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Dermatology Flashcards

1
Q

Prevalence of eczema under 5s

A

5%

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2
Q

Patch testing

A

Put patch on for 48 hours then remove.Mark sites.Check again at 96h.

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3
Q

Topical immunomodulators eczema

A

Tacrolimus, sirolimus

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4
Q

Eczema resolved by 5 years

A

40%

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5
Q

First line eczema- topicals

A

EmollientsCorticosteroidsCalcineurin

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6
Q

Systemic eczema treatment

A

Antihistamines.Prednisolone.Antibiotics (if infected)PUVA

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7
Q

Super systemic eczema treatment

A

MethotrexateCiclosporinAzathioprine

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8
Q

Lichen simplex

A

Type of eczema

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9
Q

Pompholyx

A

Eczema rapid in fingers.

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10
Q

Guttate

A

usually after infection- beta haem

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11
Q

Erythrodermic psoriasis

A

irritated by tar/dithranol/UV light.

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12
Q

Pustular psoriasis

A

Acetretin (remember pregnancy things).

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13
Q

Auspitz sign

A

Psoriasis- flake falls off and reveals blood vessels underneath.

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14
Q

Nails in psoriasis

A

Pitting and ridges.OnycholysisDystrophyHyperkeratosis.

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15
Q

Home (4 weeks) treatment psoriasis

A

TarCorticosteroid creamsVit D analogue

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16
Q

Hospital treatments for psoriasis

A

DithranolPUVA

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17
Q

Serious psoriasis treatment

A

Systemic biologics.

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18
Q

Lichen planus

A

Stress related.Self-limiting- flexors.Increased keratin and hypertrophy.Cellular inflitrate- resolves in 8-12m.

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19
Q

Wickham’s striae

A

white lines in lichen planus

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20
Q

Pterygium

A

scarring of nail bed in lichen planus.

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21
Q

Drugs causing urticaria

A

ACE inhibitors, anaesthetics, antibiotics.

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22
Q

Chronic urticaria

A

More than 6 weeks.

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23
Q

Investigations for urticaria

A

ANA titres.Hep B/CTFT

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24
Q

Urticaria hypersensitivity type

A

IgE Type 1 hypersensitivityInvolves complement cascade.

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25
Pemphigus cause
Antibodies against keratinocytes- intra epidermal desmosomes.
26
Where is pemphigus?
TrunkScalpMucus membranes.
27
Biopsy findings pemphigus
direct immunofluorescence IgG and C3
28
Treatment pemphigus
Prednisolone + Azathioprine.
29
Nikolsky sign
Pemphigus bulla breaks easily
30
Pemphigoid cause
Autoimmune against basement membrane.
31
Rosacea
no comedones.telangiectasia papulespustulesrhinophyma
32
Acne vulgasis cause
follicular pluggingenlarged glands and XS sebum.
33
1st choice acne treatment
Benzoylperoxidase 2.5-5%
34
Pityriasis rosea
Prodromal sickness.ACUTEself-limiting20-30years.Herald patch --> Christmas tree.RED AND SCALY
35
Describe tinea
itchy, central clear bit with red, scaly edge.
36
Topical antifungal
imidazole
37
Systemic antifungal
terbinafine
38
Pityriasis versicolor cause
orbiculare FUNGUSMalasezzia furfur
39
Where is versicolor?
chest, back, trunk, arms
40
Versicolor Ix
Wood's light- yellow/green fluorescence.
41
Treatment cellulitis
PenicillinFlucloxacillin.
42
Scabies name
Sarcopted scabiei
43
Incubation period for scabies
4-6 weeks.
44
What does scabies look like?
Papules and nodules.Hands and feed, axillae, breast, buttock
45
Treatment scabies
Permethrin + Malathion topical
46
Causes of dermatitis herpetiformis
HLA B3, DR3, coeliac.
47
Subepidermal blistersMicroabscesses in paillae
Dematitis herpetiformis
48
Dapsone
Leprosy drug- dermatitis herpetiformis
49
Causes of erythema nodosum(inflammed subcutaneous fat)
IBD.Lupus/sarcoidosis.Infection- strep and TB.Drugs- sulfonamides, OCP
50
Prognosis for erythema nodosum
Resolve in 6 weeks.
51
Biggest cause of erythema multiforme
HSV
52
Causese of multiforme
Infection- HSV, mycobacterium, hep B, EBV.Lupus/SarcoidosisLeukemia.Pregnancy and pre-menstrual.Drugs- sulphonamides, antibiotics.
53
Target lesions
Multiforme.Raised.
54
Steven Johnsons
Mucosal multiforme.
55
Pyoderma gangrenosum causes
IBDRheumatoidMyeloma
56
Pyoderma gangrenosum looks like
ulcerated nodues, RAPIDY growing.
57
Heals with scarring.
gangrenosum.
58
Lupus pernio
cutaneous sarcoid.
59
Where is lupus pernio?
Alar rim of nose, mid face.
60
What does lupus pernio look like?
Violet papules and plaques.
61
Lupus vulgaris
cutaneous TB
62
Lupus vulgaris looks like
brown, hears slowly, scars,Dark rim, pale in the middle. ULCERS
63
Acanthosis nigricans may be a sign of
malignancyacromegalydermatomyositissclerodermaWilson's
64
thrombophlebitis is a sign of:
intra-abdominal malignancy.
65
Necrobiosis lipoidica looks like
shiny patches that grow other m to yr.Red brown turn into yellow patches.Pre-tibia.
66
Granuloma annulare looks like
Erythema, firm ring shaped with a raised edge.
67
Hyperlipidaemias involved in Xanthelasma
types 2 and 4
68
Short contact dithranol
5-60 mins a day.
69
concentrations of dithranol
0.1%1%2%
70
Calcipotroil
Vit D derivativesGuttate and alopecia areata
71
How do you take calcipotriol?
Cream twice daily.
72
SE calcipotriol
itchy, redness in 20% etc.DON't use in Flexures.
73
Calcipotriol works by:
decreasing rate of cell division.
74
Acitretin
Vit A retinoid.
75
Acitretin dose.
0.25mg/kg/day ORAL
76
SE Acitretin
Dry mouthCrusty noseItchingDeranged LFTS.MUST USE CONTRACEPTION FOR 2 YEARS
77
CI for coal tar
Prenancy.
78
Emmolient examples.
E45DiprobaseOily creamEpaderm
79
Steroid examples
1-2.5% hydrocortisoneEumovateBetnovateDermovate.
80
Salicylic acid
Lifts scales up
81
CI for salicylic acid
ASPIRIN allergy
82
PUVA dose
0.6-0.8mg/kg 1-2 hours before.
83
Methotrexate dose
0.57-1.5mg WEEKLY
84
Monitoring methotrexate
LFTs
85
Monitoring cyclosporin
Renal function
86
Monitoring azathioprine
LFTs
87
Terbinafine
Oral or topical antifungal
88
Basal cell papilloma
seborrhoeic keratosis
89
what does a seb. keratosis look like?
brown/yellow round oval WELL demarcated.
90
Treatment seb.keratosis
CryotherapyEfudix (5-fluorouracil)Curettage
91
Keratocanthoma
low-grade malignancy.
92
What does a keratocanthoma look like?
RAPIDnodule with central ulcer (crater).
93
Seb cyst looks like
mobilefirmdomecentral punctumsmelly discharge.hairy places
94
Lipoma disease
Dercum's disease
95
Infection along fascial planes subcutaneously
Necrotising fasciitis
96
BCC
Pearly edge.Slow growing.Non-healing lesion that may bleed.TelangiectastiaTransluscent.
97
SCC
ulcerated pink/flesh coloured lesion.
98
SCC on places of chronic inflammation
Marjolin's ulcer.
99
How many SCC metastasize?
2-6%
100
Bowens
In situ SCC.
101
Causes of Bowens
HPV (on hands) 16ArsenicSun
102
Treatment for bowns
EfudixCryotherapyExcision.
103
How many Bowens become SCC?
5%
104
Most common melanoma?
Superficial spreading 70-80%
105
Nodular melanoma
vascular, fryable.
106
Lentigo maligna
melanoma very slow growing, in situ
107
Acral lentiginous
End of limbs, very slow growing.
108
Halo naevus
Benign
109
Campbell de Morgan
Red
110
Haemangioma
common in infants- will resolve.
111
Porphyria can cause
widespread blisters.
112
Milia
keratin filled cysts (babies)
113
Miliaria
sweat filled cysts, itchy.
114
Melasma
Dark, well demarcated hyperpigmentation.
115
Where is melasma?
Face.
116
Vitiligo
Melanocytes die.
117
Vitiligo is associated with:
alopeciahypothyroidismAddison'sDM
118
TENS
Full epidermal loss. Keratinocyte apoptosis.
119
Treatment for TENS
IV Ig
120
Treatment for pruritis
Calamine lotion 0.5%Menthol in aqueous.
121
Pruritis in liver failure
cholestyramine powder
122
SE of isotretinoin
DRYNESSnose bleedshigh lipis.deranged LFTsHeadachePhotosensitivity.
123
Dose of isotretinoin
0.5-1mg/kg for 16-20 weeks.
124
Breslow depth in situ
100% survival
125
Breslow depth <1cm
95-100% survival
126
Breslow depth 1-2cm
80-95% survival
127
Breslow depth 2-4cm
60-75% survival
128
Breslow >4cm
50% survival
129
Pityriasis lichenoids
ITCHYcrops that look like HSVChronic- red/brown papules (smooth beneath).
130
Seborrhoeid dermatitis
Scalp, eyebrown, medallion lesion, discrete HAIR FOLLICLES. (not itchy).
131
Drugs causing photosensitivity
AmiodaroneChlorporpamineSulphonamidesQuininePsoralensTrimethoprimTetracyclinesNSAIDSDiureticsVit A derivativesAnti-fungals
132
Conditions causing photosensitivity
SLEPorphyriaPellegra
133
Pruritis causes (diseases)
Fe deficiencyCRFPolycythaemiaHyperthyroidHodgkinsLichen planusHerpesDiabetes
134
Onycholysis causes
TraumaPsoriasisHLA B27HyperthyroidFe deficiency
135
Carbuncle
pus that discharges through multiple sinuses
136
Furuncle
perifollicular abscess.
137
Butterfly rash causes
SLE/sarcoidRosaceaTBErysipelasPhotosensative dermatosis
138
Malar flush
mitral stenosis
139
Drugs that exacerbate psoriasis
LithiumBeta blockersAntimalarialsInterferons
140
Carcinoid syndrome
Plum or purple facial eruption for 20mins.
141
Painful tumors
LeiomyomaNeuromaGlomus tumour
142
White nails?
Low albumin
143
Nutmeg grater
DLE
144
ANA, Scl 70
Systemic sclerosis
145
Gottron's papules
Dorsum of hand, red, dermatomyositis
146
Dermatomyositis
ANA, Anti-Jo 1.
147
Gaiter area
venous ulcers.
148
Type 1-6 skins
1:BURNS, 2: BURNS+tan, 3:burns+tan, 4: tan, 5:brown, 6, black.
149
Anagen
1000 days
150
Telogen
rest for 100 days.
151
Female patern baldness
Ludwig
152
Coarse and dark hair
terminal
153
fine and fair hair
vellus
154
Treatment for hirsuitism
CYPOTERONE ACETATE
155
Non-scarring alopecia
AreataPsoriasisEczema
156
Scarring alopecia
DLELichen planusfolliculitis decalvans
157
Drugs that cause hair loss
ChemotherapyAnticoagulantsThiouracil
158
Genital warts treatment
podophyllin
159
Hand warts treatment
salicylic acid 3 months.
160
Dose for emollients adults
500mg/week
161
emollients for kids dose
250-500mg/week
162
Steroid comes in
30-100mg tubes.
163
1st disease
Measles.
164
2nd disease
Scarlet fever- strep pyogenes
165
3rd disease
Rubella
166
4th disease
Staph scalded skin
167
5th disease
erythema infectiosum (Parvo19)- slapped cheek
168
6th disease
Roseola infantum (HSV 6/7)
169
Peri oral pigmentation
Peutz jeger
170
Pellagra sx
Dermatitis dementia diarrhea
171
Sensitivity type eczema
4
172
Generalized hypo pigmentation
PKUAlbinismPanpituitarism
173
Eumovate
Clobetasone
174
Betnovate
Betamethasone
175
Dermovate
Clobetasol
176
Atopic Eczema
This results from an IgE-mediated, T-cell auto-immune response.
177
Cataracts
Cataracts – are a risk in those with long-term disease. Can be a feature of the disease itself, but also result from the use of steroid agents around the eyes, so don’t prescribe steroids for eczema around the eyes!
178
Steroid side effects
Skin thinning Striae formation Telangectasia Adrenal suppression – cushing’s syndrome – rare!
179
Asteotic eczema
“Crazy paving” eczema - Fissures and cracks on dry skin. Particularly scaly. Usually occurs on the shins, typically in elderly patients, but may also be on the trunk. Thought to be the result of dehydration of the epidermis More common in winter Just moisturise and it should go away!
180
Acne and androgens
Tends to not be an excess of androgen but rather increased sensitivity to it, although: Slight tendency towards boys (girls also experience it very frequently) Boys may also experience it worse.
181
Topical antibiotics for acne
Erythromycin | Clindamycin
182
Systemic antibiotics for acne
Oxytetracycline usually first line Clindamycin and erythromycin also used Probably no greater efficacy than topical benzoyl peroxide/Abx
183
Bullous pemphigoid
Elderly (>65yrs) Vaccinations (in children with condition affecting face, palms and soles) NSAIDs, furosemide, antibiotics UV radiation / x-rays
184
>50% of bullous pemphigus present with
oral blisters
185
Protein in pemphigus
IgG against keratinocytes- desmoglein
186
Pemphigus on investigation
Acantholysis seen on biopsy (loss of cohesion between keratinocytes)
187
IgA and dermatitis herpetiformis
Is an immunologic response to chronic stimulation of the gut mucosa. IgA react to gluten-tissue transglutaminase (t-TG) in the gut, and epidermal transglutaminase (e-TG).
188
Psoriasis what is happening?
``` Parakeratosis: retained nuclei Acanthosis: thick epidermis Absent granular layer Lengthened rete ridges Thin dermal papillae Dilated, tortuous capillaries Munro’s micro-abscesses T-cells in upper dermis ```
189
escar
piece of dead skin- fibrin plug
190
inflammatory phase in wound healing
PMNs, monocytes, macrophages, lymphocytes, growth factor, cytokines
191
scars in different age groups
embryo- heals without scarring children- excessive scarring adults- slower heal to better scar
192
keloid scar age
10-30 | Afrocarribean
193
atrophie blanche
Painful purpuric ulcers with reticular pattern of the lower extremities syndrome
194
lipodermatosclerosis
upside down champagne bottle
195
more common ulcer malleolus
medial
196
UVA/UVB penetrance
UVA- to dermis (through glass) | UVB-mainly epidermis
197
Which UV for D3 synthesis?
UVB
198
MED
Minimal erythema dose
199
dermal tumours
``` Dermatofibroma (histiocytoma) Campbell de Morgan spots (cherry angiomas) Haemangioma Pyogenic granuloma Chondrodermatitis Nodularis (CNH) Intradermal naevus ```
200
who does PAN affect?
middle aged men
201
SLE ANA positive
>90%
202
how many DLE become SLE?
5%
203
CREST syndrome
less internal involvement and better prognosis.
204
morphoea
defined area of hardened skin.
205
RAST
radio-allergo-sorbent-test
206
wierd features of eczema
Infra auricular fissures Infra orbital folds Atopic shiners Shiny finger nails
207
Adult seborrheoic dermatitis
malassezia furfur face- scalp- ears, chest and back treat with topical steroid and imidazole antifungal
208
hand eczema on one hand only
FUNGAL!
209
Koebner phenomenon
``` Psoriasis Pityriasis rubra pilaris Lichen planus Lichen nitidus Vitiligo Lichen sclerosus Elastosis perforans serpiginosa Kaposi sarcoma Necrobiosis lipoidica Systemic Lupus Erythematosus ```
210
C1 esterase inhibitor deficiency causes
spontaneous activation of compelement (angioedema).
211
C1 esterase drug
Danazol | anabolic steroid
212
wide spread hair loss
iron deficiency cushings thyroid CAH
213
Menke's disease
congenital half loss. | abnormal follicles
214
dermatophyte and non-dermatophyte nail infection
ii
215
candida in hands
poor cirulation | lots of wet work.
216
skin commensals
* coagulase negative staphylococci eg staph epidermidis, staph hominis. * micrococci * diptheroids * propionobacteria.
217
folliculitis
``` usually staph (long term Abx can get gram neg) ```
218
erisepelas
STREP | systemic therapy
219
staph infection
fluclox or erythromycin
220
strep infection
penicillin or erythromycin
221
mycobacterium TB
1. Lupus vulgaris primary inoculation in person with some immunity. 2. Tuberculides cutaneous reactions to TB elsewhere 3. Warty tuberculosis- rare except in developing world 4. Scrofuloderma- TB lymph node or joint draining out onto skin
222
mycobacterium leprae
1. Tuberculoid leprosy • Nerves and skin (hypopigmented patches), strong immunity, few baccilli 2. Lepromatous leprosy • Thickened facies, macules, papules, nodules and plaques, poor immunity, lots of bacilli
223
kerion
tinea in hair
224
Microsporum
hair
225
Trichophytan
nails and hair
226
epidermophytan
nails
227
erythrasma
darkening overgrowth of corynebacterium give imidazole or erythro
228
intertrigo
candida in between skin folds, web spaces.
229
mucocutaneous candidiasis
inherited disorder of immunity.
230
porphyria cutanea tarda
light sensitivity, fragile scarred skin and hypertrichosis, usually seen in middle-aged alcoholic men. Iron stores are increased, it is treated by venesection
231
epidermolysis bullosa
AD keratin gene defect most severe- scarring and mutilation can be fatal.

COMP 2 (3 decks)

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