Dermatology Flashcards
Medication that can exacerbate psoriasis.
ACEi (-prils)
Auspitz’ Sign:
Superficial scraping of the lesion causes pinpoint bleed
Treatment of Psoriasis:
First Line:
- Topical Corticosteroid
- Emollients
- Vitamin D Analogues
Second Line:
- Phototherapy (PUVA)
Psoriatic Arthritis:
- Symmetric Polyarthritis
- Rheumatoid Arthritis pattern, but RF NEGATIVE
- DIP most involved
Treatment of Psoriatic Arthritis:
NSAIDS
DMARDs (Methotrexate, Sulfasalazine and Leflunomide)
Aspect of Plaque Psoriasis:
Plaques, covered in Silver scales
Most common type of Psoriasis
Aspect of Guttate Psoriasis:
Small (less than 1 cm), drop-shaped lesions
Usually dissapears completely after a few weeks. Some may go on to develop plaque psoriasis
What are the presentations of Liquen Planus?
Cutaneous Liquen Planus and Oral Liquen Planus
What is Erosive Liquen Planus?
A type of Oral Liquen Planus where, along with the striae, the patient develops painful ulcers that can last weeks or years
What is the presentation of Cutaneous Liquen Planus?
Purple
Pruritic
Papular
Polygonal Rash
Commonly seen on Flexor Surfaces
Management of Liquen Planus:
Symptomatic:
- Itching = Topical Steroids and Antihistamines
What is the presentation of Oral Liquen Planus?
White lacy pattern on buccal mucosa and sides of the tongue - Wickham Striae
What is Cellulitis?
An infection of the dermis and subcutaneous tissues, that has POORLY DEMARCATED BORDERS
Presentation of Cellulitis:
- Erythema
- Warmth
- Swelling and pain on the affected limb
Most common in the Lower Limb
Risk Factors for Cellulitis:
Diabetes and Immunodeficiency
Cellulitis is commonly caused by which microorganism(s)?
Streptococcus and Staphylococcus
Management of Cellulitis
- Firts Line: Flucloxacilin 500 mg QDS
- Penicilin allergy: Clarithromycin 500 BD
- MRSA+: Vancomycin
- Analgesics and limb elevation
What is Erysipela
An infection of the upper dermis and upper subcutaneous tissues, with sharply demarcated borders
Common affected areas = Face - Leg - Arm
What is the presentation of Erysipela?
Fiery-red, indurated, tense and shiny plaque
Burning sensation over the affected area
Commonly caused by: Streptococcus
Management of Erysipela:
Treatment
- First Line: Flucloxacilin 500mg QDS
- Penicillin allergy: Erythomycin or Clarithromycin
- Analgesics and Limb Elevation
Presentation of Urticaria:
Urticaria = Hives
Skin rash with red, raised and itchy bumps
Triggers for Urticaria
- Allergies: food, drugs, bee sting
- Skin contact with latex or metals
- Rubbing the place
Management of Urticaria
Treatment
- Antihistamines: Ceterizine or Loratadine (non-sedating)
- Calamine lotion
- Oral Prednisolone (severe cases)
Presentation of Malignant Melanoma:
Malignant Melanoma = Cancerous growth of melanocytes
A: Asymmetry
B: Border Irregularity
C: Colour Irregularity
D: Diameter >/= 7 mm
E: Evolving
Risk Factors: Sun exposure; fair skin
Melanomas can be raised of flat
Melanomas sometimes are itchy and can bleed
Can occur anywhere, including areas not exposed to sun
Management of Malignant Melanoma
If presenting to GP Clinic: Refer Urgently to Dermatology
Early Stages: Surgical Excision
Late Stages: Radiation and Palliative Care
When diagnosing a Malignant Melanoma, what parameter is most strongly correlated with prognosis?
Depth of Invasion (Breslow Thickness)
What’s the most common skin cancer?
Basal Cell Carcinoma
- Head and Neck are most commonly involved
- Least aggressive form of skin cancer
- Often has tiny blood vessels (Telangectasias)
- Can develop a central depression
- Sometimes itchy and can bleed
- Commonly located on sun-exposed areas: face, ears, neck
Presentation of Basal Cell Carcinoma
Initially: Pearly Lesion
Later: Rodent Ulcer with an indurated and rolled edge and ulcerated center
Sun exposure is a risk factor
Management of Basal Cell Carcinoma:
Surgical Excision
Mohs’ Micrographic Surgery
Druga
