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1MRCPCH FOP and TAS > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Which organism most often causes bullous impetigo?

A

Staph aureus

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2
Q

How is bullous impetigo treated?

A

Systemic abx - flucloxacillin

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3
Q

What are the ocular signs of albinism?

A

Failure to develop a fixation reflex
Pendular nystagmus
Photophobia causing frowning

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4
Q

Is the AD or AR form of epidermolysis bullosa more severe?

A

AR form

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5
Q

When does infantile seborrhoeic dermatitis present?

A

First 3 months life

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6
Q

How is mild seborrhoeic dermatitis treated?

A

Emollients

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7
Q

How is more persistent or severe seborrhoeic dermatitis treated?

A

Sulphur and salicylic acid ointment for scaling
Mild corticosteroid +/- antibacterial and antifungal agents

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7
Q

What 2 commonest pathogenic organisms can cause secondary infection in atopic eczema?

A

Staph aureus
HSV

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7
Q

What percentage of children with atopic eczema has settled by age 16?

A

75%

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8
Q

What percentage of children with atopic eczema has settled by age 12?

A

50%

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9
Q

How are viral warts on hands or feet typically treated?

A

Salicyclic acid and lactic acid paint or glutaldehyde 10% lotion
Cryotherapy in older children

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10
Q

What does the typical lesion in molluscum contageosum look like?

A

small, skin-coloured pearly papules with central umbilication

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11
Q

How does tinea capitis usually present?

A

Scaling and patchy alopecia with broken hairs
Woods light may reveal bright green/yellow fluorescence

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11
Q

Where do scabies lesions typically occur in older children?

A

Finger and toe webs, flexor aspects of wrists, belt line, around nipples, penis and buttocks

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12
Q

Where do scabies lesions typically occur in younger children?

A

Palms and soles

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13
Q

What is the treatment of scabies?

A

Permethrin cream 5% below the neck, left on for 8-12hours then washed off
Face and scalp included in infants
OR
Benzyl benzoate 25% left on for 12hours then washed off#
OR
Malathion lotion 0.5% left on for 12hours

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14
Q

How is head lice treated?

A

Dimeticone 4% or malathion 0.5% applied into scalp and left overnight, then hair shampooed following morning
Repeated 1 week later
Wet combing every 2-3days for 2 weeks

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15
Q

What does guttate psoriasis appear as?

A

raindrop like lesions which are scaly and on trunk and upper limbs

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15
Q

In which condition does a ‘Christmas tree’ rash occur?

A

Pityriasis Rosea

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15
Q

What is pediculosis capitis?

A

Headlice

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16
Q

At what age does the embryonic epidermis begin to stratify?

A

8 weeks

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16
Q

In which condition does a herald patch occur?

A

Pityriasis Rosea

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16
Q

Which condition has exclamation mark hairs?

A

Alopecia

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16
Q

What type of collagen is affected in Ehlers-Danlos syndrome?

A

Type V collagen

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17
Q

Which gene mutations are associated with classical Ehlers-Danlos syndrome?

A

COL5A1 and COL5A2

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17
Q

What is type I collagen used for?

A

Bone construction

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18
Q

What does type 2 collagen do?

A

Main component of cartiledge

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18
Q

What condition is associated with defects in collagen I?

A

Osteogenesis imperfecta

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19
Q

What conditions are associated with defects in type II collagen?

A

Achondroplasia and Stickler syndrome

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19
Q

What conditions are associated with defects in type III collagen?

A

Vascular type EDS

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20
Q

What does type IV collagen normally do?

A

Forms basal lamina

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20
Q

What conditions are associated with defects in type IV collagen?

A

Alport syndrome
Goodpasture syndrome

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21
Q

Keloid scars are associated with and excess of what type of cell?

A

Fibroblasts

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22
Q

At what age does keratinisation occur in the fetus?

A

19 weeks

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23
Q

How does a fixed drug eruption typically present?

A

Well demarcated, round or oval, hyperpigmented macules or plaques that recur around the same site upon re-exposure to a drug

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23
Q

What is the mechanism of action of cyproterone acetate?

A

Inhibition of 17-alpha-hydroxylase thus reducing androgen production

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24
Q

How does Gianotti-Crosti syndrome typically present?

A

Characteristic pattern of rash on thighs, buttocks, upper arm and cheeks following a URTI.
Rash typically erythematous and papular in nature

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25
Q

What is the typical rash associated with neonatal SLE?

A

Erythematous, papulosquamous rash with fine scales and central clearing

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25
Q

What are the typical features of Bloom syndrome?

A

Growth retardation
Photosensitivity
Pigment abnormalities
Telangiectasia

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26
Q

How is Bloom syndrome inherited?

A

AR pattern

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27
Q

Which cancers does Bloom syndrome predispose to?

A

Leukaemia and Lymphoma

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28
Q

What does tumour-supression gene TSC1 encode?

A

Hamartin

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29
Q

What infections can lead to SJS most commonly?

A

HSV
Mycoplasma pneumoniae

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30
Q

Which layer of the skin does vitiligo affect?

A

Epidermis

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30
Q

Which enzyme is affected in Sjogren-Larsson syndrome?

A

Fatty aldehyde dehydrogenase

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31
Q

Which drugs are known to predispose to SJS?

A

Penicillins
Barbiturates
Phenytoin
OCP

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32
Q

Which immunoglobulin is most typically seen on immunofluorescence in bullous pemphigoid?

A

IgG4

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32
Q

What type of cell is present within peribulbar infiltrate in alopecia areata?

A

T cells - these reject the hair leading to hair loss

33
Q

In what trimester does the skin become morphologically similar to adult skin?

A

Mid 3rd trimester

33
Q

At what age does skin gain full barrier function?

A

Few weeks post delivery

33
Q

Which skin layer are melanocytes derived from?

A

Ectoderm

34
Q

What route do melanocytes take to reach the epidermis?

A

Migration from neural tube

34
Q

What causes congenital dermal melanocytosis?

A

Failure of melanocytes to reach their proper epidermal location by birth - they remain trapped in the dermal layer

34
Q

What are Blaschko’s lines?

A

Represents migrational patterns of epidermal cells during development and represent a manifestation of cutaneous mosaicism

35
Q

What is cutaneous mosaicism?

A

Occurs when 2 or more genetically different populations of cells exist side by side within the skin

36
Q

What typical patterns does cutaneous mosaicism follow?

A

V-shaped on upper spine
S-shaped on abdomen
Linear on arms and legs
Spiral on the scalp
Vertical in midface

36
Q

What causes an epidermal naevus?

A

Ectoderm defect leading to overgrowth of epidermal keratinocytes

37
Q

How does an epidermal naevus present?

A

At birth or early infancy
Localised, linear, warty, hyperpigmented plaque

38
Q

How does hypomelanosis of Ito present?

A

Hypopigmented streaks which follow Blaschko’s lines

38
Q

Which gene defect causes incontinentia pigmenti?

A

NEMO gene

39
Q

How does incontinentia pigmenti present?

A

In the newborn with blisters that follow Blaschko’s lines which resolve and reveal hyperkeratotic, warty plaques. followed by increased pigmentation at 2-6months of age.
These later fade into atrophic, hypopigmented streaks

40
Q

What type of extracutaneous manifestations are associated with epidermal naevus, incontinentia pigmenti and hypomelanosis of Ito?

A

CNS, heart, eye, skeletal system and dentition defects

40
Q

What type of extracutaneous manifestations are associated with McCune-Albright syndrome?

A

Bone and hormonal abnormalities

40
Q

What type of extracutaneous manifestations are associated with focal dermal hypoplasia?

A

Eye, MSK, renal, GI, cardiac and neurological abnormalities

41
Q

What is a collodion baby?

A

Baby born encased in a taut, shiny, transparent membrane that is formed by aberrant stratum corneum

42
Q

In colloid baby - what phenotype does this most often progress to?

A

Ichthyosis

42
Q

Embryologically where does the dermis of the face and anterior scalp derived from?

A

Neural crest ectoderm

43
Q

Embryologically where does the dermis of the trunk and extremities derived from?

A

Mesoderm

44
Q

At what gestational age are dermal fibroblasts developed?

A

6-8weeks

45
Q

What is the role of dermal fibroblasts in early fetal development?

A

Synthesising collagens and microfibrillar components

46
Q

At what age is the dermis noted to be in the papillary and reticular components?

A

12-15weeks GA

47
Q

What is the role of the dermal-epidermal junction?

A

Adhesion between basal keratinocytes and dermis
Resistance against shearing forces on the skin

48
Q

What is thought to cause strawberry birthmarks?

A

Proliferation of endothelial cells and mutations in genes which encode VEGF

48
Q

What are the cutaneous features of tuberous sclerosis?

A

Ash-leaf macules
Adenoma sebaceum
Fibromatous nodules
Periungual fibromas
Shagreen patches

48
Q

What can mutations in genes which encode the dermal-epidermal junction cause?

A

Skin fragility and blister formation

49
Q

How long do infantile haemangiomas proliferate over?

A

6-9months

49
Q

What is the first line treatment for infantile haemangioma (assuming treatment is advised)?

A

Oral propranolol
(More recently topical B-blockers may also be effective)

50
Q

In what circumstances should treatment be considered for infantile haemangiomas?

A

Large with potential for disfigurement, ulceration or impairment of normal functions

50
Q

How are beta blockers thought to help with infantile haemangiomas?

A

Inhibition of angiogenesis and recruitment of endothelial progenitor cells as well as inducing apoptosis.

51
Q

Genetic mutations in what type of cell can lead to neurocutaneous syndromes?

A

Neural crest cells

51
Q

How is tuberous sclerosis inherited?

A

AD - although 50% are new mutations

51
Q

What structures are formed from the ectoderm?

A

Skin
Nails
Sweat glands
Teeth

51
Q

How is NF inherited?

A

AD

52
Q

What are the neurological features of tuberous sclerosis?

A

Seizures
Cognitive impairment

52
Q

What are the layers of the epidermis?

A

Stratum corneum
Stratum lucidium (only on palms and soles)
Stratum granulosum
Stratum spinosum
Stratum basale

52
Q

What are the cutaneous features of NF?

A

Cafe-au-lait patches
Dermal neurofibromas

52
Q

What are the cutaneous features of Sturge-Weber syndrome?

A

Port-wine stain on eye or forehead areas

53
Q

How is Sturge Weber syndrome inherited?

A

AD

54
Q

What is the mechanism of action of phototherapy?

A

Targets inflammatory cells, alters cytokine production and has an antimicrobial effect.

54
Q

How does chronic bullous disease of childhood present?

A

Children >3y/o with small tense blisters on an erythematous background.
Lesions affect perianal area and spread to trunk, thighs, limbs, hands and feet.
May also be mucosal involvement

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1MRCPCH FOP and TAS (23 decks)

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