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Dermatology 2 Flashcards

1
Q

Chronic condition affecting the head of the penis
Middle aged/ elderly men
Uncircumcised
Erythematous, well demarcated shiny patches

Mx (3)

A

Zoon’s balanitis

Circumcision
CO2 laser therapy and topical steroids

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2
Q

Acrodermatitis - red crusted lesions in the acral distribution (distal limbs), periorifical and perianal

Alopecia
Short stature
Hypogonadism
Hepatosplenomegaly
Cognitive impairment
= which condition?

A

Zinc deficiency

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3
Q

Associated conditions with vitiligo (5)

Mx (3)

A

T1DM
Addison’s
Autoimmune thyroid disease
Pernicious anaemia
Alopecia areata

Sunblock
Camouflage make up
Topical steroids

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4
Q

Name two large vessel vasculitis

Medium vessel (2)

Small vessel (4)

A

Temporal arteritis
Takyasu’s

Polyarteritis nodosa
Kawasaki

Granulomatosis with polyangitis
Churg Strauss
Henoch-Schonlein purpura
Goodpasture’s

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5
Q

Who is the shingles vaccine offered to?

A

All patients age 70-79

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6
Q

Name six drugs known to induce TEN

Mx

A

Phenytoin
Sulphonamides
Allopurinol
Penicillin
Carbamezapine
NSAIDs

IVIG

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7
Q

What it tinea capitis?
If untreated can lead to a?

Mx (2)

A

Scalp ringworm
Kerion - raised, pustular, spongy/ boggy mass

Mx PO terbinafine + topical ketoconazole shampoo for first 2 weeks

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8
Q

What is tinea corpororis?
Mx (1)

A

Fungal infection on trunk, legs or arms
Mx PO fluconazole

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9
Q

SJS characteristic lesion

A

Target lesions, can develop into vesicles/ bullae with mucosal involvement

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10
Q

SCC RF (4)

A

Smoking
Sun exposure
Bowen’s disease
Immunosuppression

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11
Q

Difference between spider naevi and telangiectasia

A

Spider naevi fill from the centre
Telangiectasia fill from the edge

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12
Q

Difference between a vesicle and a bullae

A

<5mm = vesicle fluid filled
>5mm = bullae fluid filled

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13
Q

Malar rash is seen in?
What area is spared?

A

SLE
Nasolabial sparing

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14
Q

Name four skin manifestations of SLE (4)

A

Malar rash
Discoid lupus
Alopecia
Livedo reticularis

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15
Q

Pruritic condition associated with last trimester
Lesions often appearing first in abdominal striae
=
Mx

A

Polymorphic eruption of pregnancy
Emollients, topical and PO steroids

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16
Q

Mx atopic eruption of pregnancy

A

Nil

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17
Q

Pruritic blistering lesions often developing in peri-umbilical region, spreading to trunk, back, buttocks and arms
Usually presents in 2nd and 3rd trimester
Rarely seen in first pregnancy
=
Mx

A

Pemphigoid gestationis
Mx PO steroids

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17
Q

Shiny, painless areas of yellow/red/brown skin typically on the shin - seen in diabetics
Often with surrounding telangiectasia

A

Necrobiosis lipoidica

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18
Q

Name four common skin disorders associated with diabetes

A

Necrobiosis lipoidica
Vitiligo
Neuropathic ulcers
Granuloma annulare

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19
Q

May be acquired or congenital
Describes a thickening of the skin of the palms and soles
Acquired causes include reactive arthritis
=

A

Keratoderma

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20
Q

Name four conditions that can cause keratoderma

A

Psoriasis
Dermatitis
Reactive arthritis
SLE

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20
Q

Affects people who sweat excessively
Patients may complain of damp and excessively smelly feet
Usually caused by Corynebacterium
Heel and forefoot may become white with clusters of punched-out pits
=

A

Pitted keratolysis

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21
Q

Crops of sterile pustules affecting the palms and soles
The skin is thickened, red. Scaly and may crack
More common in smokers
=

A

Palmoplantas pustulosis

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22
Q

Affects children. More common in atopic patients with a history of eczema
Soles become shiny and hard. Cracks may develop causing pain
Worse during the summer
=

A

Juvenile plantar dermatosis

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23
Q

Shingles
How long are they infectious for?
How do you reduce the risk of spread

A

Until the vesicles have crusted over
Usually 5-7 days following onset
Covering lesions reduces the risk

24
Q

Analgesia for shingles (3)

A

Paracetamol
NSAIDs
Amitriptyline

25
Q

When do you give antivirals for shingles?

A

Within 72 hours
Unless <50yo with mild truncal rash with mild pain

26
Q

Shiny orange peel skin

A

Pretibial myxoedema

27
Q

Shin lesions:
Initially small red papule
later deep, red, necrotic ulcers with a violaceous border

A

Pyoderma gangrenosum

28
Q

Mx seborrhoeic dermatitis (2)

A
  1. Head & Shoulders & Neutrogena T/Gel
    (Both contain zinc)
  2. topical ketoconazole
29
Q

Scabies mx (2)
Who should be treated?

A

permethrin 5% is first-line (8-12 hours)
malathion 0.5% is second-line (24 hours)
Repeat 7/7 later

all household and close physical contacts should be treated at the same time, even if asymptomatic

30
Q

Mx crusted scabies

A

Ivermectin

31
Q

pink and blotchy, and commonly found on the forehead, eyelids and nape of the neck
Vascular birthmark
=
Course of rash

A

Salmon patch
AKA stork mark
Fades over a few months

32
Q

typically affects nose, cheeks and forehead
flushing is often first symptom
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma
=

Mx (3)

A

Rosacea

Mx
Topical metronidazole
Topical brimonidine if predominant flushing
PO oxytetracycline

33
Q

Adverse effects of retinoids (8)

A
  1. Teratogenecity
  2. Depression
  3. Hair thinning
  4. Dry skin/eyes/mouth/lips
  5. Raised triglyc
  6. Nose bleeds
  7. Intracranial HTN
  8. Photosensitivity
34
Q

Causes of pyogenic granuloma (2)

A

Trauma
Pregnancy

Mx pregnancy - resolve spontaneously, otherwise currettage

35
Q

most common sites are head/neck, upper trunk and hands. Lesions in the oral mucosa are common in pregnancy
initially small red/brown spot
rapidly progress within days to weeks forming raised, red/brown lesions which are often spherical in shape
the lesions may bleed profusely or ulcerate
=

A

Pyogenic granuloma

36
Q

Causes of pyoderma gangrenosum (6)

Mx

A

IBD
RA
SLE
Idiopathic 50%
Lymphomas and leukemias

PO steroids

37
Q

Purpura is usually caused by

A

Low platelets (ITP)

38
Q

Pruritus particularly after warm bath
‘Ruddy complexion’
Gout
Peptic ulcer disease
=

A

Polycythaemia

39
Q

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

Mx

A

Pityriasis versicolor

Mx topical ketoconazole

40
Q

What is pompholyx?
Precipitated by? (2)

A

Type of eczema affecting the hands and feet
Sweating and high temperatures

41
Q

small blisters on the palms and soles
pruritic
often intensely itchy
sometimes burning sensation
once blisters burst skin may become dry and crack
=

Mx (3)

A

Pompholyx

Cool compress
Emollients
Topical steroids

42
Q

classically presents with photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands (most common feature)
hypertrichosis
hyperpigmentation
=

Mx (2)

A

Porphyria cutenea tarda

Mx chloroquine, venesection

43
Q

Name three factors that may exacerbate psoriasis

A

Trauma
Alcohol
Withdrawal of steroids

44
Q

Name four drugs that can exacerbate psoriasis

A

BB
Lithium
Antimalarials
NSAIDs

45
Q

What can trigger guttate psoriasis?

A

Strep infection

45
Q

Psoriasis Mx
All patient should use?
1st line treatment (2)
Length of time

If no improvement over what time period?
2nd line

If no improvement after further 8-12 weeks
3rd line (2)

4th line

A

Regular emmolients
1. Potent steroids OD + vit D analogue OD
- 4 weeks

If no improvement after 8 weeks
2. Vitamin D analogue BD

If no improvement after 8-12 weeks
3. Top steroid BD
- 4 weeks
OR
Coal tar prep OD/BD

  1. Dithranol
46
Q

Secondary care rx of psoriasis (3)

A
  1. Phototherapy
  2. PO MTX
  3. Ciclosporin
47
Q

Mx scalp psoriasis
Mx face/flexural/ genital psoriasis

A

Top potent steroids OD 4 weeks
Mil to mod OD for 2 weeks

48
Q

How long should you use potent steroids for?
Very potent steroids?
Break time?

A

No longer than 8 weeks
Very potent for no longer than 4 weeks
Try and have a break of at least 4 weeks between each treatment

49
Q

Two examples of vitamin D analogues
Maximum weekly amount for adults in grams

A

Calcipotriol
Calcitriol
100g

50
Q

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)
Koebner phenomenon may be seen (new skin lesions appearing at the site of trauma)
oral involvement in around 50% of patients: typically a white-lace pattern on the buccal mucosa
nails: thinning of nail plate, longitudinal ridging

Mx (2)

A

Lichen planus

Mx topical steroids, denzydamine mouthwash if oral

51
Q

Lichen planus can be caused by which drugs (3)

A

Gold
Quinine
Thiazides

52
Q

Presentation is usually in boys aged between 5-14 years
Appears following sun exposure
Itchy red bumps turning into blisters and crusts on light exposed parts of the ears
Occurs in spring usually
=

Mx (3)

A

Juvenile spring eruption

Sunscreen, emollients, antihistamines

52
Q

‘golden’, crusted skin lesions typically found around the mouth
very contagious
=
Caused by what bacteria?
Mx (3)

School

A

Impetigo
Staph Aur or strep pyogenes

Mx
Hydrogen peroxide 1% cream
Topical fusidic acid or mupirocin
PO fluclox/ erythro if pen allergic

School exclusion until lesions are crusted and healed or 48 hours after starting abx treatment

53
Q

Hyperhydrosis mx (3)

A

Topical aluminium chloride preparations
Iontophoresis
Botulinium toxin

54
Q

Hirsutism
Assessment/ scoring system name
What score indicates moderate or severe

A

Ferriman-Gallwey
>15

55
Q

It is characterized by the development of inflammatory nodules, pustules, sinus tracts, and scars in intertriginous areas. It should be suspected in pubertal or post-pubertal patients who have a diagnosis of recurrent furuncles or boils, especially in intertriginous areas.

A

Hidradenitis suppurativa

56
Q

Hidradenitis suppurativa RF (5)

Mx (2)

A

FH
Smoking
Obesity
T2DM
PCOS

Mx
1. Steroids
2. Fluclox

56
Q

What is Osler Weber Rendu syndrome (alternative name)

A

Hereditary haemorrhagic telangiectasia

57
Q

HHT - Hereditary haemorrhagic telangiectasia
Diagnostic criteria

A

3 or more of:
Epistaxis
Telangiectases (lips, oral cavity, fingers, nose)
Visceral lesions e.g GI telang with or without bleeding, AVM
FH

AKT (52 decks)

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