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UKMLA > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what is erythema multiforme

A

Target lesions, little bullseyes, start back of hands and feet spread to torso
Red
Can be itchy, not always
No treatment, SELF-IMITING

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2
Q

Viral and bacterial causes of eyrythema multiforme

A

Herpes and Strep/mycoplasm

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3
Q

Drugs that causes erythema multiforme

A

Penicillin
NSAIDS
Sulphonamides
Carbamazepine

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4
Q

Can erythema multiforme be idiopathic?

A

Yes

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5
Q

What is erythema nodosum

A

Tender, red lesions that cover the shins and heal without a scar
Lasts usually 6 weeks
Can be caused by pregnancy, penicillin, sulphonamides and strep

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6
Q

What is pityriasis rosea?

A

Usually self limiting affects the face, nose and cheek area
Herald patch seen on the trunk of the body usually

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7
Q

What can pityriasis rosea develop into?

A

Fir tree longitudinal rash

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8
Q

Main forms of psoriasis?

A

Chronic plaque on the extensor surfaces (knees and elbows)
Guttate psoriasis (followed by a strep infection 2-4 weeks prior usually)

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9
Q

Guttate psoriasis meaning and what it is?

A

Gutta = tear drop shapes on the trunk
Pink scaly lesions
Usually self-limiting post strep infection

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10
Q

What management is used for Guttate psoriasis

A

Mostly self-limiting 2-3 months
Topical psoriasis tx
UVB phototherapy
Tonsillectomy to prevent recurrent strep

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11
Q

Management for chronic plaque psoriasis

A

Topical corticosteroid and vitamins D
Double vitamin D
Coal tar and topical steroid
Dithranol

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12
Q

Triggers of psoriasis

A

Trauma
Smoking
Alcohol
Stress
Drugs - NSAIDS, beta blockers, ace inhibitors and lithium

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13
Q

What bacteria causes erythema nodosum?

A

TB or strep

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14
Q

What bacteria is caused by animal bites

A

Pasteurella multiocida

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15
Q

animal bite management?

A
  1. Clean wound
  2. Co-amoxiclav OR doxycycline + metronidazole if allergic to penicillin
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16
Q

What treatment is used for human bites?

A

Co-amoxiclav

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17
Q

What is bed bugs?

A

Bugs that feed on blood at night
Cause a pruritius skin rash
Linens and bedding need a hot wash and pest control

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18
Q

What is bed bugs?

A

Bugs that feed on blood at night
Cause a pruritius skin rash
Linens and bedding need a hot wash and pest control

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19
Q

What cream can be used for most bug bites but especially bed bug bites?

A

Hydrocortisone cream

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20
Q

What is Lyme disease?

A

Bacteria borrelia burgorferi causing a bullseye rash in 1-4 weeks
This develops to headache fever arthralgia
Then later causes cardiac and neurological problems

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21
Q

What bacteria is carried by bed bugs

A

Cimex hemipetru

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22
Q

management of Lyme disease

A

Elisa test
If negative but symtpomatic repeat in 2-4 weeks
Immunoblast test
+ve and acute = doxycycline
+ve and delayed = ceftriaxone

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23
Q

What is an actinic keratosis

A

Pre-malignant skin lesion that is often skin coloured (pink/brown colour)
Crusty small and scaly
Found on sun exposed skin
Multiple lesions can be seen

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24
Q

What management is used for actinic keratosis

A

Fluoruracil cream and hydrocortisone cream for inflammation post cream tx

Topical diclofenac if mild
Topical imiquimoid can be used
Cryotherapy or cutterage to. Remove

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25
Q

What is impetigo

A

Crusty, yellow/green coloured lesion usually caused by staph A (but can be caused by strep infections)
Found in flexures/facial folds and limbs
School exclusion until crusted or post 48 hours of antibitoics

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26
Q

Treatment of impetigo

A

Hydrogen peroxide 1% cream
Toptical antibiotic cream (fusidic acid cream)
Mucopuricin if allergic to prior

Oral flucloxacillin if extensive disease

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27
Q

What types of blood ulcers are there?

A

Venous and arterial

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28
Q

How are venous ulcers formed?

A

Venous hypertension second to chronic venous insufficiency = blood stasis

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29
Q

Symptoms of blood stasis and potential venous ulcer development?

A
  1. Oedema
  2. Brown pigmentation
  3. Lipodermatosclerosis
  4. Eczema
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30
Q

Can impetigo impact eczema

A

Yes

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31
Q

Location and description of venous ulcers

A

Above ankle
Painless
Large demarkated region, irregular borders
Superficial

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32
Q

Treatment of venous ulcer?

A

Compression banding

If fail to heal >12 weeks - skin graft

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33
Q

ABPI ranges? what’s normal?

A

0.9-1.2

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34
Q

What number ABPI indicates arterial disease?

A

<0.9
>1.3

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35
Q

Location and description of arterial ulcer

A

Toes, heels any pressure points
Deep hole punch appearance
Very painful
Gangrene, cold no puls and LOW ABPI

36
Q

What’s a neuropathic ulcer

A

Common on plantar surfaces in diabetics
Due to pressure and callous formation

37
Q

What is pyoderma gangrenosum

A

Can occur at stoma sites - seen in IBD patients

38
Q

What is a pressure ulcer

A

Ulcers that develop on bony prominences such as sacrum or heel

Usually due to immobility
- malnourishment
- incontinence
- immobility
- PAIN

39
Q

What score is used to screen for pressure ulcers

A

Waterlow score

40
Q

Managanebt of pressure sores

A

moist wound healing environment
- hydrocolloid dressing and hydrogels

Wound swab done and ABX given
Tissue viability nurse
Surgical debridement if necessary

41
Q

What is a lipoma

A

Benign tumour of adipoctes
Smooth mobile and painless

42
Q

Danger of lipoma?

A

Transition to liposarcoma
- size >5cm
- pain
- increasing size
- deep anatomical location

43
Q

What is a keloid scar

A

Tumour arising from an area of trauma beyond the incision

44
Q

Pre-disposing factors of keloids

A

Black
Younger

45
Q

Common sites of keloid scar?

A

Sternum
Shoulder
Neck
Face
Limbs
Trunk

46
Q

Management of keloid scar

A
  1. Early = intralesional steroid
  2. Excision if bad
47
Q

heat causing burn treatment?

A

Remove heat source
Irrigate with cool water NOT ICE COLD
Cover burn in cling film

48
Q

Electrical cause of burns

A

Switch off power
Remove from source

49
Q

Chemical cause of burns

A

Brush off powder/liquid
Irrigate with cool water

50
Q

What score is used to quantify burns

A

Wallace rule of 9

51
Q

What are the Wallace’s rule of 9

A

Head and neck
Each arm
Anterior chest
Anterior abdomen
Posterior chest
Posterior abdomen
Each anterior leg

52
Q

What is a superficial burn>

A

Red
Painful
Dry
No blisters

53
Q

What is a partial thickness superficial burn??

A

Pale pink
Painful
Blistered
Slow cap refill

54
Q

What is a partial thickness deep burn?

A

White patches of non-blanching redness
Reduced sensation
Painful to deep pressure

55
Q

Full thickness burn - what is it??

A

White/brown/black in colour
No pain
No blisters

56
Q

When are fluids needed for burns?

A

If 10/15% in children or adults

57
Q

What is acanthosis nigricans

A

Symmetrical brown plaque on neck, axilla or groin (flexure regions)

58
Q

What are causes of acanthosis nigricans

A

T2DM
GI CANCER
OBESITY
PCOS
CUSHINGS
DRUGS

59
Q

What is lichen Planus

A

Itchy rash on palms, soles, genitalia and flexor surfaces

White lines on surface

Oral involvement in 50% of patients

60
Q

Management of lichen Planus

A

Potent topical steroids
Benzydamine mouthwash
Oral steroids or immunosuppression

61
Q

What causes breakouts of lichen Planus?

A

Gold
Quinine
Thiazidess

62
Q

What is Rosacea

A

Blushing papules and pustules
Telangectasia
Can cause blepharitis

63
Q

Management of rosacea

A

Simple - high factor sun cream, camouflage cream

Erythema flushing - topical brimonidine gel

Mild-moderate papules - topical ivermectin

Moderate - severe - topical vermectin + doxycycline oral

64
Q

Complications of rosacea?

A

Rhinopyma

65
Q

Rhinopyma treatment?

A

Laser treatment

66
Q

What fungus usually causes fungal nail infections?

A

Trichophyton rubrum
Candida can as well

67
Q

Treatment of fungal nail infection?

A

Nail clipping to check for dermatophytes
Topical amorolofine nail lacquer
Oral terbinafine extensive
Oral itraconazole

68
Q

What is scabies

A

Burrowing mites in between skin webs
Itching due to eggs layer 30 days post-infection

69
Q

Management of scabies?

A

Permethrin
Malathion
Itching lasts 4-6 weeks post infection eradication.

70
Q

What is tinea?

A

Fungal infection
Three types of
Capitis
Corporis
Pedis

71
Q

What is tinea capitis?

A

Can cause scarring alopecia
Raised pustular boggy spongy mass

72
Q

Tx of topical capitis

A

Topical ketoconazole shampoo

73
Q

Tx of tinea corporis

A

Oral fluconazole

74
Q

Tx of tinea pedis

A

Terbinafine

75
Q

What is cellulitis

A

Bacterial infection of the dermis and deeper subcutaneous tissues

Usually caused by strep

76
Q

Descriptions of cellulitis

A

Unilateral
Well defined erythema
Blisters and/ore Bullard
Swelling
Fever
Maialsie
Nausea

77
Q

What classification system is used for management of patients with cellulitis

A

Eron classification

78
Q

Managament of Eron class I?

A

Oral antibiotics
Oral flucloxacillin
Oral clarithromyacin

79
Q

Eron class 2?

A

Community abx

80
Q

Eron class 3/4

A

Severe, rapidly deteriorating cellulitis
Admit for ABX

81
Q

What scars can you get with acne

A

Ice pick scars
Hypertrophic scars

82
Q

Mild acne treatment??

A

Topical adapalene + topical benzoyl peroxide

83
Q

Severe acne treatment?

A

Topical adapalene with topical benzoyl peroxide

Topical tretinoin with topical clindamyacin

WORST CASE
Azelaic acid with oral lymecycline or oral doxycycline

84
Q

What is eczema

A

Found on extensor surfaces and creases in older people
Itchy red and flaky

85
Q

Management of eczema

A

Simple emollients
Topical steroids
Wet wrapping

UKMLA (3 decks)

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