Dermatology Flashcards
Tinea - define
Dermatophyte fungal infections
Tinea capitis - where
Scalp
Tinea corporis - where
Trunk, legs or arms
Tinea pedis - where
Feet
Hereditary haemorrhagic telangiectasia
Autosomal dominant condition
Multiple telangiectasia over the skin and mucous membranes
4 main diagnostic criteria of Hereditary haemorrhagic telangiectasia
Epistaxis
Telangiectases: multiple at characteristic sites (lips, oral cavity, fingers, nose)
Visceral lesions: for example gastrointestinal telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM
Family history: a first-degree relative with HHT
Rosacea features:
Affects nose, cheeks and forehead
Flushing, erythema, telangiectasia → papules and pustules
Management of Rosacea (mild)
topical brimonidine gel
mild-to-moderate papules and/or pustules
topical ivermectin is first-line
Moderate-to-severe papules and/or pustules in Rosacea
Combination of topical ivermectin + oral doxycycline
Pyoderma gangrenosum - define
Non-infectious, inflammatory disorder.
It is an uncommon cause of very painful skin ulceration.
Pityriasis rosea
Herald patch (usually on trunk)
Followed by erythematous, oval, scaly patches
Self-limiting
Neutrophilic dermatosis
Pyoderma gangrenosum
Neutrophilic dermatoses are skin conditions characterised by dense infiltration of neutrophils in the affected tissue and this is often seen on biopsy.
Discoid eczema
Nummular eczema, meaning coin-shaped.
Round or oval plaques on the extremities
Extremely itchy
Seborrhoeic keratoses
Benign epidermal skin lesions seen in older people.
Large variation in colour from flesh to light-brown to black
Have a ‘stuck-on’ appearance
Keratotic plugs may be seen on the surface
ANCA-associated vasculitides
Granulomatosis with polyangiitis (Wegener’s granulomatosis)
Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
Microscopic polyangiitis
Immune complex small-vessel vasculitis
Henoch-Schonlein purpura
Goodpasture’s syndrome
Cryoglobulinaemic vasculitis
Wegener’s granulomatosis
Granulomatosis with polyangiitis
Churg-Strauss syndrome
Eosinophilic granulomatosis with polyangiitis
Pemphigoid gestationis
Pruritic blistering lesions
Oral corticosteroids are usually required
Topical therapies:
Mild eczema
Hydrocortisone 1%
Topical therapies:
Moderate eczema
Betamethasone valerate 0.025% or clobetasone butyrate 0.05%
Topical therapies:
Severe eczema
Betamethasone valerate 0.1%
First-line for chronic plaque psoriasis
Topical potent corticosteroid + vitamin D analogue
The following factors may exacerbate psoriasis:
Trauma
Alcohol
Drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
Withdrawal of systemic steroids
Actinic keratoses
Common premalignant skin lesion that develops as a consequence of chronic sun exposure
Small, crusty or scaly, lesions
May be pink, red, brown or the same colour as the skin
Management options for Actinic Keratoses include
Fluorouracil cream
Topical diclofenac
Topical imiquimod
Cryotherapy
Curettage and cautery
Erythema multiforme
Hypersensitivity reaction
Target lesions
Pompholyx - features
Small blisters on the palms and soles
pruritic
Intensely itchy
Burning sensation
Dermatitis herpetiformis
Deposition of IgA in the dermis
Itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
‘Normal’ ABPI
0.9 - 1.2
Values below 0.9 indicate arterial disease
Management of Venous Ulcers
Compression bandaging
Usually four layer
Dermatitis herpetiformis - treatment
Gluten-free diet
+
Topical dapsone
Pityriasis versicolor
Superficial cutaneous fungal infection caused by Malassezia furfur
Management of Pityriasis versicolor
Topical antifungal
Ketoconazole shampoo
Common causes of Erythema multiforme
Viruses: herpes simplex virus (the most common cause)
Bacteria: Mycoplasma, Streptococcus
Drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
Connective tissue disease e.g. Systemic lupus erythematosus
Sarcoidosis
Malignancy
Bullous pemphigoid - define
Autoimmune condition causing sub-epidermal blistering of the skin
There is stereotypically NO mucosal involvement
Bullous Pemphigoid - antibodies
Against the Hemidesmosomal proteins BP180 and BP230.
Erythema nodosum
Inflammation of subcutaneous fat
Usually resolves within 6 weeks
Management of Lichen Planus
Potent topical steroids
Pellagra
Niacin (B3) deficiency
Dermatitis, diarrhoea and dementia
Shingles - Define
Acute, unilateral, painful blistering rash caused by reactivation of the varicella-zoster virus
Large vessel vasculitis examples
Temporal arteritis
Takayasu’s arteritis
Medium vessel vasculitis examples
Polyarteritis nodosa
Kawasaki disease
Actinic keratoses are premalignant lesions which may develop into ?
Squamous cell carcinomas
Complications of psoriasis
Psoriatic Arthritis
Metabolic Syndrome
Scalp psoriasis - first-line treatment
Topical potent corticosteroids
Shingles - define
Herpes zoster infection
Is an acute, unilateral, painful blistering rash caused by reactivation of the varicella-zoster virus (VZV)
Factors that can exacerbate psoriasis:
Trauma
Alcohol
Drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
Withdrawal of systemic steroids
SJS can occur within ? of first drug exposure
1-4 weeks
IgG and C3 deposition at the dermo-epidermal junction
Bullous pemphigoid
Acantholysis
Loss of cohesion between adjacent keratinocytes due to a loss of intercellular connections
Pemphigus vulgaris
Systemic therapy in severe Psoriasis
Methotrexate is first line
Ciclosporin
Management options for Bowen’s disease
Topical 5-fluorouracil
Cryotherapy
Excision
Seborrhoeic dermatitis - treatment
First-line treatment is topical ketoconazole
The most common malignancy associated with acanthosis nigricans
Gastrointestinal adenocarcinoma
Scabies treatment
Permethrin treatment
All skin including scalp + leave for 12 hours + retreat in 7 days
Erythema marginatum
Manifestation of acute rheumatic fever
Annular erythematous macules or papules that spread outwards with central clearance
First line treatment for Toxic epidermal necrolysis
IVIG
Face, flexural and genital psoriasis management
Mild or moderate potency corticosteroid applied once or twice daily
Scalp psoriasis management
Potent topical corticosteroids used once daily for 4 weeks
Chronic plaque psoriasis management
Potent corticosteroid applied once daily plus vitamin D analogue applied once daily
