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1MSRA - Learning Points > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Itchy rash face scalp eyebrows

A

seborrhoeic dermatitis

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2
Q

Red rash affecting face, with flushing, non-pruritic.
Can cause blepharitis/conjunctivitis

A

Acne Rosacea

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3
Q

1st line Tx for Acne Rosacea

A

Topical Ivermectin

(Brominidine gel, an alpha agonist, can be used PRN for flushing)

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4
Q

Red rash with silver scale/plaque

A

Psoriasis

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5
Q

Treatment for extensor psoriasis

A

Potent topical steroid + Vitamin D analogue (latter reduces plaque thickness)

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6
Q

Treatment for flexural psoriasis (incl groin/axilla/face)

A

Mild topical steroid only

(since skin thinner in flexures, so is plaque, so vitamin D no benefit)

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7
Q

Treatment for keloid scarring?

A

Intralesional steroid (triamcinolone)

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8
Q

Fungal nail infection involving <50% nail or 2 or fewer nails?

A

Topical anti fungal nail cream

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9
Q

Fungal nail infection involving >50% nail or more than 2 nails?

A

Oral terbenafine

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10
Q

There are 4 skin conditions that affect the shins. What are they?

A

-Erythema Nodosum (IBD, sarcoidosis)
-Pyoderma Gangrenosum (idiopathic, IBD)
-Pretibial myxoedema
-?Necrobiosis lipidium diabeticorum

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11
Q

Treatment escalation for psoriasis?

A

1) 4 weeks potent steroid OD and vit D analogue (calpotriol)

2) 8 weeks calpotriol only BD

3) 4 weeks potent steroid BD and continue calpotriol

4) PUVA (psoralen light UV sensitising cream + UVA therapy)

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12
Q

What does PUVA increase risk of?

A

Squamous Cell Cancer only

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13
Q

Peeling of epidermal layer under pressure, affecting >30% of skin area, following drug

A

Toxic Epidermal Necrolysis (TEN)

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14
Q

Seborrhaic dermatitis - what is it caused by?
How is it treated?
What are complications?

A

Caused by fungal infection (malassazia furfur)

Treat with ketoconazole

eyes and ears - blepharitis and otitis externa

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15
Q

What is acne rosacea?
How does it present?
What is the first symptom usually?
Difference between acne rosacea and malar rash in SLE?
Treatment escalation in acne rosacea?

A

Central Red rash affecting face - unknown cause

First flushing
Rash
telangiectasia
papules and pustules can form after

No other symptoms of SLE or systemic symptoms

Brominidine gel for flushing
Topical ivermectin +/- metronidazole or if papules/pustules doxycycline

camouflage cream to help hide

if no help, refer for laser

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16
Q

Most common side effect of isotretinoin?

A

dry skin

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17
Q

What nail changes can happen in psoriasis?

A

onycholysis, loss of nail, subungual hyperkeratosis

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18
Q

Are steroids used in acne rosacea?

A

NO!

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19
Q

Depigmentation, precipitated by hot, humid weather?

A

Pityriasis Versicolour
(fungal infection - malassezia furfur)

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20
Q

Which mineral deficiency causes angular cheilosis?

A

Zinc

21
Q

Causes of hirsutism?

A

most common is PCOS

  • Cushing’s
  • Adrenal tumour
  • CAH

NB// can be normal with women ageing, as post-menopausal oestrogen level is relatively low to androgen level

22
Q

What do you treat strawberry navi (capillary hemangiomas) with if indicated?

A

Topical propranolol

23
Q

What is the difference between cellulitis and necrotising fasciitis? (and erysipelas)

A

Cellulitis affects dermis, whereas nec fasc affects deeper connective tissue (fascia) and can extend into muscle. It requires emergency surgical debridement. Significant mortality.

24
Q

Treatment of scalp psoriasis?

A

Potent topical steroid only - try 4 weeks. If no help try different formulation e.g cream/mousse

25
Q

Management of shingles?

A

If within 72hrs, aciclovir

Advise infectious until crusted over

Advise no contact with pregnant or immunosuppressed people

26
Q

What triggers pityriasis rosacea?

A

viral infection (HHV6/7)

27
Q

What triggers Guttate psoriasis?

A

bacterial infection
e.g. strep throat

28
Q

What is bullous pemphigoid?

A

autoimmune condition affecting elderly patients

causing BLISTERS that do NOT have mucosal involvement (whereas pemphigus vulgaris does have mucosal involvement)

29
Q

Management of bullous pemphigoid?

A

Life-threatening

Urgent derm referral

30
Q

Most useful investigation prior to managing suspected venous ulcer

A

ABPI (normal 0.9 - 1.2)

31
Q

Characteristics of lichen planus?

A

purple
polygonal
papules

can get white striae inside mouth known as Wickham’s striae

32
Q

Treatment of lichen planus?

A

Topical steroids

33
Q

Management of alopecia areata?

A

Topical steroids and refer to derm

Advise most patients hair eventually grows back

34
Q

Which treatment options for acne vulgaris are contraindicated in pregnancy?

A

Retinoids, even topical retinoids
(isotretinoin, dapalene)

35
Q

What is the management of impetigo?

A

1st - topical BPO
2nd - topical fusidic acid

36
Q

Which antihistamines are non-sedating?

A

loratidine
cetirizine

37
Q

What are the skin issues in pregnancy?

A

Polymorphic eruption of pregnancy vs pemphigus gestations

(essentially area of polymopric urticarial rash on abdomen and legs vs individual blisters)

3rd one is atopic dermatitis of pregnancy (eczema)

38
Q

What are the causes of erythema nodosum?

A

TB, Sarcoidosis, IBD, Pregnancy, COCP/Sulfsalazine/penicillins

39
Q

Which common medications can make plaque psoriasis worse?

A

Beta blockers, ACEi, NSAIDs

40
Q

What can cause erythema multiforme?

Is it itchy?

A

Viral, bacterial
Idiopathic
Drugs

No not itchy

41
Q

Management of BCC in GP?

A

Routine derm referral

Unless near eyes - urgent 2ww

Ultimately surgical removal

42
Q

Management of pityriasis versicolor?

A

Given it’s a fungal infection, treat with anti-fungal

i.e. ketoconazole shampoo

43
Q

Which specific cancer can acanthosis nigricans be associated with?

A

Gastric adenocarcinoma

44
Q

What is tylosis and which cancer is it associated with?

A

Keratisation of palms and soles (looks a bit like kaposi sarcoma but isn’t)

OESOPHAGEAL CANCER

45
Q

Prognosis and management of guttate psoriasis

A

NB// guttate comes from latin word for ‘tear’

Usually resolves by itself.
If lesions symptomatic, can use topical steroid

46
Q

What are the systemic complications of burns?

A

Hypovolaemia and third spacing of fluid, causing shock and ARDS

Infection of burned area

Stress ulcer called Curling’s ulcer (not Cushing’s which is associated with head injury)

47
Q

Management of actinic keratoses?

A

Effudix (5FU cream)

makes area inflamed and worse after 7 days but does get better

avoid sun on area, especially when using effudix

toxic to cats and dogs - don’t let them lick it

48
Q

What is tuberous sclerosis and what are the signs?

A

AD disease causing benign tumour growths - has several skin manifestations

Ash leaf spots (flat pale rectangle.long leaf shape patch)
Shagreen patches on back (look like areas of burn scarring)
Adenoma sebaceum (greasy spot on nose, looks a bit like acne rosacea)

1MSRA - Learning Points (20 decks)

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