tx: PO acyclovir

44
Q

Erythema multiforme

A

Immune-mediated, typically self-limiting, mucocutaneous condition characterised by ‘target’ lesions.

45
Q

Molluscum contagiosum

A

Caused by virus of same name

Mx: TOP cantharidin
cryotherpy/curettage

46
Q

Candidiasis

A

Mx: clotrimazole TOP

47
Q

Pityriasis versicolor

A

Fungal infection brown/white macules (chest and back)

Mx: ketonazole

48
Q

Basal cell carcinoma - appearance

A

Skin-coloured papule/nodule, pearly border

Depressed/ulcerated centre

49
Q

Risk factors BCC

A

Sun exposure/ UVB
Trauma
Repeated sunburn
Age (older), gender (male)

50
Q

Management BCC

A

Superficial: Imiquimod cream, 5-flurouracil

Photodynamic therapy, radiation, excision

51
Q

What is Bowen’s disease

A

SCC in situ

Erythematous patch with scale or crusting

52
Q

Squamous cell carcinoma

A

Hyperkeratotic indurated, papule/nodule

May present as cutaneous horn

53
Q

Malignant melanoma subtypes (4)

A
  1. Superficial spreading
  2. Nodular
  3. Lentigo - in situ
  4. Acral
54
Q

Management melanoma

A
  1. excision biopsy
  2. high dose IFN, chemo, radiotherapy
55
Q

Cutaneous T-cell lymphoma

A

Form of non-Hodgkin lymphoma in which malignant T-cells are initially localised

56
Q

Kaposi’s sarcoma

A

HHV-8
Associated with AIDS, endemic sub-Saharan, Mediterranean descent

Purple/blue macules/ plaques

57
Q

Androgenetic Alopecia pathophysiology

A

Due to DHT effect on hair follicles

58
Q

Hair growth cycle

A
  1. Anagen - growth stage
  2. Catagen - transitional
  3. Telogen - resting
59
Q

Telogen effluvium causes

A

Stress, post-partum, major illness

60
Q

Anagen effluvium causes

A

Chemotherapy, chemicals - thallium, boron, arsenic

61
Q

Alopecia Areata

A

Autoimmune disorder patches of complete hair loss

Dystrophic nails

Mx:
TOP and intralesional steroids
TOP immunotherapy
systemic immunosuppressants

62
Q

Cicatricial (scarring) alopecia

A

Irreversible hair loss with fibrosis

Causes: radiation, burns, TB, leprosy, fungal, bacterial, lichen planus,

63
Q

Erythema Nodosum

A

Inflammation of the subcutaneous fat

Associated with IBD, sarcoidosis, some medications, leukaemia, Hodgkin’s lymphoma

63
Q

Management erythema nodosum

A

NSAIDs
treat underlying cause
bed rest, compressive/wet dressings

Medicine (16 decks)

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