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Finals (HV) > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the pathophysiology behind acanthosis nigricans?

A

Insulin resistance leads to increased insulin secretion, which stimulates proliferation of fibroblasts and keratinocytes via IGFR-1

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2
Q

List 3 causes of acanthosis nigricans?

A

T2DM, GI malignancy, PCOS

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3
Q

Describe the lesion associated with acanthosis nigricans?

A

Symmetrical dark, brown or black, velvety patches of skin develop in the axillae, groin, neck.

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4
Q

What is acne vulgaris?

A

A chronic skin condition, usually affecting the face, which is characterised by obstruction and inflammation of the pilosebaceous units.

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5
Q

What are comedones?

A

non-inflamed blackheads/whiteheads

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6
Q

What are papules?

A

inflamed dome-shaped bumps

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7
Q

What is characterised as mild, moderate and severe acne?

A

Mild-mostly non-inflammatory (comedones)

Moderate-more widespread, papules and pustules

Severe- Widespread inflammation, with large papuyles, pustules and deeper nodules/cysts. May have scarring

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8
Q

What is the 1st line mx of mild-moderate acne?

A

Prescribe a 12 week course of a combined topical treatment. Options:
-Topical adapalene with benzoyl peroxide
-Topical tretinoin with clindamycin
-Topical benzoyl peroxide with clindamycin

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9
Q

What is the 1st line mx of moderate/severe acne?

A

Topical adapalene with benzoyl peroxide AND oral tetracycline (lymecycline/doxycycline

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10
Q

When should a referral to dermatology be made regarding acne?

A

Mild-Moderate acne has not responded to 2 x complete course of treatment
Moderate-Severe acne has not responded to treatment which included PO ABx
Scarring, pigmentary changes, or psychological distress
Secondary care treatments include: PO Isotretinoin (contraindicated in pregnancy)

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11
Q

What is actinic keratosis?

A

Premalignant skin lesions which occur secondary to chronic sun exposure.

The presence of AK suggested that the patient is at an increased risk of SCC

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12
Q

What are the mx options for actinic keratosis?

A

Topical - fluorouracil, diclofenac, imiquimod
Cryotherapy, curettage, cautery

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13
Q

What is the mainstay management of eczema?

A

Generous use of emollients/ointments

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14
Q

What is the mx of acute flares of eczema and list the stepladder of tx?

A

Topical corticosteroids
1st- Hydrocortisone 0.5-2.5%
2nd- Betnovate or EUmovate
3rd- Cutivate or betnovate (0.1)

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15
Q

What are the clinical features of a BCC?

A

Nodular BCC is the most common subtype
-Pearly, pink/flesh coloured papule with telangiectasia
-May ulcerate in the centre or bleed
-Often have rolled edges due to the presence of central depression/ulceration

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16
Q

What is the referral process for BCC?

A

enerally, if a BCC is suspected, a routine referral should be made

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17
Q

What are the mx options for a BCC?

A

surgical removal
curettage
cryotherapy
topical cream: imiquimod, fluorouracil
radiotherapy

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18
Q

What are the features of alopecia areata?

A

autoimmune condition causing localised, well demarcated patches of hair loss. At the edge of the hair loss, there may be small, broken ‘exclamation mark’ hairs

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19
Q

What is Bowens disease?

A

a type of precancerous dermatosis that is a precursor to squamous cell carcinoma.

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20
Q

What are the features of bowens disease?

A

red scaly patches (10-15mm)
slow growing
often occur on sun-exposed areas such as the head (e.g. temples) and neck, lower limbs

21
Q

what is the 1st line mx of bowens disease?

A

topical 5-fluorouracil

22
Q

What is subherroic keratosis and list its features?

A

A benign, warty spot which occurs as part of ageing

Flat or raised lesions which can be several cm
May have a “stuck-on” appearance
Can appear in groups - e.g. under the breasts, in the groin, or across the back

23
Q

What are the most common causative organisms of cellulitis?

A

Strep. pyogenes, Staph. Aureus

24
Q

What are the exam findings of cellulitis?

A

pain, erythema, swelling and warmth around affected site

25
Q

What classification is used to determine oral vs IV abx in cellulitis?

A

ERON claasification

26
Q

WHat is cellulitis?

A

Infection of the dermis and subcutaneous tissue

27
Q

What type of reaction is allergic dermatitis?

A

A T-cell mediated type 4 hypersensitivity reaction

28
Q

What is the mx of venous ulcers?

A

Compression bandaging

29
Q

What is the name of the rash associated with coeliacs and describe it?

A

Dermatitis herpetiformis intensely itchy, papular rash with vesicles affecting the extensor surfaces - especially the elbows, buttocks, shoulders and knees

30
Q

what is the mx of perioral dermatitis?

A

steroids may worsen sx thus stop usage
TX- Topical or oral Abx

31
Q

What is the 1st line mx of plaques psoriasis?

A

Potent corticosteroid applied once daily + vitamin D analogue applied once daily

32
Q

what is the 2nd line mx of plaque psoriasis?

A

Apply vitamin D analogue twice dialy

33
Q

what is the SE of phototherapy?

A

skin ageing, SCC

34
Q

List the common causes of erythema nodosum?

A

*Infection (TB, Strep)
*Sarcoidosis
*IBD
*Malignancy/lymphoma
*Drugs (penicilins, sulphonamides, COCP)
*Pregnancy

35
Q

How is bullous pemphigoid and pemphigus?

A

there is no mucosal involvemnt in bullous pehmphigoid

36
Q

What is the mainstay tx for bullous pemphigoid?

A

oral corticosteroids

37
Q

What is pityriasis versicolor and what organism is responsible?

A

a superficial cutaneous fungal infection caused by Malassezia furfur

38
Q

What are the features of pityriasis versicolor?

A

most commonly affects trunk
patches may be hypopigmented, pink or brown (hence versicolor). May be more noticeable following a suntan
scale is common
mild pruritus

39
Q

what is the mx of pityriasis versicolor?

A

topical antifungal. NICE advises ketoconazole shampoo

40
Q

List the features of lichen planus?

A

*itchy, papular rash most common on the palms, soles, genitalia and flexor surfaces of arms

*rash often polygonal in shape, with a ‘white-lines’ pattern on the surface (Wickham’s striae)

*oral involvement in around 50% of patients: typically a white-lace pattern on the buccal mucosa

*nails: thinning of nail plate, longitudinal ridging

41
Q

what si the mx of seborrhoeoic dermatitis?

A

the first-line treatment is ketoconazole 2% shampoo

42
Q

what are the complciations of seborrhoeic dermatitis?

A

otitis externa and blepharitis may develop

43
Q

List the drugs that can exacerbate plaque psoriasis?

A

Lithium
Beta-blockers
NSAIDs
ACEi
TNF-alpha inhibitors
Anti-malarials

44
Q

what organism is thought to be responsible for pityriasis rosea?

A

HHV-7
Herald patch followed by erythematous scaly patches (fir tree appearance)

45
Q

what is the 1st line mx for pyoderma gangrenosum?

A

oral steroids

46
Q

what subtype of melanoma is the most aggresive?

A

nodular

47
Q

what is the single most important prognostic factor in melanoma?

A

invasion depth of the tumour

48
Q

what is the mx of erythema nodosum?

A

no active treatment, arrange routine follow-up

49
Q
A

Finals (HV) (19 decks)

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