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COMP 2 > Dermatology > Flashcards

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
Q

Pemphigus cause

A

Antibodies against keratinocytes- intra epidermal desmosomes.

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26
Q

Where is pemphigus?

A

TrunkScalpMucus membranes.

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27
Q

Biopsy findings pemphigus

A

direct immunofluorescence IgG and C3

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28
Q

Treatment pemphigus

A

Prednisolone + Azathioprine.

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29
Q

Nikolsky sign

A

Pemphigus bulla breaks easily

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30
Q

Pemphigoid cause

A

Autoimmune against basement membrane.

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31
Q

Rosacea

A

no comedones.telangiectasia papulespustulesrhinophyma

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32
Q

Acne vulgasis cause

A

follicular pluggingenlarged glands and XS sebum.

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33
Q

1st choice acne treatment

A

Benzoylperoxidase 2.5-5%

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34
Q

Pityriasis rosea

A

Prodromal sickness.ACUTEself-limiting20-30years.Herald patch –> Christmas tree.RED AND SCALY

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35
Q

Describe tinea

A

itchy, central clear bit with red, scaly edge.

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36
Q

Topical antifungal

A

imidazole

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37
Q

Systemic antifungal

A

terbinafine

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38
Q

Pityriasis versicolor cause

A

orbiculare FUNGUSMalasezzia furfur

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39
Q

Where is versicolor?

A

chest, back, trunk, arms

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40
Q

Versicolor Ix

A

Wood’s light- yellow/green fluorescence.

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41
Q

Treatment cellulitis

A

PenicillinFlucloxacillin.

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42
Q

Scabies name

A

Sarcopted scabiei

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43
Q

Incubation period for scabies

A

4-6 weeks.

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44
Q

What does scabies look like?

A

Papules and nodules.Hands and feed, axillae, breast, buttock

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45
Q

Treatment scabies

A

Permethrin + Malathion topical

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46
Q

Causes of dermatitis herpetiformis

A

HLA B3, DR3, coeliac.

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47
Q

Subepidermal blistersMicroabscesses in paillae

A

Dematitis herpetiformis

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48
Q

Dapsone

A

Leprosy drug- dermatitis herpetiformis

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49
Q

Causes of erythema nodosum(inflammed subcutaneous fat)

A

IBD.Lupus/sarcoidosis.Infection- strep and TB.Drugs- sulfonamides, OCP

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50
Q

Prognosis for erythema nodosum

A

Resolve in 6 weeks.

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51
Q

Biggest cause of erythema multiforme

A

HSV

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52
Q

Causese of multiforme

A

Infection- HSV, mycobacterium, hep B, EBV.Lupus/SarcoidosisLeukemia.Pregnancy and pre-menstrual.Drugs- sulphonamides, antibiotics.

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53
Q

Target lesions

A

Multiforme.Raised.

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54
Q

Steven Johnsons

A

Mucosal multiforme.

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55
Q

Pyoderma gangrenosum causes

A

IBDRheumatoidMyeloma

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56
Q

Pyoderma gangrenosum looks like

A

ulcerated nodues, RAPIDY growing.

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57
Q

Heals with scarring.

A

gangrenosum.

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58
Q

Lupus pernio

A

cutaneous sarcoid.

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59
Q

Where is lupus pernio?

A

Alar rim of nose, mid face.

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60
Q

What does lupus pernio look like?

A

Violet papules and plaques.

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61
Q

Lupus vulgaris

A

cutaneous TB

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62
Q

Lupus vulgaris looks like

A

brown, hears slowly, scars,Dark rim, pale in the middle. ULCERS

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63
Q

Acanthosis nigricans may be a sign of

A

malignancyacromegalydermatomyositissclerodermaWilson’s

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64
Q

thrombophlebitis is a sign of:

A

intra-abdominal malignancy.

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65
Q

Necrobiosis lipoidica looks like

A

shiny patches that grow other m to yr.Red brown turn into yellow patches.Pre-tibia.

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66
Q

Granuloma annulare looks like

A

Erythema, firm ring shaped with a raised edge.

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67
Q

Hyperlipidaemias involved in Xanthelasma

A

types 2 and 4

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68
Q

Short contact dithranol

A

5-60 mins a day.

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69
Q

concentrations of dithranol

A

0.1%1%2%

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70
Q

Calcipotroil

A

Vit D derivativesGuttate and alopecia areata

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71
Q

How do you take calcipotriol?

A

Cream twice daily.

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72
Q

SE calcipotriol

A

itchy, redness in 20% etc.DON’t use in Flexures.

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73
Q

Calcipotriol works by:

A

decreasing rate of cell division.

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74
Q

Acitretin

A

Vit A retinoid.

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75
Q

Acitretin dose.

A

0.25mg/kg/day ORAL

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76
Q

SE Acitretin

A

Dry mouthCrusty noseItchingDeranged LFTS.MUST USE CONTRACEPTION FOR 2 YEARS

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77
Q

CI for coal tar

A

Prenancy.

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78
Q

Emmolient examples.

A

E45DiprobaseOily creamEpaderm

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79
Q

Steroid examples

A

1-2.5% hydrocortisoneEumovateBetnovateDermovate.

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80
Q

Salicylic acid

A

Lifts scales up

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81
Q

CI for salicylic acid

A

ASPIRIN allergy

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82
Q

PUVA dose

A

0.6-0.8mg/kg 1-2 hours before.

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83
Q

Methotrexate dose

A

0.57-1.5mg WEEKLY

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84
Q

Monitoring methotrexate

A

LFTs

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85
Q

Monitoring cyclosporin

A

Renal function

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86
Q

Monitoring azathioprine

A

LFTs

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87
Q

Terbinafine

A

Oral or topical antifungal

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88
Q

Basal cell papilloma

A

seborrhoeic keratosis

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89
Q

what does a seb. keratosis look like?

A

brown/yellow round oval WELL demarcated.

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90
Q

Treatment seb.keratosis

A

CryotherapyEfudix (5-fluorouracil)Curettage

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91
Q

Keratocanthoma

A

low-grade malignancy.

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92
Q

What does a keratocanthoma look like?

A

RAPIDnodule with central ulcer (crater).

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93
Q

Seb cyst looks like

A

mobilefirmdomecentral punctumsmelly discharge.hairy places

94
Q

Lipoma disease

A

Dercum’s disease

95
Q

Infection along fascial planes subcutaneously

A

Necrotising fasciitis

96
Q

BCC

A

Pearly edge.Slow growing.Non-healing lesion that may bleed.TelangiectastiaTransluscent.

97
Q

SCC

A

ulcerated pink/flesh coloured lesion.

98
Q

SCC on places of chronic inflammation

A

Marjolin’s ulcer.

99
Q

How many SCC metastasize?

A

2-6%

100
Q

Bowens

A

In situ SCC.

101
Q

Causes of Bowens

A

HPV (on hands) 16ArsenicSun

102
Q

Treatment for bowns

A

EfudixCryotherapyExcision.

103
Q

How many Bowens become SCC?

A

5%

104
Q

Most common melanoma?

A

Superficial spreading 70-80%

105
Q

Nodular melanoma

A

vascular, fryable.

106
Q

Lentigo maligna

A

melanoma very slow growing, in situ

107
Q

Acral lentiginous

A

End of limbs, very slow growing.

108
Q

Halo naevus

A

Benign

109
Q

Campbell de Morgan

A

Red

110
Q

Haemangioma

A

common in infants- will resolve.

111
Q

Porphyria can cause

A

widespread blisters.

112
Q

Milia

A

keratin filled cysts (babies)

113
Q

Miliaria

A

sweat filled cysts, itchy.

114
Q

Melasma

A

Dark, well demarcated hyperpigmentation.

115
Q

Where is melasma?

A

Face.

116
Q

Vitiligo

A

Melanocytes die.

117
Q

Vitiligo is associated with:

A

alopeciahypothyroidismAddison’sDM

118
Q

TENS

A

Full epidermal loss. Keratinocyte apoptosis.

119
Q

Treatment for TENS

A

IV Ig

120
Q

Treatment for pruritis

A

Calamine lotion 0.5%Menthol in aqueous.

121
Q

Pruritis in liver failure

A

cholestyramine powder

122
Q

SE of isotretinoin

A

DRYNESSnose bleedshigh lipis.deranged LFTsHeadachePhotosensitivity.

123
Q

Dose of isotretinoin

A

0.5-1mg/kg for 16-20 weeks.

124
Q

Breslow depth in situ

A

100% survival

125
Q

Breslow depth <1cm

A

95-100% survival

126
Q

Breslow depth 1-2cm

A

80-95% survival

127
Q

Breslow depth 2-4cm

A

60-75% survival

128
Q

Breslow >4cm

A

50% survival

129
Q

Pityriasis lichenoids

A

ITCHYcrops that look like HSVChronic- red/brown papules (smooth beneath).

130
Q

Seborrhoeid dermatitis

A

Scalp, eyebrown, medallion lesion, discrete HAIR FOLLICLES. (not itchy).

131
Q

Drugs causing photosensitivity

A

AmiodaroneChlorporpamineSulphonamidesQuininePsoralensTrimethoprimTetracyclinesNSAIDSDiureticsVit A derivativesAnti-fungals

132
Q

Conditions causing photosensitivity

A

SLEPorphyriaPellegra

133
Q

Pruritis causes (diseases)

A

Fe deficiencyCRFPolycythaemiaHyperthyroidHodgkinsLichen planusHerpesDiabetes

134
Q

Onycholysis causes

A

TraumaPsoriasisHLA B27HyperthyroidFe deficiency

135
Q

Carbuncle

A

pus that discharges through multiple sinuses

136
Q

Furuncle

A

perifollicular abscess.

137
Q

Butterfly rash causes

A

SLE/sarcoidRosaceaTBErysipelasPhotosensative dermatosis

138
Q

Malar flush

A

mitral stenosis

139
Q

Drugs that exacerbate psoriasis

A

LithiumBeta blockersAntimalarialsInterferons

140
Q

Carcinoid syndrome

A

Plum or purple facial eruption for 20mins.

141
Q

Painful tumors

A

LeiomyomaNeuromaGlomus tumour

142
Q

White nails?

A

Low albumin

143
Q

Nutmeg grater

A

DLE

144
Q

ANA, Scl 70

A

Systemic sclerosis

145
Q

Gottron’s papules

A

Dorsum of hand, red, dermatomyositis

146
Q

Dermatomyositis

A

ANA, Anti-Jo 1.

147
Q

Gaiter area

A

venous ulcers.

148
Q

Type 1-6 skins

A

1:BURNS, 2: BURNS+tan, 3:burns+tan, 4: tan, 5:brown, 6, black.

149
Q

Anagen

A

1000 days

150
Q

Telogen

A

rest for 100 days.

151
Q

Female patern baldness

A

Ludwig

152
Q

Coarse and dark hair

A

terminal

153
Q

fine and fair hair

A

vellus

154
Q

Treatment for hirsuitism

A

CYPOTERONE ACETATE

155
Q

Non-scarring alopecia

A

AreataPsoriasisEczema

156
Q

Scarring alopecia

A

DLELichen planusfolliculitis decalvans

157
Q

Drugs that cause hair loss

A

ChemotherapyAnticoagulantsThiouracil

158
Q

Genital warts treatment

A

podophyllin

159
Q

Hand warts treatment

A

salicylic acid 3 months.

160
Q

Dose for emollients adults

A

500mg/week

161
Q

emollients for kids dose

A

250-500mg/week

162
Q

Steroid comes in

A

30-100mg tubes.

163
Q

1st disease

A

Measles.

164
Q

2nd disease

A

Scarlet fever- strep pyogenes

165
Q

3rd disease

A

Rubella

166
Q

4th disease

A

Staph scalded skin

167
Q

5th disease

A

erythema infectiosum (Parvo19)- slapped cheek

168
Q

6th disease

A

Roseola infantum (HSV 6/7)

169
Q

Peri oral pigmentation

A

Peutz jeger

170
Q

Pellagra sx

A

Dermatitis dementia diarrhea

171
Q

Sensitivity type eczema

A

4

172
Q

Generalized hypo pigmentation

A

PKUAlbinismPanpituitarism

173
Q

Eumovate

A

Clobetasone

174
Q

Betnovate

A

Betamethasone

175
Q

Dermovate

A

Clobetasol

176
Q

Atopic Eczema

A

This results from an IgE-mediated, T-cell auto-immune response.

177
Q

Cataracts

A

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
Q

Steroid side effects

A

Skin thinning Striae formation Telangectasia Adrenal suppression – cushing’s syndrome – rare!

179
Q

Asteotic eczema

A

“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
Q

Acne and androgens

A

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
Q

Topical antibiotics for acne

A

Erythromycin

Clindamycin

182
Q

Systemic antibiotics for acne

A

Oxytetracycline usually first line Clindamycin and erythromycin also used Probably no greater efficacy than topical benzoyl peroxide/Abx

183
Q

Bullous pemphigoid

A

Elderly (>65yrs) Vaccinations (in children with condition affecting face, palms and soles) NSAIDs, furosemide, antibiotics UV radiation / x-rays

184
Q

> 50% of bullous pemphigus present with

A

oral blisters

185
Q

Protein in pemphigus

A

IgG against keratinocytes- desmoglein

186
Q

Pemphigus on investigation

A

Acantholysis seen on biopsy (loss of cohesion between keratinocytes)

187
Q

IgA and dermatitis herpetiformis

A

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
Q

Psoriasis what is happening?

A 
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
Q

escar

A

piece of dead skin- fibrin plug

190
Q

inflammatory phase in wound healing

A

PMNs, monocytes, macrophages, lymphocytes, growth factor, cytokines

191
Q

scars in different age groups

A

embryo- heals without scarring
children- excessive scarring
adults- slower heal to better scar

192
Q

keloid scar age

A

10-30

Afrocarribean

193
Q

atrophie blanche

A

Painful purpuric ulcers with reticular pattern of the lower extremities syndrome

194
Q

lipodermatosclerosis

A

upside down champagne bottle

195
Q

more common ulcer malleolus

A

medial

196
Q

UVA/UVB penetrance

A

UVA- to dermis (through glass)

UVB-mainly epidermis

197
Q

Which UV for D3 synthesis?

A

UVB

198
Q

MED

A

Minimal erythema dose

199
Q

dermal tumours

A 
Dermatofibroma (histiocytoma)
Campbell de Morgan spots (cherry angiomas)
Haemangioma
Pyogenic granuloma
Chondrodermatitis Nodularis (CNH)
Intradermal naevus
200
Q

who does PAN affect?

A

middle aged men

201
Q

SLE ANA positive

A

> 90%

202
Q

how many DLE become SLE?

A

5%

203
Q

CREST syndrome

A

less internal involvement and better prognosis.

204
Q

morphoea

A

defined area of hardened skin.

205
Q

RAST

A

radio-allergo-sorbent-test

206
Q

wierd features of eczema

A

Infra auricular fissures
Infra orbital folds
Atopic shiners
Shiny finger nails

207
Q

Adult seborrheoic dermatitis

A

malassezia furfur
face- scalp- ears, chest and back

treat with topical steroid and imidazole antifungal

208
Q

hand eczema on one hand only

A

FUNGAL!

209
Q

Koebner phenomenon

A 
Psoriasis
Pityriasis rubra pilaris
Lichen planus
Lichen nitidus
Vitiligo
Lichen sclerosus
Elastosis perforans serpiginosa
Kaposi sarcoma
Necrobiosis lipoidica
Systemic Lupus Erythematosus
210
Q

C1 esterase inhibitor deficiency causes

A

spontaneous activation of compelement (angioedema).

211
Q

C1 esterase drug

A

Danazol

anabolic steroid

212
Q

wide spread hair loss

A

iron deficiency
cushings
thyroid
CAH

213
Q

Menke’s disease

A

congenital half loss.

abnormal follicles

214
Q

dermatophyte and non-dermatophyte nail infection

A

ii

215
Q

candida in hands

A

poor cirulation

lots of wet work.

216
Q

skin commensals

A
  • coagulase negative staphylococci eg staph epidermidis, staph hominis.
  • micrococci
  • diptheroids
  • propionobacteria.
217
Q

folliculitis

A 
usually staph
(long term Abx can get gram neg)
218
Q

erisepelas

A

STREP

systemic therapy

219
Q

staph infection

A

fluclox or erythromycin

220
Q

strep infection

A

penicillin or erythromycin

221
Q

mycobacterium TB

A
  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
Q

mycobacterium leprae

A
  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
Q

kerion

A

tinea in hair

224
Q

Microsporum

A

hair

225
Q

Trichophytan

A

nails and hair

226
Q

epidermophytan

A

nails

227
Q

erythrasma

A

darkening
overgrowth of corynebacterium
give imidazole or erythro

228
Q

intertrigo

A

candida in between skin folds, web spaces.

229
Q

mucocutaneous candidiasis

A

inherited disorder of immunity.

230
Q

porphyria cutanea tarda

A

light sensitivity, fragile scarred skin and hypertrichosis, usually seen in middle-aged alcoholic men. Iron stores are increased, it is treated by venesection

231
Q

epidermolysis bullosa

A

AD
keratin gene defect
most severe- scarring and mutilation
can be fatal.

COMP 2 (3 decks)

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